本研究得到了成都中医药大学附属医院科技发展基金（20HL01）和四川省干部健康研究项目（2023-505）的资助。这项研究得到了四川省干部卫生厅（川赣颜2023-505）的资助。

本研究严格遵循尊重道德、仁慈正义的原则。每组30名受试者，共90例。本课题已获成都中医药大学附属医院伦理委员会批准（2021KL-040）。从纳入本研究的患者那里获得知情同意。
1. 研究对象
<ol><li>采用便捷抽样法，选择成都的3个社区。</li>
	<li>从三个社区招募 T2DM 周围神经病变患者。</li>
	<li>使用以下纳入标准。<ol><li>包括 40-75 岁的患者。</li>
		<li>包括诊断为 DPN 的患者。</li>
		<li>包括可以进行中等强度有氧运动的患者。</li>
		<li>包括在研究期间未使用任何其他补充或综合疗法的患者。</li>
	</ol></li>
	<li>排除具有以下疾病的患者：由其他疾病引起的神经系统疾病，如颈椎和腰椎病、脑血管疾病、格林-巴利综合征和血管病变;孕妇或哺乳期妇女;精神异常无法合作。</li>
	<li>抽签将三个社区的患者随机分配到对照组 （CG）、太极组 （TCG） 和正念与太极组 （MTCG）。</li>
</ol>2. 方法一：CG的练习方法
<ol><li>进行 3 次集体健康教育课程，每次持续 40 分钟。 注：健康教育内容主要包括糖尿病饮食、运动、药物、血糖监测、足部护理、足部并发症的预防和护理12。三个小组分别进行健康教育。</li>
</ol>3. 方法二：TCG的练习方法
<ol><li>选择一个公共、安静的区域来练习 24 种简化的太极拳33 之一。 注：实施方法：分为热身、训练、放松3个部分。集中锻炼每周进行 3 次，每次 60 分钟，持续 12 周。</li>
	<li>指导参与者完成两组内收肌（即内旋）、外展肌（即外旋）、腘绳肌（即单腿僵硬向前弯曲伸展）、臀肌（即髋关节屈曲和伸展）和踝关节定向（即脚踝旋转）动态伸展练习 10 分钟，作为热身准备练习的一部分34.</li>
	<li>在太极拳教练的指导下，让参与者随着太极音乐表演太极拳动作40分钟。 注：太极拳的动作包括：从两侧野马的鬃毛开始，白鹤展开翅膀，两侧刷膝盖和扭步，弹奏琵琶，击退猴子，抓住鸟的尾巴，单鞭，挥手如云，高拍马，右脚后跟踢，双拳击打对手的耳朵， 左脚跟转身踢腿，蛇匍匐而下，玉女编织梭子，针刺海底，闪臂转身，向下偏转，招架出拳，双手交叉，合拢33。</li>
	<li>做上下肢放松练习和呼吸调节练习 10 分钟作为放松练习35. 注意：首先，站立并反复摇晃肩膀和手臂。然后捶打和按摩腿部。最后，坐下并调整呼吸模式。</li>
</ol>4. 方法三：母婴传播的实践方法
<ol><li>选择一个开放安静的地方铺上瑜伽垫坐下。 注意：正念训练与太极拳练习相结合，每周进行 3 次，每次 60 分钟，共 12 周。鼓励受试者每天在家中坚持正念练习。目的是将正念融入日常生活。</li>
	<li>开始正念训练与太极拳相结合。 注：具体培训安排见 表1。<ol><li>正念训练与太极拳练习方法相结合<ol><li>正念冥想：<ol><li>坐在瑜伽垫上。</li>
