运动康复对支气管哮喘患儿肺功能、有氧能力及生存质量影响的Meta分析  

Meta-analysis of effects of exercise rehabilitation on pulmonary function,aerobic capacity and quality of life in children with bronchial asthma

作　　者：杨姝晖 刘玉琳[1] 王倩[1] 王李晶子 车小燕 罗征秀[1] Yang Shuhui;Liu Yulin;Wang Qian;Wang Lijingzi;Che Xiaoyan;Luo Zhengxiu(Respiratory Ward,Liangjiang Branch,Children's Hospital of Chongqing Medical University/Key Laboratory of Developmental Disorders in Children of Ministry of Education/National Clinical Research Center for Child Health and Disease/National International Scientific and Technological Cooperation Base for Major Childhood Development Diseases/Chongqing Municipal Key Laboratory of Pediatrics,Chongqing 401120,China)

机构地区：[1]重庆医科大学附属儿童医院两江院区呼吸科/儿童发育疾病研究教育部重点实验室/国家儿童健康与疾病临床医学研究中心/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室,重庆401120

出　　处：《中华现代护理杂志》2022年第21期2808-2816,共9页Chinese Journal of Modern Nursing

基　　金：重庆市科委联合医学科研项目(2021MSXM340);重庆医科大学附属儿童医院护理学科院级科研课题(CHCQMU2020.12)。

摘　　要：目的探讨运动康复对支气管哮喘患儿肺功能、有氧能力以及生存质量的影响。方法按照PICOS原则,在中国知网、维普网、万方数据库、中国生物医学文献服务系统、Web of Science、Cochrane Library、PubMed、Embase和CINAHL数据库中检索2000年1月1日—2021年12月23日关于运动康复对哮喘患儿影响的中英文随机对照试验研究,使用Cochrane手册对文献进行系统评价,并采用RevMan 5.3进行Meta分析。结果最终纳入15篇文献,共936例试验对象。结果显示,运动康复能改善哮喘患儿用力肺活量占预计值百分比(FVC%)[均数差(MD)=2.75,95%置信区间(CI)(1.22~4.28),P=0.0004]、第1秒用力呼气容积占预计值百分比(FEV1%)[标准化均数差(SMD)=0.22,95%CI(0.07~0.36),P=0.003]、呼气流量峰值占预计值百分比(PEF%)[MD=7.15,95%CI(3.30~11.00),P=0.0003]、最大摄氧量(VO2max)[MD=5.86,95%CI(2.53~9.19),P=0.0006]和生存质量[MD=0.67,95%CI(0.43~0.91),P<0.00001],但在第1秒用力呼气容积与用力肺活量的比值(FEV1/FVC%)[MD=-0.97,95%CI(-3.55~1.61),P=0.46]方面比较差异无统计学意义。结论运动康复能够改善哮喘患儿的部分肺功能、有氧能力及生存质量。但仍需在临床中继续推广,以期用更多的高质量研究去验证其有效性。Objective To explore the effect of exercise rehabilitation on pulmonary function,aerobic capacity and quality of life in children with bronchial asthma.Methods According to the PICOS principle,China National Knowledge Infrastructure(CNKI),VIP,Wanfang Database,SinoMed,Web of Science,Cochrane Library,PubMed,Embase and CINAHL were used to search for all Chinese and English randomized controlled trials on the effect of exercise rehabilitation on children with bronchial asthma from January 1,2000 to December 23,2021.The Cochrane manual was used to systematically review the literature.Meta-analysis was performed using RevMan 5.3.Results Finally,15 articles were included,with a total of 936 subjects.Meta-analysis results showed that exercise rehabilitation could improve percentage of forced vital capacity in the predicted value(FVC%)[mean difference(MD)=2.75,95%confidence interval(CI)(1.22-4.28),P=0.0004],percentage of forced expiratory volume in one second in predicted value(FEV1%)[standardized mean difference(SMD)=0.22,95%CI(0.07-0.36),P=0.003],percentage of peak expiratory flow in the predicted value(PEF%)[MD=7.15,95%CI(3.30-11.00),P=0.0003],maximum oxygen uptake(VO2max)[MD=5.86,95%CI(2.53-9.19),P=0.0006]and quality of life[MD=0.67,95%CI(0.43-0.91),P<0.00001],but there was no statistically significant difference in improving the ratio of FEV1%to FVC%(FEV1/FVC%)[MD=-0.97,95%CI(-3.55-1.61),P=0.46].Conclusions Exercise rehabilitation can improve partial pulmonary function,aerobic capacity and quality of life in children with asthma.However,it still needs to continue to be promoted in the clinical practice,in order to verify its effectiveness with more high-quality research.

关 键 词：儿童 支气管哮喘 运动康复 肺功能 有氧能力 生存质量 META分析 

分 类 号：R725.6[医药卫生—儿科]