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2.新生物 （C509-40 乳がん生存者）
㸰᪂⏕≀ 㸦& ஙࡀࢇ⏕Ꮡ⪅㸧 ᩥ⊩ Kiecolt-Glaser JK, et al. Yoga’s Impact on Inflammation, Mood, and Fatigue in Breast Cancer Survivors: A Randomized Controlled Trial. JOURNAL OF CLINICAL ONCOLOGY, 2014; 32: 1040-1049 . PubMed ID:24470004 ┠ⓗ ங⒴⏕Ꮡ⪅ࡳࡿ⅖ࠊẼศࠊ⑂ປᑐࡍࡿࣚ࢞ࡢຠᯝࢆホ౯ࡍࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ࢜ࣁ࢜ᕞ❧Ꮫࡢ⭘⒆་ࡢ⤂ࠊሗㄅࠊ࢙࢘ࣈࢆ㏻ࡌ࡚ເ㞟 ཧຍ⪅ ࢫࢸ࣮ࢪ ̺ϪD ᮇࡢ ṓࢃࡓࡿங⒴⏕Ꮡ⪅ ධ ࣚ࢞ࣛࣥࢫࡢࣁࢱࣚ࢞ ᅇ ศ㐌 ᅇ 㐌㛫 $UPධ⩌ࣚ࢞ᐇ⩦⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ࣚ࢞ᐇ⩦ᚅᶵ⩌ 100 ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1.MFSI-SF(ከḟඖ⑂ປホ౯) 2.SF-36(࢚ࢿࣝࢠ࣮/⑂ປ(ពḧ)ᣦᶆ) 3.CES-D(ᢚ㨚≧ែ⮬ᕫホ౯ᑻᗘ) 4.PSQI(ࣆࢵࢶࣂ࣮ࢢ╧╀㉁ၥ⚊) 5.CHAMPS 6. FFQ 7.༢⌫࡛ࡢ LPS ่⃭ࡼࡿ IL-6ࠊTNF-ĮࠊIL-1ȕ ⏘⏕ࠋ ධ๓ࠊධ┤ᚋࠊධ⤊㸱ࣨ᭶ᚋࡢ㸱ᅇࠋ ࡞⤖ᯝ ⒪┤ᚋ࡛ࡣࠊ⑂ປ㛵ࡋ࡚ࡣධ⩌ࢥࣥࢺ࣮ࣟࣝ⩌ࡢ㛫࡛ᕪࡣࡳࡽࢀ࡞ࡗࡓࡀࠊពḧ ࡣධ⩌࡛ࡼࡾ㧗್࡞ࡗࡓ㸦P=.01㸧 ࠋ⒪ᚋ 3 ࢝᭶࡛ࡣࠊධ⩌ࡳࡿ⑂ປࡣࢥࣥࢺ࣮ࣟ ࣝ⩌ࡼࡾప್ࢆ♧ࡋ㸦P=.002㸧 ࠊពḧࡣ㧗್㸦P=.01㸧࡞ࡗࡓࠋᢚ㨚≧ែࡣ࠸ࡎࢀࡢⅬ࡛ ࡶࠊ୧⩌㛫ᕪࡣࡳࡽࢀ࡞ࡗࡓࠋ㸱ࡘࡢࢧࢺ࢝ࣥࡣࠊධ┤ᚋ࡛ࡣ୧⩌ᕪࡣࡳࡽࢀ ࡞ࡗࡓࡀࠊධ⤊㸱ࣨ᭶ᚋ࡛ࡣࠊIL-6㸦P=.027㸧 ࠊTNF-Į㸦P=.027㸧 ࠊIL-1ȕ㸦P=.037㸧࠸ࡎ ࢀࡶධ⩌ࡢ᪉ࡀࢥࣥࢺ࣮ࣟࣝ⩌ࡼࡾప್࡞ࡗࡓࠋḟⓗゎᯒ㸦ࣚ࢞㠀⦎⩦⩌ࠊప㢖ᗘ⦎ ⩦⩌ࠊ㧗㢖ᗘ⦎⩦⩌࡛ࡢẚ㍑㸧ࡽࠊࣚ࢞ࡢ⦎⩦ࡢ㢖ᗘࡀ㧗࠸⑂ປࠊពḧࡣᨵၿࡋࡓࡀࠊ 㨚≧ែ࡛ࡣࡇࡢࡼ࠺࡞ഴྥࡣࡳࡽࢀ࡞ࡗࡓࠋ⒪ᚋ 3 ࢝᭶࡛ࡣࠊ⦎⩦㢖ᗘࡀከ࠸ IL-6(p=0.01) IL-1ȕ(p=0.03)⏘⏕㔞ࡣῶᑡࡋࡓࡀࠊTNF-Į ⏘⏕㔞࡛ࡣ⦎⩦㔞ࡢ㛵㐃ᛶࡣࡳࡽ ࢀ࡞ࡗࡓࠋ ⤖ㄽ ៏ᛶ⅖ࡣయຊࢆᾘ⪖ࡋࠊᙅ࠾ࡼࡧ㌟య㞀ᐖࡢཎᅉ࡞ࡿࠋࣚ࢞ࡼࡾ⑂ປ࠾ࡼࡧ⅖ໃ ຊࡀᙅࡲࡿࠊࡲࡓࡣᢚไࡉࢀࡿࡢ࡛࠶ࢀࡤࠊᐃᮇⓗᐇࡣᮏ㉁ⓗᗣࡼ࠸⪃࠼ࡽࢀ ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ዪᛶ ࡀ៏ᛶⓗ࡞⭜㒊࠾ࡼࡧࡲࡓࡣ⫪≧ࡢⓎࢆሗ࿌ࡋࡓ㸦࠾ࡑࡽࡃࣚ࢞㉳ᅉࡍࡿ㸧 ࠋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ධ⩌ࢻࣟࢵࣉ࢘ࢺ⋡㸲㸣 ᚅᶵ⩌ࢻࣟࢵࣉ࢘ࢺ⋡ 㸣୧⩌࡛⌮⏤ࡣ᫂ ࣚ࢞ࡢヲ⣽ ࣮ࢧࢼᗋ࡛ ✀ࠊ❧ ✀ࠊᗙ ✀ ᅇࡢࡓࡵࡢ࣏࣮ࢬ㸦㸲✀㸧 ࠊ྾ἲ㸲✀ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ங⒴⏕Ꮡ⪅ࡢẼศࡸ⑂ປࡑࡋ࡚⅖ࡢ⛬ᗘࡣࠊ᪥ᖖ⏕άᙳ㡪ࢆཬࡰࡍࠋࣚ࢞ࡣஙࡀࢇᝈ⪅ ࡢ⑂ປࠊᏳࠊ⅖ᛶࢧࢺ࢝ࣥࡢ࠺ࡕ ,/ ,/ș ࢆ㍍ῶࡋࠊࡑࡢຠᯝࡣ⦎⩦㔞ࡀከ ࠸㢧ⴭ⌧ࢀࡿ୍᪉࡛ࠊᢚ࠺ࡘࠊ71)Ș ࡛ࡣ୧⩌࡛ᕪࡀぢࡽࢀ࡞ࡗࡓⅬࡀ⯆῝࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ங⒴⏕Ꮡ⪅ᑐࡋ࡚ࣚ࢞ࢆ່ࡵࡿࠋ⑂ປࠊᏳࠊ⅖ᛶࢧࢺ࢝ࣥࢆ㍍ῶࡍࡿࠋ $EVWUDFWRUDQG'DWH ᮌಙஅ ᒸᏕ − 34 − 㸰᪂⏕≀ &ஙࡀࢇ ᩥ⊩ Chandwani KD, et al. Randomized, Controlled Trial of Yoga in Women With Breast Cancer Undergoing Radiotherapy. J Colin Oncol. 2014 Apr 1; 32(10): 1058-65. Pubmed ID:24590636 ┠ⓗ ᨺᑕ⥺⒪୰ࡢங⒴ᝈ⪅ᑐࡍࡿࣚ࢞ࡢධࡀᝈ⪅ࡢ 42/ ࢆᨵၿࡍࡿ࠺ࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ᨺᑕ⥺⒪ἲࢭࣥࢱ࣮㏆ࡃࡢ୍ᐊ㆟ᐊ࡛ᐇ ཧຍ⪅ ᨺᑕ⥺⒪ࢆ㛤ጞࡍࡿ๓ࡢங⒴㸦ࢫࢸ࣮ࢪ Ϫ㸧ዪᛶ㸦 ṓ௨ୖ㸧 ྡ ධ ࣚ࢞ࢭࣛࣆ࣮ ࣚ࢞ࡢᩍ⫱ࢆཷࡅࡓᣦᑟ⪅ࡽ ศ㐌 ᅇ 㐌㛫 $UPࣚ࢞⩌ ྡ $UPࢫࢺࣞࢵࢳ⩌67 ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ᚅᶵ⩌:/ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ せホ౯㡯┠㸸Medical Outcomes Study 36-item short-form survey (SF-36)(QOL): overall physical component scale (PCS, ㌟యⓗഃ㠃ࡢQOL), mental component scale (MCS,⢭⚄ⓗഃ㠃 ࡢQOL)ࠋḟホ౯㡯┠㸸SF-36 general health (GH,⯡ⓗᗣ)ࠊphysical functioning (PF,㌟య ᶵ⬟)ࠊBrief Fatigue Inventory (BFI,⑂ປ)ࠊ Pittsburgh Sleep Quality Index (PSQI, ╧╀ࡢ㉁)ࠊ Centers for Epidemiological Studies-Depression (CES-D, ࠺ࡘ) ࢆᨺᑕ⥺⒪ᚋࠊ1ࣨ᭶ࠊ3ࣨ ᭶ࠊ6ࣨ᭶ࡢ4ᅇ ᐃࠋၚᾮ୰ࢥࣝࢳࢰ࣮ࣝ:45ศࠊ8㛫ࠊ12㛫ࠊᑵᐷ ᐃࠋ ࡞⤖ᯝ SF-36 PCS(㌟యⓗQOL):ࣚ࢞⩌ࡣWL⩌ࡼࡾᨺᑕ⥺⒪ࡢ1㸪3ࣨ᭶ᚋ࡛ࠊ᭷ពᨵၿࡋ࡚ ࠸ࡓࠋPF㸦㌟యᶵ⬟㸧ࣚ࢞⩌ࡣWL⩌ࡼࡾ1㸪3㸪6ࣨ᭶ᚋࡢⅬ࡛ࠊ᭷ពᨵၿࡋ࡚࠸ࡓࠋ ST⩌ࡼࡾ1㸪3ࣨ᭶ᚋࡢⅬ࡛ࠊ᭷ពᨵၿࡋ࡚࠸ࡓࠋ BFI㸦⑂ປ㸧: ࣚ࢞⩌ࡣWL⩌ST⩌ࡼࡾᨺᑕ⥺⒪┤ᚋ࡛ࠊ᭷ពᨵၿࡋ࡚࠸ࡓࠋ CES-D (ᢚ࠺ࡘ)ࡸPSIQ (╧╀ࡢ㉁)ࡣ3⩌࡛ᕪࡣ࡞ࡗࡓࠋ ၚᾮࢥࣝࢳࢰ࣮ࣝ㸸ࣚ࢞⩌࡛ࡣࢥࣝࢳࢰ࣮ࣝ᪥ෆኚືࡢഴᩳࡀධ⤊ᨺᑕ⥺⒪ᚋ 1࢝᭶ࡢⅬ࡛ẚ࡚ᛴ࡛࠶ࡗࡓࠋ ⤖ㄽ ࣚ࢞ࡢධࡣ༢࡞ࡿࢫࢺࣞࢵࢳࡼࡾࡶࠊQOL ᨺᑕ⥺⒪ࡼࡿ⏕⌮ⓗኚࢆᨵၿࡉࡏ ࡓࠋࡲࡓࠊࡇࢀࡽࡢⅬࡣ㛗ᮇ㛫ᣢ⥆ࡍࡿࡼ࠺࡛࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ࣚ࢞⩌Q