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瑜伽治疗海湾战争病症状有效:一项随机临床试验。

Yoga is effective in treating symptoms of Gulf War illness: A randomized clinical trial.

机构信息

War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, Palo Alto, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.

War Related Illness and Injury Study Center, VA Palo Alto Healthcare System, Palo Alto, CA, USA.

出版信息

J Psychiatr Res. 2021 Nov;143:563-571. doi: 10.1016/j.jpsychires.2020.11.024. Epub 2020 Nov 11.

Abstract

Many Veterans of the 1990-1991 Gulf War report symptoms of Gulf War Illness, a condition involving numerous chronic symptoms including pain, fatigue, and mood/cognition symptoms. Little is known about this condition's etiology and treatment. This study reports outcomes from a randomized controlled single-blind trial comparing yoga to cognitive behavioral therapy for chronic pain and other symptoms of Gulf War Illness. Participants were Veterans with symptoms of GWI: chronic pain, fatigue and cognition-mood symptoms. Seventy-five Veterans were randomized to treatment via selection of envelopes from a bag (39 yoga, 36 cognitive behavioral therapy), which consisted of ten weekly group sessions. The primary outcomes of pain severity and interference (Brief Pain Inventory- Short Form) improved in the yoga condition (Cohen's d = .35, p = 0.002 and d = 0.69, p < 0.001, respectively) but not in the CBT condition (d = 0.10, p = 0.59 and d = 0.25 p = 0.23). However, the differences between groups were not statistically significant (d = 0.25, p = 0.25; d = 0.43, p = 0.076), though the difference in an a-priori-defined experimental outcome variable which combines these two variables into a total pain variable (d = 0.47, p = 0.047) was significant. Fatigue, as indicated by a measure of functional exercise capacity (6-min walk test) was reduced significantly more in the yoga group than in the CBT group (between-group d = .27, p = 0.044). Other secondary outcomes of depression, wellbeing, and self-reported autonomic nervous system symptoms did not differ between groups. No adverse events due to treatment were reported. Yoga may be an effective treatment for core Gulf War Illness symptoms of pain and fatigue, making it one of few treatments with empirical support for GWI. Results support further evaluation of yoga for treating veterans with Gulf War Illness. CLINICAL TRIAL REGISTRY: clinicaltrials.gov Registration Number NCT02378025.

摘要

许多参加过 1990-1991 年海湾战争的退伍军人报告称患有海湾战争综合征,该病涉及多种慢性症状,包括疼痛、疲劳和情绪/认知症状。目前对这种疾病的病因和治疗方法知之甚少。本研究报告了一项随机对照单盲试验的结果,该试验比较了瑜伽与认知行为疗法治疗慢性疼痛和海湾战争综合征的其他症状。参与者为患有海湾战争综合征症状的退伍军人:慢性疼痛、疲劳和认知情绪症状。75 名退伍军人通过从袋子中选择信封进行随机分组治疗(39 名瑜伽,36 名认知行为疗法),这包括十次每周的小组治疗。瑜伽组的疼痛严重程度和干扰(简明疼痛量表-短表)的主要结果有所改善(Cohen's d = 0.35,p = 0.002 和 d = 0.69,p < 0.001),而认知行为疗法组则没有改善(d = 0.10,p = 0.59 和 d = 0.25,p = 0.23)。然而,两组之间的差异没有统计学意义(d = 0.25,p = 0.25;d = 0.43,p = 0.076),尽管在一个预先定义的实验结果变量中,将这两个变量结合在一起形成一个总疼痛变量,差异具有统计学意义(d = 0.47,p = 0.047)。瑜伽组的功能性运动能力(6 分钟步行测试)的疲劳指标明显降低,而认知行为疗法组则没有(组间 d = 0.27,p = 0.044)。其他次要结局,如抑郁、幸福感和自主神经系统症状自我报告,两组之间没有差异。没有因治疗而产生的不良反应报告。瑜伽可能是治疗海湾战争综合征核心症状疼痛和疲劳的有效方法,是少数几种有实证支持治疗海湾战争综合征的方法之一。研究结果支持进一步评估瑜伽治疗海湾战争综合征退伍军人。临床试验注册:clinicaltrials.gov 注册号 NCT02378025。

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