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针刺治疗慢性呼吸系统疾病中的呼吸困难及呼吸生理学:一项随机对照试验的系统评价与荟萃分析

Acupuncture for dyspnea and breathing physiology in chronic respiratory diseases: A systematic review and meta-analysis of randomized controlled trials.

作者信息

Yu Yan, Xiao Wei, Du Long-Yi, Li Yu, Xiong Chan, Liang Fan-Rong, Mao Bing, Fu Juan-Juan

机构信息

Division of Pulmonary Medicine, Department of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.

Department of Pneumology, Pidu District Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611730, PR China.

出版信息

Heliyon. 2024 May 16;10(10):e31176. doi: 10.1016/j.heliyon.2024.e31176. eCollection 2024 May 30.

Abstract

BACKGROUND

Dyspnea, a common symptom of chronic respiratory diseases (CRDs), is closely linked to higher levels of functional impairment and death, leading to significant societal and financial challenges. Despite numerous clinical trials and systematic reviews suggested the potential benefits of acupuncture for chronic obstructive pulmonary disease (COPD) and lung cancer, there is currently insufficient evidence to conclusively prove its effectiveness in alleviating dyspnea in patients with CRDs.

METHODS

To compile and evaluate the existing data on the effectiveness and safety of acupuncture for managing dyspnea in CRDs. Randomized controlled trials investigating acupuncture for the treatment of dyspnea in patients with CRDs, such as COPD, lung cancer, asthma, bronchiectasis, interstitial lung disease, chronic pulmonary heart disease and bronchitis, were searched and retrieved from five electronic databases in English or Chinese.

RESULTS

A total of 23 studies meeting the inclusion criteria were found in databases, covering various CRDs such as COPD, lung cancer, and asthma. A meta-analysis that compared acupuncture to a control group (which included no acupuncture and sham acupuncture) found significant advantages for acupuncture in reducing dyspnea severity ( = 0.0003), increasing 6MWD ( < 0.00001), improving quality of life measured by St. George's Respiratory Questionnaire ( = 0.03) and karnofsky performance status score ( < 0.00001). No significance was found in breathing physiology represented by FEV ( = 0.34) and FVC ( = 0.15). There was a comparable incidence of negative outcomes in both groups ( = 0.07). Results were consistent when compared to sham acupuncture. In addition, subgroup analyses were also consistent when different diseases or types of acupuncture were analyzed.

CONCLUSIONS

Acupuncture may be an effective and safe non-pharmacological complementary intervention to relief dyspnea for patients with CRDs. Nevertheless, research with high quality and large sample sizes is needed for further investigation.

摘要

背景

呼吸困难是慢性呼吸系统疾病(CRD)的常见症状,与更高水平的功能障碍和死亡密切相关,给社会和经济带来重大挑战。尽管众多临床试验和系统评价提示针刺对慢性阻塞性肺疾病(COPD)和肺癌具有潜在益处,但目前尚无足够证据确凿证明其在缓解CRD患者呼吸困难方面的有效性。

方法

汇总并评估针刺治疗CRD患者呼吸困难有效性和安全性的现有数据。从五个英文或中文电子数据库中检索并获取调查针刺治疗CRD患者(如COPD、肺癌、哮喘、支气管扩张、间质性肺疾病、慢性肺源性心脏病和支气管炎)呼吸困难的随机对照试验。

结果

数据库中共找到23项符合纳入标准的研究,涵盖COPD、肺癌和哮喘等各种CRD。一项将针刺与对照组(包括无针刺和假针刺)进行比较的荟萃分析发现,针刺在降低呼吸困难严重程度(P = 0.0003)、增加6分钟步行距离(P < 0.00001)、改善圣乔治呼吸问卷测量的生活质量(P = 0.03)和卡氏功能状态评分(P < 0.00001)方面具有显著优势。在以第1秒用力呼气容积(FEV,P = 0.34)和用力肺活量(FVC,P = 0.15)表示的呼吸生理学方面未发现显著差异。两组不良结局的发生率相当(P = 0.07)。与假针刺相比结果一致。此外,在分析不同疾病或针刺类型时亚组分析结果也一致。

结论

针刺可能是缓解CRD患者呼吸困难的一种有效且安全的非药物辅助干预措施。然而,需要高质量和大样本量的研究进行进一步调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7e7/11133705/da0a8cb4a112/gr1.jpg

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