| Objective: This study sorted out the literature on Taijiquan treatment of coronary heart disease,in order to better analyze the research progress in this field;this study also evaluated the quality of the RCT research method and intervention report in this field,so as to improve the quality of future research.Finally,this study systematically evaluated the rehabilitation effect of Tai Chi exercises on patients with stable myocardial infarction,and provided evidence support for the clinical promotion of Tai Chi exercises.Methods: Part one: We systematically searched the documents in 7 databases(including: Pub Med,Cochrane Library,Embase,CBMdisc,Wan Fang Data,VIP,CNKI),and the time limit was from the establishment of the database to November 31,2020.We sorted out the journal distribution and intervention methods of related literature.Part two: Based on the existing literature of part one,the RCTs of Tai Chi treatment of coronary heart disease were screened out.The Cochrane risk of bias assessment criteria and the "Tai Chi Clinical Trial Intervention Reporting Standards and Recommendations" were used to evaluate the research methodology and the quality of the intervention measures.Part three: We screened the RCTs of Taijiquan for myocardial infarction that meet the inclusion requirements and used Revman5.3 software to merge the data.Outcome indicator includes 6MWT,LVEF,N-terminal Pro-BNP and pro BNP,V02 peak and SF-36.Results: Part one: 86 clinical research literatures were included.SCI journals contain 45 documents,Chinese core journals contain 9 documents,science and technology core journals contain 10 documents,general journals contain 9 documents,8 dissertations and 5 conference papers.There were 43 RCTs studies,6 CCT studies,13 reviews,3 systematic re-views,14 meta-analysis,and 7 other types.The number of published documents is generally increasing,and the growth of RCT research is particularly noticeable.The main intervention measures of RCTs research were: Tai Chi therapy alone,Tai Chi therapy combined with conventional drug therapy,Tai Chi therapy combined with conventional nursing,Tai Chi therapy combined with other sports,etc.Part two: This section contains 35 RCTs,of which 19 studies reported random allocation methods;2 reported allocation concealment;5 documents described blindness;3 documents described the reasons for missing data;only 5 studies was registered in 4 articles;the baseline conditions were described in words or tables in 4articles;none of the articles mentioned the sample size estimation method.The report quality evaluation of intervention measures includes a total of 7 items(16 sub-items),among which high-quality items were: intervention rationality,intervention plan;medium-quality items were: control or control intervention;low-quality items were: Tai Chi The details of the exercises,the qualifications of the coaches,and the standard status of the exercises.Part three: 7 RCTs were included,associating with a total of 577 patients.The6 MWT distance of patients with myocardial infarction in the Tai Chi group was slightly increased than that in the control group [MD=70.672,95% CI(-0.44,141.29),P=0.05];the LVEF of the Tai Chi group was higher than that of the conventional group[MD=3.51,95% CI(-0.29,7.30),P>0.05];the pro-BNP level of patients in the Taiji group was lower than that of the control group [SMD=1.91,95%CI(-2.34,-1.49),P<0.001].The overall living conditions of patients in the Tai Chi group were significantly better than those in the conventional group [MD=22.34,95%CI(15.22,29.47),P<0.001],and the above differences were all statistically significant.However,compared with other types of activities,the improvement of LVEF in the Tai Chi group was not statistically significant [MD=3.50,95%CI(-0.29,7.29),P>0.05].A descriptive analysis of the VO2 peak index was performed,and we found that Tai Chi can effectively improve the patient’s VO2 peak level.Conclusions: The number of literature on Tai Chi treatment of coronary heart disease showed an rising trend.Even though the number of randomized controlled trials was the most,the quality was not high overall.The quality of research in this field is projected to improve in the future.At present,there is no rigorously designed RCT of Tai Chi treatment of coronary heart disease.Many trials have insufficient methodologies and intervention measures,and there is still much space for improvement.In addition to acupuncture,there is still a lack ofinternational standards for reporting other non-pharmacological interventions.We recommend that people in related research fields innovate and promote the formulation of international re-porting standards for Tai Chi exercise therapy.Compared with the control group,Tai Chi has showed a certain rehabilitation effecton patients with stable myocardial infarction.However,the overall quality of the research included in the literature is not high.At the same time,Tai Chi is a complex clinical intervention.The clinical efficacy is closely related to the coaching experience and practice methods.Therefore,the conclusions drawn need to be carefully verified in the future.It is suggested that researchers can compare Tai Chi with other types of exercises,so as to better explore the differences in curative effect between these exercises. |
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