呼气肌训练对慢性阻塞性肺疾病患者训练效果的Meta分析

Effectiveness of exspiratory muscle training in patients with chronic obstructive pulmonary disease:a Meta-analysis

目的评价呼气肌训练对慢性阻塞性肺疾病(COPD)患者的干预效果。方法计算机检索PubMed、Embase、Cochrane Library、中国知网全文数据库、中国生物医学文献数据库和万方数据库中关于对COPD患者进行呼气肌训练的随机对照试验和临床对照试验,时间为建库至2019年11月,对纳入的文献进行质量评价并提取数据,采用RevMan5.3软件进行Meta分析。结果共纳入8项随机对照试验和1项临床对照试验。Meta分析表明,最大吸气压、最大呼气压、第1秒用力呼气容积、6 min步行试验距离、圣乔治呼吸问卷评分的合并均方差及其95%置信区间分别为0.58(-1.34~2.51)、8.11(-2.64~18.86)、-0.12(-0.22^-0.01)、-16.47(-40.76~7.82)、-1.52(-3.75~0.70)(除了肺功能P<0.05外,其余均P>0.05)。结论在COPD患者的康复训练中,呼气肌联合吸气肌训练并不比单独的吸气肌训练获得更好的效果,建议只进行吸气肌训练,能够花费较少的时间和费用达到同样的训练效果。

Objective To evaluate the effectiveness of expiratory muscle training in patients with chronic obstructive pulmonary disease.Methods The randomized controlled trials(RCT)and controlled clinical trials(CCT)on the effect of expiratory muscle training in patients with chronic obstructive pulmonary disease were collected using the databases of PubMed,Embase,Cochrane Library,CNKI,CBM and Wanfang,time is from the construction of the database to November 2019.The literature quality was evaluated and data were extracted from the included literature.Data were analyzed with Revman5.3 software.Results A total of 8 RCTs and 1 CCT were included.The Meta-analysis showed that Mean difference and its 95%confidence interval of PImax,PEmax,FEV1,6MWD and SGRQ score were 0.58(-1.34,2.51),8.11(-2.64,18.86),-0.12(-0.22,-0.01),-16.47(-40.76,7.82),-1.52(-3.75,0.70)(all P>0.05,except for FEV1,P=0.03).Conclusions In the pulmonary rehabilitation program of COPD patients,EMT combined with IMT does not achieve better results than IMT alone,it is recommended that we can only use IMT instead of EMT combined with IMT,and the same training effect will be achieved with less time and cost.