ࢫࢺࣞࢵࢳ⩌Q ࢥࣥࢺ࣮ࣟࣝ⩌Q ࣚ࢞ࡢヲ⣽ 69<$6$ ࡢࠕ⤫ྜⓗࣚ࢞ࣉࣟࢢ࣒ࣛࠖ 㸸࢛࣮࣑࢘ࣥࢢࢵࣉయࡢືࡁ྾ࢆ㐃ືࡉࡏ ࡿ≉ᐃࡢయࡶࡋࡃࡣ࣮ࢧࢼࢆᐇ௮⮩࡛῝࠸ࣜࣛࢵࢡࢫᕥྑࡢ 㰯྾ࡶࡋࡃࡣࣉ࣮ࣛࢼ࣮࣮࣐ࣖ▂ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࣚ࢞ࡀࢫࢺࣞࢵࢳࡼࡾ 4R/ ࢆᨵၿࡍࡿࡇࡣ⯆῝࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ᨺᑕ⥺⒪ࢆཷࡅࡿங⒴ᝈ⪅ࡢ⏕άࡢ㉁ࢆᨵၿࡍࡿࡓࡵࣚ࢞ࢆ່ࡵࡿࠋ $EVWUDFWRUDQG'DWH ᒸభ ᒸᏕ − 35 − 㸰᪂⏕≀ 㸦& ஙࡀࢇ⏕Ꮡ⪅ࡢ⑂ປ㸧 ᩥ⊩ Bower JE, et al. Yoga reduces inflammatory signaling in fatigued breast cancer survivors : A randomized controlled trial. Psychoneuroimmunology, 2014;43:20-29. Pubmed ID:24703167 ┠ⓗ ᛰឤࢆッ࠼ࡿஙࡀࢇ⏕Ꮡ⪅ࡢࡓࡵ≉ูసᡂࡋࡓ࣮ࣥ࢞ࣚ࢞ࣉࣟࢢ࣒ࣛࡀ⅖ 㛵㐃ࡍࡿ㑇ఏᏊⓎ⌧ᮎᲈ⅖ᛶࢧࢺ࢝ࣥάᛶࡢᣦᶆࢆపୗࡉࡏࡿ᳨ウࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ 8&/$ ࣓ࢹ࢝ࣝࢭࣥࢱ࣮ ཧຍ⪅ ධࡢ༙ᖺ௨ୖ๓⒪ࢆ⤊ࡋࡓࡶࡢࡢࠊ⒴క࠺ᛰឤࢆッ࠼ࡿங⒴ᝈ⪅㸦 ṓ㸧 ྡࠋ ධ ࣮ࣥ࢞ࣚ࢞ ஙࡀࢇ⏕Ꮡ⪅ࡢࡓࡵࡢࣉࣟࢢ࣒ࣛ $UPධ⩌࣮ࣥ࢞ࣚ࢞ ྡ ᅇ ศ㐌 ᅇ 㐌㛫㸦 ᅇ㸧 $UPࢥࣥࢺ࣮ࣟࣝ⩌ᗣᩍ⫱ ྡ 㐌㛫⾜࠸ ࣨ᭶ࡢࣇ࢛࣮ࣟࢵࣉ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ (1)㑇ఏᏊⓎ⌧ࣉࣟࣇࣜࣥࢢ (2)ᮎᲈ⾑୰ࡢ⅖࣐࣮࣮࢝ (3)ၚᾮ୰ࢥࣝࢳࢰ࣮ࣝ ධ๓ࠊධ┤ᚋࠊධ⤊ 3 ࣨ᭶ᚋࡢ 3 ᅇࠋ ࡞⤖ᯝ (1) NF-țB㸦⅖㸧 ࠊCREB㸦ឤ⚄⤒ ȕ ཷᐜయࢆࡋࡓࢩࢢࢼࣜࣥࢢ㸧 ࠊISRE 㸦type 1 IFN ᛂ㛵㐃ࡍࡿ㌿≀㸧ࡀࢲ࢘ࣥࣞࢠ࣮ࣗࣞࢺࡉࢀࠊࢢࣝࢥࢥࣝࢳࢥࢻཷᐜయࡢάᛶ㸦ᢠ⅖ ᛶ㸧ࡣࢵࣉࣞࢠ࣮ࣗࣞࢺࡉࢀࡓࠋࡇࡢࡼ࠺࡞ኚࢆ⏕ࡌࡿ※ࡣ༢⌫ࠊNK ⣽⬊࡛࠶ ࡗࡓࠋ(2)⾑₢୰ࠊsoluble TNF receptor type II ࡢࡳࡀ᭷ព࡞ኚ㸦TNF-Į άᛶࢆᫎࠊࣚ࢞⩌ ࡛ࡣධ๓ᚋ࡛ኚࡀ࡞ࡗࡓࡀࠊࢥࣥࢺ࣮ࣟࣝ⩌࡛ቑຍ㸧ࢆ♧ࡋࠊIL-1 receptor antagonist 㸦 IL-1ȕ άᛶࢆᫎ㸧 ࠊCRPࠊIL-6 ࡣ୧⩌࡛ᕪࡣࡳࡽࢀ࡞ࡗࡓࠋ(3)ၚᾮࢥࣝࢳࢰ࣮ࣝศἪࡶ ୧⩌࡛ᕪࡣ࡞ࡗࡓࠋ ⤖ㄽ ஙࡀࢇ⏕Ꮡ⪅⏝ࡢ࣮ࣥ࢞ࣚ࢞ࡣࠊ⅖㛵㐃ࡍࡿ㌿ᅉᏊࢆపୗࡉࡏࠊᮎᲈ⾑୰ࡢ TNF-Į ࢆᢚไࡍࡿࠋࡲࡓࢱࣉ㸯ࣥࢱ࣮ࣇ࢙ࣟࣥ㛵㐃ࡋࡓ㌿ᅉᏊࡶపୗࡋࡓࠋࣚ࢞ࡢ ࡇࡢస⏝ࡣࠊឤ⚄⤒ࡢᢚไࢢࣝࢥࢥࣝࢳࢥࢻཷᐜయឤཷᛶࡢஹ㐍ࡀ㛵㐃ࡋ࡚࠸ࡿ⪃ ࠼ࡽࢀࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ゝཬ࡞ࡋ ࣚ࢞ࡢヲ⣽ ࢧࣉࢱࣂࢲࢥࢼࢧࢼࢧࣉࢱࢫ࣡ࢫࢸ࢝ࢧࢼࢭࢶࣂࣥࢲࢧࣝ࣡ࣥ࢞ࢧࢼᮌࡢ࣋ࣥ ࢳ࡛ࢭࢶࣂࣥࢲࢧࣝ࣡ࣥ࢞ࢧࢼࣉࣝ࣎ࢵࢱࢼࢧࢼࣅࣃࣜࢱࢲࣥࢲࢧࢼࢧࣛࣥࣂࢧࣝ࣡ ࣥ࢞ࢧࢼࢧࣛࣥࣂࢩࣝࢩࣕࢧࢼࢫࣉࢱࢥࢼࢧࢼࣅࣃࣜࢱ࢝ࣛࢽࣂࣛࢹ࢘ࣂࢪࣕࢧࢼ ࢻ࣒࢝ࢫࣂࢼࢧࢼ࢘ࣝࢻࣂ࣒࢝ࢫ࣡ࢧࢼ࢘ࣝࢻࣂࣁࢫࢱࢧࢼ࢘ࣝࢻࣂࣂࢲࣥࢢࣜࣖ ࢧࢼ࣮ࣟࣉ㸯ࢩࣕࣂࢧࢼ࣎ࣝࢫࢱ࣮ࠊࣈࣛࣥࢣࢵࢺࠊࢫࢺࣛࢵࣉ⏝ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࣚ࢞ࡀ⒴㛵㐃ࡍࡿ⑂ປࢆᨵၿࡍࡿᶵᗎࢆᢠ⅖ຠᯝࡢどⅬࡽ᳨ウࡋࡓሗ࿌ࠋᑐ㇟ࡣ ๓ሗ %RZHU-(HWDO&DQFHU ྠࡌ࡛࠶ࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇ⏕Ꮡ⪅ࡢࠊ㑄ᘏࡍࡿ⒴㛵㐃ࡋࡓ⑂ປᑐࡋ࡚ࠊὀព῝ࡃᕤኵࡉࢀࡓࣚ࢞ࣉࣟࢢ ࣒ࣛࢆ⾜࡞࠺ࡇࢆ່ࡵࡿ $EVWUDFWRUDQG'DWH ᒸᏕ − 36 − 㸰᪂⏕≀ 㸦&ஙࡀࢇ⏕Ꮡ⪅ࡢ࠺ࡘࠊᏳ㸧 ᩥ⊩ Taso CJ, et al. The effect of yoga exercise on improving depression, anxiety, and fatigue in women with breast cancer: a randomized controlled trial. The Journal of Nursing Research. 2014; 22(3): 155-164 . Pubmed ID: 25111109 ┠ⓗ 㐌㛫ࡢ࢚ࣚ࢞ࢡࢧࢧࢬࣉࣟࢢ࣒ࣛࡀࠊ⿵ຓⓗ࡞Ꮫ⒪ἲࢆཷࡅ࡚࠸ࡿஙࡀࢇᝈ⪅ࡢᚰ ⌮ⓗ࣭⫗యⓗᗣࢆಁ㐍ࡉࡏࡿࡘ࠸࡚ࠊ࠺ࡘ࣭Ᏻ࣭⑂ປ࠸࠺ほⅬࡽࡑࡢ᭷ຠᛶ ࢆ᳨ドࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ 7KH&KL0HL ་⒪ࢭࣥࢱ࣮ྎ༡ྎ‴ ཧຍ⪅ ࢫࢸ࣮ࢪ ࡢ㌿⛣ࡢ࡞࠸ஙࡀࢇᝈ⪅࡛Ꮫ⒪ἲࢆཷࡅ࡚࠸ࡿ ṓ㹼 ṓ㸦ᖹᆒᖺ㱋 s㸧ࡢዪᛶ ྡࠋ ධ ࢾࢧࣛࣚ࢞ ᅇ ศ㐌 ᅇ 㐌㛫 $UPࣚ࢞⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ྡࠋࢫࢱࣥࢲ࣮ࢻࢣࡢࡳࡢ⒪ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1.Profile of Mood States(POMS) Ẽศࣉࣟࣇ᳨࣮ࣝᰝ 2.Brief Fatigue Inventory ⡆᫆ᛰឤ ᑻᗘࠋධ๓ࠊ4 㐌㛫ᚋࠊ8 㐌㛫ᚋࠊධࡢ 4 㐌㛫ᚋ㸦12 㐌㛫ᚋ㸧ࡢ 4 ᅇ ᐃࠋ ࡞⤖ᯝ ධᚋࠊࣚ࢞⩌࡛ࡣࠊࢥࣥࢺ࣮ࣟࣝ⩌ࡼࡾࡶࠊ⑂ປ⯡ࠊ⑂ປࡼࡿẖ᪥ࡢ⏕άࡢ㞀ᐖ ࡀ㍍ῶࡋࡓࠋ᭷ព࡞㍍ῶ⤖ᯝࡣ 4 㐌㛫ᚋࡽᚓࡽࢀࠊ8 㐌ᚋࠊධᮇ㛫⤊ 4 㐌ᚋ㸦12 㐌ᚋ㸧࡛ࡶほᐹࡉࢀࡓࠋࡓࡔࡋࠊᏳᢚ࠺ࡘࡢ⛬ᗘࡣኚࡋ࡞ࡗࡓࠋ ⤖ㄽ ࡇࡢ 8 㐌㛫ࡢࣚ࢞ࡣஙࡀࢇᝈ⪅ࡢ⑂ປࢆ㍍ῶࡍࡿࡇࡀࢃࡗࡓࠋࡋࡋࠊ࠺ࡘᏳࡣ ㍍ῶࡋ࡞ࡗࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ グ㍕࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ グ㍕࡞ࡋ ࣚ࢞ࡢヲ⣽ ࣚ࢞ࢡࣛࢫࡣ⥲ྜⓗ࡞ᢏἲ㸸྾ἲࠊ࣏࣮ࣚ࢞ࢬࠊ$ZDUHQHVVH[FLVHព㆑ⓗ࡞࢚ࢡࢧࢧ ࢬࠊ5HOD[DWLRQࠊࢫࢺࣞࢵࢳࠊ▂ࡀᣦᑟࡉࢀࡓࠋࣉࣟࢢ࣒ࣛࡢࢧࢡࣝ㸸 ศ㛫ࡢ ▂ࣈ࣮ࣜࢪࣥࢢ࢚ࢡࢧࢧࢬࠊ ศ㛫ࡢ࢚ࣚ࢞ࢡࢧࢧࢬࠊ ศ㛫ࡢࢡ࣮ࣝࢲ࢘ࣥ ࢚ࢡࢧࢧࢬࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࣚ࢞ࡼࡗ࡚ஙࡀࢇᝈ⪅ࡢ⑂ປࡀᨵၿࡍࡿࠋࡑࡢຠᯝࡣධ ࣨ᭶ᚋࡶᣢ⥆ࡍࡿゝ࠺⤖ ᯝࡣࠊព⩏῝࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇᝈ⪅ࡢ⑂ປࢆᨵၿࡍࡿࡓࡵࠊࣚ࢞ࢆ່ࡵࡿࠋ $EVWUDFWRUDQG'DWH ᳃㟹Ꮚ ᒸᏕ − 37 − 㸰᪂⏕≀ 㸦&ஙࡀࢇ⏕Ꮡ⪅ࡢㄆ▱ᶵ⬟㸧 ᩥ⊩ Derry HM, et al. Yoga and self-reported cognitive problems in breast cancer survivors. Psycho-Oncology, 2014; Oct 21 Pubmed ID:25336068 ┠ⓗ ࣚ࢞ࡀஙࡀࢇ⏕Ꮡ⪅ࡢ⮬ぬࡉࢀࡿㄆ▱ᶵ⬟ࡢၥ㢟ᙳ㡪ࢆཬࡰࡍࢆㄪࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ 7KH&OLQLFDO5HVHDUFK&HQWHU ཧຍ⪅ ࢫࢸ࣮ࢪ ,,,$ デ᩿ࡉࢀࡓ⾡ᚋࡢஙࡀࢇᝈ⪅ ྡ ධ $UPධ⩌ࣁࢱࣚ࢞⩌ ྡ ஙࡀࢇᝈ⪅⏝ࣉࣟࢢ࣒ࣛ ᅇ ศ㐌 ᅇ 㐌㛫 $UPࢥࣥࢺ࣮ࣟࣝ⩌ᬑẁ㏻ࡾࡢ⏕ά⩌ ྡ ᕼᮃ⪅ࡣ◊✲ᚋࣚ࢞ཧຍྍ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1. The Breast Cancer Prevention Trial ≧ࣜࢫࢺ㸦ᛀࢀࡸࡍࡉࠊ㞟୰ᅔ㞴➼ࡢㄆ▱ᶵ⬟㛵ࡍࡿ ≧㸧 2. CES-D 㸦ᢚ࠺ࡘ㸧 3. BAI㸦Ᏻ㸧 4. Pittsburgh Sleep Quality Index 㸦╧╀ࡢ㉁㸧5. The Medical Outcomes, SF-36㸦άຊ㸧 6.LPS ่⃭ࡢ IL-6,IL-1ȕ,TNF-Įࠋ ධᮇ㛫๓ᚋࠊධ⤊ 3 ࣨ᭶ᚋ㸦ࣇ࢛࣮ࣟࢵࣉ㸧ࡢ 3 ᅇࠋ ࡞⤖ᯝ ධ┤ᚋ࡛ࡣࠊ୧⩌࡛ BCPT ᚓⅬᕪࡣࡳࡽࢀ࡞ࡗࡓࡀࠊ㸱ࣨ᭶ᚋࡢࣇ࢛࣮ࣟࢵࣉ࡛ ࡣࠊࣚ࢞⩌ࡣࢥࣥࢺ࣮ࣟࣝ⩌ࡼࡾ BCPT ᚓⅬࡀ 23㸣᭷ពపࡗࡓ(p=0.003)ࠋࡇࡢᕪࡣࠊᚰ ⌮ⓗⱞ③ࠊ⑂ປࠊ╧╀ࡢ㉁ࢆㄪᩚࡋࡓᚋࡶࡳࡽࢀࡓࠋࡲࡓࣚ࢞ࡢ⦎⩦㛫ࡀ㛗ࡗࡓዪᛶࡣࠊ ⦎⩦㛫ࡀ▷ࡗࡓዪᛶẚ࡚ BCPT ᚓⅬ㸦ㄆ▱ᶵ⬟ࡢၥ㢟㸧ࡀ᭷ពῶᑡࡋ࡚࠸ࡓ (p<0.001)ࠋIL-6,IL-1ș,TNF-Ș್ࡣࠊࣇ࢛࣮ࣟࢵࣉࡢㄆ▱ᶵ⬟ࡢၥ㢟ࢆண ࡋ࡞ࡗࡓࠋ ⤖ㄽ ࣚ࢞ࡣஙࡀࢇ⏕Ꮡ⪅࡛ࡢ⮬ぬࡉࢀࡿㄆ▱ᶵ⬟ࡢၥ㢟ࢆ᭷ពᨵၿࡋࡓࠋࣚ࢞ࡣஙࡀࢇ⏕Ꮡ⪅ ࡢㄆ▱ᶵ⬟ࡢឋッࢆῶࡽࡍຠᯝࡀ࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ධ⩌㸣 ࢥࣥࢺ࣮ࣟࣝ⩌㸣 ᭱⤊⤖ᯝࡀᥦฟ࡛ࡁ࡞ࡗࡓዪᛶ࡛ࡣࠊูᒃࡸ㞳፧ ⋡ࡀ㧗ࡗࡓࠋࡲࡓࠊ⬺ⴠ⩌࡛ࡣࠊ㧗⋡࡛Ᏻ≧ࠊ╧╀ࡢ㉁ࡢᝏࠊㄆ▱ᶵ⬟ࡢឋッࡀࡳ ࡵࡽࢀࡓࠋ ࣚ࢞ࡢヲ⣽ ࢧࣉࢱࣂࢲࢥࢼࢧࢼࢧࣉࢱࢫ࣡ࢫࢸ࢝ࢧࢼࢭࢶࣂࣥࢲࢧࣝ࣡ࣥ࢞ࢧࢼᮌࡢ࣋ࣥ ࢳ࡛ࢭࢶࣂࣥࢲࢧࣝ࣡ࣥ࢞ࢧࢼࣉࣝ࣎ࢵࢱࢼࢧࢼࣅࣃࣜࢱࢲࣥࢲࢧࢼࢧࣛࣥࣂࢧࣝ࣡ ࣥ࢞ࢧࢼࢧࣛࣥࣂࢩࣝࢩࣕࢧࢼࢫࣉࢱࢥࢼࢧࢼࣅࣃࣜࢱ࢝ࣛࢽࣂࣛࢹ࢘ࣂࢪࣕࢧࢼ ࢻ࣒࢝ࢫࣂࢼࢧࢼ࢘ࣝࢻࣂ࣒࢝ࢫ࣡ࢧࢼ࢘ࣝࢻࣂࣁࢫࢱࢧࢼ࢘ࣝࢻࣂࣂࢲࣥࢢࣜࣖ ࢧࢼ࣮ࣟࣉ㸯ࢩࣕࣂࢧࢼ࣎ࣝࢫࢱ࣮ࠊࣈࣛࣥࢣࢵࢺࠊࢫࢺࣛࢵࣉ⏝ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ◊✲⤖ᯝࡽゝ࠼ࡿࡇࡣࠊ ࣨ᭶ᚋࡢⅬ࡛ࣚ࢞ࢆࡋ࡚࠸ࡓ㞟ᅋࡢ᪉ࡀࠊࣚ࢞ࢆࡋ࡚࠸࡞ ࡗࡓ㞟ᅋẚ࡚ㄆ▱ᶵ⬟ࡢឋッࡀᑡ࡞࠸࠸࠺ࡇ࡛࠶ࡿࠋࡋࡋ࡞ࡀࡽࠊ⬺ⴠ⪅࠾ ࠸࡚ឋッࡀ㔜ࡗࡓᐇࡽࠊࡑࡶࡑࡶឋッࡀ㍍࠸ே࡛࠶ࡗࡓࡽࣚ࢞ࢆ⥆ࡅࡿẼຊࡀ࠶ࡗ ࡓྍ⬟ᛶࡀ࠶ࡿࠋࡲࡓࠊឋッࡀᨵၿࡋࡓே࡛ࡣࠊࣚ࢞௨እࡢ㌟యάືࡶቑ࠼࡚࠾ࡾࠊࣚ࢞ࡔ ࡅࡀឋッࢆᨵၿࡋࡓᅉᏊ⤖ㄽ࡙ࡅࡿࡇࡣ࡛ࡁ࡞࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇ⏕Ꮡ⪅ࡢ⮬ぬࡉࢀࡿㄆ▱ᶵ⬟ࡢឋッࣚ࢞ࢆ່ࡵࡿ࠺ࡣࡕࡽࡶ࠸࠼࡞࠸ $EVWUDFWRUDQG'DWH ఀ⸨ிᏊ ᒸᏕ − 38 − 㸰᪂⏕≀ 㸦&ࡀࢇ⏕Ꮡ⪅ࡢ╧╀㸧 ᩥ⊩ Mustian KM, et al. Multicenter, randomized controlled trial of yoga for sleep quality among cancer survivors. J Colin Oncol.2013 sep ; 31(26): 3233-41. PubMed ID:23940231 ┠ⓗ ⒪ᚋࡢ⒴⏕Ꮡ⪅ࡢ╧╀ࡢ㉁ࢆᨵၿࡍࡿࡓࡵࣚ࢞⩌㏻ᖖ⒪⩌࡛ẚ㍑ࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ࣓ࣜ࢝ྜ⾗ᅜ 12 㒔ᕷࡢࣚ࢞ࢫࢱࢪ࢜ࠊࢥ࣑ࣗࢽࢸࢭࣥࢱ࣮ࠊ⭘⒆Ꮫࡢࢥ࣑ࣗࢽࢸ ཧຍ⪅ ᖹᆒᖺ㱋 54 ṓࡢᡭ⾡ࠊᏛ⒪ἲࠊ࠾ࡼࡧ㸭ࡶࡋࡃࡣᨺᑕ⥺⒪ἲࢆཷࡅ࡚ 2㹼24 ࣨ᭶ᚋࡢࠊ ୰⛬ᗘ௨ୖࡢ╧╀㞀ᐖⱞࡋࢇ࡛࠸ࡿ 410 ேࡢ⒴⏕Ꮡ⪅ࠋ ධ <2&$6ࡀࢇ⏕Ꮡ⪅ࡢࡓࡵࡢࣉࣟࢢ࣒ࣛ ᅇ ศ㐌 ᅇ 㐌㛫 $UPධ⩌㏻ᖖ⒪㸩ࣚ࢞⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌㏻ᖖ⒪⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ Pittsburgh Sleep Quality Index(╧╀)ࠊActigraphy(╧╀ぬ㓰ุᐃࠊ╧╀ຠ⋡)ࠊࢆධ๓ࠊධ ᚋࡢ 2 ᅇ ᐃࠋ ࡞⤖ᯝ ࣚ࢞⩌ࡣࠊ㏻ᖖ⒪⩌ẚ㍑ࡋ࡚ධᚋ⯡ⓗ࡞╧╀ࡢ㉁ࡀ᭷ពᨵၿࡋࡓ(P<0.001)ࠋ ࡉࡽ᪥୰ࡢᶵ⬟㞀ᐖ㸦P <0.01㸧 ࠊほⓗ࡞╧╀ࡢ㉁㸦P <0.05㸧 ࠊ࠾ࡼࡧ╧╀⸆ࡢ⏝㸦P <0.05㸧࡛᭷ពᨵၿࡋࡓࠋ⩌ෆẚ㍑࡛ࡣࠊࣚ࢞⩌ࠊ࠾ࡼࡧࢥࣥࢺ࣮ࣟࣝ⩌ࡣ╧╀ࡢ㉁㸦ࣚ ࢞ P <0.01ࠊ㏻ᖖ⒪ P <0.01㸧 ࠊ╧╀₯㸦ࣚ࢞ P <0.01㸧 ࠊ╧╀㛫㸦ࣚ࢞ P <0.05㸧 ࠊ╧╀ ຠ⋡㸦ࣚ࢞ P <0.01 ࠊ㏻ᖖ⒪ P <0.05㸧 ࠊ╧╀㞀ᐖ㸦ࣚ࢞ P <0.05ࠊP 0.01㸧 ࠊほⓗ࡞╧ ╀ࡢ㉁㸦ࣚ࢞ P <0.01ࠊ㏻ᖖ⒪ P <0.01㸧 ࠊ࠾ࡼࡧ᪥୰ࡢᶵ⬟㞀ᐖ㸦ࣚ࢞ P <0.01㸧ࡀ᭷ព ᨵၿࡋࡓࠋࡋࡋ࡞ࡀࡽ╧╀⸆≀⏝࠾࠸࡚ࡣࠊ୧⩌ඹ᭷ព࡞ᨵၿࡣぢࡽࢀࡎࠊ㏻ ᖖ⒪⩌࠾࠸࡚ࡣࠊ╧╀₯ࠊ╧╀㛫ࠊ᪥୰ࡢᶵ⬟㞀ᐖࡣ᭷ព࡞ᨵၿࡀぢࡽࢀ࡞ࡗ ࡓࠋࣚ࢞⩌ࡣ 1 㐌ࡘࡁ╧╀⸆≀⏝㔞ࡀ 21%ῶᑡࡋࡓ୍᪉ࠊ㏻ᖖ⒪⩌ࡣධᚋ 1 㐌ࡘࡁ╧╀⸆≀⏝㔞ࡀ 5%ቑຍࡋࡓࠋ ⤖ㄽ ࣚ࢞ࡀ⒪ᚋࡢ⒴⏕Ꮡ⪅ࡢ╧╀ࡢ㉁ࢆᨵၿࡋࠊ╧╀⸆ࡢ⏝㔞ࢆῶࡽࡍࡢ᭷⏝࡞᪉ἲ࡛ ࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ 1 ேࡢ᭷ᐖ㇟ࡀ࠶ࡗࡓࠋୖᐊᛶ㢖ᢿ࡛ࢢ࣮ࣞࢻ 2 ⪃࠼ࡽࢀࠊᅇࡢㄪᰝࡢධࡣ ↓㛵ಀ࡛࠶ࡿࠋࡑࡢࡢ᭷ᐖ㇟ࡢሗ࿌ࡣ࡞ࡗࡓࠋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ࣚ࢞⩌ ㏻ᖖ⒪⩌㸣 ⌮⏤㸸୍㌟ୖࡢ㒔ྜࡸࡢ⒪ ࣚ࢞ࡢヲ⣽ YOCAS㸸ࣉ࣮ࣛࢼ࣮࣮࣐ࣖ㸦྾ἲ㸧 ࠊ16 ࡢ✜ࡸ࡞ࣁࢱࣚ࢞ࣜࣛࢵࢡࢫࡢⅭࡢ ࡺࡔࡡࡿࣜࢫࢺࣛࢸࣈ࣭ࣚ࢞㸦ᑐἲ㸧▂ࡽᡂࡿࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ྡ㛛ࡢࣟࢳ࢙ࢫࢱ࣮Ꮫ་⒪ࢭࣥࢱ࣮ࡀ 9 ࡘࡢ CCOP㸦⮫ᗋ⭘⒆ࡢࢥࣥࢯ࣮ࢩ࣒㸧ࢆ ࠾ࡋ࡚࣓ࣜ࢝ྜ⾗ᅜᅵ 12 ࡢ㒔ᕷ࡛ཧຍ⪅ࢆເ㞟ࡋ࡚࠸ࡿつᶍ࡞ࡶࡢ࡛࠶ࡿࡇ ࠊ⏝ࡉࢀࡓࣚ࢞ࡢࣉࣟࢢ࣒ࣛࡣ◊✲⪅ࡼࡾタィࡉࢀࡓࡶࡢ࡛࠶ࡿࡇ࡞ࡽࠊಙ 㢗ᛶࡀ㧗࠸◊✲࡛࠶ࡾࠊᑗ᮶ⓗࣚ࢞ࡀ⮫ᗋࡢ⌧ሙ࡛άࡉࢀࡿࡇࡀ♧၀ࡉࢀࡿ◊✲ ࠸࠼ࡿࠋࡋࡋ࡞ࡀࡽࠊࡇࡢㄪᰝࡢཧຍ⪅ࡣ 96㸣ࡀዪᛶ࡛࠶ࡿࠋࣚ࢞ேཱྀࡣୡ⏺ⓗぢ ࡚ࡶዪᛶࡀከ࠸ࡇࡶ⫼ᬒ࠶ࡿࡔࢁ࠺ࡀࠊᚋ⏨ᛶࢆᑐ㇟ࡋࡓ◊✲ࢆᚅࡕࡓ࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ╧╀㞀ᐖᝎࡴ⒴⏕Ꮡ⪅ᑐࡋ࡚ࣚ࢞ࢆ່ࡵࡿ $EVWUDFWRUDQG'DWH ᯇ⏣༓㔛 ᒸᏕ − 39 − 㸰᪂⏕≀ 㸦& ࡀࢇᝈ⪅ࡢ╧╀ࡢ㉁㸧 ᩥ⊩ Andersen SR, et al. Effect of mindfulness-based stress reduction on sleep quality: Results of a randomized trial among Danish breast cancer patients. Acta Oncol, 2013; 52(2): 336-44. Pubmed ID:23282113 ┠ⓗ ஙࡀࢇᝈ⪅ࡢ╧╀ࡢ㉁࠾࠸࡚ 0%65 ࣉࣟࢢ࣒ࣛຠᯝࢆุ᩿ࡍࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ࢹ࣐࣮ࣥࢡ࠶ࡿࣁ࣮ࣦࣞ㝔ࣜࣥࢢࢫࢸࢵࢻ㝔 ཧຍ⪅ 㐣ཤࠥࣨ᭶㛫࡛ஙࡀࢇࢫࢸ࣮ࢪϨࠥϪデ᩿ࡉࢀࠊᡭ⾡ࢆཷࡅࡓṓࡢዪᛶ ධ $UPධ⩌0%65ࣉࣟࢢ࣒ࣛ⩌ྡ ᅇศ㐌ᅇ㐌㛫⮬Ꮿ࡛ࡶࢺ࣮ࣞࢽࣥࢢ $UPࢥࣥࢺ࣮ࣟࣝ⩌㏻ᖖ⒪⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ ╧╀ࡢ㉁㸦╧╀㞀ᐖࠊ࠸ࡧࡁࠊぬ㓰ࡋ࡚ࡍࡄࡢ▷࠸྾㢌③ࠊ╧╀ࡢጇᙜᛶࠊ᪥୰ࡢഴ╀ࠊ ╧╀ࡢၥ㢟ࠊ╧╀㛫ࠊ᭱㐺࡞╧╀㸧ࢆ(1)ධᚋࡍࡄ (2)ධᚋ 6 ࣨ᭶ (3)ධᚋ 12 ࣨ᭶࡛ ẚ㍑ࡍࡿ ࡞⤖ᯝ ධᚋࡍࡄࡢ MBSR ⩌ᝈ⪅ࡢ╧╀ၥ㢟ࢫࢥࡢᖹᆒ್ࡣࠊᑐ↷⩌ࡼࡾࡶ᭷ពᨵၿࡉࢀࡓ (p=.03)ࠋ╧╀ࡢၥ㢟࠾࠸࡚ࠊMBSR ⩌ࡣᑐ↷⩌ࡼࡾࡶࠊ᭷ពࡼࡾᑡ࡞࠸ቑຍࢆ♧ࡋࡓࠋ ITT ศᯒࡼࡿࠊ12 ࣨ᭶ᚋࡢ㏣㊧࡛ࡣࠊ╧╀ࡢ㉁࠾࠸࡚⩌㛫᭷ពᕪࡣࡳࡽࢀ࡞ࡗࡓࠋ ⤖ㄽ MBSR ࡣࠊஙࡀࢇᝈ⪅ධᚋࡍࡄࡣⴭࡋ࠸ຠᯝࡀࡳࡽࢀࡓࡀࠊ㛗ᮇⓗ࡞ຠᯝࡣࡳࡽࢀ࡞ ࡗࡓࠋࡉࡽ࡞ࡿ MBSR ࡢ◊✲ MBSR ࡀ╧╀ࡢ㉁ࡢྥୖຠᯝⓗホ౯ࡍࡿࡓࡵࡣࠊ ࡼࡾ῝้࡞╧╀ၥ㢟ࢆᢪ࠼ࡿᝈ⪅ᑐ㇟ࢆ㝈ᐃࡋࡓ◊✲ࢆࡍࡍࡵ࡚࠸࡞ࡅࢀࡤ࡞ࡽ࡞࠸ࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ධ⩌ධࢆ᩿ࡗࡓ ྡࠊධᚋ୰᩿ ྡࠊ㏣㊧ㄪᰝࡢ୰᩿ ྡ ࢥࣥࢺ࣮ࣟࣝ⩌ ㏣㊧ㄪᰝࡢ୰᩿ ྡ ୧⩌ඹ⌮⏤ࡣ᫂ ࣚ࢞ࡢヲ⣽ 0%65ࢫࢺࣞࢫᛂᑐࡍࡿᚰ⌮ᩍ⫱ࠊ࣐ࣥࢻࣇࣝ▂ࠊ⦆ࡸ࡞ࣚ࢞ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࡇࡢㄽᩥ࡛ࡣࣚ࢞༢⊂ࡢ᭷ຠᛶࡘ࠸࡚ゝཬࡋ࡚࠸࡞࠸ࡓࡵࠊࣚ࢞ࡀஙࡀࢇᝈ⪅ࡢ╧╀ࡢ㉁ ࠼ࡿᙳ㡪ࡣヲࡋࡃุࡽ࡞ࡗࡓࠋⴭ⪅ࡀ㏙࡚࠸ࡿᵝࠊᚋ 0%65 ࣉࣟࢢ࣒ࣛࢆࡉࡽ 㔜⠜࡞╧╀㞀ᐖᝈ⪅ࡍ◊✲ࢆࡍࡿࡇ࡛ࡑࡢ᭷ຠᛶࡀ᫂☜࡞ࡿࡢࡶࡋࢀ࡞࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇᝈ⪅ࡢ╧╀ࡢ㉁ࢆ㧗ࡵࡿࡓࡵࣚ࢞ࡀ᭷ຠ࠺ࡕࡽࡶゝ࠼࡞࠸ $EVWUDFWRUDQG'DWH ࢸ࣮ࣛዉኸ ᒸᏕ − 40 − 㸰᪂⏕≀ 㸦&ஙࡀࢇ㸧 ᩥ⊩ Kumar N, et al.: Randomized Controlled Trial in Advance Stage Breast Cancer Patients for the Effectiveness on Stress Marker and Pain through Sudarshan Kriya and Pranayama. Indian Journal of Palliative Care / Sep-Dec 2013 / Vol-19 / Issue-3. Pubmed ID:24347409 ┠ⓗ 㐍⾜ᛶஙࡀࢇࡢዪᛶᝈ⪅ᑐࡋ࡚ࠊࢫࢲࣝࢩࣕࣥࢡࣜࣖࣉ࣮ࣛࢼ࣮࣮࣐ࣖࡢㄆ▱࣭⾜ື ࢫࢺࣞࢫ࣐ࢿ࣮ࢪ࣓ࣥࢺࡀ⾑୰ࢥࣝࢳࢰ࣮ࣝ③ࡳࡢࣞ࣋ࣝ࠼ࡿຠᯝࢆㄪᰝࡍࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ゝཬ࡞ࡋ ཧຍ⪅ ࢫࢸ࣮ࢪࡀϩEࠊϪࠊϫࡢᨺᑕ⥺⒪ἲࠊᏛ⒪ἲࠊᡭ⾡ࡢᶆ‽ⓗ࡞⒪ࢆ⤊࠼ࠊ③ࡳ࣐ࢿ ࣮ࢪ࣓ࣥࢺࡢᮇ㛫࠶ࡾࠊ.DUQRIVN\ ࢫࢥࡀ ࢆ㉸࠼࡚࠸ࡿ ṓࡢ㐍⾜ᛶஙࡀࢇ ࡢዪᛶ ྡ ධ ࢫࢲࣝࢩࣕࣥࢡࣜࣖࣉ࣮ࣛࢼ࣮࣮࣐ࣖ ᪥㛫࡛ 㛫ࡢ┤᥋ᣦᑟࢆཷࡅࡓᚋࠊ⮬Ꮿ ᐇ⩦ࢆ ࣨ᭶㛫ᐇ ᪥ ศ㸩⦎⩦᪥ㄅ $UPධ⩌㏻ᖖ⒪㸩ࣚ࢞⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ㏻ᖖ⒪⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ ⾑Ύࢥࣝࢳࢰ࣮ࣝࣞ࣋ࣝࠊVerval pains scale(③ࡳホ౯ࠊ 0-10)ࢆධ๓ࠊ3 ࣨ᭶ࠊ6 ࣨ᭶ࡢ ㏣㊧ㄪᰝࡢ 3 ᅇ ᐃࠋ ࡞⤖ᯝ ⾑Ύࢥࣝࢳࢰ್࣮ࣝ㸸㛤ጞ๓࡛ࡣࠊ✵⭡⾑୰ࢥࣝࢳࢰ࣮ࣝࡢࣚ࢞⩌ᑐ↷⩌࡛᭷ពᕪࡣ ࡳࡽࢀ࡞ࡗࡓ㸦421s70vs493s51mng/l㸧 ࠋࡋࡋࠊࣚ࢞⩌ vs ࢥࣥࢺ࣮ࣟࣝ⩌ࡢࢥࣝࢳ ࢰ್࣮ࣝࡣࠊ3 ࣨ᭶ᚋ࡛ 341.4s51.4vs549.2s69.5nmg/l.6 ࣨ᭶ᚋ࡛ 376.2s74.9vs517.8s 69.7nmg/l㸧ࠊࣚ࢞⩌࡛㢧ⴭ࡞ῶᑡࡀࡳࡽࢀࡓ(Pӌ0.002)ࠋ ③ࡳ㸸Verval pains scale ࡢ 10 ẁ㝵③ࡳᣦᶆ࡛ࡣࠊ㛫ඹ③ࡳࡣቑຍࡋࡓࡀࠊࣚ࢞⩌ࡣ ᑐ↷⩌ẚ㍑ࡋ࡚ 3 ࣨ᭶ᚋ 6 ࣨ᭶ᚋ࡛ᖹᆒ 3 ࣏ࣥࢺపࡗࡓࠋ ⤖ㄽ 㐍⾜ᛶஙࡀࢇࢆᣢࡘዪᛶᝈ⪅ᑐࡍࡿࢫࢲࣝࢩࣕࣥࢡࣜࣖࣉ࣮ࣛࢼ࣮࣮࣐ࣖࡣࢫࢺ ࣞࢫࡸ③ࡳࡢ㍍ῶ᭷ຠ࡛࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ Ᏻᛶ㛵ࡍࡿゝཬࡣ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ᑐ↷⩌ࡢ࠺ࡕࣨ᭶ࡲ࡛ྡࡀ㞳⬺ࡋࠊࣨ᭶ࡲ࡛ྡࡀ㞳⬺ࡋࡓࠋࣚ࢞⩌ࡢ࠺ࡕྡ ࡀࣚ࢞ཧຍࡋ࡞ࡗࡓࠋࣚ࢞⩌ࡢ࠺ࡕࣨ᭶ࡲ࡛ྡࡀ㞳⬺ࡋࠊࣨ᭶ࡲ࡛ྡࡀ㞳⬺ ࡋࡓࠋධ⩌ࡢ⮬Ꮿ࡛ࡢࣚ࢞ᐇ⩦⋡ࡣ㸣࡛࠶ࡗࡓࠋ ࣚ࢞ࡢヲ⣽ ࢫࢲࣝࢩࣕࣥࢡࣜࣖࣉ࣮ࣛࢼ࣮࣮࣐ࣖ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࣮ࢧࢼࢆ⏝࠸ࡿࡇ࡞ࡃࢡࣜࣖࣉ࣮ࣛࢼ࣮࣮࣐ࣖࡢࡳ࡛ࢫࢺࣞࢫ③ࡳࡀ㍍ῶࡍࡿ Ⅼࡀ⯆῝࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇࡢᝈ⪅ࡢ⾑୰ࢥࣝࢳࢰ࣮ࣝ㸦ࢫࢺࣞࢫ㸧③ࡳࢆᨵၿࡍࡿࡓࡵࣚ࢞ࢆ່ࡵࡿ $EVWUDFWRUDQG'DWH ⓑ᰿ṇಟ ᒸᏕ − 41 − 㸰᪂⏕≀ 㸦&ஙࡀࢇ㸧 ᩥ⊩ Cadmus-Bertram L, et al: Predictors of Adherence to a 26-Week Viniyoga Intervention Among Post-Treatment Breast Cancer Survivors, THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 19, Number 9, 2013: 751–758. PubMed ID:23663078 ┠ⓗ ஙࡀࢇ⏕Ꮡ⪅࠾ࡅࡿࠊ㐌ࡢ࣮࣒࣮࣍࣋ࢫ࡛⟶⌮ᵓᡂࡉࢀࡓࣚ࢞ධࡢࢻࣄࣛࣥࢫ ᙳ㡪ࢆ࠼ࡿேཱྀ⤫ィᏛⓗࠊᚰ⌮Ꮫⓗࠊᗣ㛵㐃ⓗࠊᆅ⌮ⓗ࡞ண ᅉᏊࢆ᫂ࡽࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ )UHG+XWFKLQVRQ&DQFHU5HVHDUFK&HQWHU6HDWWOH:$ ཧຍ⪅ ṓࡢࢫࢸ࣮ࢪ㸮Ϫࡢஙࡀࢇ⏕Ꮡ⪅ᖹᆒᖺ㱋ṓྡࠋཧຍⓏ㘓ࡢ᭶๓ ⾡ᚋ⿵ຓ⒪ἲࢆ⤊࣍ࣝࣔࣥ⒪ἲࠊ⏕≀Ꮫⓗ⒪ἲࡢ⥆⾜ࡣࠊチྍࡉࢀ࡚࠸ࡿ㸧 ධ ࢭࣛࣆ࣮ࣗࢸࢵࢡ࣭ࣁࢱࣚ࢞ ᅇ ศ㐌 ᅇ 㐌㛫 ᐙᗞᐇ⩦ࢆྵࡵ㐌 ᪥ᐇ $UPධ⩌ࣚ࢞⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ᚅᶵ⩌ ྡ ᕼᮃࡋࡓሙྜࠊ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ ேཱྀ⤫ィᏛᅉᏊ㸸ᖺ㱋ࠊᏛṔ㸪ᑵᴗ≧ែ㸧ᆅ⌮ⓗᅉᏊ㸸ᐙࡽタࡲ࡛ࡢ㊥㞳 ㌟యⓗάື㸸㐣ཤ12࢝᭶ࡢࣞࢪ࣮ࣕࢱ࣒ࡢ㌟యάືࡢㄪᰝ ⒴㛵㐃ᅉᏊ㸸デ᩿ࡢ⭘⒆ ࡢᮇࠊデ᩿ࡽࡢ⤒㐣ᖺᩘ ᚰ⌮♫ⓗせᅉ:PSQI(ࣆࢵࢶࣂ࣮ࢢ╧╀㉁ၥ⚊)ࠊPSS(ࢫ ࢺࣞࢫ)ࠊFACIT(⑂ປ)ࠊCES-D(࠺ࡘ) ࠊISEL(ࢯ࣮ࢩࣕࣝࢧ࣏࣮ࢺ)ࠊESS(⮬ᕫຠຊ)ࠊ㌟ య ᐃ:㌟㛗ࠊయ㔜ࠊ⬗࿘ࡾ ᐃࠊධ๓ࠊධᚋ ᐃࠋ ࡞⤖ᯝ タ࣮࣋ࢫࡢฟᖍᅇᩘࡣࠊBMI(p=0.09)⬗࿘ࡾ(p= 0.04)ẚࡋࠊ⮬ᕫຠຊឤ(p= 0.06)ࠊ እ࡛ാ࠸࡚࠸ࡿ(p㸻0.07)ࠊ⭘⒆ࡢᮇ(p㸻0.02)ࡣṇẚࡋࡓࠋ⮬Ꮿ⦎⩦࡛ࡣࠊBMI(p =0.03)⬗࿘ࡾ(p=0.01)࡛ẚࠊ⮬ᕫຠຊ(p=0.01)ṇẚࡋࡓࠋ⬗࿘ࡾBMIࡣࠊ㧗࠸ ┦┦㛵㛵ಀ࡛࠶ࡿࡇࡽ(p= 0.002)ࠊBMIࡼࡾ⬗࿘ࡾࡢ᪉ࡀ⤖ᯝࡼࡾᙉ࠸┦㛵㛵ಀࡀ ࠶ࡿࠋ▱ぬࡉࢀࡓࢫࢺࣞࢫࠊ࠺ࡘ≧ࠊ⑂ປࠊ╧╀ࡣࠊタ࡛ࡢ⦎⩦ࠊ⮬Ꮿ⦎⩦ࡢࡕࡽ ࡶ᭷ពᕪࡣ࡞ࡗࡓࠋタ࣮࣋ࢫࡢ⦎⩦࡛ࡣࠊࣚ࢞ᑐࡍࡿ⮬ᕫຠຊឤࡀ㧗࠸ࡇ (p=0.004)ࠊᐙࡢእ࡛ാ࠸࡚࠸ࡿࡇ(p=0.004)ࡀࢡࣛࢫࡢฟᖍ⋡㠀ᖖ㧗࠸㛵㐃ᛶࡀ࠶ ࡗࡓࠋ⮬Ꮿ⦎⩦࡛ࡣࠊ⬗࿘ࡾࡀࡼࡾኴ࠸ࡇࠊࡼࡾᑡ࡞࠸ࣚ࢞ࡢ⮬Ꮿ⦎⩦(p=0.05)ࢆࡍ ࡿࡇࡣഹࡤࡾ㛵㐃ࡋ࡚࠾ࡾࠊࡲࡓࡼࡾ㧗࠸⮬ᕫຠຊࡼࡾከ࠸ᨭᗘ⦎⩦ࡣᑡࡋ㛵 㐃ᛶࡀ࠶ࡗࡓࠋ ⤖ㄽ ࣚ࢞ࡢ⮬ᕫຠຊឤࡀ㧗࠸ࡇࡣࠊࣚ࢞ࢡࣛࢫࡢཧຍࠊ⮬Ꮿ⦎⩦ࡢᅇᩘࡀከ࠸ࡇࢆண ࡍࡿࠋ⮬ᕫຠຊឤࡀపࡃࠊ⬗࿘ࡾࡀኴ࠸ஙࡀࢇ⏕Ꮡ⪅࡛ࡣࠊࢧ࣏࣮ࢺ㐺ษ࡞ᡭຓࡅࡀ ᚲ⏝࡛࠶ࢁ࠺ࠋ㒔ྜࡢⰋ࠸㛫ࢆ☜ಖ࡛ࡁࢀࡤࠊฟᖍ⋡ࡣࡉࡽྥୖࡍࡿࡶࡋࢀ࡞࠸ࠋ Ᏻᛶ㛵ࡍࡿゝཬ グ㍕࡞ࡋࠋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ グ㏙ࡀ࡞࠸ࡀࠊࢻࣟࢵࣉ࢘ࢺࡢྍ⬟ᛶ࠶ࡾ ࣚ࢞ࡢヲ⣽ ࣦࢽࣚ࢞㸸㛤ጞࡢࢳ࢙ࢵࢡ➼㸫ศ యἲ㸳㸶ศ࣮ࢧࢼ✀ ྾ἲࣉ ࣮ࣛࢼ࣮࣮࣐ࣖ㸧 ࢩ࣮ࣕࣂ࣮ࢧࢼศ㛫 ᆘࡢࢧࣞࣥࢺ▂ศ㛫 $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࣚ࢞ࡢࢻࣄࣛࣥࢫ㛵ࡍࡿࡣࡌࡵ࡚ࡢ◊✲࡛࠶ࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇ⏕Ꮡ⪅ࡢ⒪ᚋฎ⨨ᑐࡋ࡚ࠊࣚ࢞ࢆ່ࡵࡿ $EVWUDFWRUDQG'DWH 㧗⏣᫂⨾ ᒸᏕ − 42 − 㸰᪂⏕≀ 㸦& ஙࡀࢇ⏕Ꮡ⪅㸧 ᩥ⊩ Carlson LE, et al. Randomized Controlled Trial of Mindfulness-Based Cancer Recovery Versus Supportive Expressive Group Therapy for Distressed Survivors of Breast Cancer (MINDSET) J Clin Oncol, 2013; 1; 31(25): 3119-26. Pubmed ID:23918953 ┠ⓗ ᚰ⌮ⓗⱞ③ࢆᢪ࠼ࡓஙࡀࢇ⏕Ꮡ⪅ࡢ࣐ࣥࢻࣇࣝࢿࢫ࣮࣋ࢫࡢ⒴ࡢᅇ㸦MBCR㸧㞟ᅋ ⾲⌧⒪ἲ Expressive ࢧ࣏࣮ࢺࢢ࣮ࣝࣉ㸦SET㸧ࡢ᭷ຠᛶࢆẚ㍑ࡍࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦RCT㸧 ࢭࢵࢸࣥࢢ ࣂࣥࢡ࣮ࣂ࣮࣮࢝ࣝ࢞ࣜ ཧຍ⪅ ࢫࢸ࣮ࢪ IࠊIIࠊࡲࡓࡣ III ࡢங⒴デ᩿ࡉࢀࡓ 18 ṓ௨ୖࡢዪᛶ 271 ྡ ධ Arm1:(ධ⩌)MBCR ࢢ࣮ࣝࣉ 113 ྡ(Massachusetts Medical center ࡛㛤Ⓨࡉࢀࡓ MBCR)8 㐌 㛫/ྜィ 18 㛫 Arm2:(ධ⩌)SET ࢢ࣮ࣝࣉ 104 ྡ(Stanford University ࡛㛤Ⓨࡉࢀࡓ㞟ᅋ⾲⌧⒪ἲ)12 㐌㛫/ྜ ィ 18 㛫 Arm3:(ࢥࣥࢺ࣮ࣟࣝ⩌)ᩍ⫱ࢢ࣮ࣝࣉ 54 ྡ(The university of Miami Center for Psycho-Oncology Research ᇶ࡙ࡃࢫࢺࣞࢫ࣐ࢿ࣮ࢪ࣓ࣥࢺࢭ࣑ࢼ࣮)1 ᪥/㸴㛫 ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1.POMS㸦Ẽศ㸧 2.