八段锦对膝骨性关节炎患者干预效果的Meta分析

A Meta-analysis on effects of Baduanjin in knee osteoarthritis patients

目的系统评价八段锦对膝骨性关节炎患者的干预效果。方法计算机检索Web of Science、CINAHL、PubMed、EMbase、The Cochrane Library、CNKI、万方数据和维普数据库,搜集有关八段锦对膝骨性关节炎患者干预效果的RCT,检索时限均从建库至2019年1月23日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析,采用GRADE pro软件对结果证据质量进行评级。结果最终纳入6项RCT,328例研究对象。Meta分析结果显示,八段锦组较对照组能有效改善患者疼痛程度[SMD=-1.50,95%CI(-2.43,-0.58),P=0.001]、僵硬程度[SMD=-0.85,95%CI(-1.46,-0.23),P=0.007]、生理功能[SMD=-1.28,95%CI(-2.45,-0.10),P=0.03]、行动能力[SMD=1.04,95%CI(0.07,2.02),P=0.03]。但5项研究证据等级均为极低质量。结论当前证据显示,八段锦干预对改善膝骨性关节炎患者疼痛程度、僵硬程度及行动能力有明显的临床效果,但受纳入研究质量的限制,尚需更多高质量研究加以证实。

Objective To systematically review the effects of Baduanjin in knee osteoarthritis patients.Methods Randomized controlled trial(RCT)on effects of Baduanjin in knee osteoarthritis patients was retrieved in the Web of Science,CINAHL,PubMed,EMbase,The Cochrane Library,Chinese National Knowledge Infrastructure(CNKI),WanFang Data and VIP by computer from building database to 23rd January 2019.Two researchers independently screened literatures,extracted data and assessed the risk of bias of included literatures.The RevMan 5.3 was used to the meta-analysis and GRADE pro was applied to grade the quality of evidence.Results Finally,a total of 6 RCTs were included and involved 328 subjects.Metaanalysis showed that Baduanjin compared with control group could improve the pain of patients[SMD=-1.50,95%CI(-2.43,-0.58),P=0.001],stiff[SMD=-0.85,95%CI(-1.46,-0.23),P=0.007],physiologic function[SMD=-1.28,95%CI(-2.45,-0.10),P=0.03]and mobility[SMD=1.04,95%CI(0.07,2.02),P=0.03]with statistical differences.Evidence levels of five evidences were all the extremely low degree of quality.Conclusions The existing evidences show that Baduanjin has significant clinical effects on improving the pain of knee osteoarthritis patients,stiff and mobility.The evidences still need to be confirmed by many high quality of researches restricted by research quality of included literatures.