The Significance of Constructing TCM Psychosomatic Medicine from the Holistic View of the Unity of Nature and Man

With the development of medical technology, the problem of fragmentation of medical research has become increasingly prominent, and a series of iatrogenic diseases, drug-induced diseases and drug toxicity and side effects have resulted in an increase in the number of diseases. In the face of these problems, the medical concept has been re-examined and re-thought. The concept of the holistic view of the unity of nature and man in traditional Chinese medicine has certain enlightenment for dealing with the problems in the current medical development. Based on the holistic view of the unity of nature and man, the overall connection between human’s heart and body and nature is explained, and the further construction of TCM psychosomatic medicine is conducive to guiding the diagnosis and treatment of clinical diseases, and providing new enlightenment for the current medical concept thinking and clinical disease research.

Psychosomatic medicine research of obesity and TCM countermeasures

As an epidemic disease,obesity is on the rise globally,seriously jeopardizing human health.China now has the largest overweight or obese population in the world.In addition to causing the typical physical symptoms of obesity,obesity is often accompanied by a variety of psychosomatic diseases,which are not only closely related to health behaviors,but also psychosocial plays an important role in them.Although there are differences in the symptoms exhibited by the major systems,most of the modern research has been interpreted from the inflammatory and immune responses,which provides a direction to find the mechanism of obesity physical and mental diseases.After researching and explaining the mechanism,we give the countermeasures of Chinese medicine in treating obesity from both pharmacological and non-pharmacological treatments and explore the mechanism,hoping to build a bridge between Chinese medicine treatment and the mechanism of the above mentioned physical and mental diseases,and to provide scientific evidence for the efficacy of Chinese medicine.

Psychosomatic symptoms affect radiotherapy setup errors in early breast cancer patients

Objective: To examine the trajectory of psychosomatic symptoms and to explore the impact of psychosomatic symptoms on setup error in patients undergoing breast cancer radiotherapy.Methods: A total of 102 patients with early breast cancer who received initial radiotherapy were consecutively recruited. The M.D. Anderson Symptom Inventory(MDASI) and three different anxiety scales, i.e., the Self-Rating Anxiety Scale(SAS), State-Trait Anxiety Inventory(STAI), and Anxiety Sensitivity Index(ASI), were used in this study. The radiotherapy setup errors were measured in millimetres by comparing the real-time isocratic verification film during radiotherapy with the digitally reconstructed radiograph(DRR). Patients completed the assessment at three time points: before the initial radiotherapy(T1), before the middle radiotherapy(T2), and before the last radiotherapy(T3).Results: The SAS and STAI-State scores of breast cancer patients at T1 were significantly higher than those at T2 and T3(F=24.44, P<0.001;F=30.25, P<0.001). The core symptoms of MDASI were positively correlated with anxiety severity. The setup errors of patients with high SAS scores were greater than those of patients with low anxiety levels at T1(Z=-2.01, P=0.044). We also found that higher SAS scores were associated with a higher risk of radiotherapy setup errors at T1(B=0.458, P<0.05).Conclusions: This study seeks to identify treatment-related psychosomatic symptoms and mitigate their impact on patients and treatment. Patients with early breast cancer experienced the highest level of anxiety before the initial radiotherapy, and then, anxiety levels declined. Patients with high somatic symptoms of anxiety may have a higher risk of radiotherapy setup errors.

Value of Psychosomatic Nursing in Rehabilitation of Cardiology Patients with Coronary Heart Disease Treated with Percutaneous Coronary Intervention

[Objectives]To explore the effect of psychosomatic nursing on the daily living ability and psychosomatic state rehabilitation of cardiology patients with coronary heart disease treated with percutaneous coronary intervention (PCI). [Methods] 512 patients with coronary heart disease treated with PCI in the Cardiology Department of Taihe Hospital,Hubei University of Medicine from August 2015 to August 2018were given psychosomatic holistic nursing. Before and after the intervention,the improvement of the patients’ daily living ability,psychosomatic status and social support was analyzed by using the Barthel index of activities of daily living (ADL) scale,self-rating scale of 90 symptoms (SCL-90),and social support rating scale (SSRS). [Results]Before nursing intervention,the proportion of patients with grade Ⅰ objective score (26.56%) was lower than that of patients with grade Ⅰ subjective score (48.63%),and the difference was statistically significant (P <0.05);the proportion of patients with grade Ⅱ objective score (70.11%) was higher than that of patients with grade Ⅱ subjective score (47.27%),and the difference was statistically significant (P <0.05). After the intervention,there was no significant difference between the distribution of the subjective score and the objective score (P > 0.05). After nursing intervention,the SCL-90 total score,number of positive items,average score of positive items,physical factor,forcing factor,depression factor,anxiety factor,interpersonal factor and hostile factor score significantly dropped,and the difference was statistically significant (P < 0.05);the SSRS total score,objective support,subjective support and support utilization score significantly rose,and the difference was also statistically significant (P < 0.05). [Conclusions]Psychosomatic nursing for cardiology patients with coronary heart disease treated with PCI can effectively improve the patients’ ADL score,reduce the SCL-90 score,improve their social support,be beneficial to patients’ recovery,and improve their prognosis.

