综合心理疗法治疗慢性疲劳综合征的临床观察

目的观察心理疗法结合康复疗法治疗慢性疲劳综合征的临床疗效。方法将92例慢性疲劳综合征的患者随机分为治疗组和对照组,治疗组在传统康复治疗的基础上予心理疗法,对照组只给予传统的康复治疗,两组患者在治疗后3个月进行疗效比较。结果两组患者经治疗后均有不同程度的改善,其中治疗组的有效率82.6%,对照组有效率45%,两组治疗结果经统计学分析,组间有显著性差异(P<0.05)。结论综合心理疗法治疗慢性疲劳综合征有较好的临床疗效。     

中药治疗慢性疲劳综合征分析

慢性疲劳综合征(chronic fatigue syndrome,CFS)是一组以慢性持久或反复发作的脑力和体力疲劳为主要特征的症候群。西医对CFS的治疗没有特效疗法,本文对CFS中医病因病机进行分析,总结了CFS的辨证治疗方法,为临床治疗提供依据。     

从五脏主情志论音乐疗法结合热熨法对慢性疲劳综合征的调节作用

目的 以中医藏象学说中五脏与情志活动的关系为理论基础,初步探讨音乐疗法结合药熨法对慢性疲劳综合征的调节作用,以期为慢性疲劳综合征提供新的干预方法.方法 按照随机对照原则,将慢性疲劳综合征患者随机分为观察组和对照组.治疗组给予"五脏主情志理论"指导下的音乐疗法,结合药熨法治疗;对照组仅采用药熨法治疗.治疗前后两组患者的疲劳评定量表(FAI)及精神症状自评量表(SCL-90)评分变化,以及治疗后两组间的评分差异.结果 治疗后总有效率观察组86.05%,对照组69.44%.结论 以中医藏象学说中五脏与情志活动的关系指导音乐疗法,并结合药熨法干预慢性疲劳综合征,可改善患者的症状,从而提高其生活质量.     

慢性疲劳综合征精神情志症状的文献研究

目的通过文献研究分析慢性疲劳综合征精神情志特点与预后转归的关系。方法对慢性疲劳综合征(chronic fa-tigue syndrome,CFS)的基本概念、诊断标准、流行病学特征的文献资料以及精神情志因素与慢性疲劳综合征病程及预后的文献资料进行研究整理,评价常用的几种CFS症状测评量表,分析这些量表在评估CFS患者精神情志特点上的异同。结果文献研究发现,CFS患者普遍存在大量精神情志症状。结论有必要进行临床大样本调查,系统分析慢性疲劳综合征精神情志特点与预后转归的相关性,为进一步明确CFS情志疗法提供理论和临床依据。     

023 认知行为疗法治疗慢性疲劳综合征的效果好[英]／Prins JB…／／Lancet．

背景 认识行为疗法似乎是一种治疗慢性疲劳综合征的有效疗法，但在非专业化诊所是否能开展这项疗法还是一个问题，本研究在3个中心进行随机试验比较了认知行为疗法、指导性支持疗法和自然疗法的疗效。     

童年运动少易患疲劳综合征

据<英国医学杂志>报道,英国科学家发现,童年时运动少的人成年后容易患上慢性疲劳综合征.研究人员调查了16567名出生于1970年的人的健康情况,跟踪了他们从出生到30岁时的身体状况.他们在进行比较后发现,在那些童年时代不爱运动、喜欢久坐的人中间,慢性疲劳综合征比较常见.     

慢性疲劳综合征的综合探讨

慢性疲劳综合征俗称慢性疲劳综合症,简称CFS。本文就对CFS的病因病机及治疗方法探讨。     

近五年针灸治疗慢性疲劳综合征的研究进展

现代医学对于慢性疲劳综合征(chronic fatigue syndrome,CFS)的原因病机尚不明确,也无治疗的特效药物。中医针灸有着扶正祛邪、调节脏腑经络阴阳平衡的功效,近年来在治疗CFS方面取得了一定的疗效。现综述近五年针灸治疗慢性疲劳综合征的研究进展,并提出一些展望,为临床治疗CFS提供参考。     

