Wu Ping, Qian Xin, Hu Yijing, Yan Xiaoxia
Department of Pulmonology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Shanghai, Tongji University, Shanghai, People's Republic of China.
J Asthma Allergy. 2024 Oct 29;17:1073-1082. doi: 10.2147/JAA.S479398. eCollection 2024.
The objective of this systematic review and meta-analysis was to assess the effectiveness of TIMT on pulmonary function in children and adolescents with asthma.
We searched for randomized controlled clinical trials in the MEDLINE, Embase, the Cochrane Library, Web of Science, CINAHL, Sino Med, Wan fang, CNKI, and VIP until March 2024. In addition, the references included in the literature and the relevant systematic evaluation were manually traced in order to avoid the omission of any relevant literature. These trials compared TIMT against blank TIMT and conventional care. Eligible studies were assessed in terms of risk of bias and quality of evidence using RoB II tool. Where feasible, data were pooled and subjected to meta-analysis. The mean difference (MD) and 95% confidence interval (CI) were estimated by fixed effect models or random effect models.
Six studies were included in the present meta-analysis involving 337 children and adolescents ranged from 4 to 18 years. The meta-analysis showed that TIMT could significantly improve lung function. Compared to the control group, TIMT can significantly improve FEV1 (MD 4.63 mL, 95% CI 2.64 to 6.62 mL, I = 4%), FVC (to the control group (MD 7.46 mL, 95% CI 5.09 to 9.82 mL, I = 0%), FEV1/FVC (MD 7.33%, 95% CI: 5.01 to 9.65%) and ACT (MD 1.86, 95% CI 0.96 to 2.75 mL, I = 12%) of patients at the end of intervention. There was no significant heterogeneity in these meta-analyses.
In conclusion, the results of this systematic review and meta-analysis support the effectiveness of TIMT training in restoring lung function and relieving asthma symptoms of asthmatic children. More high-quality and RCTs with large sample size are urgently required to verify the conclusion.
本系统评价和荟萃分析的目的是评估经皮穴位电刺激（TIMT）对哮喘儿童和青少年肺功能的有效性。
我们检索了截至2024年3月的MEDLINE、Embase、Cochrane图书馆、Web of Science、CINAHL、中国生物医学文献数据库、万方、知网和维普中的随机对照临床试验。此外，还手动追溯了文献中包含的参考文献和相关的系统评价，以避免遗漏任何相关文献。这些试验将TIMT与空白经皮穴位电刺激及传统护理进行了比较。使用RoB II工具根据偏倚风险和证据质量对符合条件的研究进行评估。在可行的情况下，对数据进行汇总并进行荟萃分析。通过固定效应模型或随机效应模型估计平均差（MD）和95%置信区间（CI）。
本荟萃分析纳入了6项研究，涉及337名4至18岁的儿童和青少年。荟萃分析表明，TIMT可显著改善肺功能。与对照组相比，TIMT可显著改善干预结束时患者的第一秒用力呼气容积（FEV1）（MD 4.63 mL，95%CI 2.64至6.62 mL，I² = 4%）、用力肺活量（FVC）（与对照组相比（MD 7.46 mL，95%CI 5.09至9.82 mL，I² = 0%）、FEV1/FVC（MD 7.33%，95%CI：5.01至9.65%）和哮喘控制测试（ACT）（MD 1.86，95%CI 0.96至2.75 mL，I² = 12%）。这些荟萃分析中没有显著异质性。
总之，本系统评价和荟萃分析的结果支持经皮穴位电刺激训练在恢复哮喘儿童肺功能和缓解哮喘症状方面的有效性。迫切需要更多高质量、大样本量的随机对照试验来验证这一结论。
