Non-pharmacological interventions for fatigue in patients with chronic obstructive pulmonary disease: a systematic review and network meta-analysis.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-10-08 DOI:10.1016/j.rmed.2025.108409

Xiaona Zhang, Jiali Xue, Yan Chang, Rui Zhang, Jie Zhao, Xindan Li, Hongyan Lu, Xirui Jiang, Fang Yu, Pengfei Yang

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引用次数: 0

Abstract

Background: Fatigue is a common and debilitating symptom in patients with chronic obstructive pulmonary disease (COPD). It limits daily activities, lowers perceived health, and diminishes the overall quality of life. Although several interventions have been demonstrated to alleviate fatigue, the relative effectiveness of these interventions remains unclear.

Objective: To assess and compare the efficacy of various non-pharmacological interventions for managing fatigue in patients with COPD, and to provide evidence-based recommendations for the design of intervention programs.

Methods: A comprehensive literature search was conducted across MEDLINE, Cochrane Library, Web of Science, Embase, CINAHL, CNKI, Wanfang Database, CBM, and the VIP Chinese journal full-text database to identify randomized controlled trials and quasi-experimental studies evaluating non-pharmacological interventions for COPD-related fatigue. The search covered all records from the inception of each database up to August, 2025. The network meta-analysis was conducted using Stata 16.0 and Addis 1.16.8 software.

Results: The analysis included 35 studies involving 2565 patients with COPD and examined 12 distinct non-pharmacological interventions. Results from the network meta-analysis demonstrated that acupressure [standardized mean difference (SMD) = -20.58, 95 %CI (-36.35, -5.19), P < 0.05], aerobic exercise [SMD = -12.80, 95 %CI (-22.96, -2.57), P < 0.05], pulmonary rehabilitation [SMD = -20.07, 95 %CI (-32.61, -6.98), P < 0.05], and progressive muscle relaxation [SMD = -16.99, 95 %CI (-28.83, -5.57), P < 0.05] were significantly effective in alleviating COPD-related fatigue. Ranking probability analysis further suggested that acupressure (0.25) was the most effective intervention, followed by pulmonary rehabilitation (0.19) and progressive muscle relaxation (0.15). The sensitivity analysis indicated that the ranking probability of acupressure was influenced by the quasi-experimental studies.

Conclusion: Pulmonary rehabilitation and progressive muscle relaxation therapy provide significant therapeutic advantages and should be prioritized as key non-pharmacological strategies for managing fatigue in patients with COPD.

Trial registration: INPLASY registration number: 202290072.

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慢性阻塞性肺疾病患者疲劳的非药物干预：系统综述和网络荟萃分析

背景：疲劳是慢性阻塞性肺疾病（COPD）患者常见的衰弱症状。它限制了日常活动，降低了健康水平，降低了整体生活质量。虽然一些干预措施已被证明可以缓解疲劳，但这些干预措施的相对有效性仍不清楚。目的：评估和比较各种非药物干预治疗慢性阻塞性肺病患者疲劳的疗效，并为干预方案的设计提供循证建议。方法：通过MEDLINE、Cochrane Library、Web of Science、Embase、CINAHL、中国知网、万方数据库、CBM和VIP中文期刊全文数据库进行综合文献检索，确定评估copd相关疲劳非药物干预的随机对照试验和准实验研究。搜索涵盖了从每个数据库建立到2025年8月的所有记录。采用Stata 16.0和Addis 1.16.8软件进行网络meta分析。结果：该分析包括35项研究，涉及2565名COPD患者，并检查了12种不同的非药物干预措施。网络meta分析结果显示，穴位按压[标准化平均差(SMD) = -20.58, 95%CI (-36.35, -5.19), P < 0.05]、有氧运动[SMD = -12.80, 95%CI (-22.96, -2.57), P < 0.05]、肺部康复[SMD = -20.07, 95%CI (-32.61, -6.98), P < 0.05]、渐进式肌肉放松[SMD = -16.99, 95%CI (-28.83, -5.57), P < 0.05]对缓解copd相关疲劳有显著效果。排序概率分析进一步表明，穴位按压（0.25）是最有效的干预措施，其次是肺康复（0.19）和渐进式肌肉放松（0.15）。敏感性分析表明，准实验研究对指压排序概率有影响。结论：肺康复和渐进式肌肉放松疗法具有显著的治疗优势，应优先考虑作为治疗COPD患者疲劳的关键非药物策略。试用注册：INPLASY注册号：202290072。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.