9种运动方式对COPD患者肺康复影响的网状Meta分析
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女,硕士在读,护士

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海南省基础与应用基础研究计划(省自然科学基金)立项项目(H0105); 海南省基础与应用基础研究计划(自然科学领域)高层次人才立项项目(2019RC232);海南医学院研究生创新课题(HYYS2021A38)


Network meta-analysis of nine exercise training modalities in pulmonary rehabilitation for COPD patients
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    目的 评价不同运动方式对COPD患者肺康复的影响,为患者选择最优运动措施提供参考。方法 计算机检索国内外8个数据库关于运动训练改善COPD患者肺康复效果的随机对照试验。检索时限均从建库至2022年3月1日。由2名评价员独立筛选文献、提取内容。采用R4.1和ADDIS软件进行网状Meta分析。结果 共纳入34项研究,包括2 373例患者,运动方式共9种。网状Meta分析显示:与常规治疗和护理比较,9种运动方式均有效改善COPD患者肺功能(FEV1%pred、FEV1/FVC%)及呼吸困难程度(除瑜伽运动不能改善FEV1%pred外);FEV1%pred组间比较显示, 抗阻运动、太极拳、有氧抗阻联合运动优于八段锦,太极拳优于呼吸操和六字诀。最优概率结果显示:抗阻训练对肺功能的改善效果最好;六字诀对呼吸困难症状改善效果最好。结论 运动疗法能有效改善COPD患者肺功能和呼吸困难症状,可根据干预预期目标选择合适的运动方式。

    Abstract:

    Objective To assess the comparative impact of nine exercise training modalities on pulmonary rehabilitation in COPD patients. Methods We searched eight domestic and international electronic databases, from inception to 1 March 2022, to identify randomized controlled trails that compared the differences between different exercise training modalities in pulmonary rehabilitation for COPD patients. Two researchers independently screened the search results, extracted data and assessed risk of bias of included studies. Then, network meta-analysis was performed by R4.1 and ADDIS. Results A total of 34 studies, totaling 2,373 patients, with 9 exercise modalities were included. All exercise training modalities presented significant improvements in FEV1%pred, FEV1/FVC% and dyspnea (SGRQ symptom score) compared to usual treatment and care, however yoga showed no benefit than usual care in improving FEV1%pred. For improvement of FEV1%pred, resistance exercise, tai-chi, and combined aerobic and resistance exercise were superior to Baduanjin;and tai-chi was also better than breathing exercise and Liuzijue. The surface under the cumulative ranking curve confirmed that resistance training was most likely to result in improving pulmonary function while Liuzijue was more powerful in ameliorating dyspnea. Conclusion Exercise training can effectively improve pulmonary function and alleviate dyspnea in COPD patients. Appropriate exercise modality can be selected according to the goals of the intervention.

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张紫薇,杨婧,李文,郭洪花,刘雅萌,张彩虹.9种运动方式对COPD患者肺康复影响的网状Meta分析[J].护理学杂志,2023,38(2):85-91

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  • 收稿日期:2022-08-19
  • 最后修改日期:2022-10-25
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  • 在线发布日期: 2023-12-29