体育锻炼对哮喘儿童肺功能、有氧能力和生活质量的影响:一项随机对照试验的Meta分析

Effects of Physical Exercise on Lung Function,Aerobic Capacity and Quality of Life in Asthmatic Children:a Meta Analysis of a Randomized Controlled Trial

目的就体育锻炼作为非药物治疗手段对哮喘儿童的肺功能、最大摄氧量和生活质量的影响进行循证分析。方法计算机检索PubMed,Cochrane Library(2021年第1期),Web of Science,Medline,Embase,维普,万方和CNKI数据库中有关体育锻炼对哮喘儿童肺功能、最大摄氧量和生活质量的影响随机对照试验,检索时限均从建库至2021年1月。由两名研究者按照纳入及排除标准独立筛选文献、提取资料、评价纳入文献的偏倚风险并进行交叉核对,使用RevMan5.2软件进行数据分析。结果共纳入17项RCT,涉及900例病人,系统评价结果显示:体育锻炼组在干预结束后儿童肺功能中用力肺活量(%pred)[WMD=-3.93,95%CI(-6.27~-1.60),p=0.001]和呼气流量峰值(%pred)[WMD=-6.84,95%CI(-9.99~-3.69),p<0.001],最大摄氧量[WMD=-6.22,95%CI(-10.83~-1.61),p=0.008],生活质量[WMD=-1.00,95%CI(-1.70~-0.29),p=0.0006]和六分钟步行测试[WMD=-138.91m,95%CI(-232.00~-45.81),p=0.003]均显著高于非体育锻炼组。结论体育锻炼可显著改善哮喘儿童的用力肺活量、呼气流量峰值、最大摄氧量和生活质量,具有潜在的积极治疗意义。

Objective Evidence-based analysis on the effect of physical exercise as a non-drug treatment on the lung function,maximal oxygen uptake and quality of life of children with asthma.Methods It searched the randomized controlled trials about physical exercise on children lung function,maximum oxygen uptake and quality of life of asthmatic children based on PubMed,Cochrane Library(Issue 1,2021),Web of Science,Medline,Embase,Vip,Wanfang and CNKI databases.The search time was from the establishment of the database to January 2021.Two researchers screened the literature,extracted data,evaluated the risk of bias in the included literature and conducted cross-checks according to the inclusion and exclusion criteria independently.The date was conducted a systematic review by RevMan5.2 software.Results There were 17 RCTs totals,involving 900 children.The results of systematic review showed that:compared with the non-exercise group,the physical exercise could improve the forced vital capacity(%pred)(WMD=-3.93,95%CI=-6.27~-1.60,p=0.001),peak expiratory flow(%pred)(WMD=-6.84,95%CI=-9.99~-3.69,p<0.001),maximal oxygen uptake(WMD=-6.22,95%CI=-10.83~-1.61,p=0.008),quality of life(WMD=-1.00,95%CI=-1.70~-0.29,p=0.0006)and 6-minute walk test(WMD=-138.91m,95%CI=-232.00~-45.81,p=0.003).Conclusion Compared with non-physical exercise,physical exercise can significantly improve the forced vital capacity,peak expiratory flow,maximum oxygen uptake and quality of life of children with asthma.Physical exercise shows potential positive therapeutic effects on improving childhood asthma.