				<li>慢慢吸气和呼气 3-4 次深呼吸。</li>
				<li>感觉空气进入鼻子，充满胸部和腹部，并呼出身体。</li>
				<li>将呼吸节律调整回正常。不要试图控制呼吸。</li>
				<li>将呼吸节律调整回正常。不要试图控制呼吸。</li>
				<li>注意呼吸、身体、声音、思想、情绪等，慢慢放松身体。</li>
			</ol></li>
			<li>正念身体扫描：<ol><li>仰卧在瑜伽垫上，双腿自然分开，眼睛几乎闭不上，手臂自然坐下，不接触身体。</li>
				<li>注意整个身体的感觉，从脚趾到大脑。在进行正念身体扫描练习时，选择坐着以防止入睡。</li>
			</ol></li>
			<li>正念运动（太极拳）：<ol><li>专注于太极拳的每一个动作。 注意：在太极拳练习中，用温和的语言引导练习者感受腿部肌肉交替收缩和放松带来的压力和放松，感受脚与地面接触的感觉。</li>
				<li>尽量在任何时候都保持正念状态。</li>
				<li>当腿部肌肉交替收缩和放松时，感到压力和放松。同时，感受双脚触地的感觉。</li>
			</ol></li>
		</ol></li>
	</ol></li>
	<li>结束活动<ol><li>做上下肢放松练习和呼吸调节练习 10 分钟作为放松练习35. 注意：首先，站立并反复摇晃肩膀和手臂。然后捶打和按摩腿部。最后，坐下并调整呼吸。</li>
		<li>坐在冥想中，不要对进入头脑的各种想法做出任何判断，并始终接受这些概念。</li>
		<li>将每项日常任务（例如刷牙、淋浴或做饭）转换为正念练习。</li>
	</ol></li>
</ol>5. 收集信息
<ol><li>选派数据采集人员，开展统一培训。 注意：分别在干预之前和之后收集数据。数据收集者全权负责数据收集，对分组分配不知情，以减少数据收集者的主观偏见。<ol><li>收集多伦多临床评分系统 （TCSS）36、视觉模拟量表 （VAS）37、正念和注意力意识量表 （MAAS）38、糖尿病特异性生活质量量表 （DSQL）39 和血清肿瘤坏死因子-α （TNF-α） 水平的数据。</li>
	</ol></li>
	<li>在研究开始之前，由研究团队成员讨论并决定每个指标的详细收集标准。</li>
	<li>向受试者彻底解释量表的含义、每个项目的含义以及如何使用它。</li>
	<li>帮助参与者就位，进行身体评估，并详细记录。</li>
	<li>从附近医院的参与者那里收集血液样本，然后立即将其送到实验室。</li>
	<li>及时检查所收集信息的准确性和完整性。</li>
</ol>6. 统计分析
<ol><li>使用任何统计分析软件收集和分析数据。 注：在本研究中，使用了SPSS 24.0。</li>
	<li>通过平均值、频率或成分比率的平均值±标准误差来描述数据。</li>
	<li>使用卡方检验、方差分析、Kruskal Wallis H 检验、配对 t 检验和 Wilcoxon 符号秩检验。</li>
	<li>在每个样品的所有时间点至少读取三次读数。</li>
</ol>

