| ObjectiveBaduanjin was used for Fibromyalgia syndrome(FMS),and the patient demographic index,disease diagnosis index,efficacy index before and after treatment,and some blood samples of the patients were analyzed.The influencing factors and preliminary mechanism of FMS efficacy were explored to find the dominant patient characteristics of Baduanjin in the treatment of fibromyalgia syndrome and provide reference for clinical treatment.(1)Clinical study of Baduanjin in treating FMS1.Study subjectsFrom April 2015 to August 2020,I went to Guang’anmen Hospital of China Academy of Chinese Medical Sciences and completed a 12-week course of FMS,a total of 104 patients.2.MethodsBaduanjin was used for Fibromyalgia syndrome(FMS),and the patient demographic index,disease diagnosis index,efficacy index before and after treatment,and some blood samples of the patients were analyzed.The influencing factors and preliminary mechanism of FMS efficacy were explored to find the dominant patient characteristics of Baduanjin in the treatment of fibromyalgia syndrome and provide reference for clinical treatment.Efficacy determination method:50%of pain VAS improvement rate after ①treatment was the effective group,<50%and 30%was effective group,and<30%was invalid group.FIQ or FIQR after②treatment was 20%in the valid group and<20.Primary efficacy indicators:Fibromyalgia Impact Survey(Fibromyalgia Impact questionnaire,FIQ;pain visual simulation score(Visual analogue scale,VAS);secondary efficacy indicators:Baker Depression Scale,Pittsburgh Sleep Quality Scale,Stress perception Scale.3.Statistical methodUse SPSS26.0 statistical analysis software for calculation;all statistical tests are two-sided test,p-value less than 0.05 is considered statistically significant;measurement data will be described by mean±standard deviation.The changes before and after treatment were compared by t-test and non-parametric test;the count data were statisdescribed by frequency(composition ratio).Changes before and after treatment in both groups were tested by the x2 test or non-parametric test.4 research resultsThe comparison of demographic indexes between the two groups showed that there was no significant difference in gender,age and course of disease.Except for FIQ score(P<0.05),there was no significant difference in pain VAS score,Beck Depression Scale score,Pittsburgh Sleep Quality Scale score and stress perception scale score.4.1 comparison of effective rate between Baduanjin group and control groupThe curative effects of the two groups were compared according to the improvement rate of pain VAS score after treatment.In the Baduanjin group,10 cases were significantly effective(13.7%),47 cases were effective(64.38%),16 cases were ineffective(21.92%),and the total effective rate was 78.08%;In the control group,3 cases were markedly effective(9.68%),2 cases were effective(6.45%),26 cases were ineffective(83.87%),and the total effective rate was 16.13%(P<0.05).The curative effects of the two groups were compared by the improvement rate of FIQ scores after treatment.In the Baduanjin group,51 cases(69.86%)were effective;The control group was effective in 6 cases(19.35%)(P<0.05).4.2 Comparison of the difference between pre-treatment and post-treatment values in the Baduanjin and control groupsPain VAS score,FIQ score,Baker Depression Scale score,Pressure Perception Scale score,and Pittsburgh Sleep Quality Scale score comparisons were significant(P<0.05).In terms of improving physical pain,After treatment,the difference in VAS score of pain in Baduanjin group was 3.2 ±2.3 and was more lower than 0.47 ± 1.42 in the control group;In the improvement of somatic symptoms and function,After treatment,the difference between the FIQ score in the Baduanjin group of 13.13 ± 16.7 was more lower than that in the control group of-0.57 ± 2.43;In terms of improving the depressive mood,After treatment,the score difference of the Baker depression scale was 3.12±5.4,which was more lower than 1.16± 3.92 in the control group;In terms of improving stress resistance,After the treatment,the score score difference of 3.77 ± 8.21 was more lower than that of the control group of-0.55 ± 6.05;In terms of improving sleep quality,The Pittsburgh sleep quality score difference of 2.74±3.25 was more lower than the 0.35 ± 1.92 difference in the control group.(2)Analysis of influential factors of Baduanjin in treating FMS 1 grouping method1)According to the vas improvement rate of pain after treatment,73 patients with FMS were divided into ineffective group,effective group and significantly effective group.(1)Compare the effective group with the invalid group.(2)The effective group was compared with the ineffective group;2)The effective group and the ineffective group were compared by the improvement rate of FIQ.2 single factor screeningDemographic indicators:gender,age,body mass index,education,work,family income,marital status,smoking history and course of disease.Diagnostic indicators:number of tenderness points,generalized pain index,symptom severity score,fibromyalgia symptom severity score.Efficacy indicators:pain VAS score,FIQ score(including function,symptoms and overall situation),Baker Depression Scale score,Pittsburgh Sleep Quality Scale score,stress perception scale score,short form 36(SF-36).The SF-36 score includes two dimensions:general physical health evaluation and general mental health evaluation.The general physical health evaluation includes:physiological function,physiological function,physical pain and general health status;The general evaluation of mental health includes energy,social function,emotional function and mental health.3 Multivariate analysisThe selected univariate indicators were subjected to multivariate analysis to analyze the independent factors affecting the efficacy of Baduanjin in FMS.4 Statistical methodStatistical analysis using SPSS26.0 software,t-test or non-parametric test for measurement data and chi-square test for count data.Variables with p less than 0.2 were selected in the univariate analysis for multivariate Logistics regression analysis,which were statistically significant when p was less than 0.05.5 research results5.1 comparison between total effective group and invalid group5.1.1 single factor analysis of FMS efficacy① Comparison of demographic indexes between total effective group and ineffective group before treatmentSex,body mass index,education,work,family income,marital status and course of disease were more than 0.2,and were not included in the multivariate regression.Age and smoking history(P<0.2)could be included in the multivariate analysis.