营养支持联合功能训练对慢性阻塞性肺疾病患者的康复影响:一项荟萃分析

目的 通过meta分析营养支持联合功能训练对慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)患者的治疗效果。方法 借助EBM AI-Reviewer检索PubMed、Cochrane Library、Web of Science、中国知网、万方数据库、维普中文期刊全文数据库,收集营养支持联合功能训练对COPD患者康复影响的随机对照试验,检索时限设定为2000年1月-2022年3月,使用RevMan 5.3软件进行数据处理。结果 共纳入10篇文献,包括研究对象961例(试验组对象477例和对照组对象484例)。meta分析结果表明,与对照组相比,接受营养支持联合功能训练显著改善了COPD患者:(1)第1 s用力呼气容积(MD=0.34 L,95%CI:0.13-0.55);(2)FEV1占预计值的百分比(MD=4.24%,95%CI:2.53-5.95);(3)用力肺活量(MD=0.33 L,95%CI:0.12-0.54);(4)FEV1占FVC的比值(MD=2.35%,95%CI:1.63-3.07);(5)血清白蛋白水平(MD=2.68 g/L,95%CI:1.98-3.38);(6)血红蛋白(MD=13.93 g/L,95%CI:10.74-17.13);(7)圣乔治呼吸问卷(MD=11.97分,95%CI:9.57-14.36);(8)慢阻肺评估测试(MD=2.99分,95%CI:2.41-3.56)等合并指标。结论 营养支持联合功能训练改善了COPD患者的肺功能、营养水平和生存质量,适用于COPD患者的临床康复治疗。

Effects of nutritional support combined with functional training on recovery in patients with chronic obstructive pulmonary disease: a meta-analysis

Objective To explore the therapeutic effect of nutritional support combined with functional training on patients with chronic obstructive pulmonary disease (COPD) by a meta-analysis. Methods We searched PubMed, Cochrane Library, Web of Science, CNKI, Wanfang and VIP databases to collect randomized controlled trials (RCTs) on the effect of nutritional support combined with functional training on rehabilitation of COPD patients with the help of EBM AI-Reviewer. The search period was set from January 2000 to March 2022, and the obtained data were processed using RevMan 5.3 software. Results A total of 10 papers were enrolled into the analysis, including 961 subjects (477 subjects in the experimental group and 484 subjects in the control group). Meta-analysis results showed that nutritional support combined with functional training significantly improved the COPD patients' forced expiratory volume in one second (FEV1) (MD=0.34 L, 95%CI:0.13-0.55), percentage of predicted forced expiratory volume in 1 second (FEV1% pred) (MD=4.24%, 95%CI:2.53-5.95), forced vital capacity (FVC) (MD=0.33 L, 95%CI:0.12-0.54), FEV1/FVC (MD=2.35%, 95%CI:1.63-3.07), albumin (ALB) (MD=2.68 g/L, 95%CI:1.98-3.38), hemoglobin (Hb) (MD=13.93 g/L, 95%CI:10.74-17.13),and scores ofSt. George's Respiratory Questionnaire (SGRQ, MD=11.97, 95%CI:9.57-14.36) and COPD assessment test (CAT, MD=2.99, 95%CI:2.41-3.56). Conclusion Nutritional support combined with functional training improves the COPD patients' lung function, nutritional level and quality of survival, which is suitable for their clinical rehabilitation.