运动训练对支气管哮喘患儿干预效果的系统评价再评价

Effects of Exercise Training in Children with Bronchial Asthma:an Overview of Systematic Reviews

目的对运动训练对哮喘患儿干预效果的系统评价或Meta分析进行再评价。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Web of Science、Embase中公开发表的关于运动训练对哮喘患儿干预效果的系统评价或Meta分析,检索时限为2018年9月—2023年9月。将检索结果导入NoteExpress软件,剔除重复文献,之后由2名研究人员独立按照文献纳入和排除标准进行文献筛选、资料提取、纳入文献的方法学质量评价、证据质量评价。结果最终纳入文献8篇,其中系统评价2篇、Meta分析6篇,共涉及5975例患儿。方法学质量评价结果显示,2篇文献的方法学质量为中等、3篇为低、3篇为极低。证据质量评价结果显示,共涉及肺功能、运动耐力、有氧能力、生活质量4种结局指标、32条证据,其中12条为中等质量、19条为低质量、1条为极低质量。运动训练可增加哮喘患儿的用力肺活量占预计值百分比(FVC%)(5个中等质量证据,1个低质量证据);运动训练不能增加哮喘患儿的第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)(1个中等质量证据,1个低质量证据);运动训练可延长哮喘患儿的6分钟步行距离(6MWD)(3个低质量证据);运动训练可增加哮喘患儿的最大摄氧量(VO_(2max))(2个低质量证据);运动训练可增加哮喘患儿的儿童哮喘生活质量问卷(PAQLQ)评分(5个低质量证据)。结论运动训练可改善哮喘患儿的FVC%,而对其他肺功能指标(FEV_(1)%、PEF%)的改善作用尚存在争议;运动训练可提高哮喘患儿的运动耐力、有氧能力和生活质量。但本研究纳入的系统评价/Meta分析的方法学质量较低。

Objective To overview the systematic review/meta-analysis of exercise training in children with asthma.Methods CNKI,Wanfang Data,VIP,CBM,PubMed,Cochrane Library,Web of Science and Embase were searched by computer for the systematic review/meta-analysis of exercise training for children with asthma from September 2018 to September 2023.The searching results were imported into NoteExpress software and duplicate literature was eliminated.Then,two researchers independently screened literature and extracted data according to the inclusion and exclusion criteria,assessed the methodological quality and evidence quality of included literature.Results In total,8 studies were included,including 2 systematic reviews and 6 meta-analyses,involving 5975 children totally.The result of methodological quality showed that 2 studies were of moderate quality,3 studies were of low quality and 3 studies were of very low quality.The evaluation of evidence quality showed that there were a total of 32 pieces of evidence related to four outcome indicators:lung function,exercise endurance,aerobic capacity,and quality of life.Among them,12 were of moderate quality,19 were of low quality,and 1 was of extremely low quality.Exercise training could increase the percentage of forced vital capacity to the expected value(FVC%)in children with asthma(5 medium quality evidence and 1 low quality evidence).Exercise training could not increase the ratio of forced expiratory volume in the first second to forced vital capacity(FEV_(1)/FVC)in children with asthma(1 medium quality evidence and 1 low quality evidence).Exercise training could prolong the 6-minute walking distance(6MWD)of children with asthma(3 low quality evidence).Exercise training could increase the maximum oxygen uptake(VO_(2max))of children with asthma(2 low quality evidence).Exercise training could increase Pediatric Asthma Quality of Life Questionnaire(PAQLQ)score in children with asthma(5 low quality evidence).Conclusion Exercise training can improve FVC%in children with asthma,while the improvement effect on other lung function indicators(FEV_(1)%,PEF%)is still controversial.Exercise training can improve the exercise endurance,aerobic capacity,and quality of life of children with asthma.However,the methodological quality of the systematic evaluation/Meta analysis included in this study is relatively low.