② Comparison of disease diagnostic indexes between total effective group and ineffective group before treatmentThe number of tenderness points,generalized pain index,symptom severity score and fibromyalgia symptom severity score(P>0.2)were not included in the multivariate analysis.Comparison of pretherapeutic efficacy index between ③ total effective group and ineffective groupTotal FIQ,Baker Depression Scale,Pittsburgh Sleep Quality Scale,stress perception and mental health,physical health,physical pain,general health,energy,social,and emotional functions p greater than 0.2 were not included in the multivariate analysis.Pain VAS score,mental health,physiological function p less than 0.2 can be included in the multivariate analysis.5.1.2 Multivariate Logistics regression analysisMultivariate logistics regression analysis of age,smoking history,pain VAS score,mental health and physiological functions showed that pain VAS score(OR=1.58,P<0.05)was an independent factor affecting the efficacy of FMS,the higher the pain degree of patients,the more likely the effective treatment of FMS.5.2 Comparison of the effective group and invalid group5.2.1 Univariate analysis of the efficacy of the FMS①Comparison of predominance and ineffective group pretherapy demographic measuresThere were no significant statistical differences in sex,body mass index,education,work status,family income,marital status,and disease course.The comparison of age and smoking history with p<less than 0.2 could be included in the multivariate analysis.②Comparison of diagnostic index of effect groupThe number of tenderness points,generalized pain index,symptom severity score,and severity of fibromyalgia symptom score with p greater than 0.2 were not included in the multivariate analysis.③ Comparison of pretherapeutic efficacy index between dominant effect group and ineffective groupThe FIQ score,Baker Depression Scale score,stress perception scale score,general physical health assessment and mental health general assessment and physical function,physical pain,general health status,energy,social function,and emotional function comparisons p greater than 0.2 were not included in the multivariate analysis.The Pittsburgh Sleep Quality Scale score,pain VAS score,and mental health,physiological function comparisons of p of less than 0.2 were included in the multivariate analysis.5.2.2 Results of the multivariate Logistics regression analysisAge,smoking history,pain VAS score,Pittsburgh Sleep Quality Scale score,mental health,and physiological function were included in the multivariate logistics regression analysis.The results showed that the pain VAS score(OR=1.77,P<0.05)were the independent factors affecting the efficacy of FMS.When patients have high pain VAS scores,Baduanjin is more likely to treat FMS.5.3 comparison between effective group and invalid group5.3.1 single factor analysis of FMS efficacy① Comparison of demographic indexes between effective group and ineffective group before treatmentGender,age,education,family income,smoking history and course of disease(P>0.2)were not included in the multivariate analysis;The comparison of work status,body mass index and marital status(P<0.2)was included in the multivariate analysis.② Comparison of disease diagnostic indexes between effective group and ineffective group before treatmentThe number of tenderness points,generalized pain index and fibromyalgia severity score(P>0.2)were not included in the multivariate analysis;The symptom severity score(P>0.2)was included in the multivariate analysis.③ Comparison of efficacy indexes between effective group and ineffective group before treatmentThe scores of Beck Depression Scale,Pittsburgh sleep quality scale,stress perception scale and general mental health assessment,general health status,energy,social function,emotional function and mental health,P<0.2,were not included in the multivariate analysis.Pain VAS score,FIQ score,general physical health evaluation,physiological function,physiological function,physical pain comparison p less than 0.2,included in the multivariate analysis.5.3.2 multivariate logistic regression analysisAge,body mass index,work status,marital status,tenderness point count,symptom severity score,pain VAS score,FIQ score,general physical health evaluation,physiological function,physiological function and physical pain were included in the multivariate logistic regression analysis.The results showed that:work status(retirees or=0.00,P<0.05),symptom severity scale(or=2.47,P<0.05),physiological function(or=0.91,P<0.05)Somatic pain(or=0.69,P<0.05)was an independent factor affecting the efficacy of FMS.(3)mechanism researchThrough the quantitative analysis of the serum proteins of exome(n=6)and ineffective group(n=6),the two groups of differentially expressed proteins were screened by the standard of difference fold(FC)1.2 and P-value<0.05.A total of 25 differential proteins were identified,and 18 were upregulated(FC 1.2,P<0.05)and 8 were decreased(FC 0.83,P<0.05).Gene Ontology database and Kyoto Gene and Genome Encyclopedia are used.GO enrichment is mainly signaling and biological regulation,including acute inflammatory response,protein activation system,humoral immune response and complement activation.KEGG signaling pathway analysis indicates that the differential proteins in the ineffective group are mainly enriched in the "complement and coagulation cascade" pathway.research conclusion1.After 12 weeks of Baduanjin exercise under the guidance of medical staff,the physical pain,sleep quality,depressive mood,resilience,and somatic symptoms and somatic functions of FMS patients were significantly improved.2.Pre-treatment pain level,symptom severity score,physiological function dimension score,and physical pain dimension score may be the influencing factors affecting the efficacy of Baduanjin in FMS treatment.3.Inflammation-related pathways dominated by the complement and lectase pathways may be potential targets of action. |
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