虚拟现实康复训练在慢性阻塞性肺疾病患者中应用的系统评价

doi:10.3761/j.issn.0254-1769.2023.02.014

摘要/Abstract

摘要：

目的系统评价虚拟现实康复训练在COPD患者中的应用效果。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、Psyc-INFO等11个中英文数据库，检索时限从建库至2022年6月。纳入COPD患者使用虚拟现实康复训练的试验性研究。由2名研究者独立进行文献筛选、资料提取、文献质量评价后，采用RevMan 5.3软件进行Meta分析。结果共纳入13篇文献，包括836例患者。Meta分析结果显示，虚拟现实康复训练有助于增加COPD患者的6 min步行距离[MD=20.31，95%CI（8.74，31.89），P<0.001]；提升COPD患者的肺功能，血氧饱和度[MD=0.86，95%CI（0.33，1.39），P=0.002]，第1秒用力呼气容积占预计值的百分比[MD=6.85，95%CI（4.13，9.58），P<0.001]，第1秒用力呼气容积与用力肺活量比值[MD=9.81，95%CI（5.16，14.46），P<0.001]；改善COPD患者的认知功能[MD=4.04，95%CI（3.36，4.72），P<0.001]；在临床症状方面，采用医学研究理事会量表和COPD患者自我评估测试问卷评价，虚拟现实康复训练可以改善呼吸困难[MD=-0.20，95%CI（-0.36，-0.04），P=0.010][MD=-3.21，95%CI（-3.49，-2.93），P<0.001]，采用Borg呼吸困难评分，差异无统计学意义[MD=0.06，95%CI（-0.11，0.22），P=0.490]；在改善生活质量方面，差异无统计学意义[MD=-0.45，95%CI（-6.24，5.34），P=0.880]；在负性情绪方面的应用效果尚不明确。结论实施虚拟现实康复训练有助于提升COPD患者的运动耐力和肺功能，改善患者的认知功能，但对呼吸困难、负性情绪及生活质量的影响尚不确定，仍需更多高质量的研究进一步验证。

关键词: 虚拟现实, 康复训练, 肺疾病, 慢性阻塞性, 循证护理学

Abstract:

Objective To evaluate the effect of virtual reality rehabilitation training in patients with chronic obstructive pulmonary disease（COPD）. Methods 11 electronic databases，such as PubMed，Embase，CINAHL etc，were searched for related English and Chinese articles published from inception until June 2022. We retrieved experiment studies focused on VR-based rehabilitation training in adults with COPD. Literature screening，study selection，data extraction and methodological quality evaluation were conducted by 2 reviewers independently. Meta-analysis was performed by RevMan 5.3. Results 13 studies involving 836 patients were included. Meta-analysis indicated that VR-based rehabilitation training enhanced exercise tolerance，6MWT [MD=20.31，95%CI（8.74，31.89），P<0.001]，pulmonary function（SPO₂[MD=0.86，95%CI（0.33，1.39），P=0.002]，FEV1%[MD=6.85，95%CI（4.13，9.58），P<0.001]，FEV1/FVC%[MD=9.81，95%CI（5.16，14.46），P<0.001]），and cognitive function[MD=4.04，95%CI（3.36，4.72），P<0.001]. The breathing difficulties was improved by the MRC and CAT[MD=-0.20，95%CI（-0.36，-0.04），P=0.010]/[MD=-3.21，95%CI（-3.49，-2.93），P<0.001]. There was no significant difference in breathing difficulties by the Borg[MD=0.06，95%CI（-0.11，0.22），P=0.490].There was no significant difference in quality of life[MD=-0.45，95%CI（-6.24，5.34），P=0.880]；application effects on negative emotion were unclear. Conclusion This meta-analysis suggests that VR-based rehabilitation training can improve exercise tolerance，lung function and cognitive function in people with COPD，but the impact on dyspnea，negative emotions and quality of life is still uncertain，and high-quality research is still needed for further demonstration.

Key words: Virtual Reality, Rehabilitation, Pulmonary Disease, Chronic Obstructive, Evidence-Based Nursing

陈霞丽, 邢利民, 凡颖, 周玉梅, 高淑平. 虚拟现实康复训练在慢性阻塞性肺疾病患者中应用的系统评价[J]. 中华护理杂志, 2023, 58(2): 224-231.

CHEN Xiali, XING Limin, FAN Ying, ZHOU Yumei, GAO Shuping. Effects of virtual reality-based rehabilitation training for people with chronic obstructive pulmonary disease：a systematic review[J]. Chinese Journal of Nursing, 2023, 58(2): 224-231.

图/表 3

图1 文献筛选流程及结果

Figure 1 Flow diagram of the selection process of the studies

表1 纳入文献的基本特征（n=13）

Table 1 Characteristics of the included studies（n=13）

表2 纳入文献的方法学质量评价结果

Table 2 Methodological quality evaluation of randomized controlled trials

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