慢性疲劳综合征患者生存质量和疲劳特征及中医推拿干预研究

目的:探讨慢性疲劳综合征患者的生存质量(QOL)和疲劳特征及中医推拿的干预效应。方法:将30例慢性疲劳综合征患者作为治疗组,给予推拿治疗。手法以一指禅推法、滚法和按揉法为主;部位以督脉、膀胱经、胃经为主,主穴取风府、腰阳关、心俞、脾俞、肝俞、合谷、太溪;隔日治疗1次,共治疗10次。30例正常人为对照组,不予任何处理。借助SF-36健康调查问卷(SF-36)和MFI-20多维疲劳问卷测量工具评估两组对象的QOL和疲劳特征,并观察推拿治疗前、后治疗组患者相应量表的积分变化。结果:慢性疲劳综合征患者SF-36生理功能、生理职能、身体疼痛、总体健康、活力、社会功能、情感职能和精神健康等八个维度积分低于正常对照组,差异有显著性意义(P0.001)。MFI-20总体疲劳、生理疲劳、活动减少、兴趣减少和精神疲劳等五个维度积分高于正常对照组,差异有显著性意义(P0.001);10次推拿治疗后,治疗组SF-36八个维度上积分都表现为升高的趋势,除生理职能和身体疼痛外,其余六项因子前后差异配对比较都有显著性意义(P0.05)。MFI-20五个维度积分都表现为降低的趋势,前后差异配对比较皆有显著性意义(P0.05)。结论:慢性疲劳综合征患者存在QOL下降和主观疲劳的特性;中医推拿可提高慢性疲劳综合征患者的QOL,调整疲劳状态。     

针刺疗法联合推拿膀胱经改善慢性疲劳综合征患者失眠的效果观察

目的:观察针刺疗法联合推拿膀胱经改善慢性疲劳综合征患者失眠的效果。方法:选取2018年7月至2020年3月佛山市禅城区人民医院收治的76例慢性疲劳综合征失眠患者作为研究对象,将39例采用针刺疗法及推拿膀胱经治疗的患者作为观察组,将37例采用推拿膀胱经治疗的患者作为对照组,均治疗1个月,比较2组临床疗效,采用匹兹堡睡眠指数(Pittsburgh Sleep Quality Index,PSQI)量表评估睡眠改善状况。结果:治疗1个月后,观察组总有效率较对照组高,2组PSQI指数均较治疗前降低,且观察组低于对照组,差异有统计学意义(P 0. 05)。结论:针刺疗法联合推拿膀胱经可提高慢性疲劳综合征失眠的治疗效果,改善患者睡眠质量,值得推广。     

慢性疲劳综合征的特征与评价

目的:慢性疲劳综合征一般预后良好。随着治疗和时间的延迟,17%～64%的患者症状有改善,不到10%的患者可完全恢复,10%～20%患者病情加重。老年人、症状严重的或伴有其他心理疾病的预后较差。资料来源:应用计算机检索Medline1994-01/2005-03与慢性疲劳综合征病理生理学、病因学、治疗相关文献,检索词“chronicfatiguesyndrome/pathophysiology/etiology/treatment”,并限定文献语种为英文。资料选择:对资料进行初审,从资料中选取与慢性疲劳综合征的病因、病理生理、诊断评价、治疗等密切相关的文献。纳入标准:①以慢性疲劳综合征为研究主题。②涉及病因、病理生理、诊断评价、治疗方面的文献。排除标准:重复性研究和个案报道及无对照组的文献。资料提炼:共收集到52篇关于慢性疲劳综合征实验、个案报道、Meta分析的文章,13篇符合纳入标准。排除的39篇中27篇是重复研究,12篇为个案报道。资料综合:慢性疲劳综合征诊断主要依据症状和功能损害。其病因是多方面的,病理机制是复杂的。有的有家族倾向。虽然它与某些精神类疾病有明显的症状交叉,但与之根本不同。其治疗主要对症综合治疗,包括药物、行为、认知和锻炼等。慢性疲劳综合征是多因素诱发、加重的。生理和心理因素共同作用,使患者有患病倾向。结论:目前慢性疲劳综合征是以1994年美国疾病控制中心重新修订定义为标准。诊断主要依据症状和功能损害。其病因是多方面的,病理机制也是复杂的。治疗主要对症综合治疗,包括药物、行为、认知和锻炼等。评价和治疗尚无确定的方案,应重视患者的个体差异。研究方面还有大量的工作,如探讨慢性疲劳综合征的客观诊断指标,病因和病理机制以及有效的治疗方案等。     

