Department of Physiology and Biophysics, Georgetown University Medical Center, 3900 Reservoir Road, Washington, DC 20007, USA.
Evid Based Complement Alternat Med. 2011;2011:950461. doi: 10.1093/ecam/neq039. Epub 2011 Jun 8.
Georgetown University School of Medicine offers an elective Mind-Body Medicine Skills (MBMS) course to medical students to promote self-care and self-awareness. Participating medical students reported better management of academic stress and well-being than non-participants. In this study, we sought to assess the stress-reducing effects of MBMS by measuring physiological changes in first-year medical students. Saliva samples were collected before (January, time 1 (T1)-pre-intervention) and upon completion of the course (May, time 2 (T2p)-post-intervention), as well as from non-participating medical students (May, time 2 (T2c)-control). The T2p and T2c collections coincided with the period of final examinations. Cortisol, dehydroepiandrosterone-sulfate (DHEA-S), testosterone and secretory immunoglobulin A (sIgA) were measured. The mean morning salivary cortisol at T2p was 97% of the mean at baseline T1 which was significantly lower than for T2c (2.4) (95% confidence interval (CI) 0.57-1.60, P = .001); DHEA-S showed similar pattern as cortisol where the T2p levels were significantly lower than T2c (P < .001) in both morning and evening collections. Testosterone ratio at T2p (0.85) was also lower than T2c (1.6) (95% CI 0.53-1.3, P = .01). sIgA levels were not statistically different. On direct comparison, the T2c and T2p means were significantly different for all cortisol, DHEA-S and testosterone values. Participants maintained their hormonal balance within the normal range throughout the academic semester while the control group showed significantly increased levels, probably exacerbated by the end of the semester exam stress. To our knowledge, this is the first study to assess the physiologic benefits of a MBMS program in medical students.
乔治城大学医学院为医学生提供了一门选修的身心医学技能（MBMS）课程，以促进自我保健和自我意识。参与的医学生报告说，他们比非参与者更好地管理学业压力和幸福感。在这项研究中，我们试图通过测量一年级医学生的生理变化来评估 MBMS 的减压效果。在课程开始前（1 月，时间 1（T1）-干预前）和课程结束时（5 月，时间 2（T2p）-干预后）以及未参与的医学生（5 月，时间 2（T2c）-对照组）收集唾液样本。T2p 和 T2c 的采集时间与期末考试期间重合。测量了皮质醇、脱氢表雄酮硫酸盐（DHEA-S）、睾酮和分泌型免疫球蛋白 A（sIgA）。T2p 时的早晨唾液皮质醇平均值为 T1 基线时平均值的 97%，明显低于 T2c（2.4）（95%置信区间（CI）0.57-1.60，P = 0.001）；DHEA-S 呈现出与皮质醇相似的模式，T2p 水平在早晨和晚上采集时均明显低于 T2c（P < 0.001）。T2p 时的睾酮比值（0.85）也低于 T2c（1.6）（95%CI 0.53-1.3，P = 0.01）。sIgA 水平无统计学差异。直接比较，T2c 和 T2p 的平均值在所有皮质醇、DHEA-S 和睾酮值上均有显著差异。参与者在整个学术学期内保持了荷尔蒙平衡在正常范围内，而对照组的水平明显升高，可能是由于学期末考试压力加剧所致。据我们所知，这是第一项评估身心医学技能课程对医学生生理益处的研究。
