李琴,陈贵华,虞乐华,等.肺康复治疗慢性阻塞性肺疾病急性加重期疗效的系统评价[J].中华物理医学与康复杂志,2019,41(4):299-304
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| 肺康复治疗慢性阻塞性肺疾病急性加重期疗效的系统评价 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2019.04.014 |
| 中文关键词: 肺疾病，慢性阻塞性 急性加重 肺康复 系统评价 |
| 英文关键词: Pulmonary disease Pulmonary obstruction Pulmonary rehabilitation Dyspnea |
| 基金项目:重庆市卫生和计划生育委员会医学科研计划项目（2016MSXM025） |
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| 中文摘要: |
| 目的 系统评价肺康复对慢性阻塞性肺疾病急性加重期患者的康复效果。 方法 计算机检索PubMed、EMbase、The Cochrane Library、中国知网、维普中文科技期刊数据库和万方数据库，检索时限均为从建库至2016年8月1日，搜集肺康复治疗慢性阻塞性肺疾病急性加重期患者的相关随机对照试验。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan 5.3版Meta分析软件进行分析。 结果 本研究共纳入7篇随机对照试验文献，共计486例患者。经Meta分析结果显示，治疗后，肺康复组的呼吸困难指数［SMD=-0.79，95%CI（-1.39，-0.20），P<0.01］，6 min步行距离［SMD=0.74，95%CI（0.28，1.21），P<0.01］以及呼吸困难评分［SMD= -0.85，95%CI（-1.29，-0.40），P<0.01］均显著优于对照组，而2组在肺功能的康复方面，差异无统计学意义［SMD= 0.15，95%CI（-0.07，0.37），P>0.05］。 结论 慢性阻塞性肺疾病急性加重期进行肺康复是安全、可行的。肺康复可改善慢性阻塞性肺疾病急性加重期患者的运动耐力、呼吸困难程度以及日常生活活动能力。 |
| 英文摘要: |
| Objective To systematically review reports dealing with the efficacy of pulmonary rehabilitation for patients with acute exacerbation of chronic obstructive pulmonary disease. Methods The PubMed, EMbase, China National Knowledge Infrastructure, VIP and Wan Fang databases were searched to collect reports of randomized and controlled trials of pulmonary rehabilitation for patients with acute exacerbation of chronic obstructive pulmonary disease. The search covered from each database′s inception to August 1, 2016. Two reviewers screened the literature independently, extracted data and assessed the risk of bias for the studies eventually included. A meta-analysis was performed using version 5.3 of the RevMan software. Results After the initial selection, a total of 7 reports covering 486 patients were included in the meta-analysis. The results of the meta-analysis showed that the average mMRC score, the 6-minute walk distance and Borg score in the pulmonary rehabilitation group were all significantly higher than in the control group. There was, however, no significant difference between the two groups′ average pulmonary function values. Conclusion Pulmonary rehabilitation is safe for patients experiencing an acute exacerbation of chronic obstructive pulmonary disease. It can effectively improve their exercise tolerance, expiratory dyspnea and daily living ability. |
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