严重哮喘患者增加体力活动：一项系统综述和荟萃分析
2022/08/19
摘要
引言/目的：缺乏运动在哮喘病人中很常见，并被认为是导致不良临床结果（如哮喘控制和健康相关生活质量（HRQoL）受损）的一个重要可改变的风险。尽管有证据支持体力活动（PA）在降低这些结果风险方面的作用，但对于提高重症患者PA的最佳干预措施知之甚少。本系统回顾和荟萃分析评估了干预措施在重症哮喘患者中增加PA的有效性。
方法：在Medline、CINAHL、EMBASE、PubMed、Informit、SPORTDiscus和Cochrane数据库中搜索了截止至2021年9月的基于PA的干预研究，这些研究评估了患有严重哮喘的成年人的PA结果（例如，步数/每日，进行PA的时间）。哮喘相关（如哮喘控制）和健康相关结果（如HRQoL）的数据作为次要结果进行评估。修订后的Cochrane-ROB工具被用来评估偏倚风险。在可能的情况下，综合数据的荟萃分析的随机效应。
结果：四项RCTs（持续时间均为12周）包括176名患有中度至重度哮喘的成年人。据报道，通过中等强度的有氧和阻力训练干预（步数/每日和进行PA的时间）和无监督的基于计步器的干预（步数/每日）后PA显示出增加。Meta分析显示，与对照组相比，PA干预对步数/每日（MD=1588，95%CI：399，2778；p=0.009，I2=23）、哮喘控制（MD=-0.65，95%CI：-0.95，-0.35；p<0.0001，I2=0%）和HRQoL（MD=0.56，95%CI：0.10，1.01；p=0.02，I2=16%）具有总体积极效应。
结论：虽然有一些证据支持干预措施对改善患有严重哮喘的成年人的PA的有效性，但需要更高质量的、持续时间更长的大规模研究来确定最佳干预措施。
Increasing physical activity in severe asthma: a systematic review and meta-analysis
McLoughlin RF, Clark VL, Urroz PD, Gibson PG, McDonald VM.
Abstract
INTRODUCTION/AIM:Physical inactivity is common in asthma and is recognised as an important modifiable risk for poor clinical outcomes such as impaired asthma control and health-related quality of life (HRQoL). Despite evidence supporting the role of physical activity (PA) in reducing the risk of these outcomes, little is known about optimal interventions for increasing PA in those with severe disease. This systematic review and meta-analysis evaluates the effectiveness of interventions in increasing PA in severe asthma.
METHODS:Medline, CINAHL, EMBASE, PubMed, Informit, SPORTDiscus and Cochrane databases were searched up to September 2021 for PA-based intervention studies that assessed PA outcomes (e.g. steps·day-1, time spent undertaking PA) in adults with severe asthma. Data on asthma-related (e.g. asthma control) and health-related outcomes (e.g. HRQoL) were assessed as secondary outcomes. The Revised Cochrane ROB tool was used to assess risk of bias. Random-effects meta-analyses synthesised data where possible.
RESULTS:Four RCTs (all 12-weeks in duration) including 176 adults with moderate-to-severe asthma were included. An increase in PA was reported with a moderate-vigorous intensity aerobic and resistance training intervention (steps·day-1 and time spent undertaking PA), and an unsupervised pedometer-based intervention (steps·day-1). Meta-analyses showed that PA interventions had an overall positive effect on steps·day-1 (MD=1588, 95% CI:399, 2778; p=0.009, I2 =23), asthma control (MD=-0.65, 95% CI: -0.95, -0.35; p<0.0001, I2 =0%), and HRQoL (MD=0.56, 95% CI:0.10,1.01; p=0.02, I2 =16%) compared to control.
CONCLUSION:While there is some evidence supporting the effectiveness of interventions in improving PA in adults with severe asthma, higher-quality, large-scale studies of longer duration are needed to determine the optimal intervention.
