摘要
【目的】系统评价传统健身功法干预慢性阻塞性肺疾病(COPD)稳定期的康复疗效。【方法】计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普(VIP)、万方(Wanfang)、PubMed、Web of Science、Cochrane Library等数据库,收集试验组中含有传统健身功法治疗稳定期COPD的随机对照试验(RCT)。由2位研究者进行独立筛选文献、资料提取和质量评价后,采用RevMan 5.3软件进行Meta分析。【结果】共纳入24个研究,涉及2 171例患者。Meta分析结果显示:在常规药物治疗基础上结合传统健身功法(联合疗法),比单纯常规药物治疗更能改善患者第1 s用力呼气容积(FEV1)[MD=0.26,95%CI(0.11,0.41)]、第1 s呼气容积占预计值百分比(FEV1%)[MD=4.08,95%CI(1.94,6.21)]、FEV1与用力肺活量(FVC)的比值(FEV1/FVC)[MD=3.47,95%CI(1.21,5.72)];联合疗法在改善运动耐量指标如6-min步行距离(6MWD)[MD=40.93,95%CI(25.09,56.77)]、呼吸困难评分如慢性阻塞性肺病评估测试(COPD Assessment Test,CAT)评分[MD=-3.21,95%CI(-4.96,-1.45)]、生活质量评分如St George呼吸问卷(St George Respiratory Questionnaire,SGRQ)评分[MD=-8.20,95%CI(-12.30,-4.11)]方面亦均优于单纯常规药物治疗,差异有统计学意义(P <0.05)。与现代康复训练结合常规药物治疗比较,联合疗法在改善患者肺功能(FEV1、FEV1%、 FEV1/FVC)、运动耐量和呼吸困难等方面差异均无统计学意义(P> 0.05)。【结论】当前证据表明,传统健身功法联合常规药物治疗稳定期COPD能明显改善患者肺功能、运动耐量、呼吸困难症状及生活质量,而与现代康复训练结合常规药物治疗比较疗效差异无统计学意义。但由于纳入研究存在一定方法学偏倚,且样本量较小,该结论尚需更多高质量大样本的临床研究予以证实。
Objective To systematically review the effect of traditional health-preservation exercises for the patients with stable chronic obstructive pulmonary disease(COPD). Methods Databases of CNKI, CBM,Wanfang, VIP, PubMed, Web of Science and Cochrane Library were electronically searched to collect randomized controlled trials(RCT)of traditional health-preservation exercises for the treatment of patients with stable COPD. Two reviewers performed the screening of the literature,extraction of the data,and evaluation of the quality of the included studies independently. And then RevMan 5.3 software was adopted for the Meta-analysis.Results A total of 24 RCTs and 2 171 patients were included. The results of Meta-analysis showed that in comparison with the conventional drug therapy alone, traditional health-preservation exercises combined with conventional drug therapy(combined therapy)could significantly improve the forced expiratory volume in the first second(FEV1)[MD = 0.26,95%CI(0.11,0.41)],FEV1 predicted(FEV1%)[MD = 4.08,95%CI(1.94,6.21)],and the ratio of FEV1 to forced vital capacity(FEV1/FVC)[MD = 3.47,95%CI(1.21,5.72)];the combined therapy also had stronger effect than the conventional drug therapy alone on improving exercise tolerance index of the 6-min walking distance(6 MWD)[MD = 40.93,95%CI(25.09,56.77)],dyspnea scores of COPD Assessment Test(CAT)scores [MD =-3.21,95%CI(-4.96,-1.45)] and the scores of quality of life of the patients with St George Respiratory Questionnaire(SGRQ)[MD =-8.20, 95% CI(-12.30,-4.11)], the difference being statistically significant(P < 0.05). Compared to modern rehabilitation training combined with conventional drug therapy,the differences of the combined therapy on improving lung function(FEV1,FEV1%,FEV1/FVC), exercise tolerance and dyspnea of patients were not significant(P > 0.05). Conclusion Current evidence showed that traditional health-preservation exercises combined with conventional drug therapy can be distinctly benefit to lung function,exercise tolerance,dyspnea and the quality of life of the patients with stable COPD,but its effect is not superior to that of the modern rehabilitation training combined with conventional drug therapy. Due to methodogical bias in the included studies and the small sample size,more high-quality studies will be needed to verify the above conclusion.
作者
郑亚威
赵宇浩
舒运录
马嘉伟
杨继兵
陈昊
ZHENG Ya-Wei;ZHAO Yu-Hao;SHU Yun-Lu;MA Jia-Wei;YANG Ji-Bing;CHEN Hao(Nanjing University of Chinese Medicine,Nanjing 210023 Jiangsu,China)
出处
《广州中医药大学学报》
CAS
2019年第6期852-861,共10页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
2016年江苏省大学生科技创新训练计划项目(编号:201610315103)
关键词
传统健身功法
慢性阻塞性肺疾病
肺功能
运动耐量
呼吸困难
生活质量
META分析
traditional health-preservation exercises
chronic obstructive pulmonary disease
lung function
exercise tolerance
dyspnea
quality of life
Meta-analysis
