Mesh Meta-analysis Of Traditional Chinese Medicine Exercise Therapy For Stable COPD

Objective: This research adopts the idea of systematic evaluation in evidence-based medicine。Based on the mesh Metaanalysis method,this study systematically studied the efficacy of traditional Chinese medicine exercise therapy,such as Taijiquan,Baduan Jin,Wuqinxi,Liuzijue,Yi Jin Jing,and breathing guidance technique for patients with stable copd in terms of exercise endurance,respiratory function,symptom relief,quality of life and other aspects,and to select the better treatment,to establish the standard of traditional Chinese medicine exercise therapy for stable copd on the basis of evidence-based medicine.The results can provide evidencebased medical evidence for Guidelines of pulmonary rehabilitation in Chinese medicine of stable copd,and lay a foundation for the popularization of traditional Chinese medicine exercise therapy.Methods: China National Knowledge Infrastructure（CNKI）,Chinese Biomedical Literature Database（CBM）,Wanfang Medical Database,Chinese Science and Technology Journal Database（VIP）,Web of Science,Pub Med,Embase and other Chinese and English databases were searched by computer.Randomized controlled trials（RCTs）of different traditional Chinese medicine exercise therapy in COPD remission were collected.The retrieval period starts from the database construction to January 31,2022,and manual retrieval is carried out for the collection of books to supplement the acquisition of relevant literature.The two researchers independently conducted literature screening,data extraction and cross-checking.The two researchers independently conducted literature screening,data extraction and cross-checking,and used the ROB tool of the Cochrane Systematic Review Manual to evaluate the quality of the included literatures.In the mesh meta-analysis part,ADDIS software was used for mesh meta-analysis and inconsistency test,and mesh evidence graph,ladder graph and probability ranking graph were drawn.Finally,Stata software was used to draw publication bias funnel plot.Results: a total of 736 related literatures were detected.149 literatures were initially screened according to their titles and abstracts,and the full text was read in detail.In strict accordance with the inclusion and exclusion criteria,61 RCTS were further excluded and finally included,including 4370 patients with stable COPD,including 56 Chinese literatures and5 English literatures.Involving 6 traditional Chinese medicine exercise therapy（tai chi,Baduanjin,Wuqinxi,Liuzijue,Yi Jin Jing,breathing guidance）and 7 different outcome indicators（FEV1,FVC,FEV1% PRED,FEV1/FVC%,6MWT,SGRQ,CAT）.In terms of lung function,combined with the ladder diagram and probability ranking diagram,it could be seen that among the outcome indexes of FEV1 、 FVC 、 FEV1%pred 、 FEV1/FVC%,different traditional Chinese medicine exercise therapy had better efficacy than the control group.Among them,Wuqinxi had the most obvious effect in improving FEV1,FEV1%pred and FEV1/FVC%,and Baduanjin had a more significant advantage in improving FVC.In terms of athletic endurance,combined with the ladder diagram and probability ranking diagram,it could be seen that compared with conventional lung rehabilitation training and conventional management treatment,the results of 6MWD of Liuzijue on the ground,Liuzijue in the water,baduanjin,Wuqinxi,Taijiquan and TCM breathing guidance were superior to the control group,and TCM respiratory guidance had the best effect in improving the 6min walking distance of patients,followed by wuqinxi.In terms of quality of life,combined with the ladder diagram and probability ranking diagram,it could be seen that compared with conventional management treatment,CAT score improvement of Liuzijue on the ground,Liuzijue in the water and Baduanjin was better than that of control group before and after treatment,among them,Liuzijue in the water improved CAT score the most,suggesting that Liuzijue in the water could better improve clinical symptoms and improve the quality of life of patients.SGRQ scores comprehensively reflect COPD patients’ symptoms,exercise ability,social impairment and psychological disorders caused by the disease,and comprehensively represent patients’ quality of life.Combined with the ladder diagram and probability ranking diagram,the improvement of SGRQ score of Liuzijue on the ground 、 Baduanjin and Taijiquan were better than that of conventional lung rehabilitation training before and after treatment.The improvement of SGRQ score was the greatest in Liuzijue on the ground,suggesting that Liuzijue on the ground could better improve patients’ overall situation,including improving symptoms 、 exercise endurance 、 quality of life and alleviating anxiety and depression.In terms of improving symptoms,compared with Taijiquan、conventional lung rehabilitation training and conventional management treatment,Liuzijue on the ground improved SGRQ respiratory symptoms better than the control