太极拳锻炼对2型糖尿病患者糖脂代谢和生活质量影响的系统评价

Systematic Review on Effect of Tai Chi Regarding to Glucolipid Metabolism and Life Quality of Type 2 Diabetes Mellitus

目的:评价太极拳锻炼对2型糖尿病(T2DM)糖脂代谢和生活质量的影响。方法:检索Pub Med、FMRS、EMbase、The Cochrane Library、CNKI、Wan Fang、VIP等数据库,以T2DM患者为研究对象,全面搜集并纳入国内外有关太极拳锻炼干预T2DM的随机对照试验(RCT),检索时限设定为建库至2017年2月。由2位评价者独立进行文献筛选、基本资料提取和偏倚风险评估后,采用Rev Man 5.3软件进行Meta分析。结果:最终纳入10个RCT,中英文文献各5篇。Meta分析显示:太极拳锻炼在降低FBG[SMD=-0.39,95%CI(-0.54,-0.24),P<0.01]、Hb A1c[WMD=-0.59,95%CI(-0.73,-0.44),P<0.01];改善TG[SMD=-0.52,95%CI(-0.85,-0.19),P<0.01]、HDL-C[SMD=0.31,95%CI(0.14,0.47),P<0.01]、LDL-C[WMD=-0.32,95%CI(-0.59,-0.05),P<0.05]和改善生活质量评分的部分条目方面均优于其他疗法;在降低TC[SMD=-0.24,95%CI(-0.58,0.10),P>0.05]、改善躯体功能和缓解躯体疼痛方面与其他疗法比较,差异无统计学意义。结论:太极拳锻炼可调节T2DM患者糖脂代谢水平和改善其生活质量,可作为糖尿病运动治疗的重要组成部分。

Objective：To systematically review the effect of Tai Chi exercise on glucolipid metabolism and life quality of type 2diabetes mellitus（ T2DM）. Methods ： We searched Pub Med, FMRS, EMbase, The Cochrane Library, CNKI, Wan Fang and VIP databases to collect randomized controlled trials（ RCTs） published before February 2017 about Tai Chi exercise on glucolipid metabolism and life quality of T2 DM. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed through Rev Man 5.3 software. Results：A total of ten RCTs were included. The results of Meta-analysis demonstrated that Tai Chi exercise had positive effect on the levels of FBG [SMD=-0.39,95%CI（-0.54,-0.24）, P0.01], Hb A1 c [WMD=-0.59, 95%CI（-0.73,-0.44）, P0.01], TG [SMD=-0.52,95%CI（-0.85,-0.19）, P0.01], HDL-C [SMD =0.31, 95%CI（0.14, 0.47）, P0.01], LDL-C [WMD=-0.32,95%CI（-0.59,-0.05）, P0.05] and most items of quality of life; while there was no statistically significant on the levels of TC [SMD=-0.24, 95%CI（-0.58, 0.10）, P0.05], physical function and body pain.Conclusion：Tai Chi exercise is effective to improve the levels of glucolipid metabolism and life quality of T2 DM. Tai Chi exercise is recommendable as an essential measure in diabetes management.