Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of P.R. China, Zhengzhou, China.
Biomed Res Int. 2020 Jul 28;2020:6174936. doi: 10.1155/2020/6174936. eCollection 2020.
This study evaluated the efficacy and safety of pulmonary rehabilitation (PR) for pneumoconiosis. We systematically searched PubMed, Embase, The Cochrane Library, Web of Science, SinoMed, CNKI, VIP databases and Wanfang Data from their inception to June 1, 2019. A systematic review and meta-analysis of randomized controlled trials (RCTs) of PR for pneumoconiosis was conducted and reported in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two reviewers independently screened literature, extracted data, and assessed bias risk. All statistical analyses were performed using the RevMan software. Sixteen RCTs with 1307 subjects were ultimately included for analysis. Compared with routine treatment, PR was able to improve the 6-minute walking distance (mean difference (MD) 69.10, 95% confidence interval (CI) 61.95-76.25); the 36-Item Short Form Health Survey total score (MD 17.60, 95% CI 13.59-21.61); physical function score (MD 15.45, 95% CI 3.20-27.69); role physical score (MD 17.87, 95% CI 12.06-23.69); body pain score (MD 14.34, 95% CI 10.33-18.36); general health score (MD 20.86, 95% CI 16.87-24.84); vitality score (MD 11.66, 95% CI 0.18-23.13); social function score (MD 9.67, 95% CI 1.27-18.08); mental health score (MD 20.60, 95% CI 13.61-27.59); forced vital capacity (FVC) (MD 0.20, 95% CI 0.12-0.29); forced expiratory volume in 1 s (FEV1) (MD 0.23, 95% CI 0.09-0.38); FEV1% (MD 5.19, 95% CI 1.48-8.90); maximal voluntary ventilation (MD 4.47, 95% CI 1.14-7.81); reduction in the St. George's Respiratory Questionnaire score (MD -9.60, 95% CI -16.40 to -2.80); and the modified Medical Research Council Scale score. Furthermore, PR did not increase the FEV1/FVC (MD 3.61, 95% CI -3.43 to 10.65), nor the emotional score (MD 6.18, 95% CI -23.01 to 35.38) compared with the control. We found no reports of adverse events associated with PR. Thus, to some extent, PR can improve functional capacity and quality of life in patients with pneumoconiosis. However, these results should be interpreted with caution because of high heterogeneity. This trial is registered with registration number CRD42018095266.
本研究评估了肺康复（PR）治疗尘肺病的疗效和安全性。我们系统地检索了 PubMed、Embase、The Cochrane Library、Web of Science、SinoMed、CNKI、VIP 数据库和万方数据，检索时间从建库至 2019 年 6 月 1 日。我们按照系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）声明，对 PR 治疗尘肺病的随机对照试验（RCT）进行了系统评价和荟萃分析。两名评审员独立筛选文献、提取数据并评估偏倚风险。所有的统计分析均使用 RevMan 软件进行。最终纳入 16 项 RCT 共 1307 例患者进行分析。与常规治疗相比，PR 可提高 6 分钟步行距离（MD 69.10，95%CI 61.95-76.25）；36 项简明健康状况调查问卷总评分（MD 17.60，95%CI 13.59-21.61）；生理功能评分（MD 15.45，95%CI 3.20-27.69）；角色生理评分（MD 17.87，95%CI 12.06-23.69）；躯体疼痛评分（MD 14.34，95%CI 10.33-18.36）；总体健康评分（MD 20.86，95%CI 16.87-24.84）；活力评分（MD 11.66，95%CI 0.18-23.13）；社会功能评分（MD 9.67，95%CI 1.27-18.08）；精神健康评分（MD 20.60，95%CI 13.61-27.59）；用力肺活量（FVC）（MD 0.20，95%CI 0.12-0.29）；第 1 秒用力呼气量（FEV1）（MD 0.23，95%CI 0.09-0.38）；FEV1%（MD 5.19，95%CI 1.48-8.90）；最大自主通气量（MD 4.47，95%CI 1.14-7.81）；圣乔治呼吸问卷评分降低（MD-9.60，95%CI-16.40 至-2.80）；改良医学研究委员会呼吸困难量表评分降低。此外，与对照组相比，PR 并未增加 FEV1/FVC（MD 3.61，95%CI-3.43 至 10.65），也未增加情绪评分（MD 6.18，95%CI-23.01 至 35.38）。我们未发现与 PR 相关的不良事件报告。因此，PR 在一定程度上可以提高尘肺病患者的功能能力和生活质量。但是，由于异质性较高，这些结果应谨慎解释。本研究已在国际临床试验注册平台（CRD42018095266）注册。
