传统身心运动疗法对慢性心肺性呼吸困难的影响：一项系统评价与荟萃分析。
Effects of traditional mind-body movement therapy on chronic cardiopulmonary dyspnoea: a systematic review and meta-analysis.
作者信息
Zhang Tiange, Zhou Rui, Wang Ting, Xin Yijun, Liu Xiaohong, Huang Huiting
机构信息
The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China.
The Second Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, China.
出版信息
Thorax. 2023 Jan;78(1):69-75. doi: 10.1136/thoraxjnl-2021-218030. Epub 2022 Apr 28.
PURPOSE
To evaluate whether traditional mind-body movement therapy (TMBM) can be used as a complementary or alternative therapy for exercise-based cardiopulmonary rehabilitation (EBCR) on chronic cardiopulmonary dyspnoea.
METHODS
PubMed, Embase, Scopus, Web of Science and China National Knowledge Infrastructure were searched from their inception to 2 July 2021. Randomised clinical trials evaluating the effectiveness of TMBM versus EBCR, and TMBM +EBCR versus TMBM in the treatment of chronic cardiopulmonary dyspnoea were selected. The outcomes were exercise capacity (6 min walk distance, 6MWD) and quality of life (QoL).
RESULTS
Thirty-four randomised clinical trials with 2456 patients were included. For TMBM vs EBCR alone, statistically significant improvements in the 6MWD favoured the TMBM for chronic obstructive pulmonary disease (COPD) (mean difference(MD)=12.22 m; 95% CI 5.94 to 18.50; I=56%) and heart failure (HF) patients (MD=43.65 m; 95% CI 7.91 to 79.38; I=0%). Statistically significant improvements in QoL also favoured TMBM over EBCR for patients with HF(MD=-9.19; 95% CI -11.05 to -7.32; I=0%) but non-significant trend for COPD (standardised mean difference (SMD)=-0.31; 95% CI -0.62 to 0.01; I=78%). Comparisons of TMBM +EBCR versus EBCR alone revealed significant improvements in the QoL for COPD (SMD=-0.52; 95% CI -0.94 to -0.10; I=86%) and patients with HF (MD=-2.82; 95% CI -4.99 to -0.64; I=0%). The 6MWD results favoured the TMBM +EBCR for patients with COPD (MD=16.76 m; 95% CI 10.24 to 23.29; I=0%), but only showed a slight trend towards additional benefits of TMBM +EBCR in the HF studies (MD=13.77 m; 95% CI -1.01 to 28.54; I2=65%) .
CONCLUSIONS
TMBM has positive effects on patients' 6MWD and QoL, with similar or even better effects than EBCR. It may be beneficial to use TMBM as a supplementary or alternative strategy for EBCR in treatment plans.
PROSPERO REGISTRATION NUMBER
CRD42021241181.
目的
评估传统身心运动疗法（TMBM）是否可作为基于运动的心肺康复（EBCR）对慢性心肺性呼吸困难的补充或替代疗法。
方法
检索了PubMed、Embase、Scopus、Web of Science和中国知网，检索时间从各数据库建库至2021年7月2日。选取评估TMBM与EBCR对比，以及TMBM+EBCR与TMBM对比治疗慢性心肺性呼吸困难有效性的随机临床试验。结局指标为运动能力（6分钟步行距离，6MWD）和生活质量（QoL）。
结果
纳入了34项随机临床试验，共2456例患者。对于单独的TMBM与EBCR对比，在6MWD方面有统计学意义的改善表明，TMBM对慢性阻塞性肺疾病（COPD）患者（平均差值（MD）=12.22米；95%置信区间5.94至18.50；I²=56%）和心力衰竭（HF）患者（MD=43.65米；95%置信区间7.91至79.38；I²=0%）更有利。在生活质量方面有统计学意义的改善也表明，对于HF患者，TMBM优于EBCR（MD=-9.19；95%置信区间-11.05至-7.32；I²=0%），但对于COPD患者无显著趋势（标准化平均差值（SMD）=-0.31；95%置信区间-0.62至0.01；I²=78%）。TMBM+EBCR与单独EBCR的对比显示，COPD患者（SMD=-0.52；95%置信区间-0.94至-0.10；I²=86%）和HF患者（MD=-2.82；95%置信区间-4.99至-0.64；I²=0%）的生活质量有显著改善。对于COPD患者，6MWD结果显示TMBM+EBCR更有利（MD=16.76米；95%置信区间10.24至23.29；I²=0%），但在HF研究中，仅显示出TMBM+EBCR有额外益处的轻微趋势（MD=13.77米；95%置信区间-1.01至28.54；I²=65%）。
结论
TMBM对患者的6MWD和QoL有积极影响，效果与EBCR相似甚至更好。在治疗方案中，将TMBM作为EBCR的补充或替代策略可能有益。
国际前瞻性系统评价注册编号
CRD42021241181。
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