Table 5.
Results of evidence quality.
| Citation | Outcomes | Limitations | Inconsistency | Indirectness | Imprecision | Publication bias | Quality |
|---|---|---|---|---|---|---|---|
| Cao et al. [21] | FEV1 | -1① | -1② | 0 | 0 | -1④ | Very low |
| FVC | -1① | -1② | 0 | 0 | -1④ | Very low | |
| FEV1/FVC | -1① | -1② | 0 | 0 | -1④ | Very low | |
| 6-MWD | -1① | -1② | 0 | 0 | -1④ | Very low | |
| SGRQ | -1① | -1② | 0 | 0 | -1④ | Very low | |
| CAT | -1① | -1② | 0 | 0 | -1④ | Very low | |
|
| |||||||
| Liu et al. [22] | 6-MWD | 0 | -1② | 0 | 0 | 0 | Moderate |
| FEV1 | 0 | -1② | 0 | 0 | 0 | Moderate | |
| FEV1% | 0 | -1② | 0 | 0 | 0 | Moderate | |
| FVC | 0 | 0 | 0 | 0 | 0 | High | |
| FEV1/FVC | 0 | -1② | 0 | 0 | 0 | Moderate | |
| Quality of life | 0 | -1② | 0 | 0 | 0 | Moderate | |
|
| |||||||
| Chen et al. [23] | FEV1 | 0 | 0 | 0 | 0 | -1④ | Moderate |
| FEV1% | 0 | 0 | 0 | 0 | -1④ | Moderate | |
| FVC | 0 | 0 | 0 | 0 | -1④ | Moderate | |
| FEV1/FVC | 0 | -1② | 0 | 0 | -1④ | Low | |
| CAT | 0 | -1② | 0 | 0 | -1④ | Low | |
|
| |||||||
| Han et al. [24] | 6-MWD | 0 | 0 | 0 | -1③ | -1④ | Low |
| FEV1 | 0 | -1② | 0 | 0 | -1④ | Low | |
| FEV1% | 0 | 0 | 0 | 0 | -1④ | Moderate | |
| FVC | 0 | 0 | 0 | -1③ | -1④ | Low | |
| FEV1/FVC | 0 | -1② | 0 | -1③ | -1④ | Very low | |
|
| |||||||
| Li et al. [25] | FEV1/pred% | 0 | -1② | 0 | 0 | -1④ | Low |
| FEV1 | 0 | -1② | 0 | -1③ | 0 | Low | |
| FEV1% | 0 | -1② | 0 | 0 | 0 | Moderate | |
| FVC | 0 | 0 | 0 | -1③ | 0 | Moderate | |
| 6-MWD | 0 | -1② | 0 | 0 | 0 | Very low | |
|
| |||||||
| Xie et al. [26] | 6-MWD | -1① | -1② | 0 | 0 | -1④ | Very low |
| FEV1 | -1① | -1② | 0 | 0 | -1④ | Very low | |
| FEV1% | -1① | -1② | 0 | 0 | 0 | Low | |
| FVC | -1① | -1② | 0 | 0 | -1④ | Very low | |
| FEV1/FVC | -1① | -1② | 0 | 0 | -1④ | Very low | |
| CAT | 0 | -1② | 0 | -1③ | -1④ | Very low | |
| SGRQ | -1① | -1② | 0 | 0 | -1④ | Very low | |
| WHOQOL-BREF | 0 | -1② | 0 | 0 | -1④ | Low | |
|
| |||||||
| Xiao et al. [27] | MRC | 0 | -1② | 0 | -1③ | -1④ | Very low |
| 6-MWD | 0 | 0 | 0 | -1③ | -1④ | Low | |
| FEV1 | 0 | -1② | 0 | 0 | -1④ | Low | |
| FEV1/pred% | -1① | -1② | 0 | 0 | -1④ | Very low | |
| FEV1/FVC | 0 | -1② | 0 | 0 | -1④ | Low | |
| CAT | 0 | -1② | 0 | 0 | -1④ | Low | |
| SGRQ | 0 | -1② | 0 | -1③ | -1④ | Very low | |
|
| |||||||
| Gao et al. [28] | MRC | 0 | 0 | 0 | 0 | -1④ | Moderate |
| 6-MWD | 0 | 0 | 0 | 0 | 0 | High | |
| FEV1 | 0 | 0 | 0 | 0 | 0 | High | |