Special issue for psychosomatic medicine

Psychosomatic medicine is a branch of medicine that studies psychosomatic interactions.It focuses on the aetiology,pathology,diagnosis,treatment and prevention of psychosomatic diseases.Increasing effort is being made to improve the understanding of psychosomatic medicine in patients,their families,general hospitals and society.12 In addition,the development of psychosomatic medicine calls for wide collaboration with psychiatry,psychology,behavioural science,sociology,biology,neurochemistry and immunology.3 We initiated this special issue to encourage interdisciplinary studies in psychosomatic medicine.

Characteristics and Risk factors of Psychosomatic Symptoms Related to Female Tubal Sterilization in Rural Area in Hunan Province, China: A Prospective Study

Objectives To study characteristics of psychosomatic symptoms related to sterilization, to find out risk factors and their roles ascribed to psychosomatic symptoms, and to establish a mathematic model for screening out susceptible women. Methods: This study enrolled 776 women in rural area at three counties of Linxiang, Qiyang, Changsha of Hunan province in China between February 1990 and April 1992. Brief Neurosis Screening Scale (BNSS), Symptom Checklist 90 (SCL-90), sensitivity to pain, suggestibility were used to indicate subjects' psychological status. Logistic regression model and retrograde discriminant analysis were applied to develop a mathematical model. Results: Prevalence of psychosomatic reactions or symptoms was 54.8% before sterilization, 26.6% at three months and 16.4% at one year after operation respectively. Psychosomatic symptoms were verified to be the result of joint effects of multiple risk factors. The following risk factors were associated with postoperative symptoms: anger-hostility (RR=33.71), high suggestibility (RR=4.53), high neuroticism (RR=3.44), sensitivity to pain (RR=2.14) and operative sites (RR=2.05). A mathematical model to estimate the probability of developing psychosomatic symptoms in sterilization was established.Conclusions: More than half of women suffered from psychosomatic reactions before operation, and some of them did not recover after operation. The postoperative psychosomatic symptoms are the joint effect of multiple risk factors.

How discrimination and participation are associated with psychosomatic problems among boys and girls in northern Sweden

Background: Negative impact on health from school disturbance due to asymmetric power relations such as discrimination and offensive treatment are frequent problems among students. This study sought to analyze associations between occurrence of discrimination at schools, participation and psychosomatic problems. Methods: Pupils in grades 6 - 9 in ten schools in a northern Swedish municipality participated in the study. The frequency of discrimination at school was measured by six items: sex;culture or ethnicity;disability;religion beliefs;sexual preferences;and any other form of discrimination. The Social and Civic Objectives Scale (SCOS) was used for an estimation of the level of participation. The pupils’ health was measured by the PsychoSomatic Problem (PSP) scale. Multivariate logistic regression models were used for estimation of increased risk of PSP. The formula Z = d/s(d) was used to test mediation. Results: Two thirds of the boys and three fourths of the girls reported occurrences of discrimination at schools (p = 0.001). Discrimination was a mediating factor between participation and PSP among boys and girls as the mediating formula Z = d/s (d) was > ± 2 SD, -2.59 for boys and -39.27 for girls. Independent of each other, low participation and discrimination were associated with increased risk of PSP. Conclusion: Discrimination was a mediating factor between participation and PSP. The mediating effect was stronger in girls than in boys. There is a need for school health promotion programs focusing on participation in terms of democratic processes, communication and cooperation in the classroom.

