目的：系统评价八段锦对糖尿病患者糖脂代谢水平的影响。方法：系统检索中国知识基础设施(CNKI)、中文科技期刊数据库(VIP)、万方数据资源系统(WANFANG)、Cochrane Library、PubMed、Web of Science等数据库,纳入有关八段锦治疗糖尿病的随机对照试验,使用RevMan 5.0软件进行荟萃分析。结果：共纳入16项研究,包括1185例糖尿病患者,其中试验组共591例,对照组共594例。最大样本量200例,最小样本量30例。疗程1.5个月～6个月。Meta分析结果显示：①糖代谢方面：疗程不足6个月时,八段锦组糖尿病患者的FPG(MD=-0.60,95%CI[-0.98, -0.23])、HbA1c(MD=-0.8,95%CI[-0.99, -0.61])改善情况优于对照组；疗程达6个月时,八段锦组糖尿病患者的FPG(MD=-1.07,95%CI[-1.67, -0.47])、P2hPG(MD=-1.2,95%CI[-2.31, -0.08])、HbA1c(MD=-0.73,95%CI[-1.14, -0.32])改善程度优于对照组。②脂代谢方面：疗程不足6个月时,八段锦组糖尿病患者的TC(MD=-0.79,95%CI[-1.13, -0.45])、HDL(MD=0.21,95%CI[0.12, 0.29])改善情况优于对照组；疗程达6个月时,八段锦组糖尿病患者的TC(MD=-0.46,95%CI[-0.71, -0.20])、TG(MD=-0.60,95%CI[-1.14, -0.06])、HDL(MD=0.21,95%CI[0.09, 0.33])改善情况优于对照组。但八段锦锻炼对LDL的疗效并不确切。③仅有2项研究进行了安全性检测及不良反应观察,结果均显示八段锦组未发现安全性问题和不良反应事件。结论：八段锦作为辅助治疗手段具有进一步改善糖尿病患者糖脂代谢水平的作用,尤其在FPG、HbA1c、TC、HDL方面的疗效较为稳定,同时安全性较好,具有良好的推广应用价值。但由于本研究纳入文献数量及样本量较少,可能受到各种偏倚的影响,在一定程度上降低了结论的可靠性,亟须更多高质量研究从多个维度进一步证实八段锦之于糖尿病的防治效果。
Abstract: Objective: To systematically evaluate the effect of Baduanjin on glucose and lipid metabolism in diabetic patients. Methods: CNKI, VIP, WANFANG, Cochrane Library, PubMed, Web of Science and other databases were systematically searched and included in the randomized controlled trial of Baduanjin in the treatment of diabetes mellitus. RevMan 5.0 software was used for meta-analysis. Results: A total of 16 studies were included, including 1185 diabetic patients, including 591 in the experimental group and 594 in the control group. The maximum sample size was 200 cases and the minimum sample size was 30 cases. The course of treatment was 1.5 to 6 months. Meta-analysis results show: ① In terms of glucose metabolism: when the treatment course is less than 6 months, the improvement of FPG(MD=-0.60, 95%CI[-0.98, -0.23]), HbA1c(MD=-0.8, 95%CI[-0.99, -0.61]) in Baduanjin group is better than that in the control group; After 6 months of treatment, the improvement of FPG(MD=-1.07, 95%CI[-1.67, -0.47]), P2hPG(MD=-1.2, 95%CI[-2.31, -0.08]), HbA1c(MD=-0.73, 95%CI[-1.14, -0.32]) and HbA1c (MD =-0.73, 95% CI [-0.32]) in Baduanjin group are better than those in the control group. (2) Lipid metabolism: when the course of treatment is less than 6 months, the improvement of TC(MD=-0.79, 95%CI[-1.13, -0.45]), HDL(MD=0.21, 95%CI[0.12, 0.29]) in Baduanjin group is better than that in the control group; After 6 months of treatment, the improvement of TC(MD=-0.46, 95%CI[-0.71, -0.20]), TG(MD=-0.60, 95%CI[-1.14, -0.06]), HDL(MD=0.21, 95%CI[0.09, 0.33]) in Baduanjin group is better than that in the control group. But the effect of Baduanjin exercise on LDL is not exact. Conclusion: Baduanjin, as an adjuvant therapy, has the effect of further improving glucose and lipid metabolism level of diabetic patients, especially in FPG, HbA1c, TC, HDL, with relatively stable curative effect, good safety and good popularization and application value. However, due to the small number of documents and samples included in this study, it may be affected by various biases, which reduces the reliability of the conclusion to a certain extent. More high-quality studies are urgently needed to further confirm the prevention and treatment effect of Baduanjin on diabetes from multiple dimensions.