中医传统功法对中风患者肺功能影响的Meta分析

Meta-Analysis of Effect of Traditional Chinese Medicine Exercises on Lung Function of Stroke Patients

摘要: 目的：评价中医传统功法对中风患者肺功能的康复效果。方法：检索7个中外文数据库中使用中医传统功法对中风患者进行干预的随机对照研究，检索时间截至2024年7月，应用RevMan5.4软件进行数据分析。结果：共纳入10篇文献，包括4种功法：太极、八段锦、六字诀及五禽戏。Meta分析结果显示：试验组第1秒用力呼气容积(FEV1) (SMD = 0.80, 95% CI (0.42~1.18), P < 0.0001)、用力肺活量(FVC) (SMD = 0.56, 95% CI (0.21~0.90), P = 0.002)、呼气峰值流速(PEF) (SMD = 0.74, 95% CI (0.50~0.97), P < 0.00001)、最大自主通气量(MVV) (SMD = 0.37, 95% CI (0.08~0.66), P = 0.01)、最大吸气压(MIP)(SMD = 0.46, 95% CI (0.07~0.86), P = 0.02)的改善程度明显优于对照组。疗程3~12周时，试验组FEV1、FVC、PEF、MVV改善程度明显优于对照组(P < 0.05)。疗程4周时，2组MIP差异无统计学意义(SMD = 0.49, 95% CI (−0.24~1.23), P = 0.19)。纳入文献均未报道发生不良事件。结论：在常规康复基础上，联合中医传统功法能够更好地改善中风患者的肺功能，促进肺康复。呼吸肌功能改善方面期望未来开展多中心、大样本、长期随访的随机对照试验进一步验证疗效。

Abstract: Objective: To evaluate the effectiveness of traditional Chinese medicine (TCM) exercises in stroke patient’s lung function. Methods: 7 Chinese and foreign databases were searched to collect the randomized controlled trials (RCTs) on the intervention of stroke patients using TCM exercises that were published before July 2024, and RevMan5.4 software was utilized to analyse the data. Results: A total of 10 articles were included, involving 4 TCM exercises: Taiji, Baduanjin, Liuzijue and Wuqinxi. The experimental group demonstrated significantly better improvements in forced expiratory volume in one second (FEV1) (SMD = 0.80, 95% CI (0.42~1.18), P < 0.0001), forced vital capacity (FVC) (SMD = 0.56, 95% CI (0.21~0.90), P = 0.002), peak expiratory flow (SMD = 0.74, 95% CI (0.50~0.97), P < 0.00001), maximal voluntary ventilation (SMD = 0.37, 95% CI (0.08~0.66), P = 0.01), and maximal inspiratory pressure (SMD = 0.46, 95% CI (0.07~0.86), P = 0.02) compared to the control group. For 3~12 weeks of intervention, the improvement of FEV1, FVC, PEF and MVV in experimental group demonstrated significantly better compared to the control group (P < 0.05). However, after 4 weeks of intervention, there was no statistical difference in maximal inspiratory pressure between the two groups (SMD = 0.49, 95% CI (−0.24~1.23), P = 0.19). None of the included articles reported adverse events of TCM exercises. Conclusion: Based on conventional rehabilitation, the combination of TCM exercises can better improve the lung function for stroke patients and promote lung rehabilitation. Nevertheless, further multi-center, large-sample, long-term RCTs are required to evaluate the effectiveness on maximal inspiratory pressure.