| FEV1% | 0 | -1② | 0 | 0 | 0 | Moderate | |
| FEV1/FVC | 0 | -1② | 0 | 0 | 0 | Moderate | |
| Quality of life | 0 | -1② | 0 | 0 | -1④ | Low | |
|
| |||||||
| Liu et al. [29] | 6-MWD | -1① | 0 | 0 | -1③ | -1④ | Very low |
| FEV1 | -1① | 0 | 0 | -1③ | -1④ | Very low | |
| FEV1% | -1① | 0 | 0 | -1③ | -1④ | Very low | |
|
| |||||||
| Zhang et al. [30] | MRC | -1① | 0 | 0 | -1③ | -1④ | Very low |
| 6-MWD | 0 | -1② | 0 | 0 | -1④ | Low | |
| FEV1 | -1① | -1② | 0 | -1③ | -1④ | Very low | |
| FEV1% | -1① | -1② | 0 | 0 | -1④ | Very low | |
| CAT | -1① | 0 | 0 | -1③ | -1④ | Very low | |
|
| |||||||
| Tong et al. [31] | 6-MWD | 0 | -1② | 0 | 0 | -1④ | Low |
| FEV1 | 0 | -1② | 0 | 0 | -1④ | Low | |
| FEV1/FVC | 0 | 0 | 0 | 0 | -1④ | Moderate | |
| FEV1% | 0 | -1② | 0 | 0 | -1④ | Low | |
| CAT | 0 | -1② | 0 | -1③ | -1④ | Very low | |
|
| |||||||
| Li et al. [32] | FEV1% (3 months) | 0 | 0 | 0 | 0 | -1④ | Moderate |
| FEV1% (6 months) | 0 | -1② | 0 | 0 | -1④ | Low | |
| FEV1/FVC (3 months) | 0 | -1② | 0 | 0 | -1④ | Low | |
| FEV1/FVC (6 months) | 0 | -1② | 0 | 0 | -1④ | Low | |
| CAT | 0 | 0 | 0 | -1③ | -1④ | Low | |
| 6-MWD (3 months) | 0 | 0 | 0 | 0 | -1④ | Moderate | |
| 6-MWD (6 months) | 0 | -1② | 0 | 0 | -1④ | Low | |
|
| |||||||
| Yuan et al. [33] | FEV1 | -1① | -1② | 0 | -1③ | -1④ | Very low |
| FEV1% | -1① | -1② | 0 | -1③ | -1④ | Very low | |
| FEV1/FVC | -1① | -1② | 0 | 0 | -1④ | Very low | |
| FEV1/pred% | -1① | -1② | 0 | -1③ | -1④ | Very low | |
| 6-MWD | -1① | -1② | 0 | -1③ | -1④ | Very low | |
Note: ① the included studies have a large bias in methodology such as randomization, allocation concealment, and blinding. ② The confidence interval overlaps less or the I2 value of the combined results was larger. ③ The sample size from the included studies does not meet the optimal sample size or the 95% confidence interval crosses the invalid line. ④ The funnel chart is asymmetry; FEV1: the forced expiratory volume in one second; FVC: forced vital capacity; 6-MWD: 6 min walking distance; FEV1/FVC: the amount of air exhaled in the first second divided by all of the air exhaled during a maximal exhalation; SGRQ: St George's respiratory questionnaire; CAT: COPD assessment test; FEV1%: percentage of the forced expiratory volume in one second; QOL: quality of life; WHOQOL-BREF: the World Health Organization on quality of life brief scale; MRC: medical research council dyspnea scale; FEV1%pred: the percentage of predicted values of FEV1.