综述
ENGLISH ABSTRACT
运动联合呼吸肌锻炼对稳定期慢性阻塞性肺疾病患者康复效果的Meta分析
宋运莲
邵荣雅
韩慧
黄丽华
作者及单位信息
·
DOI: 10.3760/cma.j.cn211501-20200107-00072
Meta analysis about the influence of physical therapy and respiratory muscle training on rehabilitation of patients with chronic obstructive pulmonary disease
Song Yunlian
Shao Rongya
Han Hui
Huang Lihua
Authors Info & Affiliations
Song Yunlian
Hepatic Surgery of the First Affiliated Hospital of Zhejiang Universtiy, Hangzhou 310003, China
Shao Rongya
Nursing Department of the First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China
Han Hui
Nursing Department of the First People′s Hospital of Huzhou, 313000, China
Huang Lihua
Nursing Department of the First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China
·
DOI: 10.3760/cma.j.cn211501-20200107-00072
751
212
0
2
3
5
PDF下载
APP内阅读
摘要

目的通过对稳定期慢性阻塞性肺疾病(COPD)患者进行运动联合呼吸肌锻炼康复方式的相关文章评分并进行Meta分析,明确运动联合呼吸肌锻炼对稳定期COPD患者相关康复效果的影响,以期为临床康复护理提供依据。

方法通过计算机检索Cochrane数据库、MEDLINE、Embase、CINAHL 4个英文数据库以及中国生物医学文献数据库(CBM)、中国知网全文数据库(CNKI)、维普数据库(VIP)和万方数据库(wan fang)4个中文数据库,检索关于稳定期COPD患者进行运动联合呼吸肌锻炼的随机对照研究(randomized controlled trial,RCT)。检索时限均为从1990年1月至2017年10月。语种限制为中文、英文2种。由2名研究者独立平行的按照纳入与排除标准对检索文献进行初筛、全文筛查、提取资料,然后按照Cochrane5.1.0版的评价工具对纳入研究的方法学质量进行评价,最后采用RevMan5.3软件进行Meta分析。

结果本研究共纳入7篇相关文献,其中5篇为英文,2篇为中文,总计7项RCT研究包含267名符合纳入标准的稳定期COPD患者。本研究纳入的7项研究结果显示:踏车运动联合呼吸肌锻炼是最常见的复合康复方法。Meta分析结果显示:运动联合呼吸肌锻炼干预组与单纯运动康复组在FEV 1占预计值百分比、6MWD、mMRC方面比较,差异均有统计学意义,在用力肺活量(FVC)和1秒用力呼气容积(FEV 1)指标上敏感性分析前后存在较大差异,在FEV 1/FVC(%)、生命质量和PaO 2上比较,差异无统计学意义,PaCO 2尚不能联合。

结论运动联合呼吸肌锻炼与单纯运动康复比较对稳定期的COPD患者而言是一种可靠的康复方式,它对稳定期COPD患者的FEV 1占预计值的百分比、活动能力、呼吸困难程度的影响有正性作用;对稳定期COPD患者的FVC、FEV 1指标的改善作用结果尚不稳定;对于稳定期COPD患者的FEV 1/FVC(%)、生命质量、PaO 2和PaCO 2影响尚不能确定。

运动联合呼吸肌锻炼;慢性阻塞性肺疾病;Meta分析
ABSTRACT

ObjectiveThe purpose of this study was to conduct a Meta-analysis to assess the influence of physical therapy and respiratory muscle training on rehabilitation of patients with stable chronic obstructive pulmonary disease. To provide a basis for better rehabilitation exercise for patients, families, communities and hospitals.

MethodsAccording to the literature search strategy, the relative literatures of randomized controlled trials (RCTS) of physical therapy and respiratory muscle training on rehabilitation of patients with chronic obstructive pulmonary disease were searched in Cochrane Library、MEDLINE、Embase、CINAHL、CBM、Wan Fang、CNKI and VIP from January 1990 to October 2017. Languages are limited to Chinese and English.The literatures were screened according to the predefined inclusion and exclusion criteria by two people . Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 were used to assess the quality of articles. The data were analyzed by Revman5.3.