运动对糖尿病患者血糖的干预

糖尿病是一组由遗传和环境因素相互作用,因胰岛素分泌绝对或相对不足以致细胞对胰岛素敏感性降低,引起糖、蛋白质、脂肪和继发性水、电解质等一系列代谢紊乱的临床综合征。近年来,糖尿病患病率呈上升趋势,目前难以根治。糖尿病已成为严重影响人们生活质量的主要慢性非传染性疾病。糖尿病的运动疗法是指让糖尿病患者进行长期有规律的身体运动锻炼,作为糖尿病的基础治疗之一,运动疗法已经受到广大医务人员和部分患者的重视,3年来我们加强了2型糖尿病患者运动疗法的护理干预,取得了良好的治疗效果。     

慢性疲劳综合征的研究进展

在当代快节奏、高压力的环境中,临床上以慢性疲劳为主诉的患者日益增多,慢性疲劳综合征已成为不容忽视的健康问题,并在近年来日益成为国内外研究者关注的热点。笔者从对慢性疲劳综合征的病因、发病机制、流行病学特征、诊断及治疗,尤其对免疫系统及神经内分泌系统的发病机制方面进行了较为详细的综述。     

Treatments for chronic fatigue syndrome

AIMS: To review studies evaluating the treatment of chronic fatigue and chronic fatigue syndrome, to describe predictors of response to treatment and to discuss the role of the occupational health physician. METHODS: A literature search was carried out using Medline and PsychInfo. RESULTS: Studies evaluating cognitive behaviour therapy, graded exercise therapy, pharmacological interventions (e.g. antidepressants and corticosteroids), immunological interventions and nutritional supplements were reviewed. The most promising results have been found with cognitive behaviour therapy and graded exercise therapy, and some predictors of outcome have been identified. Most of the other interventions were evaluated in just one or two studies and therefore evidence is insufficient to draw firm conclusions. CONCLUSIONS: By applying the models of fatigue that form the bases for cognitive behaviour therapy and graded exercise therapy, occupational health physicians may play an important role in helping the patients with chronic fatigue syndrome to reduce their symptoms, improve their functioning and return to work.     

Illness experience and occupations of people with chronic fatigue syndrome

Chronic fatigue syndrome affects people's physical and cognitive capacities for participation in their occupations, but has received limited consideration by occupational therapists. This qualitative study explores the illness experiences and occupations of five people living with chronic fatigue syndrome. Narrative data were collected using the Occupational Performance History Interview-II (OPHI-II). Key aspects of participants' illness experiences, identified through thematic analysis, were: (i) experiencing and understanding chronic fatigue syndrome; (ii) experiencing different types of fatigue; (iii) 'an ending and a beginning'; (iv) experiencing doing activities; and (v) doing something towards getting well. These findings reveal participants' life stories, identities, relationships, and occupations had been dramatically altered. Their implication is that people living with this condition face issues, for which occupational therapy can be of assistance. The efficacy of interventions to enable them to adapt their occupations and rebuild their lives merits further research. The potential usefulness of OPHI-II for learning about how clients' occupations are altered by chronic illness in research and practice is illustrated.     

体力运动对慢性疲劳综合征大鼠不同脑区5-HT含量的影响

[目的]探讨慢性疲劳综合征的神经机制及运动的干预作用。[方法]40只健康雄性SD大鼠随机分为正常对照组、模型组、运动+模型组及运动组,每组10只。采用睡眠剥夺加负重力竭性游泳方式建立慢性疲劳综合征模型。采用8周跑轮运动作为自动体力运动模型。实验结束后处死各组大鼠,用高效液相色谱法检测海马、枕叶皮层5-羟色胺(5-HT)含量。[结果]与正常对照组比较,模型组不同脑区5-HT含量明显降低(P﹤0.01)。与模型组比较,运动+模型组5-HT含量明显增加。与对照组比较,运动组不同脑区5-HT升高,差异有统计学意义(P﹤0.05)。[结论]长期体力运动可作为一种有效的防护措施,通过调节神经递质的紊乱,从而降低慢性疲劳对机体神经功能的损害。     