ၚᾮࢥࣝࢳࢰ್࣮ࣝ 3.SOSI39㸦ࢫࢺࣞࢫ㸧 4.FACT-B40㸦QoL㸧 5.MOS-SSS㸦♫ⓗᨭ㸧 ࢆධ๓ᚋࡢ 2 ᅇࠋ ࡞⤖ᯝ ⥺ᙧΰྜຠᯝࣔࢹࣝࢆ⏝࠸ࡓໟᣓゎᯒศᯒ࠾࠸࡚ࠊSET ࢢ࣮ࣝࣉ㸦P=0.002㸧 MBCR ࢢ࣮ࣝࣉ㸦P=0.011㸧࡛ࡣࠊࢥࣥࢺ࣮ࣟࣝ⩌࡛ࡣධᮇ㛫ᚋࠊࢥࣝࢳࢰ࣮ࣝ໙㓄ࡢഴᩳࡀࡼࡾ ᖹᆠ࡞ࡗࡓࡢᑐࡋ࡚ࠊධᮇ㛫ᚋࡶ໙㓄ࡀ⥔ᣢࡉࢀࡓࠋ MBCR ධࢢ࣮ࣝࣉࡣࠊSET ධ㸦P=0.009㸧࠾ࡼࡧࢥࣥࢺ࣮ࣟࣝ㸦P=0.024㸧ࢢ࣮ࣝࣉẚ࡚ࢫࢺࣞࢫ≧ࡀࡼࡾᨵၿ ࡉࢀࡓࠋධ᪉ἲࡼࡿ㐪࠸ࡘ࠸࡚ࡣࠊMBCR ࢢ࣮ࣝࣉ࡛ࡣࠊࢥࣥࢺ࣮ࣟࣝ⩌ẚ࡚ QOL ࠾࠸࡚ࡁ࡞ᨵၿ(p=0.005)ࡀぢࡽࢀࠊࡲࡓࠊSET ࢢ࣮ࣝࣉẚ㍑ࡍࡿ♫ⓗᨭ ࠾࠸࡚ࡁ࡞ᨵၿ(p=0.012)ࡀぢࡽࢀࡓࠋ ⤖ㄽ ࡇࡢ᭱つᶍࡢヨ㦂࡛ࡣࠊMBCR ධࡣࠊⱞ③ࢆឤࡌࡿஙࡀࢇ⏕Ꮡ⪅࠾࠸࡚ࠊᚰ⌮♫ⓗ ࢘ࢺ࣒࢝ࢆᨵၿࡍࡿຠᯝࡀ࠶ࡿࡇࡀࢃࡗࡓࠋ SET MBCR ୧᪉ࡣࠊࢥࣥࢺ࣮ࣟࣝ⩌ ࡼࡾṇᖖ࡞ᴫ᪥ࢥࣝࢳࢰ࣮ࣝኚࢆ⏕ࡌࡿࡇࡀ♧ࡉࢀࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ MBCR ࢢ࣮ࣝࣉ㸸39 ྡ SET ࢢ࣮ࣝࣉ㸸31 ྡ ࢥࣥࢺ࣮ࣟࣝ⩌㸸17 ྡ (ྛ⩌࡛⌮⏤ࡣ᫂) ࣚ࢞ࡢヲ⣽ ࣚ࢞㛵ࡍࡿグ㏙࡞ࡋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ஙࡀࢇᝈ⪅ᑐࡍࡿ⢭⚄ⓗࢧ࣏࣮ࢺ㛵ࡋ࡚ࠊ࣐ࣥࢻࣇࣝࢿࢫࣉࣟࢢ࣒ࣛࡢຠᯝࡀ㧗࠸ࡇࡀ ࢃࡿࠋࣚ࢞ࡢຠᯝࡀࠊࢀࢆ༨ࡵࡿࡣ࡛᫂࠶ࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇ⏕Ꮡ⪅ࡢᚰ⌮ⓗⱞ③ᑐࡋ࡚ MBCR ࡣ᭷ຠࡔࡀࠊSET ࡕࡽࡀ᭷ຠࡣࢃࡽ࡞ ࠸ࠋ $EVWUDFWRUDQG'DWH ụ⏣⪽Ꮚ ᒸᏕ − 43 − 㸰᪂⏕≀ 㸦& ᪩ᮇஙࡀࢇ㸧 ᩥ⊩ Siedentopf F, et al. Yoga for Patients with Early Breast Cancer and its Impact on Quality of Life – a Randomized Controlled Trial. Geburtshilfe Frauenheilkd, 2013; 73(4):311–317. Pubmed ID:24771916 ┠ⓗ ᪩ᮇஙࡀࢇデ᩿ࡉࢀࡓᝈ⪅ᑐࡋࠊᡭ⾡ᚋ┤ࡕࣚ࢞ࢆ⾜࠺࡛ 42/ ࡢྥୖࠊ㌟యάື ࡢᨵၿࡀぢࡽࢀࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ࢻࢶ㉥༑Ꮠ㝔࢚࢘ࢫࢺ࢚ࣥࢻ⬚㒊ࢭࣥࢱ࣮ タ࣋ࣝࣜࣥ ཧຍ⪅ ஙᡣษ㝖ࠊஙᡣ Ꮡࠊࢭࣥࢳࢿࣝࣜࣥࣃ⠇⏕᳨㸦6/1㸧 ࠊ⭆❐ࣜࣥࣃ⠇㒌Ύ㸦$/1'㸧ࡢᡭ⾡㸦ฎ ⨨㸧ࢆཷࡅࡓஙࡀࢇᝈ⪅ࠋ༶⩌ࡣ 37̽78 ṓ࡛ᖹᆒᖺ㱋ࡣ 55.82±10.72 ṓࠊᚅᶵ⩌ࡢᖺ㱋ࡣ 40̽84 ṓ࡛ᖹᆒᖺ㱋ࡣ 58.41±9.91 ṓࠋ(p = 0.23) ධ Gitananda and vini yoga ஙࡀࢇᝈ⪅ࡢࡓࡵࡢࣉࣟࢢ࣒ࣛࠋ㸯ᅇ ศ/㐌 2 ᅇ/5 㐌㛫 $UP༶⩌⾡ᚋࡍࡄࣚ࢞ࢆᐇ⩦ࡋጞࡵࡿࢢ࣮ࣝࣉ $UPᚅᶵ⩌⾡ᚋ 㐌㛫ᚋࣚ࢞ࢆᐇ⩦ࡋጞࡵࡿࢢ࣮ࣝࣉ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ EORTC QLQ-C30 ORTC QLQ-BR23㸦⏕άࡢ㉁(QoL)ࡢᣦᶆࡋ࡚㸧 ධ๓ࠊࣚ࢞ධ(⤊)ᚋࠊࣚ࢞⤊ࡽ 3 ࣨ᭶ᚋࡢ 3 ᅇ ᐃࠋ ࡞⤖ᯝ ༶⩌࡛ࡣධᚋࠊ⥲ྜⓗ QOL(p=0.002)ࡸᶵ⬟≧ែ(p=0.005)ࡀྥୖࡋࡓࡀࠊᚅᶵ⩌࡛ࡣኚ ࡀ࡞ࡗࡓࠋ≧ࡣ୧⩌ࡶࣚ࢞⤊㸱ࣨ᭶ᚋࡣ㍍ῶࡋࡓࠋࣚ࢞ࡼࡗ࡚㌟యⓗάືᛶࡀ ࡼ࠸᪉ྥኚࡋࡓ⪅ࡣࠊ༶⩌࡛ࡣ 86㸣࡛࠶ࡗࡓࡢᑐࡋ࡚ࠊᚅᶵ⩌࡛ࡣ 59㸣ࠊ᭷ព ༶⩌ࡢ᪉ࡀከࡗࡓ(p=0.04)ࠋㄪᰝᚋࡶࣚ࢞ࢆ⥆ࡅࡓ࠸ᛮࡗࡓ⪅ࡣࠊ༶⩌㸦97㸣㸧ࡢ᪉ ࡀᚅᶵ⩌ࡼࡾࡶ᭷ពከࡗࡓ(p=0.03)ࠋ ⤖ㄽ ᪩ᮇஙࡀࢇᝈ⪅ࡀᨭᣢ⒪ἲࡋ࡚⾡ᚋࡍࡄࣚ࢞ࢆጞࡵࡿࡇࡣࠊ QoL ࡼ࠸ᙳ㡪ࢆ࠼ࡿࠋ ஙࡀࢇᝈ⪅ࡀ⮬ศ⮬㌟࡛ࣚ࢞ࢆ⦎⩦ࡍࡿࡇ࡛ࠊ⮬ศ⮬㌟ࡢ QoL ࢆྥୖࡉࡏࠊ㌟యάືࢆྥ ୖࡉࡏࡓࠋஙࡀࢇᝈ⪅ࡀࠊ⾡ᚋ᪩ᮇࣚ࢞ࢆ⾜࡞࠺ࡇࡣ᭷⏝࡛࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ༶⩌ࡢࢻࣟࢵࣉ࢘ࢺ⋡ධᚋ 㸣ࠊ㸱ࣨ᭶ᚋ 㸣 ⌮⏤ࡣ᫂ ᚅᶵ㌷ࡢࢻࣟࢵࣉ࢘ࢺ⋡ධᚋ 㸣ࠊ㸱ࣨ᭶ᚋ 㸣 ⌮⏤ࡣ᫂ ࣚ࢞ࡢヲ⣽ ௮ྥࡅ࡛ࡢ࣮ࢧࢼࡽጞࡲࡾࠊࢫࢺࣞࢵࢳ྾ࢆྠㄪࡉࡏࡓ࣮ࢧࢼࠊ㤳ࠊ⫪ࠊ⭎ࢆᘱ ⦆ࡉࡏࡿ࣮ࢧࢼࠊ⬚ቨࡀᣑࡀࡿឤࡌࡀࡍࡿࡼ࠺࡞ᵝࠎ࡞྾ἲࠊ࣭࢚ࢡࢧࢧࢬࠊ❧ ࡢ࣮ࢧࢼࠊᗘ௮ྥࡅ࡛ࡢ࣮ࢧࢼࠊ▂ἲ㸦࣭ࣚ࢞ࢽ࣮ࢻࣛ࡞㸧 ࠊ∦㰯ࡎࡘࡢ྾ἲ ࡸࢳࣕࣥࢸࣥࢢ࡞࡛ࢡࣛࢫࢆ⤊࠼ࡿ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࣚ࢞ࡀࠊࡀࢇᝈ⪅ࡢ 42/ ࡢᨵၿᙺ❧ࡘ࠸࠺◊✲ሗ࿌ࡣ࠶ࡿࡀࠊᮏ◊✲ࡣࣚ࢞ࢆ㛤ጞࡍࡿ ࢱ࣑ࣥࢢࢆ᳨ウࡍࡿ࠸࠺どⅬࡀ⯆῝࠸ࠋ༶⩌ࡣᚅᶵ⩌ẚ࡚ࣚ࢞⤊ࡢ⏕άࡢ ㉁㸦42/㸧ࡀ㧗ࡗࡓࡇࠊࡑࡢᚋࡢࣚ࢞ᐇ⩦ࢆ⥆ࡅࡿពᛮࡶ㧗ࡗࡓࡇࡣὀ┠್ࡍࡿࠋ ᅇࡢஙࡀࢇᝈ⪅ࡢ྾ἲࡣ⬚ቨࡀᣑࡀࡿࡼ࠺࡞࣓࣮ࢪ࡛ᣦᑟࡉࢀ࡚࠾ࡾࠊᝈ⪅ࡢ≧ࡸ Ⓨ⟠ᡤྜࢃࡏࡓ྾ࢆᣦᑟࡍࡿࡇࡢ㔜せᛶࡀ❚࠼ࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ᪩ᮇஙࡀࢇᝈ⪅ᑐࡋ࡚ᡭ⾡ᚋ࡛ࡁࡿࡔࡅ᪩ࡵࣚ࢞ࢆጞࡵࡿࡇࢆ່ࡵࡿࠋ $EVWUDFWRUDQG'DWH ᯇ⏣༓㔛 ᒸᏕ − 44 − 㸰᪂⏕≀ 㸦&ஙࡀࢇ㸧 ᩥ⊩ Kovaþiþ T, Zagoriþnik M, Kovaþiþ M: Impact of relaxation training according to the Yoga In Daily Life® system on anxiety after breast cancer surgery., J Complement Integr Med. 2013;(1):1-12. PubMed ID:21147813 ┠ⓗ <RJD,Q'DLO\/LIH<,'/ࡼࡿࣜࣛࢡࢮ࣮ࢩࣙࣥࢺ࣮ࣞࢽࣥࢢࡀᡭ⾡ᚋࡢஙࡀࢇᝈ⪅ࡢ Ᏻཬࡰࡍᙳ㡪ࢆㄪࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ⭘⒆Ꮫࣜࣗࣈࣜࣕࢼ◊✲ᡤ ཧຍ⪅ ึᮇデ᩿ࡀங⒴ࠊங⒴ࡣࢫࢸ࣮ࢪ , ࠾ࡼࡧ ,, ࡢ⾡ᚋ㸦 Ꮡᡭ⾡㸦%&6㸧ࡲࡓࡣᨺᑕ⥺⒪ ࡛ಟṇࡉࢀࡓஙᡣษ㝖⾡㸦050㸧 ࠊ࠾ࡼࡧእ⛉ᡭ⾡ࠊᨺᑕ⥺⒪ἲࠊᏛ⒪ἲࡢ࣐ࣝࢳࣉࣝ ⒪ἲ㸧 ࠊ 㐌㛫ࡢධ㝔ࠊ ṓ௨ୖࠊ◊✲࡛ࣛࣥࢲ࣒ศࡅࡽࢀࡿࡇࢆཷࡅධࢀࡓ ྡࠋ ධ $UPධ⩌ࣚ࢞⩌㸦 ྡ㸧ᶆ‽⌮Ꮫ⒪ἲຍ࠼࡚ <RJD,Q'DLO\/LIH㸦<,'/p㸧᪉ᘧ ᪥ 㛫 㐌㛫ࠋ㏥㝔ಶู⮬Ꮿᐇ⩦ࡢⅭࠊᣦᑟ㘓㡢㓄ᕸࠋẖ㐌 ᅇࡢ⦎⩦ሗ࿌ $UPࢥࣥࢺ࣮ࣟࣝ⩌ᑐ↷⩌㸦 ྡ㸧ᶆ‽⌮Ꮫ⒪ἲ ୧ࢢ࣮ࣝࣉࡣࠊ㸯᪥㸯㛫ྠࡌᶆ‽⌮Ꮫ⒪ἲࢆ㸯㐌㛫ཧຍࠋͤᶆ‽⌮Ꮫ⒪ἲ⭎ࡢືࡁ࡞ ⫪࿘ࡾࡢ㌟యᶵ⬟ࠊࣜࣥࣃᾋ⭘ࢆ⦆ࡍࡿⅭࡢ㐠ືᩍ⫱ࠋ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ STAI(≧ែ࣭≉ᛶᏳ᳨ᰝ)࣭≧ែᏳᑻᗘ:୧⩌ࡶᐇࡢࡍࡄᚋ ᐃࠋ㺃STAI ≉ᛶᏳ ᑻᗘ:୧⩌ࡶࠊ୍⯡ⓗ࡞ᡭ⾡๓(࣮࣋ࢫࣛࣥ ᐃ್)ࠊ1 㐌㛫(ධ㝔୰)ࠊ㏥㝔ᚋࡢ 3 㐌㛫 ࡢᅾᏯᮇ㛫ࡢᚋ(࣮࣋ࢫࣛࣥ ᐃᚋ 1 ࣨ᭶)ࡢ 3 ᅇ࡛ẚ㍑ࠋ ࡞⤖ᯝ ධ 1 㐌㛫ᚋࠊࣚ࢞⩌࡛ࡣ≧ែᏳࡀ᭷ពῶᑡࡋࡓ(P<0.01) ࡀࠊࢥࣥࢺ࣮ࣟࣝ⩌࡛ࡣ ኚ࡛࠶ࡗࡓࠋ≉ᛶᏳ᳨ᰝ࠾࠸࡚ࡶࠊࣚ࢞⩌࡛ࡣධ㸯㐌㛫ᚋ(P<0.01)ࠊ4 㐌㛫ᚋ(P<0.01) ࡛᭷ពῶᑡࡋࡓࡀࠊࢥࣥࢺ࣮ࣟࣝ⩌࡛ࡣኚ࡛࠶ࡗࡓࠋ ⤖ㄽ YIDL ࡼࡿࣜࣛࢡࢮ࣮ࢩࣙࣥࢺ࣮ࣞࢽࣥࢢࡣࠊᏳࡢᙉ࠸ங⒴ᝈ⪅ᑐࡍࡿ᭷⏝࡞⌮Ꮫ ⒪ἲⓗධ࡞ࡾᚓࡿ Ᏻᛶ㛵ࡍࡿゝཬ グ㍕࡞ࡋࠋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ᶆ‽⌮Ꮫ⒪ἲࠊࢺ࣮ࣞࢽࣥࢢᚋࡢࢻࣟࢵࣉ࢘ࢺࡘ࠸࡚グ㍕࡞ࡋࠋ ࣚ࢞ࡢヲ⣽ <,'/pࢩࢫࢸ࣒ࡢヲ⣽ࡣࠊືࡁ㟼ⓗ࡞࣮ࢧࢼጼໃࠊ྾ἲࣉ࣮ࣛࢼ࣐ࣖࠊࣜࣛࢡ ࢮ࣮ࢩࣙࣥἲ㸦ᘱ⦆カ⦎ࠊ㐍⾜ᛶࡢ➽ᘱ⦆ࠊ῝࠸ࣜࣛࢡࢮ࣮ࢩࣙࣥࡢࢸࢡࢽࢵࢡ㸸࣮ࣚ࢞ ࢽࢻࣛ㸧 ࠊࡑࡋ࡚▂ἲ㸦⮬ᕫ᥈ồ࣓࣮ࢪ▂㸧ࡽᵓᡂࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ᮏࡢ <,'/pࢩࢫࢸ࣒ࡢヲ⣽ࡣ᫂࡞Ⅼࡶ࠶ࡿࡀࠊ࡞ࡾ✜ࡸ࡛㌟య㈇ᢸࡀ࡞࠸༳ ㇟ࢆཷࡅࡓࠋங⒴⾡ᚋࡢᝈ⪅ᑐࡋ࡚ࠊ⌮Ꮫ⒪ἲຍ࠼࡚ධࡋࡓࡇࡣࠊ⯆῝࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇࡢᡭ⾡ᚋࣚ࢞ࢆ່ࡵࡿࠋ $EVWUDFWRUDQG'DWH ᒸెᜨ ❑⏣⨾ಖᏊ ᒸᏕ − 45 − 㸰᪂⏕≀ 㸦&ஙࡀࢇ㸧 ᩥ⊩ Wu¨rtzen H et al. Mindfulness significantly reduces self-reported levels of anxiety and depression: Results of a randomised controlled trial among 336 Danish women treated for stage I–III breast cancer. European Journal of Cancer. 2013; 49, 1365– 1373. Pubmed ID:23265707 ┠ⓗ ஙࡀࢇࡢዪᛶ࠾࠸࡚ࠊ ࣐ࣥࢻࣇࣝࢿࢫࢆ࣮࣋ࢫࡋࡓࢫࢺࣞࢫ㍍ῶࣉࣟࢢ࣒ࣛ 㸦0%65㸧 ࡀᏳᢚ࠺ࡘཬࡰࡍᙳ㡪ࢆ᳨ウࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ 'DQLVK&DQFHU6RFLHW\5HVHDUFK&HQWHU ࢹ࣐࣮ࣥࢡࡀࢇ◊✲ࢭࣥࢱ࣮ タ ཧຍ⪅ 㹼 ᭶௨ෆࢫࢸ࣮ࢪ ,̽,,, ࡢஙࡀࢇࡢᡭ⾡ࢆཷࡅࡓ 㹼 ṓࡢዪᛶ ྡࠋ ධ ࣐ࣥࢻࣇࣝࢿࢫࢆ࣮࣋ࢫࡋࡓࢫࢺࣞࢫ㍍ῶࣉࣟࢢ࣒ࣛ㸦0%65㸧 ⮬Ꮿ࡛ᐇ⩦ࡍࡿࡼ࠺ ࣐ࣚ࢞ࢵࢺࢆࠊࡲࡓࣚ࢞ࢫࢺࣞࢫ㛵ࡍࡿၨⓎⓗ࡞ෆᐜࡸ▂ࡢᣦᑟࡀྵࡲࢀࡓ &' ࡀ ᥦ౪ࡉࢀࡓࠋ ᅇ ศ㐌 ᅇ 㐌㛫ࠋ $UP0%65 ⩌ ྡࠋ㏻ᖖ⒪㏣ຍࡋ࡚ 0%65 ࢆ⾜࠺ࠋ $UPᑐ↷⩌ ྡࠋ㏻ᖖ⒪ࢆ⾜࠺ࠋ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1. the Symptom Checklist-90-r(SCL-90r) ࡢ Ᏻ 2.SCL-90r ࡢ ᢚ ࠺ ࡘ 3.Center for Epidemiological Studies-Depression (CES-D)ࡢᢚ࠺ࡘࠋධ๓ࠊ8 㐌㛫ᚋ㸦ධᚋ㸧 ࠊ6 ࣨ᭶ ᚋࠊ12 ᭶ᚋࡢ 4 ᅇ ᐃࠋ ࡞⤖ᯝ ࡍ࡚ࡢホ౯㡯┠ࡣ㛫ࡶῶᑡࡋࡓࡀࠊMBSR ⩌ࡢᏳᢚ࠺ࡘࡢᖹᆒ್ࡣ 12 ᭶ᚋࡢ⤖ᯝࡼࡾ 6 ࣨ᭶ᚋࡢ᪉ࡀపࡗࡓࠋ ⩌㛫ẚ㍑㸸ධᚋࡢ 8 㐌㛫Ⅼ࡛ࠊCES-D ࡣ MBSR ⩌ࡢ᪉ࡀᑐ↷⩌ࡼࡾ᭷ពపୗࡋࡓ (P=0.002)ࠋ6 ࣨ᭶ᚋ࡛ࡣࠊSCL-90r Ᏻ(P=0.05)ࠊSCL-90r ᢚ࠺ࡘ(P=0.01)ࠊCES-D(P=0.03) ࠸ ࡎࢀࡶ MBSR ⩌ࡢ᪉ࡀᑐ↷⩌ࡼࡾ᭷ពప್࡛࠶ࡗࡓࠋ12 ࣨ᭶ᚋ࡛ࡣࠊᢚ࠺ࡘ (SCL-90r:P=0.03࣭CES-D:P=0.05)࡛ MBSR ⩌ࡢ᪉ࡀᑐ↷⩌ࡼࡾ᭷ពప್࡞ࡗࡓࠋ ධ๓ᚋࡢẚ㍑㸦⩌ෆẚ㍑㸧 㸸ධ๓ 12 ᭶ᚋࡢኚ࡛ࡣࠊMBSR ⩌࡛ࡣ SCL-90r ࡢ ᢚ࠺ࡘࡣ᭷ពῶᑡࡋࡓ(P=0.01)ࡀࠊCES-D SCL-90r Ᏻ࡛ࡣ᭷ពᕪࡣ࡞ࡗࡓࠋ ⤖ㄽ ஙࡀࢇᝈ⪅ࢆᑐ㇟ࡋࡓ 8 㐌㛫ࡢࢢ࣮ࣝࣉ࡛ࡢ MBSR ࡢධࡣࠊ12 ࣨ᭶ᚋᏳᢚ࠺ ࡘࢆῶᑡࡉࡏࡿࡇࢆ♧ࡋࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ ධࡼࡿ᭷ᐖ㇟ࡣ࡞ࡗࡓࠋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ 0%65 ⩌ ྡࠊᑐ↷⩌ ྡࡢࢻࣟࢵࣉ࢘ࢺࡀ࠶ࡗࡓࠋ ࣚ࢞ࡢヲ⣽ 0%65 ࡢෆᐜ㸸▂ࠊࣚ࢞ࠊࢫࢺࣞࢫࢫࢺࣞࢫᛂ㛵ࡍࡿᚰ⌮Ꮫⓗࢻࣂࢫࠊ᪥ᖖ ⏕ά࡛ࡢ࣐ࣥࢻࣇࣝࢿࢫࡢ⥲ྜⓗ࡞ᐇ㊶ࡘ࠸࡚ࢢ࣮ࣝࣉ࡛ࡢពぢࢆ⾜ࡗࡓࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ 㞟ྜࡋ࡚⾜࠺ᐇ⩦ࡣ ࣨ᭶㛫ࡔࡀࠊࡑࡢᚋ㏣㊧ㄪᰝࢆ ᖺᚋࡲ࡛⥆ࡅㄪᰝࡀ㛗ᮇΏࡗ࡚ ࠾ࡾ㈗㔜࡞◊✲࡛࠶ࡿࠋᏳࡀᇶ‽ࡼࡾ㧗ࡗࡓཧຍ⪅ࡢྜࡀ ࣨ᭶ᚋ୧⩌࡛ῶࡗ ࡓ୍᪉࡛ࠊᑐ↷⩌ࡼࡾ 0%65 ⩌ࡢཧຍ⪅ᢚ࠺ࡘࡢᇶ‽ࡀ㧗ࡗࡓࢣ࣮ࢫࡀࢃࡎࡔࡀᏑ ᅾࡋࡓࡇࡶグ㍕ࡉࢀ࡚࠾ࡾࠊ0%65 ࡢ᭷ຠᛶࡀ❚࠼ὀ┠್ࡍࡿࠋ㞟ᅋ࡛ᐇ⩦ࢆ⾜ࡗࡓ ᚋಶேࡀ⮬Ꮿ࡛ᐇ⩦ࡍࡿᮇ㛫ࡀ㛗࠸ࡢࡶ㛵ࢃࡽࡎຠᯝࢆୖࡆ࡚࠸ࡿࡢࡀ⯆῝࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇᝈ⪅ᑐࡋ࡚ࠊᏳᢚ࠺ࡘࢆ㍍ῶࡍࡿࡓࡵ 0%65 ࢆ່ࡵࡿࠋ $EVWUDFWRUDQG'DWH ᯇ⏣༓㔛 ᒸᏕ − 46 − 㸰᪂⏕≀ 㸦& ஙࡀࢇ⏕Ꮡ⪅㸧 ᩥ⊩ Bower J, et al. Yoga for persistent fatigue in breast cancer survivors. Cancer, Aug 2012: 3766-3775. Pubmed ID:22180393 ┠ⓗ ⒪ᚋࡢᣢ⥆ࡍࡿᛰឤࢆッ࠼ࡿங⒴⏕Ꮡ⪅ᑐࡍࡿ࣮ࣥ࢞ࣚ࢞ࡢᐇྍ⬟ᛶ᭷⏝ᛶ ࢆࠊᗣᩍ⫱ࢥࣥࢺ࣮ࣟࣝ⩌ẚ㍑ࡋ᳨࡚ウࡍࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ 8&/$ ࣓ࢹ࢝ࣝࢭࣥࢱ࣮ ཧຍ⪅ ༙ᖺ௨ୖ๓⒪ࢆ⤊ࡋࠊ ⒴క࠺⑂ປࢆッ࠼ࡿங⒴ᝈ⪅ྡṓࢫࢸ࣮ࢪࠥϩ ධ $UPධ⩌࣮ࣥ࢞ࣚ࢞⩌ ྡ ᅇ ศ㐌 ᅇ 㛫 $UPࢥࣥࢺ࣮ࣟࣝ⩌ᗣᩍ⫱⩌ ྡ ᅇ ศ㐌 ᅇ 㛫 ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ Fatigue Symptom Inventory㸦⑂ປ㸧 