太极拳辅助康复治疗乳腺癌术后不良反应的系统评价

Systematic review on effect of Tai Chi Chuan rehabilitative therapy on side effects of postoperative patients with breast cancer

目的系统评价太极拳辅助治疗乳腺癌术后不良反应的临床疗效。方法计算机检索中英文数据库和相关学术组织网站,按Cochrane系统评价方法对纳入研究进行质量评价和资料提取,采用Stata软件进行Meta分析。结果共纳入1 979例患者12个RCT。与对照组相比,太极拳能明显减轻乳腺癌术后患者握力强度、屈肘功能、肘关节伸直度、肘关节旋转度、横向内收功能,并能明显改善体重指数,对疼痛、白介素、胰岛素样生长因子-1和生活质量结局指标作用不明显。结论太极拳能短期改善肌肉强度、灵活性和降低体重指数。由于纳入研究质量存在异质性、结局指标主观性强、例数有限且随访期短,因此开展高质量、大样本、多中心的随机对照试验对太极拳远期疗效的评价非常必要。

Objective To systematically evaluate the clinical efficacy of Tai Chi Chuan adjuvant therapy on side effect of postoperative patients with breast cancer. Methods A computational search of China and foreign academic databases was committed and related academic organizations＇ websites were searched. The quality of the included studies was evaluated and the data were retrieved according to the methods recommended by the Cochrane Collaboration. Meta-analyses were conducted by using Stata software. Results 12 randomized controlled trials（RCTs） involving 1979 patients were included. Comparing with the control groups, Tai Chi Chuan can significantly reduce handgrip dynamometer strength（kg）, elbow flexion, elbow extension, abduction ability, horizontal adduction and significantly improve the body mass index, and there is no obvious effect on pain control, interleukin-6 and insulin-like growth factor-1. Conclusion Tai Chi Chuan could improve muscle strength and upper limb flexibility and lower body mass index in the short-term. Due to the quality of the heterogeneity of the included studies, subjectivity of outcomes, limited number of cases and short follow- up time, more high- quality multicenter RCTs in large scale are required to evaluate longterm efficacy of Tai Chi Chuan.