运动对慢性疲劳综合征大鼠神经免疫功能影响

目的探讨慢性疲劳综合征的神经免疫机制及运动的干预作用。方法40只雄性Sprague-Daw ley大鼠随机分为对照组,模型组、运动+模型组及运动组;采用睡眠剥夺加负重力竭性游泳方式建立慢性疲劳综合征模型;采用8周跑轮运动作为自动体力运动模型;用高效液相色谱法检测海马、枕叶皮层5-羟色胺(5-HT)含量,应用酶联免疫吸附(ELISA)法检测血清干扰素-γ(IFN-γ)和白细胞介素-4(IL-4)水平以及IFN-γ/IL-4比值变化。结果模型组海马、枕叶皮层5-HT(11.28±5.13),(1.15±0.34)ng/g较对照组(33.56±6.42),(3.49±0.42)ng/g明显降低(P0.01);血清IFN-γ(19.36±4.34)pg/mL及IFN-γ/IL-4比值(0.96±0.62)较对照组明显下降(P0.01);与模型组比较,运动+模型组5-HT(23.35±4.36),(2.67±0.51)ng/g明显增加;IFN-γ水平(37.58±5.13)pg/mL和IFN-γ/IL-4比值(2.65±0.91)明显增高(P0.05);与对照组比较,运动组5-HT水平(54.27±5.31),(5.87±0.63)ng/g升高(P0.05)。结论长期体力运动可作为一种有效的防护措施,可降低慢性疲劳对机体神经免疫功能的损害。     

Chronic fatigue syndrome defies the mind-body-schism of medicine

The article maintains that chronic fatigue syndrome can be properly understood only by taking an integrated perspective in which evolutionary, developmental and ecological aspects are considered. The integrative approach, supplemented by a complexity theory and psychoneuroimmunological research, is capable of explaining why there are so few structural aberrations to be found in chronic fatigue syndrome and why specific treatment is so difficult to establish. A major outcome of the investigation, that all individuals with chronic fatigue syndrome are diseased in their own way, emphasises the need to study the development of personalised life histories. It also highlights an ethical dimension; personalised disease defies essentialist thinking on patient management. Another major outcome, which follows from the developmental systems perspective, is the dissolution of ontological mind-body dualism. This in turn allows for a methodological complementation of the biological and phenomenological approaches to knowledge. New research strategies that may help to resolve chronic fatigue syndrome, grounded in the revised perspective on individual development, are suggested.     

Exercise in the management and rehabilitation of selected chronic diseases

The effects of exercise on the progression of eight chronic diseases or medical conditions are reviewed. In the case of coronary artery disease (CAD), there is some suggestive evidence that exercise is associated with a survival advantage. Exercise does not consistently increase blood flow in peripheral vascular disease, nor does it improve lung function in patients with chronic obstructive pulmonary disease. However, it is associated with increased physical work capacity in these two conditions. Preliminary studies suggest that exercise may be beneficial in the management of pulmonary secretions in patients with cystic fibrosis. Exercise has no therapeutic role in acute exacerbations of rheumatoid arthritis, but in the chronic stages, exercise that does not cause pain may be beneficial. Exercise is the focal point of chronic pain syndrome programs. With exercise programs, patients with chronic pain can increase physical work capacity with a decrease in complaints of pain. Patients with osteoporosis appear to benefit from a carefully programmed low-level exercise program that avoids back flexion exercises. Blood glucose, hypertension, and serum lipid levels improve with exercise in patients with dialysis-dependent renal failure.     

Chronic fatigue syndrome versus neuroendocrineimmune dysfunction syndrome:differential attributions

Since 1988, when the term chronic fatigue syndrome (CFS) was coined, considerable discussion has occurred about stigma associated with this diagnostic term. In particular, patients with CFS have felt that this term trivializes the serious nature of this disorder. A Name Change Work group, appointed by the CFS Coordinating Committee, developed an umbrella term: chronic neuroendocrineimmune dysfunction syndrome (CNDS), and proposed that there would be sub-types under this term, one being CFS. The present study examined attributions of this new umbrella term when compared with CFS. Nurses and physician assistants (PAs) were presented a case study of a patient with symptoms of CFS. They were told that the patient had either "chronic fatigue syndrome," "chronic neuroendocrineimmune dysfunction syndrome," or "chronic neuroendocrineimmune dysfunction syndrome, which had formerly been called chronic fatigue syndrome." The different terms led to different attributions, with PA respondents rating the "CNDS" label as more severe. Results suggest that a more medical sounding term (CNDS) may lead to attributions that this syndrome is a more serious, disabling illness. The policy implications of these findings are discussed.     

