摘要
目的系统评价常见的不同院外运动康复疗法对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者肺康复的效果。方法计算机检索Pubmed、The Cochrane Library、Web of Science、中国知网、万方及维普等数据库的文献,筛选包含COPD稳定期运用院外运动康复治疗的随机对照试验,检索时间2014年1月1日—2024年5月31日。由2名研究者按照纳入与排除标准筛选文献、提取资料并评价纳入研究的方法学质量后,应用Stata 17.0、Stata 11.0以及Review Manager 5.3软件,采用传统Meta分析及网状Meta分析方法对纳入的RCT研究结果进行合并。结果共纳入62项随机对照试验研究,包含5155例患者。传统Meta及网状Meta分析均显示在COPD患者处于稳定期的院外康复阶段,常规西药治疗联合运动康复可显著改善患者的肺功能以及运动能力,差异具有统计学意义(P<0.05)。网状Meta分析结果显示,水中六字诀运动在改善患者第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、6分钟步行试验(six minutes walking test,6MWT)方面疗效最佳,而甩手运动在改善FEV1与用力肺活量(forced vital capacity,FVC)的比值时效果最为显著。八段锦、太极拳以及陆地六字诀等中医传统疗法对患者肺康复的康复效果也表现良好。结论院外运动康复在COPD稳定期的肺康复中疗效良好,不同类型的运动康复治疗效果可能不尽相同。中医传统疗法的康复效果更为显著,但受纳入研究质量和研究数量的限制,上述结论尚需要更多大样本多中心高质量的临床试验予以验证。
Objective To systematically evaluate the effectiveness of common out of hospital exercise rehabilitation therapies on pulmonary rehabilitation in stable chronic obstructive pulmonary disease(COPD)patients.Methods The literatures in Pubmed,the Cochrane Library,Web of Science,CNKI,WanFang and VIP databases were searched by computer,and randomized controlled trials involving out-of-hospital exercise rehabilitation therapy in stable COPD were screened from January 1,2014.It was last retrieved on May 31,2024.Two researchers were selected according to inclusion and exclusion criteria,extracted data,and evaluated the methodological quality of the included studies.Stata 17.0,Stata 11.0 and Review Manager 5.3 were used to combine the results of the included RCT studies using traditional Meta analysis and network Meta analysis methods.Results A total of 62 RCT were included,involving 5155 patients.Both traditional Meta analysis and network Meta analysis showed that in the stable outpatient rehabilitation stage of COPD patients,conventional western medicine treatment combined with exercise rehabilitation could significantly improve the lung function and exercise ability of the patients,with statistical significance(P<0.05).The results of the network Meta analysis showed that the six character exercise in water had the best therapeutic effect in improving FEV1%and 6WMT in patients,while the hand swinging exercise had the most significant effect in improving FEV1/FVC%.Traditional Chinese medicine therapies such as Ba duan jin,Tai Chi,and Land Six Character Formula have also shown good rehabilitation effects on patients'lung recovery.Conclusion Extracorporeal exercise rehabilitation has a good therapeutic effect on lung rehabilitation in stable COPD,and the effectiveness of different types of exercise rehabilitation treatments may vary.The rehabilitation effect of traditional Chinese medicine exercises is more significant,but limited by the quality and quantity of included studies,the above conclusions still need to be verified by more large-sample,multi-center and high-quality clinical trials.
作者
崔杨
孙婉宁
刘鑫瑶
彭成飞
姜鑫
庞立健
王琳琳
吕晓东
CUI Yang;SUN Wanning;LIU Xinyao;PENG Chengfei;JIANG Xin;PANG Lijian;WANG Linlin;LYU Xiaodong(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《中西医结合慢性病杂志》
2025年第1期26-36,共11页
JOURNAL OF INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE ON CHRONIC DISEASES
基金
国家自然科学基金青年基金项目(82104804)
国家中医药管理局高水平中医药重点学科建设项目(国中医药人教函〔2023〕85号)
辽宁省科技厅创新能力提升联合基金项目(2022-NLTS-13-3)。
关键词
院外运动疗法
慢性阻塞性肺疾病
网状Meta分析
随机对照试验
extracorporeal exercise therapy
chronic obstructive pulmonary disease
network Meta analysis
randomized controlled trial
