The Effects of Er Xian Decoction Combined with Baduanjin Exercise on Bone Mineral Density, Lower Limb Balance Function, and Mental Health in Women with Postmenopausal Osteoporosis: A Randomized Controlled Trial

Effect of traditional Chinese fitness exercises on bone mineral density in postmenopausal women: a network meta-analysis of randomized controlled trials

We aimed to evaluate the clinical efficacy of five traditional Chinese fitness exercises (Baduanjin, Taijiquan, Wuqinxi, Yijinjing, and Liuzijue), as well as their efficacy when combined with drug therapy, in the treatment of decreased bone mineral density in postmenopausal women.

Methods

This study strictly followed the evaluation guidelines of PRISMA and followed the "PICOS" principle outlined in the Cochrane Handbook. We performed a systematic search on Web of Science, Springer Link, Scopus, EMBASE, EBSCO, PubMed, the Cochrane Library, CNKI, Wanfang, CBMdisc, and the VIP Database, and we targeted RCTs studying the effect of TCE on BMD in postmenopausal women published prior to September 2023. The quality of the literature and the risk of bias of the included studies were assessed according to ROB2 and GRADE criteria, and data analysis was performed using Stata 14.

Results

A total of 33 RCTs (3658 post-menopausal women) were included. Network meta-analysis showed that Taiji (SMD=0.72, 95% CI: 0.22, 1.21, P<0.01) and Yijinjing (SMD=0.51, 95% CI: 0.03, 0.99, P<0.05) were significantly superior to conventional rehabilitation in lumbar BMD. In terms of improvement of femoral neck BMD, Baduanjin (SMD=1.63, 95% CI: -3.58, 6.85, P<0.001) and Taiji (SMD=0.46, 95% CI: 0.14, 0.79, P<0.05) had statistically different outcomes to conventional rehabilitation. Regarding Ward's triangle BMD, Taiji (SMD= 0.32, 95% CI: 0.14, 0.50, P< 0.05) had statistically different outcomes to conventional rehabilitation. The results of the SUCRA probability ranking showed that Baduanjin + drug interventions achieved the most significant improvement in lumbar BMD (SUCRA=83.6%) and femoral neck BMD (SUCRA=90.2%). Taiji + drug interventions most effectively improved Ward's triangle BMD (SUCRA=86.0%). In terms of traditional Chinese fitness exercises alone, Taiji was the most effective in improving lumbar BMD (SUCRA=64.4%) and Ward's triangle BMD (SUCRA=46.8%), and Baduanjin was the most effective in treating femoral neck BMD (SUCRA=89.9%).

Conclusion

Traditional Chinese fitness exercises can significantly improve the BMD levels of postmenopausal women. Taiji, Yijinjing, and Baduanjin combined with medication showed better intervention effects overall. However, due to the limitations of the number of studies and sample sizes of individual interventions, definitive conclusions need to be verified by more high-quality studies.

Changes in the composition of gut and vaginal microbiota in patients with postmenopausal osteoporosis

Background

Postmenopausal osteoporosis (PMO) is influenced by estrogen metabolism and immune response, which are modulated by several factors including the microbiome and inflammation. Therefore, there is increasing interest in understanding the role of microbiota in PMO.

Objectives

To investigate variations in gut microbiota (GM) and vaginal microbiota (VM) in postmenopausal women with osteoporosis.

Methods

A total of 132 postmenopausal women were recruited for the study and divided into osteoporosis (n = 34), osteopenia (n = 47), and control (n = 51) groups based on their T score. The serum levels of interleukin (IL)-10, tumor necrosis factor (TNF)-α, and lipopolysaccharide-binding protein were determined via enzyme-linked immunosorbent assay. Additionally, 16S rRNA gene V3-V4 region sequencing was performed to investigate the GM and VM of the participants.

Results

Significant differences were observed in the microbial compositions of fecal and vaginal samples between groups (p < 0.05). It was noted that for GM, Romboutsia, unclassified_Mollicutes, and Weissella spp. were enriched in the control group, whereas the abundances of Fusicatenibacter, Lachnoclostridium, and Megamonas spp. were higher in the osteoporosis group than in the other groups. Additionally, for VM, Lactobacillus was enriched in the control group, whereas the abundances of Peptoniphilus, Propionimicrobium, and Gallicola spp. were higher in the osteoporosis group than in the other groups. The predicted functional capacities of GM and VM were different in the various groups. We also found that the serum level of IL-10 in the osteoporosis group was significantly lower than that in the control group and osteopenia group, while TNF-α was significantly higher in the osteoporosis group than that in the control group (p < 0.05).

Conclusion

The results show that changes in BMD in postmenopausal women are associated with the changes in GM and VM; however, changes in GM are more closely correlated with PMO than VM.