远程肺康复在老年慢性阻塞性肺疾病患者中应用效果的Meta分析

Effectiveness of telerehabilitation in the elderly patients with chronic obstructive pulmonary disease:a Meta-analysis

目的评价远程肺康复在老年COPD患者中的应用效果,以期为远程肺康复的临床实践和推广提供循证依据。方法检索Web of Science、PubMed、Cochrane Library、Embase、CINAHL、中国生物医学文献数据库、中国知网、维普及万方等数据库中关于远程肺康复在老年COPD患者中应用的随机对照试验,检索时限为建库至2023年4月26日。采用RevMan 5.3软件进行Meta分析。结果最终纳入24篇文献,共2980例患者。Meta分析结果显示,远程肺康复能够改善老年COPD患者的肺功能(FEV_(1)/FVC)(MD=2.09,95%CI 0.30~3.89,P<0.05)、生命质量(MD=-0.66,95%CI-1.05~-0.26,P<0.05)和焦虑(MD=-0.69,95%CI-1.32~-0.05,P<0.05)、抑郁(MD=-0.81,95%CI-1.59~-0.04,P<0.05)情绪,对肺功能(FEV_(1)/FVC)的亚分组结果显示,有体育活动、干预时间≤24周、干预频率1~3次/周和使用网络平台的亚组间差异均有统计学意义(均P<0.01)。但在改善患者活动耐力方面效果不显著,差异无统计学意义(P>0.05)。结论远程肺康复可以作为改善老年COPD患者肺功能(FEV_(1)/FVC)、生命质量和心理状况的一种辅助干预措施。

Objective To evaluate the effectiveness of remote pulmonary rehabilitation in the elderly COPD patients in order to provide evidence-based basis for the clinical practice and promotion of remote pulmonary rehabilitation.Methods We searched databases including Web of Science,PubMed,Cochrane Library,Embase,CINAHL,China Biology Medicine disc,China National Knowledge Internet,VIP,and Wanfang and selected all randomized controlled trials(RCTs)that reported the effects of telerehabilitation on the elderly patients with COPD.The retrieval time was from the establishment of the database to April 26,2023.Meta-analysis was performed by RevMan 5.3.Results A total of 24 RCTs involving 2980 patients with COPD were finally included.Meta-analysis results showed that telerehabilitation in the elderly patients with COPD can improve the lung function(FEV_(1)/FVC)(MD=2.09,95%CI 0.30-3.89,P<0.05),quality of life(MD=-0.66,95%CI-1.05--0.26,P<0.05),anxiety(MD=-0.69,95%CI-1.32--0.05,P<0.05)and depression(MD=-0.81,95%CI-1.59--0.04,P<0.05),and the subgroup for the lung function(FEV_(1)/FVC)of the elderly patients with COPD emphasized that physical activity,intervention time≤24 weeks,intervention frequency 1-3 times per week,and use of network platform,there were significant differences between those subgroups(all P<0.01).But there was no statistically significant difference in improving the exercise capacity(MD=-1.54,95%CI-14.83-11.75,P>0.05).Conclusions Telerehabilitation in pulmonary can be considered a supplementary intervention for improving the lung function(FEV_(1)/FVC),the quality of life and the psychological condition on the elderly patients with COPD.