Functional status of persons with chronic fatigue syndrome in the Wichita, Kansas, population

Background

Scant research has adequately addressed the impact of chronic fatigue syndrome on patients' daily activities and quality of life. Enumerating specific problems related to quality of life in chronic fatigue syndrome patients can help us to better understand and manage this illness. This study addresses issues of functional status in persons with chronic fatigue syndrome and other fatiguing illnesses in a population based sample, which can be generalized to all persons with chronic fatigue.

Methods

We conducted a random telephone survey in Wichita, Kansas to identify persons with chronic fatigue syndrome and other fatiguing illnesses. Respondents reporting severe fatigue of at least 1 month's duration and randomly selected non-fatigued respondents were asked to participate in a detailed telephone interview. Participants were asked about symptoms, medical and psychiatric illnesses, and about physical, social, and recreational functioning. Those meeting the 1994 chronic fatigue syndrome case definition, as determined on the basis of their telephone responses, were invited for clinical evaluation to confirm a diagnosis of chronic fatigue syndrome. For this analysis, we evaluated unemployment due to fatigue, number of hours per week spent on work, chores, and other activities (currently and prior to the onset of fatigue), and energy level.

Results

There was no difference between persons with chronic fatigue syndrome and persons with a chronic fatigue syndrome-like illness that could be explained by a medical or psychiatric condition for any of the outcomes we measured except for unemployment due to fatigue (15% vs. 40%, P < .01). Persons with chronic fatigue syndrome and other fatiguing illnesses had substantially less energy and spent less time on hobbies, schooling, or volunteer work than did non-fatigued controls (P < .01).

Conclusions

Persons with chronic fatigue syndrome are as impaired as persons whose fatigue could be explained by a medical or psychiatric condition, and they have less energy than non-fatigued controls.     

Role of dietary modification in alleviating chronic fatigue syndrome symptoms: a systematic review

Objective: To review the evidence for the role of dietary modifications in alleviating chronic fatigue syndrome symptoms. Methods: A systematic literature review was guided by PRISMA and conducted using Scopus, CINAHL Plus, Web of Science and PsycINFO scientific databases (1994–2016) to identify relevant studies. Twenty‐two studies met the inclusion criteria, the quality of each paper was assessed and data extracted into a standardised tabular format. Results: Positive outcomes were highlighted in some included studies for polyphenol intakes in animal studies, D‐ribose supplementation in humans and aspects of symptom alleviation for one of three polynutrient supplement studies. Omega three fatty acid blood levels and supplementation with an omega three fatty acid supplement also displayed positive outcomes in relation to chronic fatigue syndrome symptom alleviation. Conclusions: Limited dietary modifications were found useful in alleviating chronic fatigue syndrome symptoms, with overall evidence narrow and inconsistent across studies. Implications for public health: Due to the individual and community impairment chronic fatigue syndrome causes the population, it is vital that awareness and further focused research on this topic is undertaken to clarify and consolidate recommendations and ensure accurate, useful distribution of information at a population level.     

Post-bacterial infection chronic fatigue syndrome is not a latent infection

Post-infectious chronic fatigue syndrome is a public health problem. Etiologies and physiopathological mechanisms are unknown. Some viruses are known to be involved in post-infectious chronic fatigue syndrome, but the role of bacterial infection is still questioned, especially in cases of post-treatment Lyme disease syndrome where subjective symptoms are regularly attributed to the presence of the dormant bacterium without scientific evidence. However, the medical experience of recalcitrant infections, relapses, and reactivations questions the role of “dormant bacteria” in asymptomatic latent infections as well as in subjective symptoms. We summarized scientific literature data on post-bacterial infection chronic fatigue syndrome, the role of dormant bacteria in latent infections, and bacterial asymptomatic carriage. Subjective symptoms described in post-infectious chronic fatigue syndromes are still misunderstood and there is no evidence suggesting that such symptoms could be related to dormant bacterial infection or carriage of viable bacteria. Psychological trauma may be part of these subjective symptoms. Post-infectious chronic fatigue syndrome could nonetheless be due to unknown microorganisms. Antibiotic treatment is not required for latent infections, except for latent syphilis and latent tuberculosis infections to prevent, after the primary infection, progression to the secondary or tertiary stage of the disease.