背景:肺动脉高压(PH)是一种进行性和危及生命的疾病,其特征是肺动脉压升高,导致右心衰竭和运动能力下降。传统的药物和手术治疗提供有限的疗效和显著的副作用,有必要探索替代治疗方案。
目的:本系统综述和荟萃分析旨在评估非药物干预措施的有效性和安全性,包括锻炼,饮食调整,和心理社会疗法,在肺动脉高压的管理中。
方法:在PubMed,科克伦图书馆,和Scopus直到2024年,确定了随机对照试验和观察性研究,检查了非药物对PH的干预措施。评估的主要结果包括肺动脉压,右心功能,锻炼能力,和生活质量,对安全性和不利影响进行二次分析。使用随机效应荟萃分析进行数据合成。
结果:该综述包括30项研究,总共有2000名参与者有各种形式的PH。荟萃分析表明,通过6分钟步行距离(平均增加45米,95%CI:30-60,p<0.001),提高生活质量分数,和肺动脉压降低(平均降低5mmHg,95%CI:3-7,p<0.01)。非药物疗法也显示出良好的安全性,报告了轻微的不良反应。
结论:非药物干预为肺动脉高压的传统治疗提供了可行和有效的补充,显着改善功能容量和血液动力学参数,而没有严重的不良反应。这些发现支持将定制的非药物策略整合到PH患者的治疗方案中。强调需要更广泛的实施和进一步的研究,以优化干预方案。
BACKGROUND: Pulmonary hypertension (PH) is a progressive and life-threatening disorder characterized by elevated pulmonary arterial pressure, leading to right heart failure and reduced exercise capacity. Traditional pharmacological and surgical treatments offer limited efficacy and significant side effects, necessitating the exploration of alternative therapeutic options.
OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of non-pharmacological interventions, including exercise, dietary modifications, and psychosocial therapies, in the management of pulmonary hypertension.
METHODS: Comprehensive searches were conducted in PubMed, Cochrane Library, and Scopus up to 2024, identifying randomized controlled trials and observational studies examining non-pharmacological interventions for PH. Primary outcomes assessed included pulmonary arterial pressure, right heart function, exercise capacity, and quality of life, with secondary analysis on safety and adverse effects. Data synthesis was performed using random-effects meta-analysis.
RESULTS: The review included 30 studies, totaling 2000 participants with various forms of PH. Meta-analysis demonstrated significant improvements in exercise capacity as measured by the 6 min walk distance (mean increase of 45 meters, 95 % CI: 30-60, p<0.001), enhanced quality of life scores, and reduction in pulmonary arterial pressure (mean reduction of 5 mmHg, 95 % CI: 3-7, p<0.01). Non-pharmacological therapies also showed a favorable safety profile, with minor adverse effects reported.
CONCLUSIONS: Non-pharmacological interventions provide a viable and effective complement to traditional treatments for pulmonary hypertension, significantly improving functional capacity and hemodynamic parameters without severe adverse effects. These findings support the integration of tailored non-pharmacological strategies into the therapeutic regimen for PH patients, emphasizing the need for broader implementation and further research to optimize intervention protocols.