Esch Tobias, Duckstein Jorg, Welke Justus, Braun Vittoria
Division of Integrative Health Promotion, Coburg University of Applied Sciences, Coburg, Germany.
Med Sci Monit. 2007 Nov;13(11):CR488-497.
Stress can affect health. There is a growing need for the evaluation and application of professional stress management options, i.e, stress reduction. Mind/body medicine serves this goal, e.g, by integrating self-care techniques into medicine and health care. Tai Chi (TC) can be classified as such a mind/body technique, potentially reducing stress and affecting physical as well as mental health parameters, which, however, has to be examined further.
MATERIAL/METHODS: We conducted a prospective, longitudinal pilot study over 18 weeks for the evaluation of subjective and objective clinical effects of a Yang style TC intervention in young adults (beginners) by measuring physiological (blood pressure, heart rate, saliva cortisol) and psychological (SF-36, perceived stress, significant events) parameters, i.e, direct or indirect indicators of stress and stress reduction, in a non-randomised/-controlled, yet non-selected cohort (n=21) by pre-to-post comparison and in follow-up. SF-36 values were also compared with the age-adjusted norm population, serving as an external control. Additionally, we measured diurnal cortisol profiles in a cross-sectional sub-study (n=2+2, pre-to-post), providing an internal random control sub-sample.
Only nine participants completed all measurements. Even so, we found significant (p<0.05) reductions of saliva cortisol (post and follow-up), which seems to be an indicator of general stress reduction. A significant decrease in perceived mental stress (post) proved even highly significant (p<0.01) in the follow-up, whereas physical stress perception declined to a much lesser degree. Significant improvements were also detected for the SF-36 dimensions general health perception, social functioning, vitality, and mental health/psychological well-being. Thus, the summarized mental health measures all clearly improved, pointing towards a predominantly psychological impact of TC.
Subjective health increased, stress decreased (objectively and subjectively) during TC practice. Future studies should confirm this observation by rigorous methodology and by further combining physical and psychological measurements with basic research, thereby also gaining knowledge of autoregulation and molecular physiology that possibly underlies mind/body medicine.
压力会影响健康。对专业压力管理方案(即压力减轻)进行评估和应用的需求日益增长。身心医学服务于这一目标,例如,通过将自我护理技术融入医学和医疗保健中。太极拳(TC)可归类为这样一种身心技术,它有可能减轻压力并影响身心健康参数,不过这还有待进一步研究。
材料/方法:我们进行了一项为期18周的前瞻性纵向试点研究,通过测量生理参数(血压、心率、唾液皮质醇)和心理参数(SF - 36、感知压力、重大事件),即压力和压力减轻的直接或间接指标,来评估杨氏太极拳干预对年轻人(初学者)的主观和客观临床效果。在一个非随机/非对照但未经过挑选的队列(n = 21)中,通过前后比较及随访进行测量。SF - 36值也与年龄调整后的正常人群进行比较,作为外部对照。此外,我们在一项横断面子研究(n = 2 + 2,前后测量)中测量了昼夜皮质醇水平,提供了一个内部随机对照子样本。
只有9名参与者完成了所有测量。即便如此,我们发现唾液皮质醇(在干预后和随访时)有显著降低(p < 0.05),这似乎是总体压力减轻的一个指标。感知到的精神压力在干预后显著降低,在随访时甚至极显著(p < 0.01),而身体压力感知下降程度要小得多。SF - 36维度中的总体健康感知、社会功能、活力以及心理健康/心理幸福感也有显著改善。因此,综合的心理健康指标均明显改善,表明太极拳对心理的影响占主导。
在练习太极拳期间,主观健康状况改善,压力(客观和主观上)降低。未来的研究应通过严谨的方法,并进一步将身体和心理测量与基础研究相结合来证实这一观察结果,从而也能了解可能作为身心医学基础的自我调节和分子生理学知识。