不同康复干预对尘肺患者运动耐力及肺功能影响的网状meta分析

摘要/Abstract

摘要： 目的采取网状meta分析的方法评估多种康复干预措施对尘肺患者运动耐力及肺功能影响的效果。方法计算机检索Pubmed、Embase、Cochrane library、Web of science、知网、万方、维普、中国生物医学文献数据库符合分析目的的相关文献,检索时限为建库至2022年3月。由2名分析人员独立进行文献筛选、资料提取及纳入分析的偏倚风险评价,采用Stata 16.0软件进行数据分析。结果纳入29项随机对照试验（randomized control trial,RCT）,共2 573例患者,涉及10种干预措施,主要包括综合肺康复干预、针刺、运动训练、呼吸训练、健康教育、呼吸联合运动训练、健康教育+呼吸训练、八段锦训练、呼吸训练+中医干预和常规护理。在改善尘肺患者运动耐力方面,呼吸联合运动训练、综合肺康复干预、八段锦训练、呼吸训练+中医干预、运动训练、呼吸训练、针刺均优于常规护理,差异均有统计学意义（均P<0.05）,排序结果最优为呼吸联合运动训练;在改善肺功能方面,健康教育+呼吸训练优于常规护理,差异有统计学意义（P<0.05）,排序结果最优为健康教育+呼吸训练;在改善生活质量方面,8种干预措施相互比较,差异均无统计学意义（均P>0.05）,排序结果最优为呼吸联合运动训练。结论在改善尘肺患者运动耐力及肺功能,提高生活质量时,呼吸联合运动训练、健康教育+呼吸训练可能成为最佳干预措施,在未来临床实践中,可优先考虑应用。

关键词: 尘肺, 康复, 肺功能, 运动耐力, 网状meta分析

Abstract: Objective To evaluate the effect of various rehabilitation interventions on exercise tolerance and pulmonary function in patients with pneumoconiosis by network meta-analysis. Methods The Pubmed,Embase,Cochrane library,Web of science,CNKI,Wanfang,VIP and Chinese Biomedical Literature databases were searched to collect the literature that meets the analysis purpose,and the search time limit was from inception to March 2022. Two researchers independently screened literature,extracted data,and assessed the risk of bias in included studies,and data analysis was performed by using the Stata 16.0 software. Results Totally 29 randomized control trials（RCT） were included,involving 2 573 patients and 10 interventions,including comprehensive pulmonary rehabilitation,acupuncture,exercise training,respiratory training,health education,respiratory combined exercise training,health education+respiratory training,Baduanjin,respiratory training+TCM intervention and usual care. For improving exercise tolerance in patients with pneumoconiosis,the respiratory combined with exercise training,comprehensive pulmonary rehabilitation,Baduanjin,respiratory training+TCM intervention,exercise training,respiratory training,and acupuncture had better effect than usual care,the differences were statistically significant（all P<0.05）,and the best ranking result was respiratory combined with exercise training. For improving pulmonary function,the health education+respiratory training had better effect than usual care,the difference was statistically significant（P<0.05）,and the best ranking result was health education+respiratory training. For improving the quality of life,there were no statistically significant differences among eight interventions（all P>0.05）,and the best ranking result was respiratory combined with exercise training. Conclusion The respiratory combined exercise training,and health education+respiratory training may be the best intervention measures for improving exercise endurance,pulmonary function,and quality of life in patients with pneumoconiosis,in the future,it can be prioritized in clinical practice.

Key words: Pneumoconiosis, Rehabilitation, Pulmonary function, Exercise endurance, Network meta-analysis

中图分类号:

R135.2

马秀娟, 韩欣怡, 张志刚, 赵塔娜, 曾茵茹. 不同康复干预对尘肺患者运动耐力及肺功能影响的网状meta分析. [J]职业与健康, 2023, 39(5): 692-700.

MA Xiu-juan, HAN Xin-yi, ZHANG Zhi-gang, ZHAO Ta-na, ZENG Yin-ru. Effects of different rehabilitation interventions on exercise tolerance and lung function in patients with pneumoconiosis：A network meta-analysis. [J]OCCUPATION AND HEALTH, 2023, 39(5): 692-700.

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