高頻胸壁振盪對慢性阻塞性肺病呼吸功能成效：系統性文獻回顧暨統合分析

Fen-Giuan An; Wan-Yu Lo; Pao-Hui Tsai; Li-Hsia Huang; Chia-En Liu; Chia-Chi Kuo

doi:10.6692/KJN.202412_41(3).0001

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医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.6692/KJN

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高频胸壁振荡对慢性阻塞性肺病呼吸功能成效：系统性文献回顾暨统合分析

Respiratory Function Effects of High Frequency Chest Wall Oscillation Therapy in Chronic Obstructive Pulmonary Disease Patients: Systematic Review and Meta-Analysis

安丰娟(Fen-Giuan An) ；罗婉瑜(Wan-Yu Lo) ；蔡宝慧(Pao-Hui Tsai) ；黄丽霞(Li-Hsia Huang) ；刘嘉恩(Chia-En Liu) ；郭嘉琪(Chia-Chi Kuo)

高雄护理杂志； 41 卷 3 期 (2024 / 12 / 01) ， P1 - 22

繁体中文;英文 DOI： 10.6692/KJN.202412_41(3).0001

高频胸壁振荡；慢性阻塞性肺病；呼吸功能；系统性文献回顾；统合分析； High frequency chest wall oscillation ； chronic obstructive pulmonary disease ； respiratory function ； systematic review ； meta-analysis

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摘要 │ 参考文献 (21)

摘要〈TOP〉

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Background: Chronic obstructive pulmonary disease (COPD) patients generally have a problem of excessive sputum and difficult to expel, which is managed clinically by nebulizing treatment and chest physical therapy. However, there is limited effectiveness. High frequency chest wall oscillation (HFCWO) therapy can help loosen and expel sputum, which is gradually promoted in clinical practice. Purpose: To explore the effects of HFCWO on respiratory function in the COPD patients through systematic review and meta-analysis. Methods: On January 2023, we systematically searched seven Chinese and English databases (Airiti Library, CINAHL, Cochrane Library, Embase, PubMed, ProQuest and Index of the Taiwan Periodical Literature System), and the search was limited to randomized controlled trials (RCTs). The modified Jadad scale was used to assess methodological quality, then used the grading of recommendations assessment, development and evaluation (GRADE) to rate the quality of evidence for each outcome, and RevMan 5.4 software was used to conduct the meta-analysis. Results: Seven randomized controlled trials were identified for analysis. Meta-analysis showed that HFCWO could significantly improve respiratory symptoms (SMD = -1.54), sputum expectoration (MD = -13.71mL), and quality of life (SMD = -1.19). Further, it could improve FEV_1 (MD = 152.53mL), FVC (MD = 231.21mL), FEV_1/FVC (MD = 6.73), and PaCO_2 (MD = -2.42 mmHg) in COPD patients compared with routine care. However, did not significantly improve subjects' dyspnea (SMD = -0.57).Conclusion: HFCWO could significantly improve respiratory symptom and lung function during acute exacerbation in COPD patients compared with routine care. However, the number of included articles and the sample size are too small, and the evidence is weak. We recommend that HFCWO can be introduced according to the clinical needs to treat COPD patients, and HFCWO should be performed 2~3 times/day for 15~30 minutes each time, with an oscillating frequency of 10~20 Hz and pressure of 2~5 cmH_2O, and determine its continued suitability based on patient response.

参考文献 ( 21 ) 〈TOP〉

Belli, S., Prince, I., Savio, G., Paracchini, E., Cattaneo, D., Bianchi, M., Masocco, F., Bellanti, M. T., & Balbi, B. (2021). Airway clearance techniques: The right choice for the right patient. Frontiers in Medicine, 8, 1-10. https://doi.org/10.3389/fmed.2021.544826
连结：
Chakravorty, I., Chahal, K., & Austin, G. (2011). A pilot study of the impact of high-frequency chest wall oscillation in chronic obstructive pulmonary disease patients with mucus hypersecretion. International Journal of Chronic Obstructive Pulmonary Disease, 6, 693-699. https://doi.org/10.2147/COPD.S22896
连结：
Cheng, G., Wu, J., Hu, Z., Xiao, Y., Zeng, B., & Zhou, Y. (2022). Effects of high-frequency chest wall oscillation expectoration system on pulmonary rehabilitation and cortisol function in patients with severe AECOPD. Disease Markers, 2022, 1-6. https://doi.org/10.1155/2022/3380048
连结：
Coppolo, D. P., Schloss, J., Suggett, J. A., & Mitchell, J. P. (2022). Non-pharmaceutical techniques for obstructive airway clearance focusing on the role of oscillating positive expiratory pressure (OPEP): A narrative review. Pulmonary Therapy, 8(1), 1-41. https://doi.org/10.1007/s41030-021-00178-1
连结：
Fragkos, K. C., Tsagris, M., & Frango, C. C. (2014). Publication bias in meta-analysis: Confidence intervals for Rosenthal’s fail-safe number. International Scholarly Research Notices, 2014, 1-17. https://doi.org/10.1155/2014/825383
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