传统功法对原发性骨质疏松症防治效果的系统性评价

摘要

目的 系统评价传统功法在改善骨密度、改善平衡能力及预防跌倒发生方面的效果.方法 计算机检索PubMed、Medline、中国知网、维普、万方医学数据库等数据库中有关传统功法对原发性骨质疏松证防治效果的随机对照试验.检索时间为2000年1月至2015年12月,同时追溯纳入研究的参考文献.根据纳入和排除标准筛选文献,提取资料,并评价纳入研究的方法学质量后,采用Stata 12软件进行Meta分析,若数据因异质性过高不能进行合并,则采用亚组分析或描述性系统评价.结果 共纳入19篇随机对照试验文献,合计3337例患者.Meta分析结果示:(1)传统功法组对腰椎骨密度的改善程度优于对照组,差异具有统计学意义[WMD=0.09,95％ CI(0.04,0.13),P＜0.001];(2)传统功法可以减轻患者骨痛状况[WMD=-0.81,95％ CI(-1.10,-0.53),P＜0.001];(3)传统功法组可明显降低跌倒发生率[RR =0.81,95％ CI(0.69,0.95),P=0.008],增加Berg平衡量表评分[WMD =2.43,95％CI(1.46,3.41),P＜0.001],减少起立行走测试时间[WMD=-0.59,95％CI(-0.92,-0.26),P=0.001].结论 传统功法可在一定程度上改善患者腰椎骨密度,减轻患者骨痛状况,改善老年人平衡功能,减少并预防跌倒发生.%Objective To systematically evaluate the influence of traditional exercise in improving bone mineral density (BMD),improving balance ability,and preventing falling.Methods Rand omized controlled trials about the effect of traditional exercise on primary osteoporosis were retrieved from databases such as PubMed,Medline,CNKI,VIP,and Wanfang Data.The retrieval time was from January 2000 to December 2015.The related references in the study were also retrieved.According to including and excluding criteria,we selected literature,extracted data,and evaluated the quality ofmethod using in the study.Data were analyzed using Stata 12 Meta-analysis software.If the data could not be merged due to the high heterogeneity,we used subgroup analysis or descriptive system evaluation.Results Nineteen rand omized controlled trials were included,with a total amount of 3337 patients.Meta-analysisresult showed:(1) The improvement of BMD in lumbar spine was more in traditionalmethod group than in the control group,with significant difference (WMD =0.09,95％ CI,0.04-0.13,P ＜ 0.001).(2) Traditionalmethod had significant effect on reducing the bone pain (WMD =-0.81,95％ CI,-1.096,-0.53,P ＜ 0.001).(3) Traditionalmethod decreased the incidence of fall (RR =0.81,95％ CI,0.69-0.95,P =0.008),increased the Berg score (WMD =2.43,95％ CI,1.46-3.41,P ＜0.001),and reduced stand-walk test time (WMD =-0.59,95％ CI,-0.92,-0.26,P =0.001).Conclusion The traditional exercise improves BMD of the lumbar spine to some extent.It relieves bone pain,improves the balance function of the elderly,reduces and prevents falling.