慢性疲劳综合征的特征与评价

目的：慢性疲劳综合征一般预后良好。随着治疗和时间的延迟，17％-64％的患者症状有改善，不到10％的患者可完全恢复，10％～20％患者病情加重。老年人、症状严重的或伴有其他心理疾病的预后较差。资料来源：应用计算机检索Medline1994-01／2005-03与慢性疲劳综合征病理生理学、病因学、治疗相关文献，检索词“chronic fatigue syndrome／pathophysiology／etiology／treatment”，并限定文献语种为英文。资料选择：对资料进行初审，从资料中选取与慢性疲劳综合征的病因、病理生理、诊断评价、治疗等密切相关的文献。纳入标准：①以慢性疲劳综合征为研究主题。②涉及病因、病理生理、诊断评价、治疗方面的文献。排除标准：重复性研究和个案报道及无对照组的文献。资料提炼：共收集到52篇关于慢性疲劳综合征实验、个案报道、Meta分析的文章，13篇符合纳入标准。排除的39篇中27篇是重复研究，12篇为个案报道。资料综合：慢性疲劳综合征诊断主要依据症状和功能损害。其病因是多方面的，病理机制是复杂的。有的有家族倾向。虽然它与某些精神类疾病有明显的症状交叉，但与之根本不同。其治疗主要对症综合治疗，包括药物、行为、认知和锻炼等。慢性疲劳综合征是多因素诱发、加重的。生理和心理因素共同作用，使患者有患病倾向。结论：目前慢性疲劳综合征是以1994年美国疾病控制中心重新修订定义为标准。诊断主要依据症状和功能损害。其病因是多方面的，病理机制也是复杂的。治疗主要对症综合治疗，包括药物、行为、认知和锻炼等。评价和治疗尚无确定的方案，应重视患者的个体差异。研究方面还有大量的工作，如探讨慢性疲劳综合征的客观诊断指标，病因和病理机制以及有效的治疗方案等。     

美英澳国家青少年慢性疲劳综合征健康教育管理计划介绍及启示

慢性疲劳综合征日益影响青少年,本文着重介绍英美澳国家青少年慢性疲劳综合征健康教育管理计划。通过对国外慢性疲劳综合征健康教育计划的了解,结合我国国情,得到一些启示,有助于我国对青少年人群慢性疲劳综合征发病的有效预防和治疗。     

美英澳国家青少年慢性疲劳综合征健康教育管理计划介绍及启示

慢性疲劳综合征日益影响青少年,本文着重介绍英美澳国家青少年慢性疲劳综合征健康教育管理计划.通过对国外慢性疲劳综合征健康教育计划的了解,结合我国国情,得到一些启示,有助于我国对青少年人群慢性疲劳综合征发病的有效预防和治疗.     

慢性疲劳综合征患者食物不耐受检测的临床意义

目的探讨食物不耐受在慢性疲劳综合征发病机制及治疗中的意义。方法对56例慢性疲劳综合征患者进行食物不耐受检测,把三种以上食物不耐受患者随机分为饮食调整治疗组和对照组,应用疲劳量表、疲劳评定量表于治疗前和治疗1个月后各评价1次。结果慢性疲劳综合征患者食物不耐受阳性率92.9%,50%患者具有三种以上食物不耐受;对饮食调整治疗组患者进行饮食调整后,症状改善明显(P<0.05)。结论食物不耐受可能是慢性疲劳综合征的致病因素之一,饮食调整对慢性疲劳综合征治疗有效。     

护士慢性疲劳综合征的原因分析与应对策略

慢性疲劳综合征是一个渐进的过程,它与长期过重的工作压力和精神高度紧张、过度劳累、睡眠不足以及心理应激有关,主要表现为对工作丧失热情、同情心和责任感,对工作产生反感。护士慢性疲劳综合征严重干扰了护理人员的身心健康,成为医疗差错产生的重要原因。现就护士慢性疲劳综合征发生的原因和应对策略介绍如下。     

慢性疲劳综合征常用动物模型研究进展

慢性疲劳综合征又称肌性脑脊髓炎,其被定义为使人衰弱的疲劳无法通过充足的休息得到缓解。是一种发病机制不明确的异质性疾病,尚无有效的治疗方法。为研究慢性疲劳综合征的发病机制和治疗方法,目前已制备出多种动物模型,本文系统整理分析近年来慢性疲劳综合征常用的动物模型及其评价标准,以期为进一步探索其发病机制和新的治疗方法提供研究依据与思路。     

眼科抑郁焦虑症误诊25例分析

抑郁焦虑症属于一种心理疾病.目前随着社会节奏的加快,人的心理压力越来越大,心理疾病逐年增多,而心理疾病所表现的自身症状各种各样,抑郁焦虑引起的眼部不适、疲劳症状更易误诊.我院近年来,门诊接诊280例上睑下垂、慢性结膜炎、眼睑痉挛中,最后诊断抑郁焦虑症25例,误诊率11.2%.分析如下.     

