基于文献计量分析的八段锦临床研究证据

Evidence of Clinical Studies on Baduanjin(八段锦) Based on Bibliometric Analysis

目的全面总结八段锦的临床研究现状,为八段锦应用于临床医疗提供循证依据。方法检索中国知网、万方数据、维普网、中国生物医学文献数据库,以及Pub Med,EMbase,Cochrane Library外文数据库,检索时间自建库起至2017年12月31日,搜集所有与八段锦相关的临床研究,严格按照标准进行文献筛选与数据提取,采用SPSS 22.0软件分析基本信息、研究对象、样本量、八段锦练习、结局指标、研究结果等,采用Rev Man 5.3软件中的Risk of bias(ROB)工具对纳入的随机对照试验进行方法学质量评价。结果共纳入文献552篇,其中系统评价33篇(6.0%),随机对照试验379篇(68.6%),非随机对照试验46篇(8.3%),病例对照研究5篇(0.9%),队列研究6篇(1.1%),病例系列报道76篇(13.8%),以及研究方案7篇(1.3%)。八段锦应用前10位的疾病依次为糖尿病、慢性阻塞性肺疾病、高血压病、冠心病、中风、颈椎病、高脂血症、腰椎间盘突出症、围绝经期综合征及膝关节骨性关节炎。八段锦的标准多选用国家体育总局2003年整理创编版本,平均每次练习时间为41 min,习练频次多为每天1或2次,每周练习3天以上,平均疗程4个月。93.6%(510/545)的八段锦临床疗效研究获得了阳性结果,4.6%(25/545)的研究疗效未明确,1.8%(10/545)的研究为阴性结果。纳入的研究多为小样本量研究,随机对照试验的方法学质量一般。尚未发现与八段锦干预有关的严重不良事件报道。结论八段锦临床研究的数量较多,不同研究之间八段锦的干预措施差异明显,需要进一步规范统一。

Objective To make a comprehensive summary of the clinical research statues of Baduanjin( 八段锦)and to provide the evidence basis for the application of Baduanjin clinical healthcare. Methods We performed a search for Chinese and English studies in the following databases: Chinese National Knowledge Infrastructure,Wanfang Data,VIP database,Sino Med Pub Med,EMbase and Cochrane Library. The search strategy included terms relating to or describing Baduanjin. Studies published between the day since the database was established and December31,2017 were retrieved. The literature screening and data extraction was conducted strictly according to the criteria.SPSS 22. 0 software was used to analyze the basic information,subjects,sample size,Baduanjin exercises,outcomes,and research results. The method of quality evaluation was included in the randomized controlled trials using the Risk of bias( ROB) tool in Rev Man 5. 3 software. Results A total of 552 papers were identified,including 33( 6. 0%) systematic reviews,379( 68. 6%) randomized controlled trials,46( 8. 3%) quasi-randomized controlled trials,and 5( 0. 9%) case-control trials,6( 1. 1%) cohort studies,76( 13. 8%) case series reports,and 7( 1. 3%) study protocols. The top 10 diseases of the application with Baduanjin were diabetes,chronic obstructive pulmonary disease,hypertension,coronary heart disease,stroke,cervical spondylosis,hyperlipidemia,lumbar disc herniation,perimenopausal syndrome,and knee osteoarthritis. The most chosen standard of Baduanjin was the version compiled by the General Administration of Sport of China in 2003. Baduanjin was practiced 41 minutes at average,with a frequency of once or twice per day and at least 3 days a week,and the average treatment cours was 4 months.The vast majority of the studies( 93. 6%,510/545) obtained positive results,with 4. 6%( 25/545) did not clarify the effects of Baduanjin,and 1. 8%( 10/545) of the studies were negative. Most of the studies had a small sample size,and the methodological quality of randomized controlled trials was relatively low. No serious adverse events related to Baduanjin were reported. Conclusion The quantity of clinical studies on Baduanjin is substantial. However,the differences of Baduanjin intervention among included studies were obvious,which needs further standardization and unification.