太极拳锻炼对老年心力衰竭患者疗效的Meta分析

Meta-analysis of the effect of Tai Chi exercise on elderly patients with heart failure

目的系统评价太极拳对老年心力衰竭患者心脏功能的影响及改善效果。方法使用计算机系统地检索中国知网(CNKI)、维普网、万方数据库(Wanfang Data)、中国生物医学文献数据库(CBM)、PubMed、EMbase、Web of Science、The Cochrane Library共8个中英文数据库中与太极拳锻炼对老年心力衰竭患者心脏功能结局影响有关的随机对照试验,检索时限为自建库起至2023年1月10日。由2名护理专业研究者根据设置的纳入和排除标准独立筛选文献、提取所选文献中的重要资料并进行文献质量评价,使用RevMan5.4软件进行Meta分析。结果共纳入10篇中英文文献,包括5篇中文文献和5篇英文文献,共734例心力衰竭患者。Meta分析结果显示,老年心力衰竭患者通过太极拳锻炼可以有效降低血浆脑钠肽(BNP)水平(MD=-10.91,95%CI-13.36~-8.46,Z=8.72,P<0.00001)、增加6分钟步行距离(MD=33.12,95%CI 22.79~43.45,Z=6.29,P<0.00001)、提升左心室射血分数(LVEF)(MD=4.73,95%CI 0.64~8.82,Z=2.27,P=0.02),降低明尼苏达心力衰竭生活质量问卷(MLHFQ)评分(SMD=-1.06,95%CI-1.30~-0.82,Z=8.60,P<0.00001)。结论与常规锻炼相比,太极拳锻炼在改善老年心力衰竭患者的心脏功能和生活质量方面效果更好。但由于本次纳入分析的文献数量太少及纳入文献的质量欠佳,在将来需要质量更高、样本量更大的随机对照试验验证分析结果,以进一步评估太极拳在老年心力衰竭患者中的应用价值。

Objective To systematically evaluate the effect of Tai Chi on cardiac function in elderly patients with heart failure.Methods The databases including CNKI,VIP,Wanfang Data,CBM,PubMed,EMbase,Web of Science and The Cochrane were systematically searched The Library included 8 Chinese and English databases for randomized controlled trials related to the effect of Tai Chi on cardiac function outcomes in elderly patients with heart failure.The search time limit was from the establishment of the database to January 10,2023.Two nursing researchers independently screened literature according to the inclusion and exclusion criteria,extracted the important data in the selected literature,and evaluated the quality of the literature.RevMan5.4 software was used for Meta-analysis.Results A total of 10 Chinese and English studies involving 734 patients with heart failure were included in the Meta-analysis,including 5 Chinese and 5 English studies.Meta-analysis results showed that Tai Chi could effectively reduce plasma brain natriuretic peptide(BNP)levels in elderly patients with heart failure(MD=-10.91,95%CI-13.36~-8.46;Z=8.72,P<0.00001),increased 6-minute walking distance(MD=33.12,95%CI 22.79~43.45,Z=6.29,P<0.00001),and improved left ventricular ejection fraction(LVEF)(MD=4.73,95%CI 0.64~8.82,Z=2.27,P=0.02)and MLHFQ score(SMD=-1.06,95%CI-1.30~-0.82,Z=8.60,P<0.00001).Conclusion Compared with conventional exercise,Tai Chi is more effective in improving heart function and quality of life in elderly patients with heart failure.However,due to the small number and poor quality of the included literatures,higher quality and larger sample size randomized controlled trials are still needed to verify the analysis results in the future to further evaluate the application value of Tai Chi in elderly patients with heart failure.