太极拳配合正念训练治疗糖尿病周围神经病变

作者没有什么可透露的。

以前的许多研究都报道了如何应用太极拳来治疗和康复慢性疾病40,41。虽然太极拳在慢性病的治疗和康复方面显示出积极的作用，但真正实现身心锻炼对于增强太极拳的效果至关重要。 本研究将太极拳与正念训练相结合，成功提高了太极拳的练习效果，确实实现了身心运动。
这项研究成功地将正念训练融入了太极拳。 参与者必须?...

糖尿病 （DM） 是全球严重的健康问题，影响着全球数百万人1.国际糖尿病联合会 （IDF） 显示，到 2045 年，糖尿病的患病率可能会增加至 12.2%2。2 型糖尿病 （T2DM） 约占DM 2 的 90%。T2DM 患者，尤其是那些难以控制血糖水平的患者，可能会出现不良并发症，包括大血管疾病、微血管病和糖尿病周围神经病变 （DPN）3。DPN 是一种普遍存在的微血管并发症，随着时间的推移，至少 50% 的 DM 患者会出现 DPN 体征和症状4。不幸的是，DPN 经常被忽视，患者的实际数字远高于大多数病例报告的数字2。
血糖控制不佳的患者容易发生起病隐匿的 DPN。DPN 的初始症状通常不明显，这使得患者很容易忽视病情。当出现明显的症状和功能障碍时，已造成不可逆的神经损伤5.DPN 具有复杂的临床表现。患者患有长期代谢紊乱和氧化应激损伤。这可能导致对称性肢体麻木、疼痛或感觉异常 6,7。随着疾病的进展，神经和血管损伤进一步加重，最终导致不可逆的组织损伤8.糖尿病足溃疡和截肢的发生率与 DPN9 的死亡率相关。此外，由于 DPN 的症状经常持续存在，许多患者会出现抑郁、睡眠障碍和活动受限，导致整体生活质量下降甚至残疾10。
目前，除了血糖控制和药物治疗外，生活方式干预（包括运动、饮食、心理治疗等）是公认的对 DPN 患者的有效治疗方法11。根据美国糖尿病协会（ADA）的说法，“有价值的运动对所有糖尿病患者都有好处”。例如，它可以改善糖脂代谢和胰岛素抵抗1。研究表明，运动可以改善 DPN12,13 患者的代谢、血管损伤和神经功能。然而，DPN 患者由于缺乏运动、疼痛和对足部受伤的恐惧而不愿运动。
根据恐惧回避模型 （FAM），糖尿病周围神经病变 （DPN） 患者的身体不适和日常活动受限会降低他们的社交互动能力，进而导致焦虑和抑郁等负面情绪反应14.相反，负面情绪会影响血糖控制并增加并发症的发生率15,16,17,18。因此，DPN推荐采用身心疗法，其重点是思想、情绪、身体和行为之间的相互作用。目的是实现身体和心灵的平衡。
太极拳是中国传统的身心运动。太极拳因其独特的运动方式和对疾病的治疗作用而受到世界学者的广泛关注。在国际期刊上发表的多项高质量临床试验证实了太极拳对帕金森病19、中风20、代谢综合征21、膝关节炎22、乳腺癌23等慢性病的治疗和康复的有效性。太极拳属于一类中等强度的有氧运动，它使用连续的身体螺旋运动和调节呼吸来提高有氧能力、肌肉力量、平衡和运动能力。中医认为太极拳可以平衡阴阳，跑气流血，放松经络24。对于DPN患者来说，这是一种合适的运动形式。许多研究发现，太极拳可以改善胰岛素抵抗和血脂，并降低焦虑和抑郁的发生率25,26。此外，太极拳可以改善T2DM 27患者的生活质量并降低体重指数。
正念训练是另一种突出的身心干预，其重点是培养一种有意识的、即时的、非评判性的体验意识28.它有助于增强对当前体验的关注，包括思想、感觉、呼吸和身体感觉。Zeidan的研究发现，正念训练可以使患者更客观地评估不适并改善自我调节29。Wielgosz的研究表明，运动干预的最大问题是依从性差，这可以通过在运动30中增加正念训练来解决。正念训练结合运动可有效提高患者运动意愿，增加运动时间和频率，促进患者在活动中感知身体感觉。
同时，运动结合正念训练，可以拓宽患者的视野，增强对自己的了解。这有助于身体变得更加灵活、放松和平衡，有效缓解患者的负面体验。正念训练的概念与太极拳的“形灵合一”的理念是一致的。 由于感觉功能受损，大多数DPN患者经常从大脑提供的脚部接收错误信息31。正念训练可以通过心理调节和神经调节来增强运动的效果32.因此，本研究旨在验证正念训练结合太极拳的可行性，并探讨其对 DPN 患者的影响。

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effects of mindfulness training combined with tai chi in patients with diabetic peripheral neuropathy

糖尿病周围神经病变（DPN）是糖尿病最常见的慢性并发症之一。其关键的治疗方法之一是身心锻炼。最近，研究了各种运动方式，包括踏步、阻力、有氧运动、平衡和全身振动，以构建最适合 DPN 患者的运动形式。本研究的目的是描述正念训练与太极拳相结合的标准方案。 采用便利抽样法从3个社区中选取90例符合纳入和排除标准的DPN患者。将3个社区随机分为对照组（CG）、太极拳组（TCG）和正念训练联合太极拳组（MTCG）。CG每月接受一次常规健康教育指导，共3次。根据CG，TCG练习了三次太极拳;MTCG每周接受正念训练和太极拳练习，共计12周。采用多伦多临床评分系统（TCSS）、正念注意力意识量表（MAAS）、视觉模拟量表（VAS）、糖尿病特异性生活质量量表（DSQL）和肿瘤坏死因子-α评估受试者的临床症状、神经功能、注意力意识水平、疼痛和生活质量。总的来说，在太极拳中加入正念训练，有效增强了太极拳的运动效果，因此，正念训练与太极拳相结合，是值得推广和应用的。

