八段锦对糖尿病前期患者影响的系统评价与Meta分析

Systematic review and meta-analysis of the effect of Baduanjin on pre-diabetic patients

关键词:  糖尿病前期  八段锦  系统评价  Meta分析  随机对照试验

Key words:  pre-diabetes  Baduanjin  systematic review  meta analysis  randomized controlled trial

摘要:

[目的] 系统评价八段锦功法运动对糖尿病前期患者（PDM）的影响。[方法] 计算机检索PubMed、Embase、Cochrane Library、CBM、中国知网、万方和VIP数据库，收集八段锦运动对PDM患者影响的随机对照试验（RCTs），检索时限均为建库至2022年9月。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Revman5.4.1软件进行Meta分析。[结果] 共纳入11项RCT研究，包括665例患者。Meta分析结果显示：1）糖代谢方面，与对照组相比，八段锦功法运动可降低空腹血糖[MD=-0.46，95%CI（-0.60，-0.31），P＜0.01]、糖化血红蛋白[MD=-0.46，95%CI（-0.82，-0.10），P=0.01]、空腹胰岛素[MD=-1.32，95%CI（-2.06，-0.57），P=0.000 5]和胰岛素抵抗指数[MD=-0.60，95%CI（-0.87，-0.33），P＜0.01]。2）形体改善方面，与对照组相比，八段锦功法运动可降低身体质量指数[MD=-1.04，95%CI（-1.28，-0.80），P＜0.01]；腰臀比指标亚组分析结果提示：与常规治疗组相比，八段锦功法运动可降低PDM患者腰臀比[MD=-0.03，95%CI（-0.04，-0.02），P＜0.01]，与健步走或步行对照组相比，两组的腰臀比差异无统计学意义[MD=-0.01，95%CI（-0.03，-0.01），P=0.43]。3）生活质量改善方面，与对照组相比，八段锦功法运动可提高生理健康评分[MD=8.68，95%CI（5.06，12.29），P＜0.01]和心理健康评分[MD=6.95，95%CI（4.86，9.04），P＜0.01]。[结论] 当前证据显示八段锦功法运动能改善PDM患者空腹血糖、糖化血红蛋白、空腹胰岛素和胰岛素抵抗指数，降低身体质量指数和腰臀比，提高生理健康评分和心理健康评分，安全性较好，对于PDM患者具有较好的推广应用价值。但受纳入研究数量和质量的限制，上述结论尚待开展更多高质量随机对照临床试验进一步验证。

Abstract:

[Objective] To systematically evaluate the effect of Baduanjin exercise on patients with pre-diabetes （PDM）. [Methods] Computer retrieval of PubMed，Embase，CochraneLibrary，CBM，CNKI，WanFang，and VIP databases was conducted to collect randomized controlled trials（RCTs） on the impact of Baduanjin exercise on PDM patients. The retrieval time was from the database establishment until September 2022. Two researchers independently screened the literature，extracted the data，and evaluated the risk of bias included in the study. Then，a metaanalysis was conducted using Revman 5.4.1 software. [Results] A total of 11 RCT studies were included，including 665 patients. Meta analysis results showed that：1）In terms of glucose metabolism，compared with the control group， the Baduanjin exercise can reduce fasting blood glucose [MD=-0.46，95%CI （-0.60，-0.31），P＜0.01]，glycated hemoglobin [MD=-0.46，95%CI （-0.82，-0.10），P=0.01]，fasting insulin [MD=-1.32，95%CI （-2.06，-0.57），P= 0.0005]，and insulin resistance index [MD=-0.60，95%CI （-0.87，-0.33），P＜0.01]. ２）In terms of body improvement，compared with the control group，Baduanjin exercise can reduce body mass index [MD=-1.04，95%CI（-1.28， -0.80），P＜0.01]；The results of subgroup analysis of waist to hip ratio indicators indicate that compared with the conventional treatment group，the Baduanjin exercise can reduce the waist to hip ratio of PDM patients [MD=-0.03， 95%CI（-0.04，-0.02），P＜0.01]. Compared with the control group of walking or walking，there is no statistically significant difference in the waist to hip ratio between the two groups [MD=-0.01，95%CI（-0.03，-0.01），P=0.43]. 3）In terms of improving quality of life，compared with the control group，Baduanjin exercise can improve physiological health scores [MD=8.68，95%CI（5.06，12.29），P＜0.01] and psychological health scores [MD=6.95，95%CI（4.86， 9.04），P＜0.01]. [Conclusion] Current evidence shows that Baduanjin exercise can improve fasting blood glucose， glycated hemoglobin，fasting insulin，and insulin resistance index in PDM patients，reduce body mass index and waist to hip ratio，improve physical and mental health scores，and have good safety. It has good promotion and application value for PDM patients. However，due to the limitations of the number and quality of included studies，the above conclusions still need to be further validated through more high-quality randomized controlled clinical trials.