The Prevalence of Psychosomatic Symptoms and Spirituality Levels among University Students in South Jordan

Psychosomatic symptoms are present in various stages of life. University students have also manifested such symptoms, which were also found to be linked to the level of spirituality affecting physical and psychological well-being. This study aims to examine whether spirituality can predict the presence of psychosomatic symptoms by investigating the relationship between the prevalence of psychosomatic symptoms and the level of spirituality among university students in South Jordan. An exploratory cross-sectional design involving convenience samples and self-administered questionnaires using the twelveitem general health questionnaire including spirituality-based items were used to collect data for this study. A total of 1269 completed the study questionnaire. Students’ responses indicated various psychosomatic symptoms causing issues to better academic achievement, including students’ feeling of uselessness, followed by their lack of happiness, inability to make decisions and solve problems, and lack of concentration on what they are doing. They considered spirituality as an important part of their life. Lower scores on general health questionnaire were observed to have higher scores on spirituality items indicating that students with better spirituality practices have less psychological symptoms. Based on the findings of this study, the level of spirituality influences the prevalence of psychosomatic symptoms. Conducting educational programs to improve the spiritual well-being of students could be beneficial. Further, it is important that students’ affairs board at the university perform proper assessment and interventions to improve the spirituality level to decrease the impact of psychosomatic symptoms among students.

Liaison conference for adolescent psychosomatic disease in pediatric ward

We held the liaison case conferences for two adolescent cases with psychosomatic disease in the pediatric ward to understand the patient's emotional problems and family situations, and to discuss how approach their psychological problems. We considered that the liaison conference played a useful role in both the clinical diagnosis and treatment. Furthermore, the liaison conference was useful for reducing the staff’s anxieties and for contributing to have a proper understanding for the disease. We suggest that a liaison conference should be implemented in pediatric units, for pediatric patients with emotional and behavioral problems.

Relationship between Stress and Psychosomatic Complaints among Nurses in Tabarjal Hospital

This research was conducted to examine the relationship between stress and psychosomatic complaints among nurses in Tabarjal hospital. To achieve this aim, the researcher used the descriptive method and selected a sample consisting of (56) nurses working in hospital through the simple random sampling technique. The respondents were requested to complete a questionnaire for rating of stress and the most common psychosomatic diseases. The collected data were analyzed statistically by using SPSS. The results revealed that the stress was dominant among nurses in Tabarjal hospital, the prevalence of psychosomatic complaints was significantly higher in nurses, and there was significant correlation between stress and psychosomatic complaints among nurses. Conclusion: This research confirmed the effect of strains on the prevalence of psychosomatic symptoms among nurses in Tabarjal hospital. Further, implications of the results were discussed on the light of some related researches.

Study on the mechanism of acupuncture analgesia from the perspective of psychosomatic medicine

Acupuncture is a kind of traditional Chinese therapy which has gained increased attention in recent years.It has been shown that acupuncture is effective in treating many types of pain pathologically as well as psychologically.For instance,as a promising therapy for psychiatric disorders,acupuncture is helpful to alleviate depression,reduce the adverse effects of drug treatment at the same time.It is most widely utilized for management of chronic,noncancer pain in adults.As a non-pharmaceutical measure,acupuncture has the potential to make contribution to reduction in opioid overuse.Acupuncture analgesia can be analyzed from the perspective of psychosomatic medicine,contributing to a better understanding of its mechanism and function.The mechanisms are closely related to regulation of neurotransmitters and inflammatory factors,including down-regulation of Glutamate,5-hydroxytryptamine,dopamine,Substance P,Tumor necrosis factor-α,Interleukin(IL)-1,IL-6 and up-regulation ofβ-endorphin,endogenous opioid peptide,γ-aminobutyric acid,etc.Electro-acupuncture(EA)has pain-relief effects under some specific parameter values.Low frequency EA is more commonly used in clinical practice than high frequency EA.Our study conducts a comprehensive analysis of acupuncture analgesia and discusses associated characteristics of its mechanisms.

Discussion on Treatment of Asthenospermia from the Perspective of Psychosomatic Medicine of Traditional Chinese Medicine

The views of the unities between heaven and man and between form and spirit in The Yellow Emperor’s Classic of Internal Medicine essentially reflect the mutual influence of physical and psychological factors.In today’s social environment,psychological and social factors have become important factors that affect the incidence of male asthenospermia.Therefore,the treatment of asthenospermia focuses more on the principle of simultaneous treatment of mind and body.With the development of modern biological-psychological-social medicine,the characteristics and advantages of psychosomatic medicine of traditional Chinese medicine are more prominent,which may provide new ideas for the diagnosis and treatment of asthenospermia.

