太极运动对中老年人群骨密度影响的Meta分析

Effect of Tai Chi on bone mineral density in the middle-aged and older adults: a meta-analysis

背景:已有部分临床研究表明太极运动可提高中老年人群的骨密度,但是证据等级不高,仍缺乏对这些文献论据的系统评估。目的:系统评价太极运动对中老年人群骨密度的影响,为临床上预防和治疗中老年人群骨质疏松提供更为有效的临床指导,也为运动处方的制定提供循证医学的参考。方法:通过系统检索万方数据库、中国知网、中国生物医学文献数据库、Cochrane Library和PubMed、Embase数据库,对太极运动对中老年人群骨密度影响的临床随机对照试验(RCTs)和临床对照试验(CCTs)进行收集分析,检索时间由该数据库建库至2018年9月,RCTs采用Cochrane风险评价表对文献进行评价,CCTs采用法国外科医师Slim等制定的临床干预研究的质量评价工具进行评价,提取文献资料后使用RevMan 5.3软件和State13.0软件对数据进行分析。结果与结论:太极运动可以显著改善中老年人群的腰椎[MD=0.09, 95%CI (0.06,0.12),P <0.000 01]、股骨颈[MD=0.09,95%CI(0.06,0.13),P<0.00001]、股骨大转子[MD=0.06,95%CI(0.03,0.10),P <0.000 01]、Ward’s三角区[MD=0.07,95%CI (0.06,0.09),P <0.000 2]等部位骨密度。同时对跟骨骨密度测定分析,发现太极运动可以显著提高中老年人群的超声振幅衰减(BUA)值和骨超声传播速度(SOS)值等跟骨骨密度指标(P <0.05)。结果表明,太极运动可以显著改善中老年人群不同部位的骨密度,对中老年人群的骨质疏松有较好的预防和治疗作用。

BACKGROUND: Tai Chi has been shown to improve the bone mineral density of the middle-aged and elderly patients, and the quality is poor, so a systematic assessment is required. OBJECTIVE: To evaluate the effect of Tai Chi on bone mineral density in the middle-aged and elderly, thereby providing accurate and reliable reference for the prevention and treatment of osteoporosis, and providing the reference of evidence-based medicine for making exercise prescription. METHODS: Databases of WanFang, CNKI, CBM, Cochrane Library, PubMed and Embase were searched from inception to September 2018 to identify the randomized controlled trials or clinical controlled trials concerning the effect of Tai Chi on bone mineral density in the middle-aged and elderly. The quality of the included randomized controlled trials and clinical controlled trials was evaluated by Cochrane system and criteria made by Slim. RevMan 5.3 software and State 13.0 software were used for meta-analysis. RESULTS AND CONCLUSION: Tai Chi could significantly improve the bone mineral density of the lumbar vertebrae [MD=0.09, 95%CI(0.06, 0.12), P < 0.000 01], femoral neck [MD=0.09, 95%CI(0.06, 0.13), P < 0.000 01], large trochanter [MD=0.06, 95%CI(0.03, 0.10), P < 0.000 01] and Ward’s triangle [MD=0.07, 95%CI(0.06, 0.09), P < 0.000 2] in the middle-aged and elderly. At the same time, Tai Chi could significantly increase the bone mineral density of calcaneus, such as speed of sound and broadband ultrasound attenuation(P < 0.05). These results indicate that Tai Chi can significantly improve the bone mineral density in the middle-aged and elderly patients, and possesses the good roles in the prevention and treatment of middle-aged and elderly osteoporosis.