Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (19): 3109-3116.doi: 10.3969/j.issn.2095-4344.1259
Hao Jianying1, Xie Baocheng2
Received:
2019-01-20
Contact:
Hao Jianying, Institute of Physical Education, Nanchang Institute of Technology, Nanchang 330044, Jiangxi Province, China
About author:
Hao Jianying, Master, Lecturer, Institute of Physical Education, Nanchang Institute of Technology, Nanchang 330044, Jiangxi Province, China
CLC Number:
Hao Jianying1, Xie Baocheng2 . Effect of Tai Chi on bone mineral density in the middle-aged and older adults: a meta-analysis [J]. Chinese Journal of Tissue Engineering Research, 2019, 23(19): 3109-3116.
2.2 纳入研究的基本情况和特征分析 研究对象的例数、年龄、研究的类型、所使用的干预措施、治疗的时间和结局指标均进行基线一致性分析,纳入研究的基本特征见表1。 2.3 纳入文献的质量评价情况 使用Cochrane风险评价表对纳入的21篇随机对照研究进行质量评价,有8篇提及研究分组的随机方法如随机数字法[8,10-12,14,18,23-24],但未发现有分组隐藏的情况,选择性偏倚评估为低风险。其余文章均只提及随机两字,没详细说明随机的方法,也未说明分组隐藏的情况,选择性偏倚评估为不清楚或高风险。有4篇文献有提及盲法情况[12,23-24,36],实施偏倚和检测偏倚评估为低风险。有9篇文献有报道病例退出研究、失访的情况[5-6,10-11,15,23-24,36,38],其随访偏倚和报告偏倚均评价为不清楚。质量评价显示纳入的研究质量较高,见图2。"
2.4 Meta分析结果 2.4.1 腰椎骨密度 共11个研究报道了L2-L4腰椎骨密度情况[7,14-17,29,34-38],其中实验组320例,对照组322例,对研究进行异质性检验I2=65% > 50%,使用随机效应模型分析。Meta分析显示,太极运动(实验组)可以显著提高中老年人群L2-L4腰椎骨密度[MD=0.09,95%CI (0.06,0.12),P < 0.000 01],差异有统计学意义,见图3。亚组分析结果显示,太极运动可以显著提高中老年人群的L1,L2,L3和L4骨密度,差异有统计学意义(P < 0.01),详细见表3。同时,对中老年人群性别进行亚组分析发现,相对于女性人群,太极运动能更好提高男性人群的腰椎骨密度(P=0.03),有统计学差异。"
2.4.3 骨超声传播速度(SOS),超声振幅衰减(BUA)和骨密度指数T值测定 共有5个研究报道了SOS情况[6,22,26,28,33],5个研究报道了BUA情况[6,22,26,30,33],对文献进行异质性检验均I2 > 50%,使用随机效应模型进行分析。Meta分析显示,太极运动(实验组)可以显著性提高中老年人群的SOS指标[MD=16.74,95%CI(1.87, 31.60), P=0.03],差异有统计学意义,见图5。亚组分析显示,太极运动可以显著性提高中老年女性人群的SOS指标[MD=21.04,95%CI(1.78,40.29),P=0.03]和BUA[MD=2.96,95%CI (0.64,5.28),P=0.01],差异有统计学意义。骨密度指数T值有4个研究报道。经异质性检验均I2 > 50%,使用随机效应模型进行分析,Meta分析显示,太极运动可以显著性提高中老年人群的骨密度指数T值[MD=0.67, 95%CI (0.55,0.80),P < 0.000 01]。 2.4.4 睾酮 共有4个研究报道了经过太极运动后中老年男性睾酮的情况[13,16,26,33],对文献进行异质性检验均I2 > 50%,使用随机效应模型进行分析。Meta分析显示,与对照组相比,太极运动(实验组)可以显著改善中老年男性睾酮含量[MD=0.78,95%CI(0.26,1.30), P,差异有统计学意义,见图6。=0.003] 2.5 发表偏倚 对纳入的文献发表偏倚的情况使用漏斗图的方式进行评价,同时使用Stata13.0对结局指标进行Egger检验,从而对研究中可能存在的发表偏倚进行更准确的定性及定量的评价。对Ward’s三角区骨密度指标进行漏斗图和Egger检验分析,结果显示,根据漏斗图的分布判断,纳入研究之间分布对称,定量Egger’s test检验结果发现[P=0.288 > 0.05,95%CI(-1.86,5.70)],可信区间包括零区域,说明纳入的文献发表偏倚的情况较低,见图7,8。"
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