左旋肉碱治疗慢性疲劳综合征的研究

目的　通过对 10例慢性疲劳综合征 (chronicfatiguesyndrome ,CFS)病人的左旋肉碱治疗 ,探讨左旋肉碱缺乏在CFS发病中的作用。方法　经临床确诊的血浆左旋肉碱含量低于正常的CFS病人 10例 ,进行静脉注射左旋肉碱治疗。观察疗效并复查血浆左旋肉碱的含量。结果　 10例病人全部有效 ,其中 7例完全治愈 ,3例症状明显改善。 10例病人治疗后血浆左旋肉碱含量全部达到正常水平。结论　左旋肉碱缺乏是造成CFS的一个重要原因。对CFS病人应常规进行血浆左旋肉碱的测定 ,对缺乏者应进行左旋肉碱的补充治疗。     

Therapy of chronic fatigue syndrome]

Chronic fatigue syndrome (CFS) is characterized by unexplained, debilitating fatigue or easy fatigability lasting longer than six months. While a number of clinical trials have been performed in CFS patients, there is currently no established therapy for CFS. Treatment with acyclovir of CFS patients is ineffective. Intravenous immunoglobulin therapy appears to be effective, though the results are controversial. Antidepressants might help the associated depression and anxiety but not other symptoms. Trials with magnesium have improved the well-being of patients. Restoration of NK activity by biological response modifiers, such as sizofirann, resulted in restoration of NK cell activity and recovery from CFS. Taken together, immunological abnormalities may be involved in CFS, and its restoration may produce clinical benefit in CFS.     

Neuro-psychiatric aspects of chronic fatigue syndrome]

Chronic fatigue syndrome (CFS) is easily differentiated from various neurological organic disorders by conventional clinical examinations. The most important disease for distinguishment from CFS is fibromyalgia syndrome, in which the prominent and cardinal feature is a deprivation of stage 4 slow wave sleep. Experimentally, the sleep disturbance in controls can induce general myalgia, muscle tender points, severe fatigue and stiffness on awakening. The EEG abnormality is slow alpha wave contaminants on slow wave background, which is identical to EEG of CFS. The results clearly imply that CFS is not a hysterical or psychogenic disease, and that fibromyalgia may be a central fundamental of CFS. Fibromyalgia, however, has distinct features such as no antecedent inflammatory process and no endemics. Therefore, the syndrome has features distinct from, in addition to common features to CFS. It is also very difficult to distinguish CFS from depression. The above-mentioned features can be observed in depression. Now, study of brain blood flow or metabolism by PET or SPECT can be a possible tool for establishment of the CFS identity.     

Identification and application of marker genes for differential diagnosis of chronic fatigue syndrome

Chronic fatigue syndrome (CFS) is a complex disease and has no laboratory biomarkers, which makes diagnosis of CFS difficult. Several research groups challenged to identify genes specific for CFS; however, there are no overlaps between studies. The U.S. Centers for Disease Control and Prevention reported remarkable gene expression profiles of a large scale cohort study recruited 227 people. Reported genes were mostly different from the previously reported genes, again featuring the complexity of CFS. Separately, we identified 9 genes that were significantly and differentially expressed between CFS patients and healthy subjects using an original microarray. The changes in expression of 9 genes were confirmed by quantitative PCR. We also demonstrated the usefulness of 9 genes for differential diagnosis of CFS.     

beta-Alanine and gamma-aminobutyric acid in chronic fatigue syndrome

BACKGROUND: Due to the occurrence of sleep disturbances and fatigue in chronic fatigue syndrome (CFS), an investigation was performed to examine if there is an abnormal excretion of gamma-aminobutyric acid (GABA) and/or its structural analogue beta-alanine in the urine from CFS patients. Both GABA and beta-alanine are inhibitory neurotransmitters in the mammalian central nervous system. METHODS: The 24 h urine excretion of GABA and beta-alanine was determined by isotope dilution gas chromatography mass spectrometry in 33 CFS patients and 43 healthy controls. The degree of symptoms in both patients and controls was measured by grading of three typical CFS symptoms using a Visual Analogue Scale. RESULTS: Men had a significantly higher excretion of both beta-alanine and GABA than women. Comparing CFS patients with healthy controls showed no significant difference in excretion of neither beta-alanine nor GABA. No correlation was found between the excretion of beta-alanine or GABA and any of the three characteristic CFS symptoms measured. However, two female and two male CFS patients excreted considerably higher amounts of beta-alanine in their 24 h urine samples than control subjects. CONCLUSIONS: Increased excretion of beta-alanine was found in a subgroup of CFS patients, indicating that there may be a link between CFS and beta-alanine in some CFS patients.     

