健身氣功用於睡眠品質之改善效果:隨機對照試驗之系統性文獻回顧與統合分析

研究目的：本研究旨在系統性摘錄健身氣功對睡眠品質的改善成效之文獻並統合分析綜合效果。研究設計：隨機對照試驗之系統性文獻回顧與統合分析。研究方法：以系統性文獻回顧方式，蒐集採健身氣功為介入措施、睡眠品質為成效指標的中、英文隨機臨床試驗報告並進行統合分析。使用共十一個電子資料庫進行文獻索引。採用The Cochrane Collaboration’s Tool for Assessing Risk of Bias 進行品質評讀。統計方法採用Comprehensive Meta-Analysis Software 2.0 軟體來進行統合分析，並運用隨機模式與 Hedge’s g 評定其效果量；Cochrane Q test 及퐼2 檢測異質性，並以Funnel plot 與Fail safe Number 判定有無出版偏差。研究結果：文獻搜尋後共有392 篇文章，經過刪除重複文獻、檢視文章標題、摘要及全文後，符合納入條件的文章共有17 篇，其中一篇有2 組的健身氣功介入措施，故最後納入18 筆研究資料進行文獻回顧及統合分析。總效果量為-0.47 (95% CI: -0.66 ~ -0.28, p < .001), 結果顯示健身氣功可有效改善睡眠品質且在統計上呈現顯著差異，異質性檢定Q = 47.23, p < .001, I 2= 64.01%，文章中存有中度到高度的異質性，因此進行次族群分析與後設回歸分析。Fail-safe N 結果呈現需要有265 篇沒有顯著的原始研究才能推翻健身氣功能有效改善睡眠品質的結論。研究結論：此研究結果發現健身氣功具中等程度的改善效果量，顯示健身氣功可提供促進睡眠的有益效果。

關鍵字

健身氣功；睡眠品質；系統性文獻；統合分析

並列摘要

Objective: This study aims to assess the effects of health qigong on sleep quality. Design: Systematic review and meta-analysis of randomized controlled trials. Method: This study systematically identified relevant studies through searching 11 databases, including Airiti Library, CINAHL, Cochrane Library, EMBASE, Google Scholar, NCL Periodical Information Center, PsycINFO, Pubmed, Scopus, Wanfang Database, and Web of Science. Studies that (1) used a randomized controlled trials design (2) were published in Chinese or English, (3) investigated “Health qigong”, “Yijinjing”, “Wuqinxi”, “Liuzijue”, or “Baduanjin”, and (4) used sleep quality as the main outcome were included. Two reviewers independently extracted data according to the inclusion criteria and performed quality appraisal based on the Cochrane Collaboration’s Tool for Assessing Risk of Bias. Hedge’s g with a random effects model was used to evaluate the effects of health qigong on sleep quality. Cochrane Q test and I2were used to determine the heterogeneity. Publication bias were assessed by constructing funnel plot and calculating the fail-safe number. Statistical analyses were performed using Comprehensive Meta-Analysis Software version 2.0. Results: The initial search yielded 392 studies. Seventeen studies were included after excluding duplicates and those not meeting the inclusion criteria. One of the included studies had with two health qigong groups. Hence, 18 trials were included for meta-analyses. The overall effect size was -0.47 (95% Confidence Interval, -0.66~-0.28, p < .001). Cochrane Q test (47.23, p < .001), and I2 (64.01%) indicate moderate to high heterogeneity among the analyzed studies. Moderator analyses and meta-regression were subsequently conducted. The funnel plot showed symmetry, and the fail-safe number was 265, indicating that publication bias was rather unlikely. Conclusion: Health qigong exerted a medium effect size on sleep quality. The findings support that health qigong offers beneficial effects for sleep quality improvement.