太極拳對慢性病患之血壓、血糖、血脂控制成效探討－－系統性文獻回顧

The Effect of Tai Chi for Blood Pressure, Blood Sugar, Blood Lipid Control for Patients With Chronic Diseases: A Systematic Review

背景：太極拳講求溫和、平衡、緩慢與呼吸調節的活動特性，廣泛的被運用在老人保健及健康促進。陸續有學者以實證性研究探討太極拳應用在降血壓、血糖及血脂等三高慢性病危險因子之成效，但研究結果分歧，需統整研究文獻以探討太極拳介入實證成效。目的：藉由系統性文獻回顧統整太極拳對慢性病患之血壓、血糖、血脂控制之成效探討。方法：搜尋六個電子資料庫，時間自1990至2011年5月，依納入及排除條件篩選後，以Modified Jadad Scale評價文獻品質。結果：共有7篇隨機對照試驗研究符合標準，研究對象為中老年慢性病患。研究參與人數的範圍從38-207人，總人數有947人參加研究，研究參與者大部分是女性（6篇研究女性比率> 50%），研究對象年齡範圍自51 ± 9.8至81.2 ± 6.1歲，研究結果顯示太極拳介入有效降低血壓、血脂；但對於降血糖與糖化血色素、改善胰島素敏感度等指標無顯著成效。結論／實務應用本系統性文獻回顧顯示太極拳介入對於血壓、血脂有顯著效果，但對血糖成效不明顯，建議仍需進行較大規模、介入較長時間及增加研究對象，以觀察持續效果；並將太極拳劑量化、精準化，作為實證介入的參考。

Background: Tai chi emphasizes gentle, balanced, slow, deep-breathing activity and is widely applied in healthcare and health promotion in elderly populations. Researchers have applied tai chi as an intervention to reduce hypertension, hyperglycemia, and hyperlipidemia with unclear results. This article conducts a systematic review of tai chi intervention research with regard to its effectiveness in addressing three risk factors.Purpose: This study conducted a systematic review of reports discussing the blood pressure, blood sugar and blood lipid effects of tai chi in chronic diseases clients.Method: Researchers searched six electronic databases for relevant articles published between 1990 and May 2011. Data were collected using inclusion and exclusion criteria. A modified Jadad Scale was used to evaluate the quality of the identified articles.Results: Seven studies met our inclusion criteria of targeting middle-aged subjects with chronic diseases. There was a total of 947 participants, with studies ranging from 38-207 participants. The majority of participants were women (six studies with a female ratio of ＞ 50%); participant ages ranged from 51 ± 9.8 to 81.2 ± 6.1; four studies reported that tai chi reduced blood pressure and blood lipid levels; three studies reported that tai chi did not improve blood glucose, insulin sensitivity, or HbA1C.Conclusion: Systematic review results indicate that tai chi interventions have a significant and positive effect on blood pressure and lipid levels but not for blood sugar levels. Larger scale studies with more subjects and longer time periods are necessary to further confirm and illuminate the effects of tai chi and guide the design of effective, empirical- based intervention programs.