太极对老年人跌倒预防效果的Meta分析

Meta-analysis of Tai chi's fall prevention effect in the elderly

目的:评价太极在预防老年人跌倒发生中的效果。方法:计算机检索PubMed、Cochrane、Web of Science、EMBASE、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库,搜集有关太极在预防老年人跌倒的随机对照试验(RCT),检索时限为建库至2019年1月6日。由2名研究者独立筛选文献、提取资料并进行文献质量评价,研究采用漏斗图、Begg's检验及Egger's检验评价发表偏倚。应用STATA14.0软件对太极与跌倒的关系进行Meta分析,文章已在国际前瞻性系统评价登记册中注册,注册编号为:CRD42019122958。结果:共纳入6篇RCT,Meta分析结果显示:和空白对照相比,太极可以降低老年人跌倒的发生[RR=0.44,95%CI(0.21~0.90)]。太极加教育对比教育在降低老年人跌倒方面没有统计学差异[RR=0.96,95%CI(0.76~1.22)],亚组分析也支持这一结果。太极对比教育在降低老年人跌倒方面没有统计学差异[(RR=0.73,95%,CI(0.51~1.06))]。结论:当前证据显示,太极可以降低老年人跌倒的发生,太极加教育或太极在降低老年人跌倒发生方面的效果与教育一致,我们应该重视老年人跌倒相关健康教育。

Objective:To assess the effect of Tai Chi on the prevention of fall among the elderly.Methods:Relevant randomized controlled trials(RCT)published and indexed in the databases including PubMed,Cochrane Library,Web of Science,EMBASE,CBM,CNKI and Wan fang from the very beginning to 6 January 2019 were selected.Two researchers independently screened the literature,extracted data and evaluated the literature quality.Publication bias was assessed by Forest plot,Begg's test and Egger's test.STATA 14.0 software was used to do meta-analysis on the relationship between Tai Chi and fall.This study was registered at international prospective register of systematic Reviews(No.CRD42019122958).Results:A total of 6 RCTs were included.The results showed that the incidence of fall among the elderly in Tai Chi group was less than that of blank group[RR=0.44(0.21-0.90)]without any statistical difference in the comparison of Tai Chi education and normal education alone[RR=0.96(0.76-1.22)],which was also supported by subgroup analysis.Meanwhile,similar result also appeared in the comparison of Tai Chi group and education group[RR=0.73(0.51-1.06)].Conclusion:Tai Chi could reduce the incidence of falls among the elderly,but the effect of Tai Chi plus education/Tai Chi on the incidence of falls is consistent with education alone.Therefore,we should pay attention to fall-related education among the elderly.