对功能锻炼预防鼻咽癌患者放疗后张口困难效果的系统评价

目的系统评价功能锻炼对预防鼻咽癌(NPC)放疗患者张口困难的效果。方法计算机检索Cochrance Library、PubMed、Embase、CNKI、维普、万方数据库,收集关于功能锻炼对预防NPC患者放疗后张口困难的RCT,检索时限为建库至2018年12月31日。由2人根据纳入与排除标准进行文献筛选、提取及文献质量评价后,采用RevMan 5.3对结局指标进行Meta分析。结果本研究共纳入10篇文献、978例患者;纳入文献的质量等级均为B级。6篇文献以门齿距为结局指标,Meta分析结果显示,功能锻炼能缓解NPC放疗患者的门齿距缩小进程[MD=4.59,95%CI(3.29,5.90),P<0.0001];8篇文献以张口困难程度分级作为结局指标,Meta分析结果显示,功能锻炼对NPC放疗患者张口困难程度的改善有一定积极作用[OR=0.23,95%CI(0.13,0.41),P<0.0001]。结论功能锻炼可以延缓NPC放疗患者的门齿距缩小进程,减轻张口困难的程度,对改善功能、提高患者生活质量有积极作用。

Systematic assessment of the effect of functional exercise on the prevention of radiation-induced trismus among patients with nasopharyngeal carcinoma after radiotherapy:a Meta-analysis

Objective To systematically review the effect of functional exercise on the prevention of radiation-induced trismus among patients with nasopharyngeal carcinoma(NPC).Methods Articles about the randomized controlled trials(RCT)of functional exercise to prevent radiation-induced trismus in patients with NPC after radiotherapy were retrieved from the established date of databases to the 31st December of 2018 in electronic databases such as Cochrane Library,PubMed,EMbase,China National Knowledge Internet(CNKI),VIP and Wanfang database.After literature selection,extraction and literature quality evaluation by two people according to inclusion and exclusion criteria,Revman 5.3 was used for Meta-analysis of outcome indicators.Results A total of 10 articles were enrolled,including 978 patients.The quality grade of all included literature was B.Maximum interincisal opening(MIO)is the outcome index of 6 articles.Meta-analysis showed that functional exercise could alleviate the reduction of MIO in NPC patients receiving radiotherapy[MD=4.59,95%CI(3.29,5.90),P<0.0001].The degree of difficulty in opening the mouth was the outcome index of 8 articles.The results of Meta-analysis showed that functional exercise had a positive effect on the improvement of the difficulty of opening mouth in NPC patients[OR=0.23,95%CI(0.13,0.41),P<0.0001].Conclusions Functional exercise can delay the process of reducing MIO of patients with NPC after radiotherapy,reducing the difficulty of opening the mouth,and have a positive effect on improving function and patients'quality of life.