Diabetes Mellitus (DM) is a serious health concern globally, affecting millions of people worldwide1. The International Diabetes Federation (IDF) reveals that the prevalence of DM could increase up to 12.2% by 20452. Type 2 diabetes (T2DM) accounts for about 90% of DM2. Patients with T2DM, particularly those who struggle to control their blood glucose levels, are likely to suffer from adverse complications, including macrovascular disease, microangiopathy, and diabetic peripheral neuropathy (DPN)3. DPN is a prevalent microvascular complication, with at least 50% of DM patients showing DPN signs and symptoms over time4. Unfortunately, DPN is often ignored, and the actual figures of patients suffering are much higher than reported in most cases2.
Patients with poor glycemic control are prone to developing DPN with an insidious onset. The initial symptoms of DPN are often unremarkable, which makes it easy for patients to overlook the condition. When obvious symptoms and functional impairment appear, irreversible neurological damage has been caused5. DPN has a complex clinical presentation. Patients suffer from long-term metabolic disturbances and oxidative stress damage. This can result in symmetrical limb numbness, pain, or paresthesia6,7. As the disease progresses, neurological and vascular injuries are further aggravated, eventually leading to irreversible tissue damage8. The incidence of diabetic foot ulcers and amputations is associated with mortality from DPN9. In addition, as symptoms of DPN often persist, many patients experience depression, sleep disturbances, and activity limitations, leading to a decrease in overall quality of life and even disability10.
Currently, lifestyle interventions (including exercise, diet, psychotherapy, etc.) are well recognized as effective treatments for DPN patients in addition to glycemic control and pharmacotherapy11. According to the American Diabetes Association (ADA), &#34;valuable exercise is beneficial to all patients with DM&#34;. For example, it can improve glycolipid metabolism and insulin resistance1. Studies have shown that exercise can improve metabolic, vascular damage, and neurological function in patients with DPN12,13. However, patients with DPN are reluctant to exercise due to a lack of motility, pain, and fear of foot injury.
The diabetic peripheral neuropathy (DPN) patients&#39; physical discomfort and limitations on daily activities, according to the Fear-Avoidance Model (FAM), can reduce their capacity for social interaction, which in turn can contribute to negative emotional reactions like anxiety and depression14. Conversely, negative emotions can affect glycemic control and increase the rate of complications15,16,17,18. Therefore, mind-body therapy is recommended for DPN, which focuses on the interaction between thoughts, emotions, bodies, and behaviors. The aim is to achieve homeostasis of the body and mind.
Tai Chi is a traditional Chinese mind-body exercise. Tai Chi has received much attention from scholars worldwide because of its unique exercise modes and therapeutic effects on diseases. Multiple high-quality clinical trials published in international journals have confirmed the effectiveness of Tai Chi for the treatment and rehabilitation of chronic diseases such as Parkinson&#39;s disease19, stroke20, metabolic syndrome21, knee arthritis22, and breast cancer23. Tai Chi belongs to a class of moderate-intensity aerobic exercises that uses continuous body spiral exercise and regulated breathing to improve aerobic capacity, muscle strength, balance, and exercise capacity. Traditional Chinese medicine holds that Tai Chi can balance yin and Yang, run Qi and blood, and relax meridians24. It is a suitable form of exercise for patients with DPN. Many studies have found that Tai Chi improves insulin resistance and blood lipids, and reduces the incidence of anxiety and depression25,26. In addition, Tai Chi could improve quality of life and decrease body mass index for patients with T2DM 27.
Mindfulness training is another prominent mind-body intervention that focuses on cultivating an intentional, moment-to-moment, nonjudgmental awareness of experience28. It helps to enhance attention to the present experience, including thoughts, feelings, breathing, and body sensations. Zeidan&#39;s research found that mindfulness training could make patients more objectively evaluate discomfort and improve self-regulation29. Wielgosz&#39;s study showed that the biggest problem of exercise intervention was poor compliance, which could be solved by adding mindfulness training to exercise30. Mindfulness training combined with exercise could effectively improve patients&#39; willingness to move, increase the time and frequency of movement, and promote patients&#39; perceiving body sensations in activity.
Meanwhile, exercise combined with mindfulness training can expand patients&#39; vision and enhance their understanding of themselves. This helps the body to become more flexible, relaxed, and balanced, effectively relieving the negative experience of patients. The concept of mindfulness training is consistent with the idea of &#34;unity of form and spirit&#34; of Tai Chi. Most patients with DPN often receive misinformation from the feet provided by the brain due to impaired sensory function31. Mindfulness training can enhance the effect of movement through psychological regulation and nervous regulation32. Therefore, this study aims to verify the feasibility of mindfulness training combined with Tai Chi and explore its effect on DPN patients.

