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系統識別號 U0026-2807201020470500
論文名稱(中文) 淨化呼吸法對於乳癌患者的心理健康及血清皮質素含量的影響
論文名稱(英文) Effects of Sudarshan Kriya Yoga on psychological health and serum cortisol levels in breast cancer women
校院名稱 成功大學
系所名稱(中) 生理學研究所
系所名稱(英) Department of Physiology
學年度 98
學期 2
出版年 99
研究生(中文) 王昱文
研究生(英文) Yu-Wen Wang
學號 s3697403
學位類別 碩士
語文別 英文
論文頁數 43頁
口試委員 指導教授-黃阿敏
召集委員-黃朝慶
口試委員-林梅鳳
中文關鍵字 淨化呼吸法  乳癌 
英文關鍵字 Sudarshan Kriya Yoga  breast cancer 
學科別分類
中文摘要 罹患乳癌對女性而言是相當大的衝擊。伴隨著罹病壓力,常見的乳癌患者心理反應為焦慮、害怕、憂鬱以及不確定感,甚至促使壓力荷爾蒙,例如:皮質素(cortisol)的上升。淨化呼吸法(Sudarshan Kriya Yoga, SKY)為一套特別的呼吸技巧,教導人們透過呼吸調整身心健康,其課程內容包含調身法、調息法、淨化呼吸法、引導靜心、團體互動以及瑜珈知識分享。目前研究指出,常規練習淨化呼吸法可舒緩憂鬱並且降低血清中可體松含量。然而,淨化呼吸法對於乳癌病人是否適用,又是否對於乳癌病人的身心健康有所幫助尚不清楚。本篇論文透過心理量表的評估及血清皮質素含量的分析,探討淨化呼吸法課程以及常規練習淨化呼吸法三個月是否有效改善乳癌患者的心理健康以及改變生理參數。受試者分成兩組,乳癌對照組(BC),共21人;乳癌實驗組(BS),共25人。在課程前、課程後,以及課後追蹤的第一個月和第三個月抽血並填寫心理量表。取得的血清樣本進行皮質素的分析。在家練習記錄及團體追蹤練習簽到表可知,BS在家練習次數平均每週約六天,十二次的團體追蹤練習平均約六次,顯示乳癌患者願意規律練習淨化呼吸法,尤其在課程結束後的前兩個月。結果顯示,在BS組別,情境及特質焦慮分數在課程後及常規的練習均顯著下降。而復原力分數在課程後即顯著增加。癌症心理適應分數則在課程後和規律練習一個月明顯提昇,尤其在「絕望」、「正向」和「焦慮」三個向度。生活品質分數在規律練習第一個月有顯著的上升,尤其在「生理」、「心理」和「環境」三個向度。在BC組別,情境焦慮分數在追蹤的第三個月有顯著下降,其他心理量表則無改變。血清中的皮質素含量在BS組別可以看到在第一個月的時候顯著下降,BC組別也有相似的趨勢,但未達顯著。再者,皮質素含量下降與情境焦慮分數下降及癌症心理適應分數增加呈現相關。總結以上結果,淨化呼吸法不僅適用於乳癌患者,且在六天課程之後及常規練習,可看到淨化呼吸法對於乳癌患者的效益,包括縮短降低焦慮所需的時間、加速癌症適應力和復原力的提昇、也加快了生活品質的改善並且降低皮質素的含量。
英文摘要 Suffering from breast cancer is a devastating impact for women. Anxiety, fear, depression, and uncertainty are prevalent, and secretion of stress hormones, like cortisol, is increasing. Sudarshan Kriya Yoga (SKY) is a special kind of breathing technique which includes Yoga stretch, Ujjayi breathing, Bhastrika breathing and the core technique Sudarshan Kriya. Regular SKY practice not only relieves depression, but also decreases serum cortisol levels. In this study, we proposed that psychological health will be improved and serum cortisol levels will be decreased after the SKY training course and regular practice of SKY in breast cancer women. Subjects were divided into two groups: breast cancer subjects without SKY (BC, n=21), and breast cancer subjects with SKY (BS, n=25). Psychological health questionnaires were self-evaluated and blood samples were collected at 4 time points, pre-SKY training (T0), post-SKY training (T1), the first month (T2), and the third month (T3) after the SKY training courses. The frequency of daily SKY practice at home was ~6 times/week and follow-up group practice of SKY was ~6 times/12 weeks, suggesting that women with breast cancer were able to practice SKY regularly, especially in the first two months. In the BS group, State Anxiety Inventory (SAI) scores decreased at T1, T3 and Trait Anxiety Inventory scores decreased at T1, T2, and T3. Resilience Scale increased at T1. The total Mental Adjustment to Cancer scores increased at T1 and T2, especially in the domains of “Hopeless”, “Positive”, and “Anxious”. The total scores of Quality of Life increased at T2, especially in the domains of “Physical”, “Psychological”, and “Environment”. In the BC group, SAI and TAI scores decreased at T3, but no changes of the other psychological questionnaires. Serum cortisol levels significantly decreased at T2 in BSs, but not in BC. Decrease of serum cortisol level is correlated with the decrease of SAI scores and with the increase of MAC scores throughout the 3-month of regular practice. This study indicates that SKY is feasible for breast cancer women. The SKY training course and regular SKY practice reduce the time to improve anxiety, to increase mental adjustment to cancer, resilience and the quality of life and to decrease of serum cortisol levels.