ResultsA total of 7 articles were finally included, among of these 5 of which were written in English , Others were written in Chinese .They included 7 studies of randomized controlled trial and 267 patients with chronic obstructive pulmonary disease .7 studies show that treadmill exercise and respiratory muscle exercise are the most common rehabilitation methods.7 articles result of Meta-analysis showed that there were statistical differences between physical therapy and respiratory muscle training and other therapies in 6MWD、mMRC and FEV 1%;More research is needed on the impact of other outcome measures.

ConclusionsPhysical therapy and respiratory muscle training is a reliable way of rehabilitation, it to the stabilization of COPD patients FEV 1 % of expected value, activity ability, the influence of the degree of difficulty in breathing has a positive role.It is not stable for the positive effect of FVC and FEV 1 .However, the effects of other outcome measures were not determined.

Physical;Respiratory muscle;COPD;Meta-analysis
Shao Rong ya, Email: nc.defudabe.ujz8048780401, Tel: 0086-13957128968
引用本文

宋运莲,邵荣雅,韩慧,等. 运动联合呼吸肌锻炼对稳定期慢性阻塞性肺疾病患者康复效果的Meta分析[J]. 中国实用护理杂志,2020,36(29):2313-2321.

DOI:10.3760/cma.j.cn211501-20200107-00072

PERMISSIONS

Request permissions for this article from CCC.

