Oka Takakazu, Tanahashi Tokusei, Lkhagvasuren Battuvshin, Yamada Yu
1Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582 Japan.
2Department of Psychosomatic Medicine, International University of Health and Welfare Hospital, Iguchi 537-3, Nasushiobara-shi, Tochigi-ken, 329-2763 Japan.
Biopsychosoc Med. 2019 Nov 5;13:28. doi: 10.1186/s13030-019-0168-x. eCollection 2019.
In a previous randomized controlled trial, we found that practicing seated isometric yoga regularly for 2 months improved the fatigue of patients with chronic fatigue syndrome (CFS) who are resistant to conventional therapy. The aim of this pilot study was to investigate the possible mechanisms behind this finding by comparing blood biomarkers, autonomic nervous function, and psychological indices before versus after an intervention period of seated isometric yoga practice.
Fifteen patients with CFS who did not show satisfactory improvements after at least 6 months of conventional therapy practiced seated isometric yoga (biweekly 20-min sessions with a yoga instructor and daily practice at home) for 2 months. The longitudinal effects of seated isometric yoga on fatigue, blood biomarkers, autonomic function, and psychological state were investigated by comparing the following parameters before and after the intervention period: Fatigue severity was assessed by the Chalder fatigue scale (FS) score. Levels of the blood biomarkers cortisol, DHEA-S, TNF-α, IL-6, prolactin, carnitine, TGF-β1, BDNF, MHPG, HVA, and α-MSH were measured. The autonomic nervous functions assessed were heart rate (HR) and HR variability. Psychological indices included the 20-item Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS).
Practicing seated isometric yoga for 2 months resulted in significant reductions in the Chalder FS ( = 0.002) and HADS-depression ( = 0.02) scores. No significant changes were observed in any other parameter evaluated. The change in Chalder FS score was not correlated with the change in HADS-depression score. However, this change was positively correlated with changes in the serum TNF-α levels ( = 0.048), the high frequency component of HR variability ( = 0.042), and TAS-20 scores ( = 0.001).
Regular practice of seated isometric yoga for 2 months reduced the fatigue and depressive symptom scores of patients with CFS without affecting any other parameters we investigated. This study failed to identify the markers responsible for the longitudinal fatigue-relieving effect of seated isometric yoga. However, considering that the reduced fatigue was associated with decreased serum TNF-α level and TAS-20 scores, fatigue improvement might be related to reduced inflammation and improved alexithymia in these patients.
University Hospital Medical Information Network (UMIN CTR) UMIN000009646. Registered Dec 27, 2012.
在之前的一项随机对照试验中，我们发现，对于常规治疗无效的慢性疲劳综合征（CFS）患者，定期进行2个月的坐姿等长瑜伽练习可改善其疲劳状况。这项初步研究的目的是通过比较坐姿等长瑜伽练习干预期前后的血液生物标志物、自主神经功能和心理指标，来探究这一发现背后可能的机制。
15名在至少6个月的常规治疗后未显示出满意改善效果的CFS患者进行了2个月的坐姿等长瑜伽练习（每两周与瑜伽教练进行20分钟的课程，并在家中每日练习）。通过比较干预期前后的以下参数，研究坐姿等长瑜伽对疲劳、血液生物标志物、自主神经功能和心理状态的纵向影响：疲劳严重程度通过查尔德疲劳量表（FS）评分进行评估。测量血液生物标志物皮质醇、脱氢表雄酮硫酸盐（DHEA-S）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、催乳素、肉碱、转化生长因子-β1（TGF-β1）、脑源性神经营养因子（BDNF）、3-甲氧基-4-羟基苯乙二醇（MHPG）、高香草酸（HVA）和α-促黑素（α-MSH）的水平。评估的自主神经功能包括心率（HR）和心率变异性。心理指标包括20项多伦多述情障碍量表（TAS-20）和医院焦虑抑郁量表（HADS）。
进行2个月的坐姿等长瑜伽练习后，查尔德FS评分（=0.002）和HADS抑郁评分（=0.02）显著降低。在评估的任何其他参数中均未观察到显著变化。查尔德FS评分的变化与HADS抑郁评分的变化不相关。然而，这一变化与血清TNF-α水平的变化（=0.048）、心率变异性的高频成分（=0.042）和TAS-20评分（=0.001）呈正相关。
定期进行2个月的坐姿等长瑜伽练习可降低CFS患者的疲劳和抑郁症状评分，而不影响我们研究的任何其他参数。本研究未能确定导致坐姿等长瑜伽纵向缓解疲劳效果的标志物。然而，考虑到疲劳减轻与血清TNF-α水平降低和TAS-20评分降低有关，疲劳改善可能与这些患者炎症减轻和述情障碍改善有关。
大学医院医学信息网络（UMIN CTR）UMIN000009646。2012年12月27日注册。