A Case Report:Traditional Chinese Medicine for Curing Psychosomatic Tinnitus Symptoms

Patients with tinnitus are associated with adverse psychological reactions to varying degrees.Psychological interventions are currently the primary treatment to help patients eliminate negative responses to tinnitus.Traditional Chinese medicine uses four diagnostic methods or consultations.Interrogation is one such method.Through consultation,doctors can analyze the causes of tinnitus in patients,collect an accurate description,and assess the severity of the condition.At the same time,when doctors ask about other symptoms in a guided manner,they help patients refocus their attention to the symptoms so that their perception of tinnitus is changed,the vicious circular thinking patterns are broken,and their quality of life improves.When the patient understands why the physician establishes a medical plan,they are willing to cooperate actively and participate in a constructive doctor-patient relationship.This article analyzes the clinical methods and techniques of diagnosing tinnitus patients from the vantage of psychosomatic medicine,which has particular significance for the clinical treatment of tinnitus.

Evidence Based Medicine in Psychosomatics:Prospects and Challenges

Evidence-based Medicine(EBM)means"Medicine based on scientific Evidence"[1].Its core idea is that medical staff should use the latest and best scientific Evidence obtained in clinical research prudently,clearly and wisely.It also combine the professional skills and clinical experience of doctors,take into account individual values and expectations of patients and combine the three perfectly to formulate the best treatment measures for each patient[2].

Psychosomatic Medicine and Evidence-Based Surgery:Reflections and Perspectives

This article reflects on the need for psychosomatic medicine research in the field of surgery by complementing psychological/psychiatrist approaches with a physician’s(particularly surgeon’s)point of view.Focusing on esthetic/cosmetic surgery,a broader notion of“psychosomatic surgery”is also used regarding plastic surgery as well as examples of vascular and general surgery.Relevant literature reviews are utilized to gain a more comprehensive bio-psycho-social perspective.By providing a deeper understanding in the specialty areas,it makes a case for evidence-based practice by shedding light on psychosomatic medicine research on surgery in the United States with cross-cultural implications.

The Psychosomatic Thought of Tibetan Medicine and its Treatment Methods

Objectives:Call on people to treat the causes of physical diseases is to take into account the causes of psychological factors as well as external causes.Materials and Methods:The analysis was conducted by combining the classical medical books of Tibetan medicine,as well as the traditional culture and living habits of Tibetan people,with modern research results.Results:Many of the theories mentioned in Tibetan medicine related to mind-body medicine have been confirmed by modern research.Mental and physical treatment related to psychosomatic diseases should be administered simultaneously.First,when a person is healthy,he should cultivate his mind to build a solid psychological defense against diseases.Developing both the mind and body contributes to creating a stable physical protection barrier against diseases.When a person is ill,he should realign his mind and help his body adjust and promote its early recovery with the help of medications.Conclusions:Treating related psychosomatic diseases should treat the mind and body simultaneously.And the mind and body should be cultivated before diseases to reinforce the psychological and physical defense against diseases.

Psychosomatic skin disease treated by acupuncture and moxibustion

Based on the theory of "regulating body" integrated with "regulating mind",following the principle of "treating the body and mind simultaneously,treating both symptoms and root causes",Prof.Shao-jun WANG adopts flexibly the different techniques,including body acupuncture,wrist-ankle acupuncture,umbilical acupuncture,fire needling,moxibustion,and cupping,etc.for the treatment of psychosomatic skin diseases.According to the manifestations of skin diseases in different stages,she adopts different acupuncture and moxibustion techniques for the comprehensive treatment of psychosomatic skin diseases,including senile pruritus,alopecia areata,neurodermatitis,eczema,urticaria,and acne,on the basis of syndrome differentiation and different acupoint selections,and achieves good results.

