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结节病的肺康复:系统评价和荟萃分析。

Pulmonary rehabilitation in sarcoidosis: A systematic review and meta-analysis.

机构信息

Department of Pulmonary Medicine, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

Department of Pulmonary Medicine, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.

出版信息

Respir Med. 2023 Nov-Dec;219:107432. doi: 10.1016/j.rmed.2023.107432. Epub 2023 Oct 18.

Abstract

BACKGROUND

Exercise intolerance, muscle weakness, dyspnoea, and fatigue are frequent complications in symptomatic sarcoidosis patients. Pulmonary rehabilitation improves exercise capacity, symptoms, and quality of life in patients with chronic respiratory diseases. Our objective was to systematically determine the effects of pulmonary rehabilitation in patients with sarcoidosis.

METHODS

A systematic review was conducted in seven databases. Studies that applied pulmonary rehabilitation in patients with sarcoidosis were reviewed. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence.

RESULTS

Of the 406 reports returned by the initial search, five articles reporting on 184 patients were included in the data synthesis. Two studies included multi-component exercise, one inspiratory muscle training, one a physical activity incentivisation programme, and one a telerehabilitation program. In the intervention group (IG), we found significant improvement in exercise capacity (SMD 1.65, 95%CI 0.45, 2.86 points, p = 0.006). If we only analyse the studies that performed the 6-min walking test, the IG walked 40.3 (CI95% 20.3, 60.2) m higher than the control group (CG) (p < 0.001). Additionally, dyspnoea score was reduced (MD -0.42 95%CI -0.75, -0.10, p = 0.002). However, fatigue, quality of life and pulmonary function did not show any change.

CONCLUSION

Pulmonary rehabilitation could improve exercise capacity and dyspnoea perception in patients with sarcoidosis.

摘要

背景

运动不耐受、肌肉无力、呼吸困难和疲劳是症状性结节病患者常见的并发症。肺康复可改善慢性呼吸系统疾病患者的运动能力、症状和生活质量。我们的目的是系统地确定肺康复对结节病患者的影响。

方法

在七个数据库中进行了系统评价。综述了应用肺康复治疗结节病患者的研究。两名独立的审查员分析了研究,提取数据并评估了证据质量。

结果

初始搜索返回了 406 份报告,其中有 5 篇文章报道了 184 名患者,纳入了数据综合分析。两项研究包括多组分运动,一项吸气肌训练,一项身体活动激励计划,一项远程康复计划。在干预组(IG)中,我们发现运动能力显著改善(SMD 1.65,95%CI 0.45,2.86 分,p = 0.006)。如果我们只分析进行 6 分钟步行试验的研究,IG 比对照组(CG)多走 40.3(CI95% 20.3,60.2)米(p < 0.001)。此外,呼吸困难评分降低(MD -0.42 95%CI -0.75,-0.10,p = 0.002)。然而,疲劳、生活质量和肺功能没有任何变化。

结论

肺康复可以改善结节病患者的运动能力和呼吸困难感知。

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