Abstract:

Objective　To systematically evaluate the clinical effectiveness of Baduanjin for patients with non-small cell lung cancer. Methods　The databases, PubMed, EMBASE (Ovid), The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Weipu, Wanfang, and CBM were searched for the randomized controlled trials (RCTs) on Baduanjin (or combined with other treatments) in the treatment of patients with non-small cell lung cancer from their establishment to July 26, 2022. Meta analysis was performed using the Stata 17 software. The risk of bias was assessed according to the Cochrane's Handbook for systematic reviewers' risk of bias criteria for literature quality assessment. The outcome measures were pulmonary function tests (FEV1 and FVC), Borg dyspnea score, 6-min walk test, Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and Functional Assessment of Lung Cancer Therapy (FACT-L) (version 4.0). Results　Six RCTs with a total of 322 patients were included. Meta analysis showed that the test group had better FEV1 [SMD= 0.53, 95%CI (0.13, 0.94), P=0.01], FVC [SMD=0.58, 95%CI (0.17, 0.98), P=0.005], 6-min walk test [SMD=0.56, 95%CI (0.34, 0.79), P<0.01], and SAS score [SMD=-1.18, 95%CI (-1.51,-0.85), P<0.01] than the control group. The test group had significantly greater improvement in the Borg dyspnea score [SMD=-0.32, 95%CI (-0.72, 0.07), P=0.11], SDS [SMD=-0.62, 95%CI (-1.68, 0.44), P=0.253], and scores of physical status [SMD=0.35,95%CI(-0.44,1.13),P=0.385], social and family status [SMD=0.44, 95%CI (-0.29, 1.17), P=0.242], affective status [SMD=0.36, 95%CI (-0.31, 1.04), P=0.293], and additional concern [SMD=0.43, 95%CI (-0.41, 1.27), P=0.313] and total score [SMD=1.22, 95%CI (-0.18, 2.63), P=0.088] of FACT-L (version 4.0) than the control group, with statistical differences. Conclusions　Baduanjin is able to improve the patients' lung function, exercise tolerance, and anxiety status; its effects on dyspnea, depression status as well as improvement on the functional assessment scale for lung cancer treatment are not significant, so it needs further study.

Key words:

Baduanjin, Non-small cell lung cancer, Meta analysis

摘要：

目的　系统评价八段锦应用于非小细胞肺癌的临床有效性。方法　检索Pubmed、Embase（Ovid）、The Cochrane Library、Web of Science、中国知网（CNKI）、维普、万方、CBM数据库，检索八段锦（或配合其他治疗方法）治疗非小细胞肺癌的随机对照试验（RCT），检索时限设定为数据库各自建库时间至2022年7月26日。采用Stata 17软件进行meta分析，根据Cochrane的系统评价员手册risk of bias标准评估偏倚风险进行文献质量评价。结局指标为肺功能测试［第一秒用力呼气量（FEV1）、用力肺活量（FVC）］、Borg呼吸困难评分、6 min步行试验、焦虑自评量表（SAS）、抑郁自评量表（SDS）、肺癌治疗功能评价量表（FACT-L）（4.0版）。结果　共纳入6项RCT研究，合计322例患者。meta分析显示，试验组在FEV1测试结果［SMD=0.53，95%CI（置信区间）（0.13，0.94），P=0.01］、FVC测试结果［SMD=0.58，95%CI（0.17，0.98），P=0.005］、6 min步行试验结果［SMD=0.56，95%CI（0.34，0.79），P<0.01］、SAS评分［SMD=-1.18，95%CI（-1.51，-0.85），P<0.01］均优于对照组。另外，试验组在改善Borg呼吸困难评分［SMD=-0.32，95%CI（-0.72，0.07），P=0.11］、SDS评分［SMD=-0.62，95%CI（-1.68，0.44），P=0.253］、FACT-L（4.0版）中的生理状况评分［SMD=0.35，95%CI（-0.44，1.13），P=0.385］、社会家庭状况评分［SMD=0.44，95%CI（-0.29，1.17），P=0.242］、情感状况评分［SMD=0.36，95%CI（-0.31，1.04），P=0.293］、功能状况评分［SMD=0.66，95%CI（-0.59，1.92），P=0.30］、附加关注评分［SMD=0.43，95%CI（-0.41，1.27），P=0.313］以及总分［SMD=1.22，95%CI（-0.18，2.63），P=0.088］与对照组相比，差异均无统计学意义。结论　八段锦能够改善肺功能、运动耐力以及焦虑状况，对于呼吸困难、抑郁状况以及肺癌治疗功能评价量表改善效果不明显，尚需进一步研究。

关键词:

八段锦, 非小细胞肺癌, meta分析