Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA.
J Integr Complement Med. 2024 May;30(5):450-458. doi: 10.1089/jicm.2023.0234. Epub 2023 Oct 16.
Evaluate feasibility and impact of a multimodal integrative therapeutic intervention in patients presenting with chronic symptoms attributed to a postinfectious syndrome. This was a prospective longitudinal single-center pilot study conducted from January 2019 to December 2020. University of Maryland Lyme Program, Baltimore Maryland. Persons presenting for Lyme evaluation for symptoms attributed to Lyme disease. Participants attended two 1-h individual instructional sessions consisting of Ayurveda-based dietary intervention and breath-coordinated mind-body practice to be used for home practice. Standard measures of impact were obtained at baseline, 1, 3, 6, and 12 months using the following validated survey instruments: Perceived Stress Scale (PSS), PROMIS Global Health v1.2 (GH), and PROMIS 29 v2.0 survey. From 216 patients presenting for Lyme evaluation, 19 participants enrolled with 84% completing the study ( = 16). Baseline PROMIS GH scores consisting of general Physical Health (GPH) and general Mental Health (GMH) scores were lower in the study population than in the general U.S. population. PROMIS 29 scores were higher for fatigue, anxiety, and pain than those in the general U.S. population. Over 12-month period, improvement in both the GPH and GMH was 6.09 (confidence interval [95% CI] = 2.71-9.46; < 0.001) and 4.65 (95% CI = 1.50-7.80; = 0.004), respectively. PROMIS 29 scores showed the greatest improvement in fatigue at -7.91 (95% CI = -12.34 to -3.48; < 0.001), pain interference -5.08 (95% CI = -9.20 to -0.96; = 0.016), and ability to participate in social roles and activities 7.48 (95% CI = 3.21-11.75; = 0.001) and least with depression -1.82 (95% CI = -4.74 to 1.10; = 0.223). Employment status had significant effects on almost all outcome scores. Postinfectious state was associated with improvement in anxiety and PSS scores. A multimodal Ayurvedic and breath-coordinated mind-body therapeutic intervention is feasible and a potential nonpharmacologic therapeutic option for persons presenting with pain, stress, fatigue, physical dysfunction, and sleep disturbance attributed to a postinfectious syndrome. Further research is needed to determine efficacy in this population and in other groups with similar symptom complexes due to postinfectious syndromes.
评估针对感染后综合征相关慢性症状患者的多模式综合治疗干预的可行性和影响。这是一项从 2019 年 1 月至 2020 年 12 月进行的前瞻性纵向单中心试点研究。马里兰大学莱姆病项目，马里兰州巴尔的摩。因莱姆病相关症状就诊于莱姆病评估的人。参与者参加了两个 1 小时的个人指导课程，包括基于阿育吠陀的饮食干预和呼吸协调身心练习，用于家庭练习。使用以下经过验证的调查工具在基线、1、3、6 和 12 个月时获得了标准的影响测量：感知压力量表 (PSS)、PROMIS 全球健康 v1.2 (GH) 和 PROMIS 29 v2.0 调查。在 216 名因莱姆病评估而就诊的患者中，有 19 名参与者入组，其中 84%完成了研究（ = 16）。研究人群的 PROMIS GH 评分（包括一般身体健康 (GPH) 和一般心理健康 (GMH) 评分）低于一般美国人群。与一般美国人群相比，PROMIS 29 评分的疲劳、焦虑和疼痛得分更高。在 12 个月期间，GPH 和 GMH 分别改善了 6.09（置信区间 [95%CI] = 2.71-9.46； < 0.001）和 4.65（95%CI = 1.50-7.80； = 0.004）。PROMIS 29 评分在疲劳方面的改善最大，为-7.91（95%CI = -12.34 至 -3.48； < 0.001），疼痛干扰-5.08（95%CI = -9.20 至 -0.96； = 0.016），以及参与社会角色和活动的能力 7.48（95%CI = 3.21-11.75； = 0.001），而在抑郁方面的改善最小为-1.82（95%CI = -4.74 至 1.10； = 0.223）。就业状况对几乎所有的结果评分都有显著影响。感染后状态与焦虑和 PSS 评分的改善有关。多模式阿育吠陀和呼吸协调身心治疗干预是可行的，并且可能是一种非药物治疗选择，适用于因感染后综合征导致疼痛、压力、疲劳、身体功能障碍和睡眠障碍的患者。需要进一步的研究来确定该人群和其他具有类似感染后综合征症状的人群的疗效。
