在患有多发性硬化症的成年人中,呼吸肌训练的有效性:系统性审查和元分析
Yuping Xiang1, Oufeng Tang2, Ling Zeng1
1Department of Critical Care Medicine, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Frontiers in neurology
|November 10, 2025
概括
呼吸肌肉训练 (RMT) 显著改善呼吸肌肉强度,并减少多发性硬化症 (MS) 患者的疲劳. 然而,低质量的证据意味着对肺功能和生活质量的影响仍然不确定.
科学领域:
- 神经学和康复医学 神经学和康复医学
- 呼吸系统生理学和治疗
背景情况:
- 多发性硬化症 (MS) 是一种慢性神经疾病,影响呼吸功能和生活质量.
- 呼吸道肌肉衰弱是MS的常见并发症,可能会加剧症状并降低功能能力.
- 呼吸道肌肉训练 (RMT) 是解决这些呼吸系统缺陷的潜在干预措施.
研究的目的:
- 系统地评估RMT对MS患者呼吸肌肉强度,肺功能,疲劳和生活质量的影响.
- 综合来自随机对照试验 (RCT) 和准实验 (QE) 研究的证据,将RMT与对照干预进行比较.
主要方法:
- 在四个数据库 (PubMed,Web of Science,Embase,Cochrane) 进行了全面的搜索,截至2024年8月26日.
- 包括的研究将RMT与假RMT或传统护理进行了比较.
- 进行了数据提取,偏差风险评估 (RoB 2.0,JBI工具) 和GRADE确定性评估. 在可行的情况下进行了元分析.
主要成果:
- 分析了与376名多发性硬化症患者的14项试验 (8项RCT,6项QAE).
- RMT显著改善了最大吸入压力 (MIP) 和最大呼气压力 (MEP).
- RMT显著降低了疲劳 (修改疲劳影响量表),但对肺功能,运动能力或生活质量没有显著影响.
结论:
- 在MS患者中,RMT在增强呼吸肌肉强度和减轻疲劳方面表现出有效性.
- 目前的证据基础受到低质量,小样本大小和偏差风险的限制,导致对肺功能和生活质量影响的不确定性.
- 需要进一步进行高质量的随机对照试验来证实这些发现,并阐明RMT在MS治疗中的更广泛影响.
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