评价本文
*以上评分为匿名评价
慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)是一种累及呼吸系统、心血管系统、消化系统和外周肌群的全身性、多因素参与的老年慢性系统性疾病 [ 1 ]。WHO统计资料显示,预计到2020年,COPD将成为导致全人类身心健康毁损乃至终止的第3大致死原因,也将是导致患者劳动能力丧失、疾病负担、疾病障碍调整生存年数的长短位居世界第5的疾病 [ 2 , 3 , 4 ]。在COPD相关的康复指南中,肺康复属于I类推荐证据,以运动锻炼为基础的肺康复在缓解COPD患者症状,改善COPD患者运动耐力和生命质量,降低COPD致残率、致死率等方面作用显著 [ 5 ]。康复方式按照康复部位主要分为运动康复和肺康复。近年来随着运动康复研究的不断深入,发现运动并呼吸肌锻炼对COPD患者肺康复的积极作用不容忽视 [ 6 ]。但由于医疗机构、护理水平及康复理念的差异,采用运动方式各不相同。因此,本研究选择国内外COPD患者运动联合呼吸肌锻炼的文献进行系统评价,客观评价各种锻炼方式,旨在促进该运动方式在国内进一步推广与应用,为COPD患者肺康复提供新的理论依据和指导。
试读结束,您可以通过登录机构账户或个人账户后获取全文阅读权限。
参考文献
[1]
中华医学会重症医学分会. 慢性阻塞性肺疾病急性加重患者的机械通气指南(2007)[J]. 中华危重病急救医学, 2007,19(9):513-518.
返回引文位置Google Scholar
百度学术
万方数据
[2]
Obaseki DO , Erhabor GE , Gnatiuc L ,et al. Chronic Airflow Obstruction in a Black African Population: Results of BOLD Study, Ile-Ife, Nigeria. Copd; 2016(13):1-42. 9
返回引文位置Google Scholar
百度学术
万方数据
[3]
Varraso R , Willett WC , Camargo CA ,et al. Prospective Study of Dietary Fiber and Risk of Chronic Obstructive Pulmonary Disease Among US Women and Men[J]. Am J Epidemiol, 2010,171(7):776-784. DOI: 10.1093/aje/kwp455 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Vogelmeier CF , Criner GJ , Martinez FJ ,et al. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease 2017 Report[J]. Am J Respir Crit Care Med, 2017,195(5):557.
返回引文位置Google Scholar
百度学术
万方数据
[5]
实用内科学上海医科大学实用内科学编辑委员会编[M]. 8版. 北京:人民卫生出版社, 1986:36.
[6]
中国卫生统计年鉴--2007[M]. 北京:中华人民共和国卫生部.中国协和医科大学出版社. 2007:8.
[7]
Lopez AD , Murray CC . The global burden of disease, 1990-2020[J]. Nature Medicine, 1998,4(11):1241.
返回引文位置Google Scholar
百度学术
万方数据
[8]
赵东兴周玉民李风雷,. 改良运动处方对慢性阻塞性肺疾病稳定期患者的康复疗效[J]. 国际呼吸杂志, 2012,32(9):678-682.
返回引文位置Google Scholar
百度学术
万方数据
[9]
Wanke T , Formanek D , Lahrmann H ,et al. Effects of combined inspiratory muscle and cycle ergometer training on exercise performance in patients with COPD[J]. Eur Res J, 1994,7(12):2205.
返回引文位置Google Scholar
百度学术
万方数据
[10]
Weiner P , Azgad Y , Ganam R . Inspiratory muscle training combined with general exercise reconditioning in patients with COPD.[J]. Chest, 1992,102(5):1351-1356.
返回引文位置Google Scholar
百度学术
万方数据
[11]
罗裕文. 踏车运动联合吸气肌肉锻炼在稳定期慢性阻塞性肺疾病患者肺康复治疗中的应用及效果评价[D]. 广州:南方医科大学, 2016.
返回引文位置Google Scholar
百度学术
万方数据
[12]
Majewska-Pulsakowska M , Wytrychowski K , Roek-Piechura K . The role of inspiratory muscle training in the process of rehabilitation of patients with chronic obstructive pulmonary disease[J]. Adv Exp Med Biol, 2015,885:47.
返回引文位置Google Scholar
百度学术
万方数据
[13]
Wang K , Zeng G Q , Li R ,et al. Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: a comprehensive assessment in stable COPD patients.[J]. Int J Chron Obstruct Pulmon Dis, 2017,12:2655.
返回引文位置Google Scholar
百度学术
万方数据
[14]
Wada JT , Borges-Santos E , Porras DC ,et al. Effects of aerobic training combined with respiratory muscle stretching on the functional exercise capacity and thoracoabdominal kinematics in patients with COPD: a randomized and controlled trial[J]. Int J Chron Obstruct Pulmon Dis, 2016,11:2691-2700.
返回引文位置Google Scholar
百度学术
万方数据
[15]
敬仁芝. 老年慢性阻塞性肺疾病患者心理状况分析及护理[J]. 齐鲁护理杂志, 2007,13(15):11-12.
返回引文位置Google Scholar
百度学术
万方数据
[16]
李伟健. 呼吸康复训练应用于慢性阻塞性肺疾病康复的临床疗效观察[J]. 中国当代医药, 2010,21(24):14-17.
返回引文位置Google Scholar
百度学术
万方数据
[17]
黄方高莹. 八段锦联合呼吸训练在社区慢性阻塞性肺疾病患者康复中的应用[J]. 护理实践与研究, 2016,13(18):146-147.
返回引文位置Google Scholar
百度学术
万方数据
[18]
Gupta RB , Brooks D , Lacasse Y ,et al. Effect of rollator use on health-related quality of life in individuals with COPD[J]. Chest, 2006,130(4):1089-1095.
返回引文位置Google Scholar
百度学术
万方数据
[19]
罗慧洁. 运动和呼吸训练在慢阻肺康复治疗中的作用[J]. 黑龙江医药科学, 2014,37(6).
返回引文位置Google Scholar
百度学术
万方数据
备注信息
A
邵荣雅,Email: nc.defudabe.ujz8048780401,电话:13957128968
评论 (0条)
注册
登录
时间排序
暂无评论,发表第一条评论抢沙发
MedAI助手(体验版)
文档即答
智问智答
机器翻译
回答内容由人工智能生成,我社无法保证其准确性和完整性,该生成内容不代表我们的态度或观点,仅供参考。
生成快照
文献快照

你好,我可以帮助您更好的了解本文,请向我提问您关注的问题。

0/2000

《中华医学会杂志社用户协议》 | 《隐私政策》

《SparkDesk 用户协议》 | 《SparkDesk 隐私政策》

网信算备340104764864601230055号 | 网信算备340104726288401230013号

技术支持:

历史对话
本文全部
还没有聊天记录
设置
模式
纯净模式沉浸模式
字号