参加太极随机对照试验的老年女性癌症幸存者的血压、唾液皮质醇和炎性细胞因子结果
Blood pressure, salivary cortisol, and inflammatory cytokine outcomes in senior female cancer survivors enrolled in a tai chi chih randomized controlled trial.
作者信息
Campo Rebecca A, Light Kathleen C, O'Connor Kathleen, Nakamura Yoshio, Lipschitz David, LaStayo Paul C, Pappas Lisa M, Boucher Kenneth M, Irwin Michael R, Hill Harry R, Martins Thomas B, Agarwal Neeraj, Kinney Anita Y
机构信息
Program on Integrative Medicine, Department of Physical Medicine & Rehabilitation, University of North Carolina at Chapel Hill, CB# 7200, Chapel Hill, NC, 27599-7200, USA,
出版信息
J Cancer Surviv. 2015 Mar;9(1):115-25. doi: 10.1007/s11764-014-0395-x. Epub 2014 Aug 28.
PURPOSE
Older cancer survivors are a vulnerable population due to an increased risk for chronic diseases (e.g., cardiovascular disease) compounded with treatment late-effects and declines in physical functioning. Therefore, interventions that reduce chronic disease risk factors (i.e., blood pressure, chronic inflammation, and cortisol) are important in this population. Tai chi chih (TCC) is a mind-body exercise associated with reductions in chronic disease risk factors, but has not been examined with older cancer survivors. In a feasibility randomized controlled trial of TCC, we examined secondary outcomes of blood pressure, salivary cortisol, and inflammatory cytokines (interleukin (IL)-6, IL-12, tumor necrosis factor-α, IL-10, IL-4) due to their implications in chronic diseases.
METHODS
Sixty-three senior female cancer survivors (M age = 67 years, SD = 7.15) with physical functioning limitations (SF-12 physical functioning ≤80 or role-physical ≤72) were randomized to 12-weeks (60-min, three times a week) of TCC or Health Education control (HEC) classes. Resting blood pressure, 1-day salivary cortisol samples, and fasting plasma samples for cytokine multiplex assays were collected at baseline and 1-week post-intervention.
RESULTS
Controlling for baseline values, the TCC group had significantly lower systolic blood pressure (SBP, p = 0.002) and cortisol area-under-curve (AUC, p = 0.02) at post-intervention than the HEC group. There was no intervention effect on inflammatory cytokines (p's > 0.05).
CONCLUSIONS
This TCC feasibility trial was associated with significant reductions in SBP and cortisol AUC in senior female cancer survivors. Larger, definitive trials are needed to confirm these findings.
IMPLICATIONS FOR CANCER SURVIVORS
Senior survivors' have an increased risk for chronic diseases; however, TCC interventions may help reduce associated risk factors.
目的
老年癌症幸存者是弱势群体,因为他们患慢性病(如心血管疾病)的风险增加,再加上治疗的后期影响以及身体机能下降。因此,降低慢性病风险因素(即血压、慢性炎症和皮质醇)的干预措施对这一人群很重要。太极智(TCC)是一种身心锻炼方式,与慢性病风险因素的降低有关,但尚未在老年癌症幸存者中进行过研究。在一项TCC的可行性随机对照试验中,我们研究了血压、唾液皮质醇和炎性细胞因子(白细胞介素(IL)-6、IL-12、肿瘤坏死因子-α、IL-10、IL-4)的次要结果,因为它们与慢性病有关。
方法
63名身体机能受限(SF-12身体机能≤80或角色-身体≤72)的老年女性癌症幸存者(平均年龄67岁,标准差7.15)被随机分为12周(每次60分钟,每周三次)的TCC组或健康教育对照组(HEC)。在基线和干预后1周收集静息血压、1天的唾液皮质醇样本以及用于细胞因子多重检测的空腹血浆样本。
结果
在控制基线值后,干预后TCC组的收缩压(SBP,p = 0.002)和皮质醇曲线下面积(AUC,p = 0.02)显著低于HEC组。对炎性细胞因子没有干预效果(p值>0.05)。
结论
这项TCC可行性试验与老年女性癌症幸存者的SBP和皮质醇AUC显著降低有关。需要更大规模的确定性试验来证实这些发现。
对癌症幸存者的启示
老年幸存者患慢性病的风险增加;然而,TCC干预可能有助于降低相关风险因素。