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Abstract：
OBJECTIVE: Traditional Chinese exercises (Taichi, Wuqinxi, Liuzijue, and Baduanjin) are considered effective alternative treatments for improving symptoms in the stable phase of COPD. However, the most effective exercise remains unknown. This study compared the effectiveness of different traditional Chinese exercises on pulmonary function in patients with stable chronic obstructive pulmonary disease (COPD) using a network meta-analysis.
METHODS: From database establishment until September 2023, eligible randomized controlled trials (RCTs) were searched. Two reviewers performed the risk of bias assessment of the included studies using the Cochrane Collaboration tool, and the evidence level was suggested using the GRADE system.
RESULTS: Fifty-seven studies comprising 4294 patients were included. The results of the network meta-analysis show that Baduanjin was most effective in improving the forced expiratory volume in the first second (FEV1). However, Liuzijue significantly improved the first-second forced vital capacity percentage of expected value (FEV1%) and the ratio of the forced expiratory volume in the first second to the forced vital capacity (FEV1/FVC). The probability ranking results indicated that Liuzijue was the most effective, followed by Baduanjin, Wuqinxi, and Taichi. Subgroup analysis in conjunction with intervention duration revealed that Liuzijue had a significant advantage over other interventions for improving FEV1, FEV1%, and FEV1/FVC within 6 months and improved FEV1% and FEV1/FVC for ≥ 6 months. Moreover, Subgroup analysis based on baseline pulmonary function revealed that Liuzijue had a significant advantage over other interventions for improving FEV1% within severe and moderate groups. Finally, Subgroup analysis based on the frequency of interventions showed that Liuzijue was still more effective in improving FEV1, FEV1%, and FEV1/FVC in the ≥ three times one week.
CONCLUSIONS: Liuzijue was more effective than Taichi, Wuqinxi, Liuzijue, and Baduanjin in improving pulmonary function in patients with stable COPD.
METHODS: From database establishment until September 2023, eligible randomized controlled trials (RCTs) were searched. Two reviewers performed the risk of bias assessment of the included studies using the Cochrane Collaboration tool, and the evidence level was suggested using the GRADE system.
RESULTS: Fifty-seven studies comprising 4294 patients were included. The results of the network meta-analysis show that Baduanjin was most effective in improving the forced expiratory volume in the first second (FEV1). However, Liuzijue significantly improved the first-second forced vital capacity percentage of expected value (FEV1%) and the ratio of the forced expiratory volume in the first second to the forced vital capacity (FEV1/FVC). The probability ranking results indicated that Liuzijue was the most effective, followed by Baduanjin, Wuqinxi, and Taichi. Subgroup analysis in conjunction with intervention duration revealed that Liuzijue had a significant advantage over other interventions for improving FEV1, FEV1%, and FEV1/FVC within 6 months and improved FEV1% and FEV1/FVC for ≥ 6 months. Moreover, Subgroup analysis based on baseline pulmonary function revealed that Liuzijue had a significant advantage over other interventions for improving FEV1% within severe and moderate groups. Finally, Subgroup analysis based on the frequency of interventions showed that Liuzijue was still more effective in improving FEV1, FEV1%, and FEV1/FVC in the ≥ three times one week.
CONCLUSIONS: Liuzijue was more effective than Taichi, Wuqinxi, Liuzijue, and Baduanjin in improving pulmonary function in patients with stable COPD.
摘要：
目的：繁体中文练习（太极，五禽戏,刘子爵,和八段锦）被认为是改善COPD稳定期症状的有效替代疗法。然而,最有效的锻炼仍然未知。这项研究使用网络荟萃分析比较了不同传统中医运动对稳定期慢性阻塞性肺疾病（COPD）患者肺功能的有效性。
方法：从数据库建立到2023年9月，检索符合条件的随机对照试验（RCT）。两名评审员使用CochraneCollaboration工具对纳入的研究进行了偏倚风险评估，并使用等级系统建议了证据水平。
结果：纳入了57项研究，包括4294名患者。网络荟萃分析结果显示八段锦对提高第1秒用力呼气量(FEV1)效果最好。然而,Liuzijue显着提高了第一秒用力肺活量的期望值百分比（FEV1％）和第一秒用力呼气量与用力肺活量的比率（FEV1/FVC）。概率排序结果表明，六子爵是最有效的，其次是八段锦,五禽戏,还有太极.亚组分析结合干预时间显示，六子觉在改善FEV1、FEV1%、6个月内FEV1/FVC改善，≥6个月FEV1％和FEV1/FVC改善。此外，基于基线肺功能的亚组分析显示，六子觉在改善重度和中度组中的FEV1%方面比其他干预措施具有显著优势。最后,基于干预频率的亚组分析显示，六子觉在改善FEV1、FEV1%、FEV1/FVC在一周内≥3次。
结论：六子爵比太极更有效，五禽戏,刘子爵,八段锦对COPD稳定期患者肺功能的改善作用.
方法：从数据库建立到2023年9月，检索符合条件的随机对照试验（RCT）。两名评审员使用CochraneCollaboration工具对纳入的研究进行了偏倚风险评估，并使用等级系统建议了证据水平。
结果：纳入了57项研究，包括4294名患者。网络荟萃分析结果显示八段锦对提高第1秒用力呼气量(FEV1)效果最好。然而,Liuzijue显着提高了第一秒用力肺活量的期望值百分比（FEV1％）和第一秒用力呼气量与用力肺活量的比率（FEV1/FVC）。概率排序结果表明，六子爵是最有效的，其次是八段锦,五禽戏,还有太极.亚组分析结合干预时间显示，六子觉在改善FEV1、FEV1%、6个月内FEV1/FVC改善，≥6个月FEV1％和FEV1/FVC改善。此外，基于基线肺功能的亚组分析显示，六子觉在改善重度和中度组中的FEV1%方面比其他干预措施具有显著优势。最后,基于干预频率的亚组分析显示，六子觉在改善FEV1、FEV1%、FEV1/FVC在一周内≥3次。
结论：六子爵比太极更有效，五禽戏,刘子爵,八段锦对COPD稳定期患者肺功能的改善作用.
