神奇的医嘱冥想.doc

Doctors Orders: 20 Minutes Of Meditation Twice A Day神奇的医嘱：冥想At Beth Israel Deaconess Medical Center in Boston, doctors orders can include an unlikely prescription: meditation.I recommend five minutes, twice a day, and then gradually increase, said Aditi Nerurkar, a primary-care doctor and assistant medical director of the Cheng & Tsui Center for Integrative Care, which offers alternative medical treatment at the Harvard Medical School-affiliated hospital. Its basically the same way I prescribe medicine. I dont start you on a high dose right away. She recommends that patients eventually work up to about 20 minutes of meditating, twice a day, for conditions including insomnia and irritable bowel syndrome.Integrative medicine programs including meditation are increasingly showing up at hospitals and clinics across the country. Recent research has found that meditation can lower blood pressure and help patients with chronic illness cope with pain and depression. In a study published last year, meditation sharply reduced the risk of heart attack or stroke among a group of African-Americans with heart disease.At Beth Israel Deaconess, meditation and other mind-body therapies are slowly being worked into the primary-care setting. The program began offering some services over the past six months and hopes eventually to have group meditation classes, said Dr. Nerurkar.Health experts say meditation shouldnt be used to replace traditional medical therapies, but rather to complement them. While it is clear that when you breathe in a very slow, conscious way it temporarily lowers your blood pressure, such techniques shouldnt be used to substitute for medications to manage high blood pressure and other serious conditions, said Josephine Briggs, director of the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health. In general, she said, meditation can be useful for symptom management, not to cure or treat disease.Dr. Briggs said the agency is funding a number of studies looking at meditation and breathing techniques and their effect on numerous conditions, including hot flashes that occur during menopause. If meditation is found to be beneficial, it could help women avoid using hormone treatments, which can have detrimental side effects, she said.Martha OBoyle, a 51-year-old in Fremont, Calif., has suffered from chronic pain in her arms, chest and elsewhere since suffering from a heart attack two years ago.Heres a cardiologist telling me to go and meditate, said Ms. OBoyle. Im thinking, does she think Im crazy?Ms. OBoyle began taking meditation classes at Stanford Hospital & Clinics in 2011. The eight-week class consisted of once-a-week sessions lasting two to three hours. Once I started the class I saw the benefits of it, she said. Now, Ms. OBoyle meditates every day for 20 to 45 minutes. The pain is not gone, but it helps me cope with it, she said.The most common type of meditation recommended by doctors and used in hospital programs is called Mindfulness-Based Stress Reduction, which was devised at the University of Massachusetts Medical School. Dr. Nerurkar said she doesnt send patients to a class for training. Instead, she and other physicians at Beth Israel Deaconess will demonstrate the technique in the office. Really its just sitting in a quiet posture thats comfortable, closing your eyes and watching your breath, she said.Murali Doraiswamy, a professor of psychiatry at Duke University Medical Center in Durham, N.C., says it isnt clearly understood how meditation works on the body. Some forms of meditation have been found to activate the parasympathetic nervous system, which stimulates the bodys relaxation response, improves blood supply, slows down heart rate and breathing and increases digestive activity, he said. It also slows down the release of stress hormones, such as cortisol.Dr. Doraiswamy says he recommends meditation for people with depression, panic or