作者聚焦：将太极拳与正念训练相结合，实现有效的身心锻炼 

正念训练联合太极拳对糖尿病周围神经病变患者的影响

Our research focused on the Chinese traditional sports Tai Chi. We are exploring the possibility and the effectiveness of mindfully training combined with Tai Chi as the mind-body exercise for treating diabetic peripheral neuropathy. Ensuring that subjects complete three intensive training sessions per week is an important challenge in this study.Our research show that Tai Chi can be well-integrated with mindfulness training. Our outline the steps to integrate mindfulness training with Tai Chi. It will pave the way for the future development of Tai Chi, making this traditional sports more engaging and beneficial for practitioner.In the future, we will focus on the application of mindfulness training combined with Tai Chi in other chronic diseases. We will also make efforts to promote mindfulness training combined with Tai Chi.

在这项研究中，有 7 人未能完成试验。所有必要的数据都是从完成试验的83个人中收集的。有38名女性和45名男性。年龄从44岁到75岁不等，平均年龄为（60.57+8.76）。DM 可能持续 4 到 22 年，平均为 14.10 + 4.85 年。DPN 持续了 1 年到 15 年不等，平均为 5.76 + 2.78 年。三组的一般数据差异无统计学意义（p>0.05）。
干预后，3组患者TCSS评分差异有统计学意义（P < 0.001）（见?...

Watch this Scientific Journal Video about Integrating Tai Chi with Mindfulness Training to Achieve an Effective Mind-Body Exercise at JoVE.com

在研究运动治疗糖尿病周围神经病变 （DPN） 时，实现身心锻炼至关重要。本研究提出了一种正念训练与太极拳相结合的方案，以实现身心锻炼。

Diabetic peripheral neuropathy (DPN) is one of the most prevalent chronic complications of diabetes. One of its crucial therapy approaches is mind-body ...

我们的研究集中在中国传统运动太极拳上，我们正在探索正念训练与太极拳相结合作为治疗糖尿病周围神经病变的身心锻炼的可能性和有效性。确保受试者每周完成三次强化训练是本研究的一项重要挑战。我们的研究表明，太极拳可以与正念训练很好地结合在一起。我们概述了将正念训练与太极拳相结合的步骤。 它将为太极拳的未来发展铺平道路，使这项传统运动对练习者更具吸引力和益处。未来，我们将专注于正念训练与太极拳相结合在其他慢性疾病中的应用。我们还将努力推广与太极拳相结合的正念训练。

effects-mindfulness-training-combined-with-tai-chi-patients-with

Research

JoVE Journal

Medicine

Effects of Mindfulness Training Combined with Tai Chi in Patients with Diabetic Peripheral Neuropathy

1.2K 次观看.  Hospital of Chengdu University of Traditional Chinese Medicine. 我们的研究集中在中国传统运动太极拳上，我们正在探索正念训练与太极拳相结合作为治疗糖尿病周围神经病变的身心锻炼的可能性和有效性。确保受试者每周完成三次强化训练是本研究的一项重要挑战。我们的研究表明，太极拳可以与正念训练很好地结合在一起。我们概述了将正念训练与太极拳相结合的步骤。 它将为太极拳的未来发展铺平道路，使这项传统运动对练...

