中医肺康复措施改善慢性阻塞性肺疾病稳定期患者肺功能及运动耐力的贝叶斯网状Meta分析

Bayesian network Meta-analysis of traditional Chinese medicine pulmonary rehabilitation measures for improving pulmonary function and exercise tolerance in patients with stable phase of chronic obstructive pulmonary disease

  • 摘要: 目的 系统评价不同中医肺康复措施对慢性阻塞性肺疾病(简称慢阻肺)稳定期患者肺功能和运动耐力的疗效。方法 检索中国知网、万方、维普、中国生物医学、PubMed和Cochrane Library数据库从建库至2023年6月30日慢阻肺相关的随机临床试验(RCT), 由2名研究者独立进行文献筛选、信息提取和偏倚风险评价, 并采用Stata 17.0和R4.4.1软件进行统计分析。结果 共纳入239篇RCT研究,总计20 719例患者,涉及穴位贴敷、针刺、灸法、中医功法、推拿、拔罐等18类干预措施。网状Meta分析表明,与常规治疗相比,中医功法、灸法、穴位贴敷、穴位贴敷+耳穴压豆、穴位贴敷+灸法、穴位推拿+中医定向透药、中药足浴+灸法、中医综合康复、五音疗法、肺康复训练和穴位贴敷+穴位注射可改善第1秒用力呼气容积(FEV1)值; 中医功法、灸法、穴位贴敷、穴位贴敷+灸法、中药、中药足浴+灸法、中医综合康复、五音疗法和针刺对降低用力肺活量(FVC)值均有显著疗效; 中医功法治疗、穴位贴敷治疗、穴位贴敷+针刺治疗、穴位贴敷+灸法治疗和针刺治疗能够显著提高患者运动耐力(P < 0.05)。累积排序图显示,中药足浴+灸法治疗和穴位贴敷+针刺治疗在改善慢阻肺稳定期患者肺功能和提高运动耐力方面疗效最好。结论 中医肺康复治疗慢阻肺患者确有疗效,但各有侧重。中药足浴+灸法和穴位贴敷+针刺可能是改善慢阻肺稳定期患者肺功能指标和提高运动耐力的最佳措施。

     

    Abstract: Objective To systematically evaluate the efficacy of different traditional Chinese medicine pulmonary rehabilitation interventions on pulmonary function and exercise tolerance in patients with stable phase of. Methods Databases including CNKI, Wanfang, VIP, China Biology Medicine, PubMed, and the Cochrane Library were searched for randomized clinical trials (RCTs) related to chronic obstructive pulmonary disease from their inception to June 30, 2023. Two researchers independently conducted literature screening, data extraction, and bias risk assessment. Statistical analysis was performed using Stata 17.0 and R 4.4.1 software. Results A total of 239 RCTs involving 20, 719 patients were included, encompassing 18 types of interventions, such as acupoint application, acupuncture, moxibustion, traditional Chinese medicine exercises, massage, cupping, etc. Network Meta-analysis revealed that compared with conventional treatment, traditional Chinese medicine exercises, moxibustion, acupoint application, acupoint application plus auricular point pressing, acupoint application plus moxibustion, acupoint massage plus traditional Chinese medicine directed drug penetration, Chinese herbal footbath plus moxibustion, comprehensive traditional Chinese medicine rehabilitation, five-element music therapy, pulmonary rehabilitation training, and acupoint application plus acupoint injection significantly improved forced expiratory volume in the first second (FEV1). Traditional Chinese medicine exercises, moxibustion, acupoint application, acupoint application plus moxibustion, Chinese herbal medicine, Chinese herbal footbath plus moxibustion, comprehensive traditional Chinese medicine rehabilitation, five-element music therapy, and acupuncture exhibited significant efficacy in reducing forced vital capacity (FVC). Traditional Chinese medicine exercise therapy, acupoint application therapy, acupoint application plus acupuncture therapy, acupoint application plus moxibustion therapy, and acupuncture therapy significantly enhanced exercise tolerance in patients (P < 0.05). The cumulative ranking plot demonstrated that Chinese herbal footbath plus moxibustion and acupoint application plus acupuncture were the most effective interventions for improving pulmonary function and enhancing exercise tolerance in patients with stable phase of chronic obstructive pulmonary disease. Conclusion Traditional Chinese medicine pulmonary rehabilitation interventions are effective in treating patients with chronic obstructive pulmonary disease, with each intervention demonstrating distinct advantages. Chinese herbal footbath plus moxibustion and acupoint application plus acupuncture may represent the optimal strategies for improving pulmonary function indices and enhancing exercise tolerance in patients with stable phase of chronic obstructive pulmonary disease.

     

/

返回文章
返回