anxiety disorders, ongoing stress, or for general health maintenance of brain alertness and cardiovascular health.Thousands of studies have been published that look at meditation, Dr. Doraiswamy said. Of these, about 500 have been clinical trials testing meditation for various ailments, but only about 40 trials have been long-term studies. It isnt known whether there is an optimal amount of time for meditating that is most effective. And, it hasnt been conclusively shown that the practice causes people to live longer or prevents them from getting certain chronic diseases.Some short-term studies have found meditation can improve cognitive abilities such as attention and memory, said Dr. Doraiswamy. Using imaging, scientists have shown that meditation can improve the functional performance of specific circuits in the brain and may reduce age-related shrinkage of several brain centers, particularly those that may be vulnerable in disorders such as Alzheimers disease.In a study published last year in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes, African-Americans with heart disease who practiced Transcendental Meditation regularly were 48% less likely to have a heart attack or stroke, or to die, than those who attended a health-education class. Among the meditation group, there were 20 such occurrences, compared with 32 in the control group. The study, which ran for more than five years, involved about 200 people.Recent research found that meditation can result in molecular changes affecting the length of telomeres, a protective covering at the end of chromosomes that gets shorter as people age. The study involved 40 family caregivers of dementia patients. Half of the participants meditated briefly on a daily basis and the other half listened to relaxing music for 12 minutes a day. The eight-week study found that people who meditated showed a 43% improvement in telomerase activity, an enzyme that regulates telomere length, compared with a 3.7% gain in the group listening to music. The participants meditating also showed improved mental and cognitive functioning and lower levels of depression compared with the control group. The pilot study was published in January in the International Journal of Geriatric Psychiatry.Government-funded research also is exploring meditations effect on dieting and depression.波士顿柏斯以色列狄肯尼斯医学中心(Beth Israel Deaconess Medical Center)开出的医嘱中会包含一项令人难以置信的处方：冥想。郑与崔中西医结合护理中心(Cheng & Tsui Center for Integrative Care)的医疗主管助理、初级保健医师阿底提内鲁卡(Aditi Nerurkar)说，“我建议进行五分钟的冥想，每天两次，然后循序渐进、逐渐增量。”内鲁卡还说，“这与我开药的方式基本相同。我不会让你在一开始就立马尝试高剂量的药物。”她建议患者循序渐进、最终达到约20分钟时量的冥想，且每天进行两次。这种疗法适用于失眠症和肠道易激综合症等疾病。郑与崔中西医结合护理中心在哈佛医学院附属医院向患者提供替代性医学治疗。包括冥想在内的中西医结合项目在全美各地的医院、诊所变得越来越常见。新近一项研究已发现，冥想能降低血压、帮助慢性病患者应对疼痛和抑郁。去年发表的一项研究表明，在一组患有心脏病的非洲裔美国人中，冥想极大地减少了他们的心脏病和中风的发病风险。在柏斯以色列狄肯尼斯医学中心，冥想和其他身心疗法正慢慢融入初级保健体系。内鲁卡说，该项目在过去的六个月中已开始提供一些服务，他们希望最终能开办团体冥想班。健康专家说，冥想不该被用来替代传统药物治疗，而应当作为补充疗法。隶属于美国国立卫生研究院(National Institutes of Health)的国家补充替代医学中心(National Center for Complementary and Alternative Medicine)负责人约瑟芬布里格斯(Josephine Briggs)说，“很明显，当你以一种非常缓慢、刻意的方式呼吸，这么做能暂时降低你的血压。”但这样的方法不该被当作治疗高血压和其他严重疾病的药物替代品。她还称，一般而言，冥想在并发症和综合症处理上是有所作用的，但它却无法治愈或治疗疾病。布里格斯说，国家补充替代医学中心正在资助一系列针对冥想、呼吸方法及它们对诸多疾病影响的研究，包括女性在更年期出现的热潮红现象。如果冥想被发现对这些疾病有疗效的话，它有可能帮助女性避免使用激素治疗。后者会产生不良的副作用。来自加州弗里蒙特(Fremont)，现年51岁的玛莎奥博伊(Martha OBoyle)自两年前突发一场心脏病后，就一直饱受着遍布胳膊、胸部及其他部位慢性疼痛的折磨。奥博伊说，“这儿有位心脏病专家建议我去进行冥想。当时我就想，她是以为我疯了吗？”2011年，奥博伊开始参加斯坦福医院诊所(Stanford Hospital & Clinics)开办的冥想课。该课程为期八周，每周上课一次，每次持续两到三个小时。奥博伊说，“我一上课，就感受到它的好处了。”奥博伊现在每天都会冥想20到45分钟。她说，“疼痛虽然没有消失，但冥想却能帮我应对它。”医生最常推荐的，且最常用于医院项目中的一种冥想类型叫做“正念减压”。它是由麻省大学医学院(University of Massachusetts Medical School)研发出来的。内鲁卡说，她并未将患者送到那里参加课程训练。相反，内鲁卡和柏斯以色列狄肯尼斯医学中心的其他内科医生将在办公室演示这种冥想方法。内鲁卡说，“实际上就是以一种你觉得舒服的姿势安静地坐着，闭上你的眼睛、并注意你的呼吸。”北卡罗莱纳州达勒姆的杜克大学医学中心(Duke University Medical Center)精神病学教授穆拉利多雷斯瓦米(Murali Doraiswamy)说，目前还不清楚冥想是如何作用于身体的。有些形式的冥想已被发现能激活副交感神经系统，而这又会刺激身体的放松反应，改善血液供给、降低心率、放缓呼吸并促进消化活动。多雷斯瓦米还称，冥想也能减缓皮质醇等压力激素的分泌。多雷斯瓦米说，他向那些患有抑郁症、恐慌