正念冥想疗法干预阿尔茨海默病患者神经损伤及焦虑抑郁的效果分析The effect of mindfulness meditation on nerve damage,anxiety and depression in patients with Alzheimer's disease
张营丽;周艳华;李卓;王瑾;唐伟;王威;
摘要(Abstract):
目的探讨正念冥想疗法对阿尔茨海默病患者神经损伤及焦虑、抑郁的干预效果。方法选择2018-01—2019-07在盘锦市中心医院接受治疗的70例老年痴呆患者为研究对象,随机分为2组,实验组接受正念冥想疗法,对照组接受常规治疗。测定干预前后2组血清神经损伤指标水平,应用汉密尔顿焦虑量表(HAMA-14)、汉密尔顿抑郁量表(HAMD-17)评估治疗前后2组患者焦虑、抑郁情况。结果干预后实验组患者血清Aβ_(1-42)、Tau蛋白含量明显降低,血清PON1、SOD含量明显升高,差异均有统计学意义(P<0.05);实验组血清Aβ_(1-42)、Tau蛋白含量低于对照组,血清PON1、SOD含量高于对照组,差异均有统计学意义(P<0.05)。干预后实验组HAMD-17评分、HAMA-14评分明显低于对照组,差异均有统计学意义(P<0.05)。结论正念冥想能够减轻阿尔茨海默病患者的脑内神经损伤,改善焦虑、抑郁症状。
关键词(KeyWords): 阿尔茨海默病;正念冥想;神经损伤;焦虑;抑郁
基金项目(Foundation): 大连市卫计委科研课题(编号:1911105);; 辽宁省教育厅高等学校科学研究项目(编号:2008033)
作者(Authors): 张营丽;周艳华;李卓;王瑾;唐伟;王威;
参考文献(References):
- [1] FROZZA R L,LOURENCO M V,DE FELICE F G.Challenges for Alzheimer’s disease therapy:Insights from novel mechanisms beyond memory defects[J].Front Neurosci,2018,12:37.DOI:10.3389/fnins.2018.00037.
- [2] CASTELLANI R J,PERRY G.Pathogenesis and disease-modifying therapy in Alzheimer’s disease:The flat line of progress[J].Arch Med Res,2012,43(8):694-698.DOI:10.1016/j.arcmed.2012.09.009.
- [3] KULLMANN S,HENI M,HALLSCHMID M,et al.Brain insulin resistance at the crossroads of metabolic and cognitive disorders in humans[J].Physiol Rev,2016,96(4):1169-1209.DOI:10.1152/physrev.00032.2015.
- [4] 郑伟,林敬源,林小娟.阿尔茨海默病早期快速筛查的简易风险评估模型探索[J].中国实用神经疾病杂志,2019,22(18):1981-1987.DOI:10.12083/SYSJ.2019.18.331.
- [5] CHAN K Y,WANG W,WU J J,et al.Epidemiology of Alzheimer’s disease and other forms of dementia in China,1990-2010:a systematic review and analysis[J].Lancet,2013,381(9882):2016-2023.DOI:10.1016/S0140-6736(13)60221-4.
- [6] CHHETRI J K,CHAN P,VELLAS B,et al.Report from the First Clinical Trials on Alzheimer’s Disease (CTAD) Asia-China 2018:Bringing together Global Leaders[J].J Prev Alzheimers Dis,2019,6(2):144-147.DOI:10.14283/jpad.2019.2.
- [7] HAN Y,SHENG C.Current situation and prospect of non-pharmacological intervention in preclinical Alzheimer’s disease[J].Chin J Neuromed,April 2020,19(4):325-329.DOI:10.3760/cma.j.cn115354-20200220-00092.
- [8] INNES K E,SELFE T K,KHALSA D S,et al.Effects of meditation versus music listening on perceived stress,mood,sleep,and quality of life in adults with early memory loss:a pilot randomized controlled trial[J].J Alzheimers Dis,2016,52(4):1277-1298.DOI:10.3233/JAD-151106.
- [9] JACK C R JR,ALBERT M S,KNOPMAN D S,et al.Introduction to the recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagno-stic guidelines for Alzheimer’s disease[J].Alzheimers Dement,2011,7(3):257-262.DOI:10.1016/j.jalz.2011.03.004.
- [10] CHETELAT G,MEZENGE F,TOMADESSO C,et al.Reduced ageassociated brain changes in expert meditators:a multimodal neuroimaging pilot study[J].Sci Rep,2017,7(1):10160.DOI:10.1038/s41598-017-07764-x.
