中医导引术对肺癌患者干预效果的网状Meta分析*

作者：褚天璐1,2，杨培培1,2，任雯沁1,2，徐媛媛2，滕钰浩2，舒 鹏2

单位：1.南京中医药大学，江苏 南京 210029； 2.南京中医药大学附属医院，江苏 南京 210029

引用：引用：褚天璐，杨培培，任雯沁，徐媛媛，滕钰浩，舒鹏.中医导引术对肺癌患者干预效果的网状Meta分析[J].中医药导报,2025,31(11):169-178.

DOI：10.13862/j.cn43-1446/r.2025.11.029

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摘要：

目的：运用网状Meta分析方法评价中医导引术对肺癌患者的临床干预效果。方法：计算机检索中国知网、万方数据知识服务平台、维普中文期刊服务平台、中国生物医学文献数据库、PubMed、Cochrane Library、Embase、Web of Science，检索时间范围从各数据库建库至2025年5月6日。采用Cochrane手册推荐的偏倚风险评价工具（ROB）对纳入研究进行偏倚风险评价。结果：共纳入24项随机对照试验（RCTs），涉及1 935例肺癌患者。ROB评价结果表明大多数纳入的RCTs质量等级较低。网状Meta分析结果显示，与常规治疗（包括常规护理、运动等）相比：（1）肺功能用力肺活量（FVC）提升方面，中医外治（耳穴贴压或穴位贴敷）+八段锦干预效果最优[累计排序曲线下面积（SUCRA）73.7%]；（2）肺功能第一秒用力呼气量（FEV1）提升方面，单纯八段锦干预效果最优（SUCRA：71.2%）；（3）肺功能FEV1/FVC提升方面，单纯六字诀干预效果最优（SUCRA：82.2%）；（4）活动耐量6 min步行距离（6MWD）提升方面，五禽戏+基于中医辨证的中医适宜技术（穴位按摩+辨证施膳+情志干预）干预效果最优（SUCRA：78.9%）。亚组分析显示：（1）无论肺癌患者接受放化疗与否、干预时间长或短，八段锦均具有良好的干预效果；（2）在放化疗期间或干预时间较短的情况下，采用五禽戏+基于中医辨证的中医适宜技术的干预效果更佳。结论：中医导引术对肺癌患者肺功能FVC、FEV1干预效果最佳的是八段锦；对肺功能FEV1/FVC干预效果最佳的是六字诀；活动耐量6MWD方面，五禽戏对肺癌患者起到了最积极的干预作用。放化疗期间推荐采用五禽戏以提高干预效果，并鼓励患者在日常康复过程中坚持使用八段锦等导引术。然而，未来需要开展更多高质量的研究以进一步验证该结论。

关键词：肺癌；导引；功法；随机对照试验；网状Meta分析；八段锦；六字诀；五禽戏

Abstract：

Objective: To analyze and evaluate the clinical intervention effect of traditional Chinese medicine (TCM) daoyin exercise on lung cancer patients by network meta-analysis method. Methods: China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform (Wanfang Data), China Science and Technology Journal Database (CSTJ), Chinese Biomedical Literature Service System (SinoMed), PubMed, Cochrane Library, Embase, and Web of Science were searched by computer. The search period spanned from the establishment of each database to May 6, 2025. The Risk of Bias (ROB) assessment tool recommended in the Cochrane handbook was used to evaluate the risk of bias of the included studies. Results: A total of 24 randomized controlled trials (RCTs) involving 1935 lung cancer patients were included. The ROB assessment results showed that most of the included RCTs were of low quality. Network meta-analysis results showed that compared with conventional treatments (including routine care, exercise, etc.): (1) For the improvement of lung function forced vital capacity (FVC), TCM external treatment (auricular point sticking or acupoint sticking) + Baduanjin intervention effect was the best [surface under the cumulative ranking curve (SUCRA: 73.7%)]; (2) For the improvement of lung function FEV1, Baduanjin alone had the best effect (SUCRA: 71.2%); (3) For the improvement of lung function FEV1/FVC, the effect of Liuzijue intervention was the best (SUCRA: 82.2%); (4) For the improvement of exercise tolerance 6 min walking distance (6MWD), the effect of Wuqinxi + appropriate TCM techniques based on TCM syndrome differentiation (acupoint massage + dialectical diet + emotional intervention) intervention was the best (SUCRA: 78.9%). Subgroup analysis showed that: (1) Baduanjin had a good intervention effect regardless of whether lung cancer patients received radiotherapy and chemotherapy or not,, and whether the intervention time was long or short. (2) During radiotherapy and chemotherapy or in the case of short intervention time, the intervention effect of Wuqinxi + appropriate TCM techniques based on TCM syndrome differentiation is better. Conclusion: The best intervention effect of traditional Chinese medicine daoyin exercise on lung function FVC and FEV1 is Baduanjin. The best intervention effect on lung function FEV1/FVC is Liuzijue. In terms of activity tolerance 6MWD, Wuqinxi has the most active intervention effect on lung cancer patients. Wuqinxi is recommended to improve the intervention effect during radiotherapy and chemotherapy, and patients are encouraged to insist on using Baduanjin and other daoyin exercise in the daily rehabilitation process. However, more high-quality research is needed in the future to further verify this conclusion.

Key words：lung cancer; daoyin; exercise; randomized controlled trial; network meta-analysis; Baduanjin; Liuzijue; Wuqinxi

发布时间：2025-11-30

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