Psychiatric morbidities in respiratory disorders:a cross sectional report providing insight into consultation-liaison psychiatry services in India

Background:Respiratory disorders are among the leading disorders contributing to extensive morbidity and mortality worldwide.Disorder variants,like Chronic Obstructive Pulmonary Diseases(COPD)in developed and developing countries,as well as infectious causes,like Tuberculosis(TB)in developing countries,contribute to significant disease burden.The literature points towards the coexistence of psychiatric disorders with respiratory disorders responsible for poorer outcomes.Despite the extensive burden of respiratory disorders and the presence of concurrent psychiatric disorders,studies focusing on their prevalence are limited in India.Methods:A cross-sectional psychiatric screening was carried out on sequential patients attending the tertiary respiratory unit over eight months.Those screened positive were interviewed in detail for psychiatric diagnosis and challenges in the management were discussed.Psychiatric diagnosis,pulmonary TB and medical comorbidity were assessed for correlation with demographic and clinical variables and analyzed by using the Chi-square test and logistic regression method using SPSS version 20.Results:Psychiatric morbidity was present in 100 out of 350 patients(28.57%).Tuberculosis was the most common diagnosis(46%)in subjects attending the respiratory clinic services while common mental disorders like depression,anxiety,and insomnia were the most common psychiatric concern(88%)in this study.Conclusion:Psychiatric disorders and medical morbidities are common in patients with respiratory disorders.Multiple factors determine the treatment adherence in both respiratory and psychiatric disorders.Screening for psychiatric disorders with the help of a consultation-liaison psychiatrist in respiratory units is recommended.Future studies should focus on developing dedicated psychiatry services to enhance overall outcomes in patients with respiratory disorders.

Aspects of the non-pharmacological treatment of irritable bowel syndrome

Irritable bowel syndrome(IBS) is one of the most commonly diagnosed gastrointestinal conditions. It represents a significant healthcare burden and remains a clinical challenge. Over the years IBS has been described from a variety of different perspectives; from a strict illness of the gastrointestinal tract(medical model) to a more complex multi-symptomatic disorder of the brain-gut axis(biopsychosocial/psychosomatic model). In this article we present aspects of the pathophysiology and the non-pharmacological treatment of IBS based on current knowledge. Effects of conditioned stress and/or traumatic influences on the emotional system(top-down) as well as effects on the intestine through stressors,infection,inflammation,food and dysbiosis(bottom-up) can affect braingut communication and result in dysregulation of the autonomic nervous system(ANS),playing an important role in the pathophysiology of IBS. Conditioned stress together with dysregulation of the autonomic nervous system and the emotional system may involve reactions in which the distress inside the body is not recognized due to low body awareness. This may explain why patients have difficulty identifying their symptoms despite dysfunction in muscle tension,movement patterns,and posture and biochemical functions in addition to gastrointestinal symptoms. IBS shares many features with other idiopathic conditions,such as fibromyalgia,chronic fatigue syndrome and somatoform disorders. The key to effective treatment is a thorough examination,including a gastroenterological examination to exclude other diseases along with an assessment of body awareness by a body-mind therapist. The literature suggests that early interdisciplinary diagnostic cooperation between gastroenterologists and body-mind therapists is necessary. Re-establishing balance in the ANS is an important component of IBS treatment. This article discusses the current knowledge of body-mind treatment,addressing the topic from a practical point of view.

Body awareness therapy: A new strategy for relief of symptoms in irritable bowel syndrome patients

AIM: To compare irritable bowel syndrome (IBS) pa- tients with apparently healthy persons and to evaluate body awareness therapy, which is a physiotherapeutic remedy focusing on normalising tensions in the body, for the treatment of IBS with the hypothesis that altered body tension is associated with the syndrome. METHODS: Twenty-one IBS patients received body awareness therapy two hours weekly for 24 wk. At base- line as well as after 12 and 24 wk, they underwent ex- aminations including resource oriented body examination in combination with body awareness scale evaluation and f illed in gastrointestinal and psychological symptom questionnaires. Saliva cortisol was analysed. A group of 21 apparently healthy persons underwent the same ex- aminations once. RESULTS: Compared to the apparently healthy group, IBS patients scored higher at baseline for gastrointestinal and psychological symptoms. They showed more often alterations in normal body tension patterns, as well as deviating cortisol slopes in saliva. After 24 wk of body awareness therapy, their gastrointestinal and psychologi- cal symptoms were reduced overall. Somatic symptoms decreased in parallel with depressive symptoms. Whole body pain score decreased, coping ability as well as bio- chemical stress markers improved. CONCLUSION: IBS patients scored higher for gastroin- testinal and psychological symptoms, and presented with altered biochemical stress markers. Their body tension deviated compared to healthy controls. Furthermore,body awareness therapy gave relief of both somatic com- plaints, psychological symptoms and normalised body tension. These findings indicate that distorted tension constitutes an important part of the symptoms in IBS.