太极拳锻炼周期对原发性高血压的血压及心血管危险因素的影响:系统性评价和Meta分析

目的 采用Meta分析系统性评价太极拳锻炼持续周期是否影响原发性高血压患者的治疗效果,为原发性高血压患者提供合理的运动干预方案。方法 检索从中国知网、万方数据库、PubMed、Cochrane Library、Science Direct、Web Of Science等电子数库中关于太极拳对原发性高血压治疗效果的随机对照试验,采用RevMan 5.3软件进行Meta分析。结果 最终筛选21篇文献,总计有2 129名参与者。Meta分析结果提示:与对照组相比太极拳锻炼持续周期12周以上更有利于收缩压M D=-10.20,95% C I(-14.57,-5.83)]和舒张压M D=-5.12,95% C I(-7.63,-2.60)]水平的降低;能提高原发性高血压患者NO含量M D=6.87,95% C I(4.83,8.90)];改善高血压患者除HDL-C之外的血脂代谢水平:TCM D=-0.51,95% C I(-0.69,-0.33)]、TGM D=-0.72,95% C I(-1.09,-0.36)]、LDL-CM D=-0.59,95% C I(-0.87,-0.32)]。亚组分析结果提示运动频率≥5次/周、运动时间<60 min/d有较好的降压效果。结论 Meta分析表明,与其他持续周期相比,太极拳锻炼持续周期12周以上,每次运动时长控制在60 min以内,每周运动5次以上对降低血压水平、提高NO含量,改善血脂代谢效果最为明显,应值得在临床上推广。

Impacts of Tai Chi exercise cycle on blood pressure and cardiovascular risk factors in essential hypertension: a systematic review and meta-analysis

Objective To provide a reasonable exercise intervention program for patients with essential hypertension(EH) by systematically reviewing, the aiming is to assess if the continuous cycle of Tai Chi Chuan exercise impacts the therapeutic effects on EH patients by the meta-analysis. Methods The randomized controlled trials(RCT) of Tai Chi Chuan treating EH were retrieved from electronic databases involving CNKI,WANFANG Database,PubMed,Cochrane Library,Science Direct and Web Of Science,and the meta-analysis was conducted by RevMan5.3 software. Results Twenty-one papers with 2 129 participants were finally selected. Meta-analysis results showed that Tai Chi Chuan exercise lasting over 12 weeks was more conductive to the decreased level of systolic blood pressure M D=-10.20,95% C I(-14.57,-5.83)] and diastolic blood pressure M D=5.12,95% C I(-7.63,-2.60)] compared with the control group. Tai Chi Chuan was found to increase the NO content of EH patients M D=6.87,95% C I(4.83,8.90)], improve blood lipid metabolism level including total cholesterol (TC) M D=0.51, 95% C I(-0.69,-0.33)], triglyceride (TG)M D=0.72,95% C I(-1.09,-0.36)],low-density lipoprotein cholesterol (LDL-C) M D=0.59,95% C I(-0.87,-0.32)] excluding high-density lipoprotein cholesterol (HDL-C). The results of subgroup analysis showed that exercise frequency ≥5 times/week and exercise duration< 60 min/d had better antihypertensive effect. Conclusion Meta-analysis indicate that Tai Chi Chuan exercise with the continuous cycle>12 weeks, the frequency ≥5 times/week and exercise duration< 60min/d demonstrates obvious effect in reducing blood pressure level and improving NO content and lipid metabolism, being worthy of promotion in clinic practices.