吸气肌训练对稳定型COPD患者呼吸功能影响的系统评价及Meta分析

Systematic evaluation and Meta-analysis of the effect of inspiratory muscle training on respiratory function in patients with stable COPD

目的系统评价吸气肌训练对缓解稳定性慢性阻塞性肺疾病(COPD)患者呼吸困难症状的效果。方法本研究系统、全面地检索PubMed、Cochrane图书馆、CINAL、Joanna Briggs Institute Database、Embase、CBM、CNKI、万方数据库、维普数据库(VIP),查找关于吸气肌训练对稳定型COPD患者影响的随机对照研究,检索时限均从建库至2019年1月31日。由两名研究人员独立对纳入的文献进行质量评价并提取数据。采用RevMan 5.3软件进行数据分析。对不适宜进行Meta分析的结局指标采用描述性分析方法研究。结果共纳入8篇文献,987例患者。Meta分析结果显示,吸气肌训练能够提升患者最大呼吸压[MD=8.03,95%CI(4.23,11.84),P<0.05]和改善患者呼吸困难,提升患者生存质量;但对6 min步行试验Meta分析结果差异无统计学意义[MD=-1.82,95%CI(-11.34,7.69),P>0.05]。结论现有证据支持吸气肌训练能够提升稳定型COPD患者吸气肌肌力,缓解患者呼吸困难症状,提升患者生存质量。

Objective To systematically evaluate the effect of inspiratory muscle training on relieving dyspnea in patients with stable chronic obstructive pulmonary disease(COPD).Methods In this study,PubMed,Cochrane Library,CINAL,Joanna Briggs Institute Database,Embase,CBM,CNKI,Wanfang Database and VIP were systematically and comprehensively searched for randomized controlled studies on the effect of inspirating muscle training on stable COPD patients.The retrieval time was from the database construction to January 31,2019.Two researchers independently evaluated the quality of the included literature and extracted data.RevMan 5.3 software was used for data analysis.Descriptive analysis was used to study the outcome indicators that were not suitable for Meta-analysis.Results A total of 8 articles were included,with 987 patients.The results of Meta-analysis showed that inspiratory muscle training could improve patients′maximal respiratory pressure[MD=8.03,95%CI(4.23,11.84),P<0.05],improve patients′dyspnea and improve their quality of life,however,there was no significant difference in the Meta-analysis results of the 6 min walking test[MD=-1.82,95%CI(-11.34,7.69),P>0.05].Conclusion Existing evidence supports that inspiratory muscle training can improve inspiratory muscle strength in stable COPD patients,relieve the symptoms of respiratory distress,and improve the quality of life of patients.