論文目次 Table of contents
Abstract………………………………..………………………………………………3
摘要…………………………………………….……………………………………...4
致謝…………………………………………………….……………………………...5
Abbreviations……………………………………………………..…………………...7
I. Introduction……………………………………………………………...……........10
II. Materials and methods…………………………………………………………….13
2.1 Subjects…………………………………...……………………….…………13
2.2 The Sudarshan Kriya yoga (SKY) course……………………………………13
2.3 Daily SKY practice and follow-up group practice…………………………...13
2.4 Requirements for the recruitment of subjects………………………………...14
2.5 Psychological measurements…………………………………………………14
2.5.1 State-trait anxiety inventory (STAI)……………………………………14
2.5.2 Mental adjustment to cancer (MAC) scale……………………………..15
2.5.3 Resilience scale (RS)…………………………………………………...15
2.5.4 Brief version of the world health organization quality of life instrument (WHOQOL-BREF)………………………………………………........15
2.6 Cortisol analyzed………………………………..……………………………16
2.6.1 Blood samples collection………………………………………………16
2.6.2 Cortisol…………………………………………………………………16
2.7 Statistical methods……………………………………………………………16
III. Results……………………………………………………………………………18
3.1 The SKY training course and regular SKY practice decreased state and trait anxieties……………………………………………………………………....18
3.2 The SKY training course increased the resilience in breast cancer women….19
3.3 The SKY training course increased the mental adjustment to breast cancer…19
3.4 Regular SKY practice increased the quality of life…………………………..20
3.5 Serum cortisol levels increased after SKY training course and decreased at the first month of regular SKY practice in BSs………………………….……….21
3.6 The correlation between the change of serum cortisol and the change of psychological scores …………………………………………………………21
IV. Discussion………………………………………………………………………...23
Conclusion…………………………………………………………………………27
V. References…………..……………………………………………………………..28
VI. About the author……………….…………………………………………………31
List of table
Table 1. Characteristics of subjects recruited in this study…………………………..32
Table 2. Feasibility of the 6-day SKY training course and regular SKY practice in breast cancer women…………………………………………………..…..33
Table 3. Scores of the mental adjustment to cancer scale (MAC) in two groups at each assessment point…………………………………………………………..34
Table 4. The quality of life in two groups at T0, T2, and T3………………………...35


List of figures
Figure 1. Sudarshan Kriya yoga training course and follow-up group practice……...36
Figure 2. State-trait anxiety inventory (STAI) scores in two groups at four time points………………………………………………………………………37
Figure 3. Resilience scale (RS) scores in two groups at each assessment point………………………………………………………………………..38
Figure 4. Serum cortisol levels in two groups at four time points…………………...39
Figure 5. The correlation between the change of cortisol levels and the change of psychological scores in BCs……………………………………………....40
Figure 6. The correlation between the change of cortisol levels and the change of psychological scores in BSs…………………………………………….....41

Supplementary data
S1. The medicine record table of breast cancer control subjects in this study…….....42
S2. The medicine record table of breast cancer subjects with SKY in this study…....43
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