视频: 作者聚焦：将太极拳与正念训练相结合，实现有效的身心锻炼 

Diabetic peripheral neuropathy (DPN) is one of the most prevalent chronic complications of diabetes. One of its crucial therapy approaches is mind-body exercise. Recently, various exercise modalities, including stepping, resistance, aerobics, balance, and whole-body vibration, were investigated to construct the most suitable form of exercise for patients with DPN. The purpose of this study is to describe a standard protocol for mindfulness training combined with Tai Chi. The convenience sampling method was used to select 90 patients with DPN who met the inclusion and exclusion criteria from three communities. The three communities were randomly divided into the control group (CG), the Tai Chi group (TCG), and the mindfulness training combined with the Tai Chi group (MTCG). The CG was given routine health education guidance once a month, a total of three times. Based on the CG, the TCG practiced Tai Chi three times; the MTCG received mindfulness training combined with Tai Chi exercise a week for a total of 12 weeks. Before the intervention and 12 weeks after the intervention, the clinical symptoms, neurological function, attention awareness level, pain, and quality of life of the subjects were evaluated by Toronto Clinical Scoring System (TCSS), Mindful Attention Awareness Scale (MAAS), Visual analog scale (VAS), Diabetes Specificity Quality of life Scale (DSQL) and tumor necrosis factor-&#945;. Overall, the addition of mindfulness training to Tai Chi effectively enhances the exercise effects of Tai Chi. Therefore, mindfulness training combined with Tai Chi is worthy of promotion and application.

When studying exercise for treating diabetic peripheral neuropathy (DPN), achieving mind-body exercise is essential. This study proposes a protocol for mindfulness training combined with Tai Chi to achieve mind-body exercise.

科研

医学

Practicing Mindfulness Combined with Tai Chi for Diabetic Peripheral Neuropathy Management

To begin mindfulness training combined with Tai Chi, select an open and tranquil space. Spread the yoga mat and sit on it to perform mindfulness meditation. Slowly and deeply breathe in and out three to four times, focusing on the sensation of air, entering through the nostrils, filling the chest and abdomen, and then exiting the body.Then allow the breathing rhythm to return to normal and do not control the breathing. Next, focus on various elements such as breath, physical sensation, audio cues, thought processes, and emotions, while consciously relaxing the body. Transition into the mindfulness body scan by lying supine on the yoga mat.Legs resting apart at a natural distance, eyes nearly closed, and arms beside the body without making contact with the body. Concentrate on the sensations throughout the body from the toes up to the brain. If falling asleep, choose to sit to avoid dozing off during the mindfulness body scanning exercises.Next, perform Tai chi or mindfulness movement by focusing on every individual movement aiming to maintain a state of deep mindfulness throughout the process. Take note of the alternating stress and relaxation in the leg muscles, as well as the tactile sensation of the feet touching the ground. To end the activity engage in relaxation exercises for both the upper and lower limbs.Also, perform breathing adjustments for a 10 minute duration, which acts as a relaxed balancing conclusion to the activity. Sit in a meditative state, refrain from making judgements about the thoughts that arise and always accept these concepts. After the intervention, there was a statistically significant difference in the TCSS score of MTCG, the group practicing mindfulness training with Tai Chi, TCG, the group practicing only Tai Chi and the control group, or cg.The TCSS score of MTCG was significantly lower than TCG and CG.The MAAS score of the MTCG not only improved after the intervention, but it was also significantly higher than that of the TCG and CG.After the intervention, there was a statistically significant difference in the VAS scores between the three groups. The score of the MTCG was significantly lower than the other groups. A similar trend was observed in the case of the serum necrosis factor alpha or TNF alpha levels.After the intervention, there was a statistically significant difference in the DSQL scores between the three groups. The DSQL score of the MTCG was significantly lower than that of the other groups.