Frailty is not independently associated with intensive care unit length of stay: An observational study

BackgroundFrailty is independently associated with morbidity and mortality in critically ill patients. However, the association between preadmission frailty and the degree of treatment received in the intensive care unit (ICU) remains unclear.ObjectiveTo describe patient length of stay in an ICU and the treatments provided according to the extent of patient frailty.MethodsSingle-centre retrospective cohort study of adult patients admitted to a tertiary ICU between January 2018 and December 2019. Frailty was assessed using the Clinical Frailty Scale (CFS). The primary outcome was ICU length of stay stratified by CFS score (1–8). Secondary outcomes were the proportion of patients with each CFS score treated with vasoactive agents, invasive ventilation, noninvasive ventilation, renal replacement therapy, and tracheostomy. Poisson regression and competing risks regression was used to analyse associations between ICU length of stay and potential confounders.ResultsThe study cohort comprised 2743 patients, with CFS scores known for 2272 (83%). Length of stay in the ICU increased with each increment in the CFS up to a score of 5, beyond which it decreased with higher frailty scores. After adjusting for age, illness severity, admission type, and treatment limitation, CFS scores were not independently associated with length of stay in the ICU (P = 0.31). The proportion of patients receiving specific ICU treatments peaked at different CFS scores, being highest for vasoactive agents at CFS 5 (47%), invasive ventilation CFS 3 (51%), noninvasive ventilation CFS 6 (11%), renal replacement therapy CFS 6 (8.2%), and tracheostomy CFS 5 (2.2%). Increasing frailty was associated with increased mortality and discharge to a destination other than home.ConclusionsThe extent of frailty is not independently associated with length of stay in the ICU. The proportion of patients receiving specific ICU treatments peaked at different CFS scores.     

Considerations for the treatment of chronic fatigue syndrome

The etiology of chronic fatigue syndrome(CFS) is still unknown and under active discussion, but involvement of psychosocial factors appear to be essential for the onset and clinical course of CFS. As CFS patients complain of many stress-related physical and psychological symptom, it is important to understand the CFS from psychosomatic point of view. Not only for the pharmaceutical treatment, attentive consideration is required for treatment of exhaustion of body and mind of CFS patients. Use of anti-depressants or oriental herb medicine is often effective to relieve the anxiety and depressive condition. Furthermore to augment the self-healing potential, psychosomatic approach is important to modify the life style and behavioral characteristics.     

Symptoms of autonomic dysfunction in chronic fatigue syndrome

BACKGROUND: Chronic fatigue syndrome (CFS) is common and its cause is unknown. AIM: To study the prevalence of autonomic dysfunction in CFS, and to develop diagnostic criteria. DESIGN: Cross-sectional study with independent derivation and validation phases. METHODS: Symptoms of autonomic dysfunction were assessed using the Composite Autonomic Symptom Scale (COMPASS). Fatigue was assessed using the Fatigue Impact Scale (FIS). Subjects were studied in two groups: phase 1 (derivation phase), 40 CFS patients and 40 age- and sex-matched controls; phase 2 (validation phase), 30 CFS patients, 37 normal controls and 60 patients with primary biliary cirrhosis. RESULTS: Symptoms of autonomic dysfunction were strongly and reproducibly associated with the presence of CFS or primary biliary cirrhosis (PBC), and correlated with severity of fatigue. Total COMPASS score >32.5 was identified in phase 1 as a diagnostic criterion for autonomic dysfunction in CFS patients, and was shown in phase 2 to have a positive predictive value of 0.96 (95%CI 0.86-0.99) and a negative predictive value of 0.84 (0.70-0.93) for the diagnosis of CFS. DISCUSSION: Autonomic dysfunction is strongly associated with fatigue in some, but not all, CFS and PBC patients. We postulate the existence of a 'cross-cutting' aetiological process of dysautonomia-associated fatigue (DAF). COMPASS >32.5 is a valid diagnostic criterion for autonomic dysfunction in CFS and PBC, and can be used to identify patients for targeted intervention studies.