Abstract:

Objective To evaluate the effect of threshold-pressure inspiratory muscle training on pulmonary rehabilitation and quality of life in asthma patients by meta-analysis. Methods We searched the Cochrane Library,PubMed,Embase,Web of Science,Wanfang,CNKI,VIP,and CBM databases for randomized controlled trial studies on the effects of inspiratory muscle training on pulmonary rehabilitation and quality of life in patients with asthma. The search time is from the establishment of databases to January 6,2021. After the quality evaluation,meta-analysis was performed using RevMan 5.3 software. Results A total of 10 publications including 456 patients were included,and the meta-analysis showed that threshold-pressure inspiratory muscle training improved patients’ forced vital capacity[SMD=0.90,95%CI（0.68,1.11）,P<0.001],forced expiratory volume in a second[SMD=0.62,95%CI（0.41,0.83）,P<0.001],peak expiratory flow [WMD=0.32,95%CI（0.01,0.62）,P=0.040],maximum voluntary ventilation[WMD=11.89,95%CI（6.42,17.37）,P<0.001],and maximum inspiratory pressure[SMD=29.76,95%CI（18.15,41.36）,P<0.001],reduced their dyspnea[SMD=-0.51,95%CI（-0.95,-0.06）,P<0.001],and increased their 6-min walk distance[WMD=77.13,95%CI（24.58,129.67）,P=0.004]. However,the difference in improving their quality of life was not statistically significant[SMD=1.21,95%CI（-2.11,4.52）,P=0.480]. Conclusion Threshold-pressure inspiratory muscle training can significantly improve patients’ lung function indicators,enhance respiratory muscle strength,reduce dyspnea,and increase 6-min walking distance in asthmatic patients,but the effect in improving quality of life is not significant,and more clinical high-quality studies need to further verify its effectiveness.

Key words: Threshold-Pressure, Resistance Training, Asthma, Pulmonary Function, Quality of Life, Meta-Analysis, Nursing Care

摘要：

目的 通过Meta分析评价阈值压力负荷吸气肌训练对哮喘患者肺康复及生活质量的影响。 方法 计算机检索Cochrane Library、PubMed、Embase、Web of Science、万方、中国知网、维普及中国生物医学文献数据库中有关吸气肌训练对哮喘患者肺康复及生活质量影响的随机对照试验,检索时限为建库至2021年1月6日。经质量评价后,采用RevMan 5.3软件进行Meta分析。 结果 共纳入10篇文献,包括456例患者。Meta分析结果显示,阈值压力负荷吸气肌训练可改善患者的用力肺活量[SMD=0.90,95%CI（0.68,1.11）,P<0.001]、第1秒用力呼气容积[SMD=0.62,95%CI（0.41,0.83）,P<0.001]、呼气峰值流速[WMD=0.32,95%CI（0.01,0.62）,P=0.040]、最大自主通气量[WMD=11.89,95%CI（6.42,17.37）,P<0.001],增强患者的最大吸气压[SMD=29.76,95%CI（18.15,41.36）,P<0.001],减轻其呼吸困难程度[SMD=-0.51, 95%CI（-0.95,-0.06）,P<0.001],延长6 min步行距离[WMD=77.13,95%CI（24.58,129.67）,P=0.004],但在改善患者生活质量方面,差异无统计学意义[SMD=1.21,95%CI（-2.11,4.52）,P=0.480]。 结论 阈值压力负荷吸气肌训练可改善哮喘患者的多项肺功能指标,增强其呼吸肌肌力,减轻呼吸困难程度,延长患者6 min步行距离,但在改善生活质量方面效果不显著,后期需开展更多临床高质量研究进一步验证其有效性。

关键词: 阈值压力负荷, 抗阻训练, 哮喘, 肺康复, 生活质量, Meta分析, 护理