group before and after treatment.Compared with conventional management treatment,Taijiquan improved SGRQ respiratory symptoms better than the control group before and after treatment.Liuzijue on the ground improved the symptoms of SGRQ the most,suggesting that Liuzijue on the ground could better improve the symptoms of dyspnea and fatigue.In terms of improving mobility,Compared with conventional pulmonary rehabilitation training and conventional management treatment,the improvement degree of SGRQ activity limitation of Liuzijue on the ground before and after treatment was better than that of the control group.Compared with conventional management treatment,the improvement degree of SGRQ activity limitation in taijiquan before and after treatment was better than that in the control group.The improvement degree of SGRQ activity limitation was the greatest in Liuzijue on the ground,suggesting that Liuzijue on the ground could better improve patients’ activity ability.In terms of daily life improvement,Compared with conventional management treatment,the improvement degree of SGRQ daily life of Liuzijue on the ground before and after treatment was better than that of the control group.Compared with conventional management treatment,the improvement degree of SGRQ daily life of taijiquan before and after treatment was better than that in the control group.The improvement degree of SGRQ daily life is the greatest in Liuzijue on the ground,suggesting that Liuzijue on the ground could better improve the damage of the disease to the patients’ social ability and relieve the patients’ psychological barriers.Probability ranking: In terms of lung function,the probability weight of the top 5 in improving FEV1 indicators was as follows: wuqinxi（53%）>Yijinjing（31%）> Yijinjing（27%）>Baduanjin（36%）> Baduanjin（40%）;In terms of improving FEV1%pred,the probability weight of the top 3 was as follows: TCM respiratory guidance（50%）> Wuqinxi（36%）> Wuqinxi（23%）;In improving FEV1/FVC%,the probability weight of top 5 was as follows: Wuqinxi（49%）> Wuqinxi（39%）> Liuzijue on the ground（40%）> Baduanjin（26%）> Taijiquan（29%）;In improving FVC,the probability weight of the top 4 was as follows:Wuqinxi（71%）>Baduanjin（51%）>Taijiquan（31%）>Taijiquan（30%）.In terms of exercise endurance,the probability weight of the top 4 in improving 6MWT indexes was as follows: TCM breathing guidance（48%）> Liuzijue in the water（33%）> Wuqinxi（38%）> Taijiquan（43%）> Taijiquan（48%）.In terms of comprehensive improvement,the probability weight of the top 5 in improving SGRQ total score was as follows: Liuzijue in the water（40%）> Liuzijue on the ground（29%）> Liuzijue on the ground（26%）> Taijiquan（26%）>Baduanjin（20%）;In terms of symptom relief,the probability weight of the top 5 in improving SGRQ respiratory symptoms was as follows: Liuzijue on the ground（32%）> Liuzijue on the ground（39%）> Liuzijue on the ground（21%）> Taijiquan（21%）>Taijiquan（28%）;In terms of improving daily activity ability,the probability weight of the top 4 in improving SGRQ activity limitation score was as follows: Liuzijue on the ground（34%）> Liuzijue on the ground（36%）> Taijiquan（26%）>Taijiquan（27%）;In terms of improving patients’ social ability and alleviating psychological disorders,the probability weight of top 5 in improving SGRQ disease impact score was as follows:Liuzijue in the water（54%）> Wuqinxi（24%）> Liuzijue on the ground（27%）> Taijiquan（27%）> Taijiquan（22%）.In terms of improving the quality of life,the probability weight of the top 4 in CAT score was as follows: Liuzijue in the water（57%）> Baduanjin（28%）> Baduanjin（31%）> Liuzijue on the ground（32%）.Conclusion: 1.Traditional Chinese medicine exercise therapy such as six-word formula and Wuqinxi can improve lung function,exercise endurance,quality of life,alleviate symptoms,improve the damage of the disease to patients’ social ability,relieve psychological disorders and other six aspects to achieve the prevention and treatment of COPD in remission.2.Considering to comprehensively improve the quality of life of patients,Liuzijue in the water and Liuzijue on the ground can be both used as the clinical first choice for lung rehabilitation physicians and patients.Considering to improve the lung function of patients,Wuqinxi can be used as the clinical first choice for pulmonary rehabilitation physicians.Considering to improve sports ability,TCM breathing guidance can be the first choice,followed by wuqinxi.Considering to improve the symptoms of dyspnea,Liuzijue on the ground can be used as the first clinical choice.Considering to improve the patient’s social ability,relieve anxiety and depression and other psychological disorders,Liuzijue on the ground can be the first choice,followed by Taijiquan.3.Different traditional Chinese medicine exercise therapies have different focuses in terms of efficacy.Pulmonary rehabilitation physicians should select appropriate individualized treatment methods according to the comprehensive evaluation results of patients.