Lloyd A R, Hickie I, Brockman A, Hickie C, Wilson A, Dwyer J, Wakefield D
Department of Immunology, Prince Henry Hospital, Sydney, Australia.
Am J Med. 1993 Feb;94(2):197-203. doi: 10.1016/0002-9343(93)90183-p.
To evaluate the potential benefit of immunologic therapy with dialyzable leukocyte extract and psychologic treatment in the form of cognitive-behavioral therapy (CBT) in patients with chronic fatigue syndrome (CFS).
Immunologic and psychologic treatments were administered to 90 adult patients who fulfilled diagnostic criteria for CFS in a double-blind, randomized, and placebo-controlled study. A four-cell trial design allowed the assessment of benefit from immunologic and psychologic treatment individually or in combination. Outcome was evaluated by measurement of global well-being (visual analogue scales), physical capacity (standardized diaries of daily activities), functional status (Karnofsky performance scale), and psychologic morbidity (Profile of Mood States questionnaire), and cell-mediated immunity was evaluated by peripheral blood T-cell subset analysis and delayed-type hypersensitivity skin testing.
Neither dialyzable leukocyte extract nor CBT (alone or in combination) provided greater benefit than the nonspecific treatment regimens.
In this study, patients with CFS did not demonstrate a specific response to immunologic and/or psychologic therapy. The improvement recorded in the group as a whole may reflect both nonspecific treatment effects and a propensity to remission in the natural history of this disorder.
评估用可透析白细胞提取物进行免疫治疗以及采用认知行为疗法（CBT）形式的心理治疗对慢性疲劳综合征（CFS）患者的潜在益处。
在一项双盲、随机、安慰剂对照研究中，对90名符合CFS诊断标准的成年患者进行免疫和心理治疗。四组试验设计允许分别评估免疫治疗和心理治疗单独或联合使用的益处。通过测量总体幸福感（视觉模拟量表）、身体能力（日常活动标准化日记）、功能状态（卡诺夫斯基表现量表）和心理发病率（情绪状态剖面图问卷）来评估结果，并通过外周血T细胞亚群分析和迟发型超敏皮肤试验评估细胞介导的免疫。
可透析白细胞提取物和CBT（单独或联合使用）均未比非特异性治疗方案带来更大益处。
在本研究中，CFS患者未表现出对免疫和/或心理治疗的特异性反应。整个组中记录到的改善可能既反映了非特异性治疗效果，也反映了该疾病自然病程中的缓解倾向。
