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对乳腺癌和前列腺癌门诊患者进行基于正念减压疗法(MBSR)的心理、免疫、内分泌及血压指标干预前后一年的随访

One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients.

作者信息

Carlson Linda E, Speca Michael, Faris Peter, Patel Kamala D

机构信息

Department of Psychosocial Resources, Tom Baker Cancer Centre Holy Cross Site, Alberta Cancer Board, 2202 Second St. S.W., Calgary, Alta., Canada T3B 0W7.

出版信息

Brain Behav Immun. 2007 Nov;21(8):1038-49. doi: 10.1016/j.bbi.2007.04.002. Epub 2007 May 22.

DOI:10.1016/j.bbi.2007.04.002
PMID:17521871
Abstract

OBJECTIVES

This study investigated the ongoing effects of participation in a mindfulness-based stress reduction (MBSR) program on quality of life (QL), symptoms of stress, mood and endocrine, immune and autonomic parameters in early stage breast and prostate cancer patients.

METHODS

Forty-nine patients with breast cancer and 10 with prostate cancer enrolled in an eight-week MBSR program that incorporated relaxation, meditation, gentle yoga and daily home practice. Demographic and health behaviors, QL, mood, stress symptoms, salivary cortisol levels, immune cell counts, intracellular cytokine production, blood pressure (BP) and heart rate (HR) were assessed pre- and post-intervention, and at 6- and 12-month follow-up.

RESULTS

Fifty-nine, 51, 47 and 41 patients were assessed pre- and post-intervention and at 6- and 12-month follow-up, respectively, although not all participants provided data on all outcomes at each time point. Linear mixed modeling showed significant improvements in overall symptoms of stress which were maintained over the follow-up period. Cortisol levels decreased systematically over the course of the follow-up. Immune patterns over the year supported a continued reduction in Th1 (pro-inflammatory) cytokines. Systolic blood pressure (SBP) decreased from pre- to post-intervention and HR was positively associated with self-reported symptoms of stress.

CONCLUSIONS

MBSR program participation was associated with enhanced quality of life and decreased stress symptoms, altered cortisol and immune patterns consistent with less stress and mood disturbance, and decreased blood pressure. These pilot data represent a preliminary investigation of the longer-term relationships between MBSR program participation and a range of potentially important biomarkers.

摘要

目的

本研究调查了参与基于正念减压(MBSR)计划对早期乳腺癌和前列腺癌患者生活质量(QL)、压力症状、情绪以及内分泌、免疫和自主神经参数的持续影响。

方法

四十九名乳腺癌患者和十名前列腺癌患者参加了为期八周的MBSR计划,该计划包括放松、冥想、轻柔瑜伽和日常家庭练习。在干预前后以及6个月和12个月随访时评估人口统计学和健康行为、QL、情绪、压力症状、唾液皮质醇水平、免疫细胞计数、细胞内细胞因子产生、血压(BP)和心率(HR)。

结果

分别有59名、51名、47名和41名患者在干预前后以及6个月和12个月随访时接受评估,尽管并非所有参与者在每个时间点都提供了所有结果的数据。线性混合模型显示,压力总体症状有显著改善,且在随访期内保持。在随访过程中,皮质醇水平系统性下降。全年的免疫模式支持Th1(促炎)细胞因子持续减少。收缩压(SBP)从干预前到干预后下降,HR与自我报告的压力症状呈正相关。

结论

参与MBSR计划与生活质量提高、压力症状减轻、皮质醇和免疫模式改变(与压力和情绪干扰减少一致)以及血压降低相关。这些初步数据代表了对参与MBSR计划与一系列潜在重要生物标志物之间长期关系的初步调查。

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