頂級(jí)醫(yī)學(xué)期刊證明中國功夫的治療作用

生物通報(bào)道：中國功夫早已隨著各種電影娛樂節(jié)目在全球聲名顯赫，但是在疾病治療方面卻提及不多，2月來自俄勒岡研究院的研究人員發(fā)表了題為“Tai Chi and Postural Stability in Patients with Parkinson's Disease”的文章，證明了中國的太極鍛煉能極大的幫助帕金森綜合癥患者恢復(fù)平衡穩(wěn)定的能力，相關(guān)成果公布在醫(yī)學(xué)領(lǐng)域頂級(jí)刊物《新英格蘭雜志》（NEJM）上（NEJM是目前世界醫(yī)學(xué)界最權(quán)威的學(xué)術(shù)刊物之一，也是影響因子最高的SCI刊物之一）。iso

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文章的第一作者，俄勒岡研究院李福中（Fuzhong Li，音譯）博士表示，“這些成果具有重要的臨床意義，因?yàn)檫@說明太極這種低到中強(qiáng)度的鍛煉也許能作為目前物理治療的一種補(bǔ)充手段，用于針對(duì)帕金森患者的幾個(gè)關(guān)鍵臨床問題的治療，比如平衡性和步伐穩(wěn)定性。由于太極鍛煉中許多練習(xí)特征都是具有功能針對(duì)性，因此研究證明的平衡性和穩(wěn)定性的恢復(fù)，突出了以太極為基礎(chǔ)的運(yùn)動(dòng)在具有這些問題的康復(fù)患者身上的潛力，而且這也減輕了患者的主要癥狀，提升了靈活性，平衡性，以及運(yùn)動(dòng)的范圍”。

這個(gè)為期四年項(xiàng)目得到了美國神經(jīng)系統(tǒng)疾病和中風(fēng)研究院的資助，研究人員隨機(jī)抽取了195個(gè)帕金森癥患者進(jìn)行了三個(gè)方面的鍛煉，包括太極，抗阻鍛煉（resistance training），以及伸展運(yùn)動(dòng)。這些患者在24周的時(shí)間里堅(jiān)持每周兩次的60分鐘鍛煉。

研究結(jié)果表明，相比于伸展運(yùn)動(dòng)組，太極鍛煉組作用更有效，更長期，因?yàn)檫@種鍛煉能幫助患者在任何方面傾斜，而不會(huì)失去平衡，從而有助于身體方向性的掌控和步行能力。太極參與鍛煉的患者也比抗阻鍛煉組的患者，在平衡性和步幅檢測中表現(xiàn)更突出，除此之外，在防治摔倒等事故方面，太極鍛煉比伸展運(yùn)動(dòng)優(yōu)越，效果與抗阻鍛煉相同。

這項(xiàng)由李博士發(fā)展的太極項(xiàng)目包含有6個(gè)太極動(dòng)作，整合成了八式招法，主要集中于重量平移，有支撐的重心控制位移，關(guān)節(jié)運(yùn)動(dòng)，前端至后端和側(cè)身的運(yùn)動(dòng)，這些鍛煉方法還加入了自然呼吸方法。

“利用太極鍛煉恢復(fù)帕金森癥患者的運(yùn)動(dòng)能力，具有很多優(yōu)點(diǎn)，比如這是一種低成本的運(yùn)動(dòng)，不需要器材，其次這一運(yùn)動(dòng)能在任何地方，任何時(shí)候進(jìn)行，而且這些動(dòng)作也很容易學(xué)，可以納入到目前的治療中去。同樣由于其簡單性，太極鍛煉的某些項(xiàng)目可以作為患者在家里進(jìn)行的鍛煉”，李博士說。

近年來越來越多的研究證明了古老中醫(yī)藥在疾病治療方面的重要作用，沉淀多年的中國傳統(tǒng)也許會(huì)煥發(fā)出越來越耀眼的光芒。

（生物通：張迪）

原文摘要：

Tai Chi and Postural Stability in Patients with Parkinson's Disease

Background
Patients with Parkinson's disease have substantially impaired balance, leading to diminished functional ability and an increased risk of falling. Although exercise is routinely encouraged by health care providers, few programs have been proven effective.

Methods
We conducted a randomized, controlled trial to determine whether a tailored tai chi program could improve postural control in patients with idiopathic Parkinson's disease. We randomly assigned 195 patients with stage 1 to 4 disease on the Hoehn and Yahr staging scale (which ranges from 1 to 5, with higher stages indicating more severe disease) to one of three groups: tai chi, resistance training, or stretching. The patients participated in 60-minute exercise sessions twice weekly for 24 weeks. The primary outcomes were changes from baseline in the limits-of-stability test (maximum excursion and directional control; range, 0 to 100%). Secondary outcomes included measures of gait and strength, scores on functional-reach and timed up-and-go tests, motor scores on the Unified Parkinson's Disease Rating Scale, and number of falls.

Results
The tai chi group performed consistently better than the resistance-training and stretching groups in maximum excursion (between-group difference in the change from baseline, 5.55 percentage points; 95% confidence interval [CI], 1.12 to 9.97; and 11.98 percentage points; 95% CI, 7.21 to 16.74, respectively) and in directional control (10.45 percentage points; 95% CI, 3.89 to 17.00; and 11.38 percentage points; 95% CI, 5.50 to 17.27, respectively). The tai chi group also performed better than the stretching group in all secondary outcomes and outperformed the resistance-training group in stride length and functional reach. Tai chi lowered the incidence of falls as compared with stretching but not as compared with resistance training. The effects of tai chi training were maintained at 3 months after the intervention. No serious adverse events were observed.

Conclusions
Tai chi training appears to reduce balance impairments in patients with mild-to-moderate Parkinson's disease, with additional benefits of improved functional capacity and reduced falls. (Funded by the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT00611481.)
 

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