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      A systematic review and meta-analysis of Liuzijue in stable patients with chronic obstructive pulmonary disease

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          Abstract

          Background

          To investigate the effectiveness of Liuzijue exercise on chronic obstructive pulmonary disease (COPD) in the stable phase.

          Methods

          We searched six electronic bibliographic databases (PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, and Wan Fang Data) from inception to August 2018. Randomized controlled trials (RCTs) were included if they evaluated the effect of Liuzijue exercise on stable COPD. Cochrane Collaboration risk-of-bias tool (Cochrane Handbook 5.1.0) was used to assess the risk of bias of included RCTs. Meta-analysis was performed using the Review Manager software (RevMan V.5.3.5) provided by the Cochrane Collaboration. Outcomes assessed included dyspnea, exercise capacity, lung function, and quality of life.

          Results

          Fourteen RCTs involving 920 stable COPD patients were included in this systematic review and meta-analysis. The control groups received usual care. The average number of training sessions per participant was 9.3 per week, and the average length of these training sessions was 31.6 min per week. Training duration varied from 3 to 12 months. Meta-analysis results showed that Liuzijue exercise can effectively improve patients’ Modified Medical Research Council Dyspnea Scale scores (MD = − 0.73, 95% CI: − 1.13 to − 0.33, P < 0.05), 6MWD (MD = 17.78, 95% CI: 7.97 to 27.58, P < 0.05), forced expiratory volume in one second (FEV 1) (MD = 0.23, 95% CI: 0.07 to 0.38, P < 0.05), the percentage of predicted values of FEV 1 (FEV 1%pred) (MD = 7.59, 95% CI: 2.92 to 12.26, P < 0.05), FEV 1/FVC (Forced vital capacity) ratio (MD = 6.81, 95% CI: 3.22 to 10.40, P < 0.05), Quality of life: St. George’s Respiratory Questionnaire total score (MD = − 9.85, 95%CI: − 13.13 to − 6.56, P < 0.05), and Chronic Obstructive Pulmonary Disease Assessment Test score (MD = − 2.29, 95%CI: − 3.27, − 1.30, P < 0.05).

          Conclusion

          Evidence from meta-analysis suggested that Liuzijue exercise could improve dyspnea, exercise endurance, lung function, and quality of life for stable COPD patients. However, owing to the methodological bias and the placebo effect of Liuzijue exercise, there is a need for further research to confirm these findings.

          Trial registration

          PROSPERO (ID: CRD42019130973).

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          Most cited references35

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          Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study

          Although exposure to cigarette smoking and air pollution is common, the current prevalence of chronic obstructive pulmonary disease (COPD) is unknown in the Chinese adult population. We conducted the China Pulmonary Health (CPH) study to assess the prevalence and risk factors of COPD in China.
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            Disease burden of COPD in China: a systematic review

            Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease. The aim of this systematic review was to quantify the disease burden of COPD in China and to determine the risk factors of the disease. The number of studies included in the review was 47 with an average quality assessment score of 7.70 out of 10. Reported COPD prevalence varied between 1.20% and 8.87% in different provinces/cities across China. The prevalence rate of COPD was higher among men (7.76%) than women (4.07%). The disease was more prevalent in rural areas (7.62%) than in urban areas (6.09%). The diagnostic rate of COPD patients in China varied from 23.61% to 30.00%. The percentage of COPD patients receiving outpatient treatment was around 50%, while the admission rate ranged between 8.78% and 35.60%. Tobacco exposure and biomass fuel/solid fuel usage were documented as two important risk factors of COPD. COPD ranked among the top three leading causes of death in China. The direct medical cost of COPD ranged from 72 to 3,565 USD per capita per year, accounting for 33.33% to 118.09% of local average annual income. The most commonly used scales for the assessment of quality of life (QoL) included Saint George Respiratory Questionnaire, Airways Questionnaire 20, SF-36, and their revised versions. The status of QoL was worse among COPD patients than in non-COPD patients, and COPD patients were at higher risks of depression. The COPD burden in China was high in terms of economic burden and QoL. In view of the high smoking rate and considerable concerns related to air pollution and smog in China, countermeasures need to be taken to improve disease prevention and management to reduce disease burdens raised by COPD.
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              Prevalence of chronic obstructive pulmonary disease in China: a large, population-based survey.

              The prevalence of chronic obstructive pulmonary disease (COPD) in China is largely unknown. To obtain the COPD prevalence in China through a large-population, spirometry-based, cross-sectional survey of COPD. Urban and rural population-based cluster samples were randomly selected from seven provinces/cities. All residents 40 years of age or older in the selected clusters were interviewed with a standardized questionnaire revised from the international BOLD (Burden of Obstructive Lung Diseases) study. Spirometry was performed on all eligible participants. Patients with airflow limitation (FEV(1)/FVC < 0.70) were further examined by post-bronchodilator spirometry, chest radiograph, and electrocardiogram. Post-bronchodilator FEV(1)/FVC of less than 70% was defined as the diagnostic criterion of COPD. Among 25,627 sampling subjects, 20,245 participants completed the questionnaire and spirometry (response rate, 79.0%). The overall prevalence of COPD was 8.2% (men, 12.4%; women, 5.1%). The prevalence of COPD was significantly higher in rural residents, elderly patients, smokers, in those with lower body mass index, less education, and poor ventilation in the kitchen, in those who were exposed to occupational dusts or biomass fuels, and in those with pulmonary problems in childhood and family history of pulmonary diseases. Among the patients who had COPD, 35.3% were asymptomatic; only 35.1% reported lifetime diagnosis of bronchitis, emphysema, or other COPD; and only 6.5% have been tested with spirometry. COPD is prevalent in individuals 40 years of age or older in China.
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                Author and article information

                Contributors
                hzhp403@126.com
                Journal
                BMC Complement Med Ther
                BMC Complement Med Ther
                BMC Complementary Medicine and Therapies
                BioMed Central (London )
                2662-7671
                14 October 2020
                14 October 2020
                2020
                : 20
                : 308
                Affiliations
                [1 ]GRID grid.412540.6, ISNI 0000 0001 2372 7462, School of Rehabilitation Science, , Shanghai University of Traditional Chinese Medicine, ; Shanghai, China
                [2 ]Department of Rehabilitation, the Second Rehabilitation Hospital of Shanghai, Shanghai, China
                [3 ]GRID grid.412543.5, ISNI 0000 0001 0033 4148, Department of Sports Medicine, , Shanghai University of Sport, ; Shanghai, China
                [4 ]GRID grid.412540.6, ISNI 0000 0001 2372 7462, Institute of Rehabilitation Medicine, , Shanghai Academy of Traditional Chinese Medicine, ; Shanghai, China
                Article
                3104
                10.1186/s12906-020-03104-1
                7557061
                33054800
                634085e0-e9bc-4ed4-8d85-34cace58e0fa
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 15 May 2019
                : 5 October 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Award ID: 81902307
                Award Recipient :
                Funded by: Health Qigong Administrative Center of the General Administration of Sport of China
                Award ID: QG2019011
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                chronic obstructive pulmonary disease,liuzijue,exercise

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