Sports Medicine ( IF 9.3 ) Pub Date : 2024-06-14 , DOI: 10.1007/s40279-024-02046-9 Chenyang Dong 1 , Ruoya Liu 1 , Ran Li 1 , Zhiyang Huang 1 , Shiyuan Sun 1
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Background
Currently, most studies on the health benefits of traditional Chinese exercises on type 2 diabetes mellitus have explored the effects of a single type of traditional Chinese exercise on type 2 diabetes. Although a previous study evaluated the combined clinical effects of traditional Chinese exercises on type 2 diabetes, the studies included in that review were deficient in their study design. In addition, previous studies have not explored the ideal exercise dose that should be taken by patients with type 2 diabetes when performing traditional Chinese exercises.
Objective
To understand whether the findings of previous systematic reviews and meta-analyses are still applicable and to try to address the deficiencies in the previous review, this review conducted a meta-analysis of existing randomized controlled trials to investigate the impact of traditional Chinese exercises on glycemic control with type 2 diabetes.
Methods
The literature was searched in seven Chinese and English databases. Randomized controlled trials published in English and Chinese, from database inception to March 2023, were included in this review. Two reviewers independently reviewed the search results, extracted the data, and assessed the risk of bias. A meta-analysis of the included studies was conducted using Rev Man 5.4 and Stata 15.1 software. Heterogeneity was investigated using a sensitivity analysis, a subgroup analysis, and a meta-regression analysis. Pre-determined subgroups included the duration of the intervention, frequency of exercise, and duration of the single exercise session.
Results
A total of 31 randomized controlled trials (2077 subjects) were selected in this review. The meta-analysis revealed that traditional Chinese exercises were more effective than control groups in lowering glycated hemoglobin (Z = 6.06; mean difference [MD] = − 0.64, 95% confidence interval [CI] − 0.85, − 0.44; P < 0.00001), fasting blood glucose (Z = 7.81; MD = − 0.82, 95% CI − 1.03, − 0.62; P < 0.00001), 2-h plasma glucose (Z = 5.61; MD = − 1.03, 95% CI − 1.39, − 0.67; P < 0.00001), total cholesterol (Z = 4.23; MD = − 0.37, 95% CI − 0.54, − 0.20; P < 0.0001), high-density lipoprotein cholesterol (Z = 5.94; MD = 0.12, 95% CI 0.08, 0.16; P < 0.00001), low-density lipoprotein cholesterol (Z = 6.20; MD = − 0.34, 95% CI − 0.44, − 0.23; P < 0.00001), and triglyceride levels (Z = 3.74; MD = − 0.44, 95% CI − 0.67, − 0.21; P = 0.0002) among patients with type 2 diabetes.
Conclusions
Traditional Chinese exercises can significantly improve blood glucose and lipid levels in patients with type 2 diabetes. When performing traditional Chinese exercise interventions for type 2 diabetes, it is recommended that exercise programs are designed for 30–50 min/session, 4–5 sessions/week for at least 3 months.
中文翻译：
中医传统运动对 2 型糖尿病患者血糖控制的影响：随机对照试验的系统评价和荟萃分析
背景
目前，大多数关于传统中医运动对 2 型糖尿病健康益处的研究都探讨了单一类型的中医传统运动对 2 型糖尿病的影响。尽管之前的一项研究评估了传统中医运动对 2 型糖尿病的综合临床影响，但该综述中纳入的研究在研究设计上存在缺陷。此外，以前的研究尚未探讨 2 型糖尿病患者在进行传统中式锻炼时应服用的理想运动剂量。
目的
为了了解以前的系统评价和荟萃分析的结果是否仍然适用，并试图解决以前评价中的不足，本综述对现有的随机对照试验进行了荟萃分析，以调查中医传统运动对 2 型糖尿病血糖控制的影响。
方法
在 7 个中英文数据库中检索文献。本综述纳入了从数据库建库到 2023 年 3 月以英文和中文发表的随机对照试验。两名评价员独立评价检索结果、提取资料并评估偏倚风险。使用 Rev Man 5.4 和 Stata 15.1 软件对纳入的研究进行荟萃分析。使用敏感性分析、亚组分析和 meta 回归分析研究异质性。预先确定的亚组包括干预持续时间、运动频率和单次运动的持续时间。
结果
本综述共纳入 31 项随机对照试验 （2077 名受试者）。荟萃分析显示，传统中医运动在降低糖化血红蛋白方面比对照组更有效 （Z = 6.06;平均差 [MD] = − 0.64,95% 置信区间 [CI] − 0.85，− 0.44;P < 0.00001）、空腹血糖 （Z = 7.81;MD = − 0.82,95% CI − 1.03，− 0.62;P < 0.00001），2 小时血糖 （Z = 5.61;MD = − 1.03,95% CI − 1.39，− 0.67;P < 0.00001）、总胆固醇 （Z = 4.23;MD = − 0.37,95% CI − 0.54，− 0.20;P < 0.0001）、高密度脂蛋白胆固醇 （Z = 5.94;MD = 0.12,95% CI 0.08,0.16;P < 0.00001）、低密度脂蛋白胆固醇 （Z = 6.20;MD = − 0.34,95% CI − 0.44，− 0.23;P < 0.00001） 和甘油三酯水平 （Z = 3.74;MD = − 0.44,95% CI − 0.67，− 0.21;P = 0.0002）。
结论
传统的中医运动可以显着改善 2 型糖尿病患者的血糖和血脂水平。在对 2 型糖尿病进行传统的中医运动干预时，建议将锻炼计划设计为 30-50 分钟/次，每周 4-5 次，至少持续 3 个月。
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