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研究生：	陳思怡 Chen, Sz-I
論文名稱：	淨化呼吸法改善精神症狀並調整血清中腦中滋養因子與可體松含量 Sudarshan Kriya Yoga Improved Psychiatric Aspects and Alter Serum Levels of Brain-Derived Neurotrophic Factor and Cortisol in Human Subjects
指導教授：	黃阿敏 Huang, A-Min
學位類別：	碩士 Master
系所名稱：	醫學院 - 生理學研究所 Department of Physiology
論文出版年：	2010
畢業學年度：	98
語文別：	英文
論文頁數：	45
中文關鍵詞：	淨化呼吸法、可體松、腦中滋養因子
外文關鍵詞：	SKY, cortisol, BDNF, MPI, SCL-90, PSQI, BDI
相關次數：	點閱：55 下載：10
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淨化呼吸法（Sudarshan Kriya yoga (SKY) breathing）是藉由調身法、調息法、淨化呼吸法、引導靜心、團體互動過程及瑜珈知識要點，教導人們如何減壓與快樂的療程。目前已知淨化呼吸法可以減輕焦慮症、憂鬱症、日常的壓力、受傷後壓力症候群和壓力有關影響身心方面的臨床症狀，像是持久的沮喪的心情、疲憊感和失眠等症狀。儘管如此，淨化呼吸法對於改善憂鬱心理及生理方面的分子機制目前並不清楚。許多研究指出憂鬱症者血清中腦中滋養因子較低（brain-derived neurotrophic factor, BDNF），而可體松（cortisol）含量較高。本論文目的想探討經由淨化呼吸法的課程及持續練習下，是否會改善的精神症狀並調整血清中BDNF 與cortisol含量。並進一步探討這些精神症狀的改變與血清BDNF與cortisol的變化是否有所關聯。本實驗招募了83名受試者參與，篩選人口資料配對的受試者分成健康及憂鬱兩族群，此兩族群再各分成參與及不參與課程兩組。憂鬱症對照組(DC)，共13人；憂鬱症實驗組(DS)，共22人；健康對照組(HC)，共25人；健康實驗組(HS)，共23人。採用六天淨化呼吸法課程，並且進行三個月追蹤練習；並在課程前、課程後、第1、2及3個月抽血並填寫貝氏憂鬱量表(BDI) ，而在課前及第3個月填寫症狀自評量表(SCL-90)、莫茲利人格量表(MPI-30)、睡眠品質量表(PSQI)等身心量表評估受試者的身心狀況。並且測量受試者血清中BDNF及cortisol含量。結果顯示，(1)BDI分數在DS、HS有顯著下降。MPI-30和PSQI在DS和HS發現顯著改善。SCL-90分數在DS、HS及DC皆有顯著下降。(2) DS血清中cortisol在第二個月顯著下降，而HS有相同的趨勢；DC則有不規則的升高其血清中cortisol含量在第一和二個月顯著上升。(3) HS血清中BDNF含量在六天課程後及一個月和二個月後有上升趨勢但未達顯著，其他組則無顯著差異。(4)在憂鬱症族群中， BDNF含量的改變程度與人際敏感度的改變有顯著的負相關。總而言之，六天程課後及規律地練習下，可以有效地改善許多精神方面的症狀及負面情緒，而生理方面發現淨化呼吸法有效地改善了睡眠品質、舒緩身體疼痛，並且在健康參與課者血清中BDNF有上升的趨勢；憂鬱症參與課者，血清中cortisol在持續練習後會顯著下降，顯示淨化呼吸法之減壓效果。雖然我們在憂鬱症族群中並無觀察到憂鬱症參與課者其BDNF含量有顯著上升，但是有發現BDNF含量的改變程度與人際敏感度的改變呈負相關，或許可以用在未來探討個別的憂鬱症者其體內BDNF的變化可能會伴隨改變的人際敏感度的現象。

