Objective

To evaluate clinical trial evidence of the effects of Qigong practice on self-reported fatigue among cancer patients or survivors.

Methods

13 articles published before 31 December 2019 involving 1154 participants were selected according to PICO guidelines in the Cochrane Handbook. Relevant randomized controlled trials (RCTs) were included. Hedges d effect sizes were calculated and random effects models were used to estimate the pooled effects. I² tests were applied to assess the heterogeneity. Moderating effects were tested by mixed model meta-regression analysis according to moderators derived from participant characteristics, features of Qigong exposure and research design. Study quality was judged using the Wayne Checklist.

Results

Qigong practice relieved cancer-related fatigue by a heterogeneous (I² = 81.4%) standardized mean effect size 0.46 (95% CI, 0.15 to 0.78, z = 2.89, p = 0.0039). Reductions were larger in participants having elevated fatigue at baseline. Trials with blinded allocation or blinded assessment of participants had larger effects. Qigong had a significant effect on cancer-related fatigue when Qigong was compared with usual care or waitlist control (Hedges d = 0.66, 95% CI, 0.07 to 1.26, p < 0.001), but not when Qigong was compared with Western exercise (Hedges d = 0.46, 95%CI, −0.02 to 0.95, p = 0.06) or no treatment control (Hedges d = 0.10, 95%CI, −0.23 to 0.43, p = 0.60) in sub-analysis.

Conclusion

Qigong practice may have small-to-moderate efficacy for management of cancer-related fatigue, but the limited number of RCTs and methodological flaws in most of the trials make it premature to conclude clinical effectiveness. Further high-quality RCTs are needed to mitigate potential methodological bias.

中文翻译：

---

气功练习对癌症相关疲劳的功效：随机对照试验的系统评价和荟萃分析

目的

评估气功练习对癌症患者或幸存者自我报告的疲劳的影响的临床试验证据。

方法

根据Cochrane手册中的PICO指南，选择了2019年12月31日之前发表的涉及1154名参与者的13篇文章。相关的随机对照试验（RCT）也包括在内。赫奇斯d效应大小进行了计算和随机效应模型来估计汇集效果。我²测试被用来评估异质性。根据参与者特征，气功暴露特征和研究设计的主持人，通过混合模型元回归分析对主持人的效果进行了测试。使用韦恩清单对研究质量进行判断。

结果

气功练习通过异类（I ²  = 81.4％）标准化平均效应大小0.46（95％CI，0.15至0.78，z = 2.89，p = 0.0039）缓解了癌症相关的疲劳。基线时疲劳程度升高的参与者的减少幅度更大。对参与者进行盲目分配或盲目评估的试验效果更大。当将气功与常规护理或等待清单对照进行比较时，气功对癌症相关的疲劳有显着影响（对冲d  = 0.66，95％CI，0.07至1.26，p <0.001），但是当对气功与西方锻炼进行对比时（对冲）在子分析中d  = 0.46，95％CI，-0.02至0.95，p = 0.06）或无治疗对照（对冲d  = 0.10，95％CI，-0.23至0.43，p = 0.60）。

结论

气功实践可能对管理与癌症相关的疲劳具有小到中等的疗效，但是在大多数试验中，RCT的数量有限和方法学上的缺陷使得结论临床效果为时尚早。需要进一步的高质量RCT来减轻潜在的方法学偏见。