引言/目的：缺乏运动在哮喘病人中很常见，并被认为是导致不良临床结果（如哮喘控制和健康相关生活质量（HRQoL）受损）的一个重要可改变的风险。尽管有证据支持体力活动（PA）在降低这些结果风险方面的作用，但对于提高重症患者PA的最佳干预措施知之甚少。本系统回顾和荟萃分析评估了干预措施在重症哮喘患者中增加PA的有效性。
方法：在Medline、CINAHL、EMBASE、PubMed、Informit、SPORTDiscus和Cochrane数据库中搜索了截止至2021年9月的基于PA的干预研究，这些研究评估了患有严重哮喘的成年人的PA结果（例如，步数/每日，进行PA的时间）。哮喘相关（如哮喘控制）和健康相关结果（如HRQoL）的数据作为次要结果进行评估。修订后的Cochrane-ROB工具被用来评估偏倚风险。在可能的情况下，综合数据的荟萃分析的随机效应。
结果：四项RCTs（持续时间均为12周）包括176名患有中度至重度哮喘的成年人。据报道，通过中等强度的有氧和阻力训练干预（步数/每日和进行PA的时间）和无监督的基于计步器的干预（步数/每日）后PA显示出增加。Meta分析显示，与对照组相比，PA干预对步数/每日（MD=1588，95%CI：399，2778；p=0.009，I2=23）、哮喘控制（MD=-0.65，95%CI：-0.95，-0.35；p<0.0001，I2=0%）和HRQoL（MD=0.56，95%CI：0.10，1.01；p=0.02，I2=16%）具有总体积极效应。
结论：虽然有一些证据支持干预措施对改善患有严重哮喘的成年人的PA的有效性，但需要更高质量的、持续时间更长的大规模研究来确定最佳干预措施。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Eur Respir J. 2022 Jul 26;2200546. DOI: 10.1183/13993003.00546-2022)
(Eur Respir J. 2022 Jul 26;2200546. DOI: 10.1183/13993003.00546-2022)
Increasing physical activity in severe asthma: a systematic review and meta-analysis
McLoughlin RF, Clark VL, Urroz PD, Gibson PG, McDonald VM.
Abstract
INTRODUCTION/AIM:Physical inactivity is common in asthma and is recognised as an important modifiable risk for poor clinical outcomes such as impaired asthma control and health-related quality of life (HRQoL). Despite evidence supporting the role of physical activity (PA) in reducing the risk of these outcomes, little is known about optimal interventions for increasing PA in those with severe disease. This systematic review and meta-analysis evaluates the effectiveness of interventions in increasing PA in severe asthma.
METHODS:Medline, CINAHL, EMBASE, PubMed, Informit, SPORTDiscus and Cochrane databases were searched up to September 2021 for PA-based intervention studies that assessed PA outcomes (e.g. steps·day-1, time spent undertaking PA) in adults with severe asthma. Data on asthma-related (e.g. asthma control) and health-related outcomes (e.g. HRQoL) were assessed as secondary outcomes. The Revised Cochrane ROB tool was used to assess risk of bias. Random-effects meta-analyses synthesised data where possible.
RESULTS:Four RCTs (all 12-weeks in duration) including 176 adults with moderate-to-severe asthma were included. An increase in PA was reported with a moderate-vigorous intensity aerobic and resistance training intervention (steps·day-1 and time spent undertaking PA), and an unsupervised pedometer-based intervention (steps·day-1). Meta-analyses showed that PA interventions had an overall positive effect on steps·day-1 (MD=1588, 95% CI:399, 2778; p=0.009, I2 =23), asthma control (MD=-0.65, 95% CI: -0.95, -0.35; p<0.0001, I2 =0%), and HRQoL (MD=0.56, 95% CI:0.10,1.01; p=0.02, I2 =16%) compared to control.
CONCLUSION:While there is some evidence supporting the effectiveness of interventions in improving PA in adults with severe asthma, higher-quality, large-scale studies of longer duration are needed to determine the optimal intervention.
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空气原油化学物质与基于症状哮喘间的相关性分析
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鼻炎与支气管哮喘发病率和严重程度之间的关系