- [11] CHETELAT G,LUTZ A,ARENAZA-URQUIJO E,et al.Why could meditation practice help Promote mental health and well-being in aging[J].Alzheimers Res Ther,2018,10(1):57.DOI:10.1186/s13195-018-0388-5.
- [12] NAGAHARA A H,MERRILL D A,COPPOLA G,et al.Neuroprotective effects of brain-deerived neurotrophic factor in rodent and primate models of Alzheimer’s disease[J].Nat Med,2009,15(3):331-337.DOI:10.1038/nm.1912.
- [13] ZIEGLER-WALDKIRCH S,D’ERRICO P,SAUER J F,et al.Seed-induced Aβ deposition is modulated by microglia under environmental enrichment in a mouse model of Alzheimer’s disease[J].EMBOJ,2018,37(2):167-182.
- [14] MA Q L,ZOU X,YANG F,et al.Loss of MAP function leads to hippocampal synapse loss and deficits in the morris water maze with aging[J].J Neurosci,2014,34(21):7124-7136.DOI:10.1523/JNEUROSCI.3439-13.2014.
- [15] GUERRERO-MUNOZ M J,JULIA G,CASTILLO-CARRANZA D L.Tau oligomers:the toxic player at synapses in Alzheimer’s disease[J].Front Cell Neurosci,2015,9(23):464-473.DOI:10.3389/fncel.2015.00464.
- [16] IQBAL K,LIU F,GONG C X.Tau and neurodegenerative disease:the story so far[J].Nat Rev Neu,2016,12(1):15-27.DOI:10.1038/nrneurol.2015.225.
- [17] CHISTIAKOV D A,MELNICHENKO A A,OREKHOV A N,et al.Paraoxonase and atherosclerosis-related cardiovascular diseases[J].Biochimie,2016,132:19-27.DOI:10.1016/j.biochi.2016.10.010.
- [18] TURKES C,SOYUT H,SUKRU B.Effect of calcium channel blockers on paraoxonase-1 (PON1) activity and oxidative stress[J].Pharmacol Rep,2014,66(1):74-80.DOI:10.1016/j.pharep.2013.08.007.
- [19] INNES K E,SELFE T K,KHALSA D S,et al.Meditation and music improve memory and cognitive function in adults with subjective cognitive decline:a pilot randomized controlled trial[J].J Alzheimers Dis,2017,56(3):899-916.DOI:10.3233/JAD-160867.
- [20] LENZE E J,HICKMAN S,HERSHEY T,et al.Mindfulness-based stress reduction for older adults with worry symptoms and co-occurring cognitive dysfunction[J].Int J Geriatr Psychiatry,2014,29(10):991-1000.DOI:10.1002/gps.4086.
- [21] THOMAS Z,NOVAK M,GABRIELA S,et al.Brief mindfulness meditation for depression and anxiety symptoms in patients undergoing hemodialysis a pilot feasibility study[J].Clin J Am Soc Nephro,2017,12(12):2008-2015.DOI:10.2215/CJN.03900417.
- [22] KOX M,VAN EIJK L T,ZWAAG J,et al.Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans[J].Proc Natl Acad Sci USA,2014,111(20):7379-7384.DOI:10.1073/pnas.1322174111.
- [23] VALERIO T D,KIM M J,SEXTONRADEK K.Association of stress,general health,and alcohol use with poor sleep quality among U.S.college students[J].Am J Heal Edu,2016,47(1):17-23.
- [24] DESBORDES G,NEGI L T,PACE T W,et al.Effects of mindful attention and compassion meditation training on amygdale response to emotional stimuli in an ordinary,non-meditative state[J].Front Hum Neurosci,2012,6:292.DOI:10.3389/fnhum.2012.00292.
- [25] HOLZEL B K,CARMODY J,VANGEL M,et al.Mindfulness practice leads to increases in regionalbrain gray matter density[J].Psychiatry Res,2011,191(1):36-43.DOI:10.1016/j.pscychresns.2010.08.006.
- [26] CRAMER H,RABSILLER S,LAUCHE R,et al.Yoga and meditation for menopausal symptoms in breast cancer survivors-A randomized controlled trial[J].Cancer,2015,121(13):2175-2184.
- [27] KHOURY B,SHARMA M,RUSH S E,et al.Mindfulness-based stressreduction for healthy individuals:A meta-analysis[J].J Psychosom Res,2015,78(6):519-528.DOI:10.1016/j.jpsychores.2015.03.009.