【摘要】 目的:系统评价体外膈肌起搏（EDP）对稳定期慢性阻塞性肺疾病病人肺康复的有效性。方法:系统检索维普数据库、中国知网、万方数据库、中国生物医学文献数据库、EMbase、PubMed、Web of Science、OVID、the Cochrane Library、医脉通、世界卫生组织（WHO）网站等获取文献，检索时限为建库至2022年3月，由2名评价员单独对纳入的文献进行数据提取，使用Cochrane风险偏倚评估工具进行质量评价，使用RevMan 5.4进行Meta分析。结果:共纳入9篇随机对照试验。Meta分析结果显示，试验组第一秒用力呼气容积占用力肺活量百分比（FEV₁/FVC）[MD=4.14,95%CI（2.54,5.74）,P<0.000 01]、第1秒用力呼气量（FEV₁）[MD=0.34,95%CI（0.18,0.49）,P<0.000 1]、第1秒用力呼气量占预计值百分比（FEV₁%）[MD=8.98,95%CI（8.75,9.21）,P<0.000 01]、用力肺活量（FVC）[MD=0.30,95%CI（0.15,0.44）,P<0.000 1]均优于对照组；6分钟步行距离[MD=31.13,95%CI（8.46,53.81）,P=0.007]、PaO₂[SMD=0.73,95%CI（0.04,1.43）,P=0.04]高于对照组，COPD评估测试（CAT）得分[MD=-3.91,95%CI（-5.00,-2.83）,P<0.000 01]、PaCO₂[SMD=-0.88,95%CI（-1.24,-0.52）,P<0.000 01]低于对照组。结论:现有证据表明，体外膈肌起搏可以改善稳定期慢性阻塞性肺疾病病人的肺功能、生活质量，提高病人的运动耐力，受纳入研究质量和数量的限制，需更多高质量、大样本研究进一步验证。更多还原

【Abstract】 Objective:To systematically evaluate the effectiveness of external diaphragm pacemaker（EDP） in pulmonary rehabilitation of patients with stable chronic obstructive pulmonary disease.Methods:VIP,CNKI,WanFang Database, CBM,EMbase, PubMed, Web of Science, OVID,the Cochrane Library, Yimaitong, and WHO websites were systematically searched.The retrieval time limit was extracted from the establishment of the database to March 2022.Two evaluators independently extract the data of the included documents, using the Cochrane risk bias assessment tool for quality evaluation.RevMan 5.4 was used for Meta-analysis.Results:A total of 9 randomized controlled trials were included.Meta-analysis results showed that FEV₁/FVC[MD=4.14,95%CI（2.54,5.74）,P<0.000 01],FEV₁[MD=0.34,95%CI（0.18,0.49）,P<0.000 1],FEV₁%[MD=8.98,95%CI（8.75,9.21）,P<0.000 01],FVC[MD=0.30,95%CI（0.15,0.44）,P<0.000 1]in the test group were better than those in the control group.The 6MWD[MD=31.13,95%CI（8.46,53.81）,P=0.007],PaO₂[SMD=0.73,95%CI（0.04,1.43）,P=0.04]was higher than the control group, and the COPD evaluation test（CAT） score[MD=-3.91,95%CI（-5.00,-2.83）,P<0.000 01],PaCO₂[SMD=-0.88,95%CI（-1.24,-0.52）,P<0.000 01]was lower than the control group.Conclusion:Existing evidence shows that extracorporeal diaphragm pacing can improve the lung function and quality of life of patients with stable chronic obstructive pulmonary disease, and improve their exercise tolerance.Limited by the quality and quantity of studies included, more high-quality and large sample studies are needed for further proof.更多还原