氣功對乳癌存活者的癌因性疲憊、睡眠障礙、認知障礙及生活品質之效應－－系統性文獻回顧暨統合分析

Effects of Qigong on Cancer-Related Fatigue, Sleep Disturbance, Cognitive Impairment, and Quality of Life in Breast Cancer Survivors: A Systematic Literature Review and Meta-Analysis

背景：氣功被美國國家癌症資訊網列為乳癌存活者在癌因性疲憊的建議運動項目之一。探討有關氣功對乳癌存活者癌因性疲憊、睡眠障礙、認知障礙及生活品質之成效結果分歧，對其影響值得進一步探討。
目的：透過系統性文獻回顧暨統合分析，探討氣功對乳癌存活者的癌因性疲憊、睡眠障礙、認知障礙及生活品質之效應。
方法：依據PRISMA 2020準則進行文獻篩選，搜尋PubMed、EMBASE、Cochrane Library、CINAHL及華藝線上圖書館資料庫，搜尋截至2024年3月。文獻品質以Risk of Bias 2.0進行評估，以Comprehensive Meta-Analysis Version 2.0軟體進行統合分析。
結果：8篇隨機對照試驗，總共469人。氣功可以顯著改善乳癌存活者之癌因性疲憊（SMD = -0.86, 95% confidence interval, 95% CI [-1.24, -0.48], p < .001）、睡眠障礙（SMD = -1.03, 95% CI [-1.36, -0.69], p < .001）及整體生活品質（SMD = 0.59, 95% CI [0.27, 0.92], p < .001）。
結論／實務應用：透過每週3至5次，每次60至90分鐘「行功體態」及「動工體勢」氣功練習，持續8至12週，有助於改善乳癌存活者的癌因性疲憊及睡眠障礙，進而提升生活品質。

Background: The National Comprehensive Cancer Network recommends qigong as an aerobic exercise for reducing cancer-related fatigue in breast cancer survivors. However, findings regarding the effects of qigong on cancer-related fatigue, sleep disturbance, cognitive impairment, and quality of life in this population remain inconclusive and contradictory. Further study is warranted to better understand the impact of this exercise.
Purpose: The aim of this study was to assess the effects of qigong on cancer-related fatigue, sleep disturbance, cognitive impairment, and quality of life in breast cancer survivors using a systematic literature review and meta-analysis.
Methods: The search of the literature was conducted in accordance with PRISMA 2020. The databases searched included PubMed, EMBASE, Cochrane Library, CINAHL, and Airiti Library, and relevant articles published between inception and March 2024 were retrieved systematically. The quality of the retrieved articles was assessed using the Risk of Bias 2.0 tool, and statistical analyses were performed using Comprehensive Meta-Analysis Version 2.0.
Results: Eight randomized controlled trials with a total of 469 participants were analyzed. Qigong was shown to significantly reduce cancer-related fatigue (SMD = -0.86, 95% confidence interval, 95% CI [-1.24, -0.48], p < .001) and sleep disturbance (SMD = -1.03, 95% CI [-1.36, -0.69], p < .001) and to improve overall quality of life (SMD = 0.59, 95% CI [0.27, 0.92], p < .001).
Conclusion/ Implications for Practice: Qigong exercises that include specific“moving meditation”and“dynamic posture”components and are performed for session durations of 60 to 90 minutes with 3 to 5 sessions per week for a period of 8 to 12 weeks may reduce cancer-related fatigue and sleep disturbance in survivors of breast cancer. Furthermore, the overall effects of these improvements were shown to enhance survivor quality of life.