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。

Study on the characteristics of quality of life and fatigue in patients with chronic fatigue syndrome and the therapeutic effect of tuina of traditional Chinese medicine

Abstract Objective: To explore the characteristics of quality of life(QOL) and fatigue in patients with chronic fatigue syndrome(CFS) and the therapeutic effect of tuina of traditional Chinese medicine. Method: Thirty patients with CFS were assigned into treatment group and treated with 10 times of tuina therapy which was carried out every other day. Thirty normal objects were assigned into control group without any intervention. Tuina techniques were composed with one-finger scrubbing, rolling, pressing and kneading manipulation. The manipulations were emphasized on DU meridian(DU) and bladder meridian(BL) and stomach meridian(ST). The acupoints were selected, such as Fengfu(Du16), Yaoyangguan(Du3), Xinshu(BL15), Ganshu(BL18), Pishu(BL20), Hegu(L14) and Taixi(KL3), et al. The features of health status, QOL and fatigue of two groups were evaluated by Medical Outcomes Survey Short Form-36(SF-36) and Multidimensional Fatigue Inventory(MFI-20) respectively. Result: In treatment group the scores of physical function, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health in SF-36 items decreased, while the scores of general fatigue, physical fatigue, reduced activity, reduced motivation and mental fatigue in MFI-20 items increased. The differences were significant (P<0.001). After 10 times of tuina treatment, there were higher scores of eight items in SF-36 and lower scores of five items in MFI-20(P<0.05). The differences of scores were significant (P<0.05), excluding role physical and bodily pain items of SF-36. Conclusion: CFS patients had the features of decreasing QOL and subjective fatigue. Tuina therapy showed identified therapeutic effects in improving QOL and relieving fatigue symptoms.