目的 系统评价八段锦辅助治疗慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)的疗效与Meta分析.方法 检索中国知网(CNKI)、维普中文科技期刊数据库(VIP)、万方数据知识服务平台(Wan fang)、中国生物医学文献数据库(CBM)、PubMed、Embase、Cochrane Library建库至2022年10月1日期间八段锦辅助治疗COPD的随机对照试验(Randomized Controlled Trials,RCTs),最终纳入35篇RCTs,共计3320例患者,其中对照组1651例,观察组1669例.结局指标包括临床总有效率、肺功能(FEV1(Forced Expiratory Volume in the first second)、FEV1%(Forced Expiratory Volume in the first second/Predicted)、FVC(Forced Vital Capacity)、FEV1/FVC)、CAT(COPD Assessment Test)评分、6 min步行距离,对纳入的研究使用RevMan 5.4软件进行Meta分析,证据质量分级采用GRADE评分系统进行评价.结果 与对照组比较,八段锦辅助治疗COPD,能够提高临床总有效率[RR=1.34,95%CI(1.24,1.45),P<0.000 01],长期锻炼能够改善肺功能状态,提高 FEV1[MD=0.28,95%CI(0.21,0.35),P<0.000 01]、FEV1%[MD=6.52,95%CI(4.42,8.63),P<0.000 01]、FVC[MD=0.24,95%CI(0.11,0.36),P=0.0002]、FEV1/FVC[MD=4.49,95%CI(2.60,6.37),P<0.000 01],可以降低 CAT 评分[MD=-3.74,95%CI(-4.29,-3.20),P<0.000 01],提高 6 min 步行距离[MD=50.35,95%CI(32.32,68.39),P<0.000 01],从而改善生活质量,安全性较高;GRADE证据分级提示:总有效率、FEV1、FEV1/FVC、FEV1%、FVC、6 min步行距离为低质量证据,CAT评分为极低质量证据.结论 八段锦辅助治疗COPD,能够提高临床总有效率,改善肺功能状况,减轻不适症状,提高活动耐力,且无严重不良反应,值得推广应用.
Systematic Review and Meta-analysis of the Intervention Effect of Baduanjin on Chronic Obstructive Pulmonary Disease
Objective To conduct a systematic review and Meta-analysis of the effectiveness of Baduanjin as an adjuvant therapy for Chronic Obstructive Pulmonary Disease(COPD).Methods CNKI,VIP,Wanfang Data,Sinomed,PubMed,Embase,and The Cochrane Library were systematically searched for randomized controlled trials(RCTs)investiga-ting Baduanjin as an adjuvant therapy for COPD from the inception of the database to October 1,2022.A total of 35 RCTs were finally included,involving 3,320 patients,with 1,651 in the control group and 1,669 in the observation group.Out-come measures included the total clinical efficacy,pulmonary function[Forced Expiratory Volume in the first second(FEV1),FEV1%,Forced Vital Capacity(FVC),FEV1/FVC),COPD Assessment Test(CAT)]scores,and the 6-minute walk distance.Meta-analysis of the included RCTs was conducted using RevMan 5.4,and the evidence quality was as-sessed using the GRADE.Results Baduanjin as an adjuvant therapy for COPD improved the total clinical efficacy[RR=1.34,95%CI(1.24,1.45),P<0.000 01]compared with the control group.Long-term exercise enhanced lung func-tion,indicated by increases in FEV1[MD=0.28,95%CI(0.21,0.35),P<0.000 01],FEV1%[MD=6.52,95%CI(4.42,8.63),P<0.000 01],FVC[MD=0.24,95%CI(0.11,0.36),P=0.000 2],and FEV1/FVC[MD=4.49,95%CI(2.60,6.37),P<0.000 01].Baduanjin exercise also reduced CAT scores[MD=-3.74,95%CI(-4.29,-3.20),P<0.000 01]and increased the 6-minute walking distance[MD=50.35,95%CI(32.32,68.39),P<0.000 01],thus enhancing quality of life with high safety.GRADE result suggested that the total efficacy,FEV1,FEV1/FVC,FEV1%,FVC and the 6-minute walk test were of low-quality evidence,while evidence regarding CAT scores was of very low quality.Conclusion Baduanjin as an adjuvant therapy can increase the total clinical efficacy,improve pulmonary function,allevi-ate symptoms,and enhance exercise tolerance,without serious adverse reactions,which is worthy of widespread application.