Sudarshan Kriya yoga (SKY) breathing is composed of a sequence of special breathing techniques including ujjayi, bhastrika, and Sudarshan Kriya. It has been reported that regular practice of SKY has antidepressant and stress-reducing effects. However, the effectiveness of SKY and the underlying mechanisms of improving psychological and physiological symptoms remain unknown. Many studies showed that serum brain-derived neurotrophic factor (BDNF) levels are low and plasma cortisol levels are high in depressed patients. The purpose of this study was to investigate whether the psychological symptoms improved and whether the serum BDNF and cortisol levels changed after SKY training and regular practice. Recruited subjects were divided into four groups: depressed controls without SKY (DC, n = 13), depressed subjects with SKY (DS, n = 22), healthy controls without SKY (HC, n = 25), and healthy subjects with SKY (HS, n = 23). Daily SKY practice at home was self-reported and weekly group practice was arranged. Blood samples were collected and questionnaires were completed before and after the 6-day SKY training courses, and 1, 2, and 3 months later. Serum BDNF and cortisol levels were determined by enzyme-linked immunosobent assay. Results showed that (1) Beck Depression Inventory (BDI) scores decreased in DS and HS, Symptom Checklist-90 (SCL-90) decreased in DS, HS, and DC, the Maudsley Personality Inventory (MPI) scores changed, and Pittsburgh Sleep Quality Index (PSQI) score decreased in DS and HS, but not in HC; (2) the average concentration of serum cortisol levels decreased at 2 months in DS and increased at 1 and 2 months in DC; (3) BDNF slightly but not significantly increased after the 6-day SKY course and at 1 and 2 months in HS; (4) there was a negative correlation between the change of BDNF and the change of interpersonal sensitivity score of SCL-90 in depressed subjects. In conclusion, SKY is effective in improving psychological health. We also found the interpersonal sensitivity personality was negatively correlated to the change of BDNF in depressed subjects.

Abstract	3
摘要	5
Acknowledgement	8
I. Introduction	14
II. Materials and methods	18
2.1 The Sudarshan Kriya yoga course	18
2.2 Home SKY practices and follow-up group SKY practices	18
2.3 Subjects	18
2.4 Requirements for the recruitment of subjects	19
2.5 Beck depression inventory	20
2.6 Symptom checklist 90	20
2.7 Maudsley personality inventory	21
2.8 Pittsburgh sleep quality index	21
2.9 Blood samples	21
2.10 Serum BDNF levels	21
2.11 Serum cortisol levels	22
2.12 Statistics	23
III. Results	24
3.1 Beck depression inventory (BDI) scores decreased after the SKY course and regular follow-up practice.	24
3.2 Symptom checklist 90 (SCL-90) scores decreased after the SKY course and regular follow-up practice.	24
3.3 Maudsley Personality Inventory (MPI) changed after the SKY course and regular follow-up practice.	25
3.4 Pittsburgh sleep quality index (PSQI) decreased after the SKY course and regular follow-up practice.	26
3.5 Serum cortisol levels increased immediately after the SKY course and decreased after regular follow-up practice in depressed SKY users.	26
3.6 Serum BDNF levels did not change significantly immediately after SKY course and at 1, and 2 months later in healthy SKY users.	27
3.7 Negative correlation between change of BDNF and change of interpersonal sensitivity score of SCL-90 in depressed subjects.	27
IV. Discussion	28
Conclusion	31
V. References	32
Supplementary data	45

List of Table
Table 1. Characteristics of subjects recruited in this study   35
Table 2. Mean baseline and follow-up Pittsburgh sleep quality index scores    36
List of figures
Figure 1. Sudarshan Kriya yoga training program.   37
Figure 2. Median scores on Beck depression inventory (BDI) at each assessment point during the SKY program.  38
Figure 3. Scores in ten dimensions of self-checklist-90 (SCL-90) of the four groups before SKY (T0) and after three months of regular practice (T4   39
Figure 4. Scores on three dimensions of Maudsley personality inventory (MPI) of the four groups before SKY (T0) and after three months of regular practice (T4)  40
Figure 5. Serum cortisol levels at each assessment points during the SKY program  41
Figure 6. Serum BDNF levels at each assessment points during the SKY program   42
Figure 7. Correlation of the change of BDNF levels and the change of interpersonal sensitivity scores in SCL-90 (A) healthy subjects and (B) depressed subjects   43
 

                                    

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