ࠊMultidimensional Fatigue Symptom Inventory㸦άẼ㸧 ࠊBeck ࠊ Depression Inventory 㸦ᢚ࠺ࡘ㸧 ࠊPittsburgh Sleep Quality Index㸦ほⓗ╧╀ࡢ㉁㸧 Perceived Stress Scale㸦⮬ぬࢫࢺࣞࢫ㸧 ࠊ᳔Ꮚ❧ࡕୖࡀࡾࢸࢫࢺ㸦㌟యືస⬟ຊࡢホ౯㸧 ධ๓ࠊධ⤊┤ᚋࠊධ⤊ࡢ㸱ࣨ᭶ᚋࡢ㸱ᅇホ౯ࠋ ࡞⤖ᯝ ࣮࣋ࢫࣛࣥࠊᐇ⩦ᚋࠊ࠾ࡼࡧ 3 ᭶ࡢࣇ࢛࣮ࣟࢵࣉࡢ㛫⤒㐣క࠸ࠊࣚ࢞⩌࡛ࡣࢥࣥ ࢺ࣮ࣟࣝ⩌ࡼࡾ᭷ព⑂ປࡀపୗࡋ㸦P=0.032㸧άຊࡀቑຍࡋࡓ㸦P=0.011㸧 ࠋ ᢚ࠺ࡘ⮬ぬࢫࢺࣞࢫࡣࠊ୧⩌ࡶホ౯ᮇ㛫୰ῶᑡࡋࡓ(p<0.05)ࠋほⓗ࡞╧╀ࡢ㉁ᑐࡋ ࡚ࡣ᭷ព࡞ຠᯝࡣ࡞ࡗࡓࠋ㌟యⓗ⬟ຊࡢㄢ㢟ࡣࠊ୧⩌ඹ㛫ඹᨵၿࡋࠊ᳔Ꮚ❧ࡘ ㄢ㢟࡛ࡣ᭷ព࡞㛫ຠᯝࡀ࠶ࡗࡓ㸦P<0.0001㸧 ࠋ ⤖ㄽ ධ⩌ࡣᮇ㛫୰ࠊ᭷ព࡞⑂ປࡢῶᑡάຊࡢቑຍࢆ⤒㦂ࡋࡓࡀࠊࢥࣥࢺ࣮ࣟࣝ⩌ኚࡣ࡞ ࡗࡓࠋࡇࢀࡣ⑂ປᨵၿࢆࢱ࣮ࢤࢵࢺࡋࡓࣚ࢞ධࡀࠊங⒴⏕Ꮡ⪅ࡗ࡚ᐇ⌧ྍ⬟࡛᭷ ຠ࡞ᐇ⩦ἲࡶࡋࢀ࡞࠸ࡇࢆ♧ࡍࠋ Ᏻᛶ㛵ࡍࡿゝཬ ྡ୰㸯ྡࡢ⿕㦂⪅㸦⫼㒊ᝈࡢ᪤ ࠶ࡾ㸧ࡀࠊ࣮ࣚ࢞ࢡࣛࢫ୰⫼୰ࡢ②ᨥࢆッ࠼ࡓࠋ ࡋࡋ་ࡀホ౯ࡋࡓᚋࠊධ⤊ࡲ࡛ࣚ࢞ࢆ⥅⥆࡛ࡁࡓࠋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ධ⩌㸣⌮⏤ࣇ࢛࣮ࣟࢵࣉࡽ㞳⬺ࡀ ྡࠊẼ࡛㞳⬺ࡀ㸯ྡ ࣚ࢞ࡢヲ⣽ ࢫࣉࢱࣂࢵࢲࢥ࣮ࢼ࣮ࢧࢼ ศ ᯖࡢୖࡢࢭࢶࣂࣥࢲࢧࣝࣂ࣮ࣥ࢞ࢧࢼ ศ ࢻ࣒࢝ࢩࣦ࣮ࣕࢧࢼ ศ ࢧࣛࣂࢩ࣮ࣛࢧࢼ ศ ࣦࣃ࣮ࣜࢱࢲࣥࢲ ࢧࢼ ศ ⟽ᯖࢆഛ࠼ࡓᮌ〇ࡢ࣋ࣥࢳୖࡢࢭࢶࣂࣥࢲࢧࣝࣂ࣮ࣥ࢞ࢧࢼ ศ ࣦࣃ࣮ࣜࢱ࢝ࣛࢽ ศ ᯖẟᕸࢆഛ࠼ࡓࢩࣦ࣮ࣕࢧࢼ ศ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ධ๓ࠊཧຍ⪅ࡣᙉ࠸ᛰឤࢆッ࠼࡚࠸ࡓࠋࡋࡋࠊ㸣௨ୖࡢཧຍ⪅ࡀᅇࡢࢡࣛࢫࡢ࠺ࡕ ᅇ௨ୖཧຍ࡛ࡁࡓࡋ࡚࠸ࡿࠋⴭ⪅ࡽࡣࠊ 㸦㸯㸧⑂ປࢆᨵၿࡍࡿࡓࡵ࣏࣮ࢬࢆὀព῝ࡃ㑅ᢥࡋࠊ 㸦㸰㸧ᨭᣢලࢆ⏝ࡍࡿ࡞ࡢᕤኵࢆࡋ࡚࠸ࡿࠋᮏ◊✲ࡣࡇࡢࡼ࠺࡞ᕤኵࡉࢀࡓࣚ࢞ࡢຠᯝ㛵 ࡍࡿ◊✲࡛࠶ࡾࠊ୍⯡ࡣ㞴ࡋ࠸ࠋࡲࡓᮏ◊✲࡛ࢻࣟࢵࣉ࢘ࢺࡀᑡ࡞ࡗࡓࡇࡣࠊྛ✀ ࣮ࢧࢼࡀ㐺ᗘ࡞㐠ື㔞࡛࠶ࡗࡓࡇࡀ᥎ ࡉࢀࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ 㑄ᘏࡍࡿ⒴㛵㐃ࡋࡓ⑂ປࢆᨵၿࡍࡿࡓࡵࠊஙࡀࢇ⏕Ꮡ⪅ࡀὀព῝ࡃᕤኵࡉࢀࡓࣚ࢞ࣉࣟࢢࣛ ࣒ࢆ⾜࡞࠺ࡇࢆ່ࡵࡿࠋ $EVWUDFWRUDQG'DWH ⏣㑓᱈㤶 ⳥ụ᭸ ᒸᏕ ⚽ − 47 − 㸰᪂⏕≀ 㸦& ஙࡀࢇ⏕Ꮡ⪅⫧‶㸧 ᩥ⊩ Littman AJ, et al. Randomized Controlled Pilot Trial of Yoga in Overweight and Obese Breast Cancer Survivors Effects on Quality of Life and Anthropometric Measures. Support Care Cancer, 2012 February; 20(2): 267–277. Pubmed ID:21207071 ┠ⓗ ⫧‶ࢆక࠺ங⒴⏕Ꮡ⪅ᑐࡍࡿࣚ࢞ࡢࣛࣥࢲ࣒ẚ㍑ヨ㦂ࠊ42/ᑐࡍࡿຠᯝ࠾ࡼࡧ㌟యィ ್ࡘ࠸࡚ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ࣓ࣜ࢝ࡢࢩࢺࣝ࠶ࡿࣇࣞࢵࢻ࣭ࣁࢵࢳࣥࢯ࣭ࣥ࢞ࣥ◊✲ࢭࣥࢱ࣮)+&5& ཧຍ⪅ ங⒴⒪ᚋࡢ⏕Ꮡ⪅ࢫࢸ࣮ࢪ̽,,,௨ୖ࡛⫧‶ࢆక࠺⪅%0,ӋNJPࠋ㐺ྜᇶ‽ࡣࠊ ṓᖹᆒṓࠊᑡ࡞ࡃࡶࣨ᭶๓ࡣங⒴⒪ࢆࢫࢸ࣮ࢪ,,,ࡋ࡚࠾ࡾࢱࣔ࢟ࢩࣇ ࢙ࣥࡲࡓࡣ࣐ࣟࢱ࣮ࢮ㜼ᐖ⸆࠸ࡗࡓ࣍ࣝࣔࣥ⒪ἲࡢ⥅⥆ࡣእࠊ%0,ࡣӋNJP㸦ࢪ ⣔ࡢሙྜࡣӋNJP㸧 ධ ࣦࢽࣚ࢞ ᅇ ศ㐌 ᅇࣚ࢞ᩍᐊᅾᏯ࡛ '9' ࡚㸴ࣨ᭶㛫 $UPධ⩌ࣚ࢞⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ 1.FACT-G(QoL) 2.FACIT-Fatigue㸦⑂ປ㸧 3.㌟య ᐃ್㸦య㔜ࠊBMIࠊ⭡ᅖࠊ⭜ᅇࡾ㸧 4.Modifiable Activity Questionnaire 㸦άືᛶ㸧 ࠊࢆධ๓ 6 ࣨ᭶ᚋࡢ 2 ᅇࠋ ࡞⤖ᯝ ධᚋࠊධ⩌࡛ࡣࢥࣥࢺ࣮ࣟࣝ⩌ẚ㍑ࡋ࡚ࠊ⭡ᅖࡀ 3.1 cm (95% CI: í5.7, í0.4)ῶᑡࡋࡓࠋ ࡋࡋࠊయ㔜ࠊBMIࠊ⭜ᅇࡾࡢኚ㛵ࡋ࡚ࡣ୧⩌㛫ᕪࡣぢࡽࢀ࡞ࡗࡓࠋQOL ⑂ປᗘ 㛵ࡋ࡚ධ⩌ࡣࢥࣥࢺ࣮ࣟࣝ⩌ẚ㍑ࡋᨵၿࡋࡓࡀࠊ⤫ィᏛⓗ᭷ពᕪࡣࡳࡽࢀ࡞ࡗࡓࠋ 6 ࣨ᭶㛫ࡢ㏣㊧ㄪᰝ࠾࠸࡚ࣚ࢞ᐇ⩦㛵ࡍࡿ‶㊊ᗘㄪᰝࢆ⾜ࡗࡓ(⿕㦂⪅ࡢ 50.8%ࡀཧຍ)ࠋ ࣥࢫࢺࣛࢡࢱ࣮ࠊDVD,ࣚ࢞ᐇ⩦ࡢᴦࡋࡉࡘ࠸࡚ࠊ࠸ࡎࢀࡶ 10 ẁ㝵ᑻᗘ࡛ᖹᆒ 9 ࠸࠺ 㧗ホ౯࡛ࠊࣚ࢞ᐇ⩦ᑐࡍࡿ⫯ᐃឤࡀఛ࠼ࡓࠋ ⤖ㄽ ࡇࡢணഛⓗ◊✲࠾࠸࡚ࠊࣚ࢞ᐇ⩦ࡣࠊ⭡ᅖࢆῶᑡࡉࡏ QOL ࢆᨵၿࡉࡏࡿྍ⬟ᛶࡀ♧၀ࡉ ࢀࡓࠋࡇࡢ⤖ᯝࢆ☜ᐃࡉࡏࡿࡓࡵࡣࡉࡽ࡞ࡿ◊✲ࡀᚲせ࡛࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ゝཬ࡞ࡋ ࣚ࢞ࡢヲ⣽ ࣦࢽࣚ࢞㸦ࢫࢺࣞࢵࢳࢆྵࡴ࣮ࢧࢼࠊ྾ἲࠊ▂࠸ࡗࡓ⒪ἲࡋ࡚ࡢࣁࢱࣚ࢞㸧ࢆ ᇶᮏࡋࠊ᭱ึࡢศࣜࣛࢡࢮ࣮ࢩࣙࣥ⮬ᕫࡢෆࢆぢࡘࡵࡿࡓࡵࡢࢭࣥࢱࣜࣥࢢࠊ⥆ ࡃศࡣᗙ❧࡛ࡢࣚ࢞ᐇ⩦ࠊ᭱ᚋࡢศࡣࣚ࢞ᣦᑟኈࡢᣦ♧ࡼࡿࣜࣛࢡࢮ ࣮ࢩࣙࣥࠊ྾ἲࠊ▂ࢆ⾜ࡗࡓࠋ࣮ࢧࢼࡣࠊEKXMDQJDVDQDࠊFKDNUDYDNDVDQDࠊOXQJHVࠊ ZDUULRUYDULDWLRQVࠊEULGJHࠊIRUZDUGEHQGVࠊWULDQJOHࠊWZLVWVࠊࡑࡋ࡚VDYDVDQD࡛࠶ࡗࡓࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࣃࣟࢵࢺࢫࢱࢹ࡞ࡢ࡛ࠊ๓ẁ㝵ⓗ࡞せ⣲ࡀከࡃᵓ㐀ࡀ㞴ࡋ࠸ࠋᚋࡢ◊✲ࡢཧ⪃ࡣ ࡞ࡿࡀࣚ࢞ᐇ⩦ࡢຠᯝࡘ࠸࡚ࡣグ㏙ࡀ࡞࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ⫧‶ࢆక࠺ங⒴⏕Ꮡ⪅ᑐࡋ࡚ࠊࣚ࢞ࢆ່ࡵࡿ࠺ࡕࡽࡶ࠸࠼࡞࠸ $EVWUDFWRUDQG'DWH ᮌᮧ┿ඃᏊ ࢫࢱࢵࣈ㝧Ꮚ ᒸᏕ − 48 − 㸰᪂⏕≀ 㸦&ஙࡀࢇ㸧 ᩥ⊩ Lengacher CA et al: Mindfulness based stress reduction in post-treatment breast cancer patients: an examination of symptoms and symptom clusters. J Behav Med (2012) 35:86–94. Pubmed ID:21506018 ┠ⓗ 㸦0%65࣐ࣥࢻࣇࣝࢿࢫࢫࢺࣞࢫపῶἲࠊ%& ࡣ࢜ࣜࢪࢼࣝࡢ 㐌㛫ࣉࣟࢢ࣒ࣛࢆ 㐌㛫 ▷⦰ࡋࡓࡶࡢ㸧ཧຍࡋࡓ⒪ᚋࡢஙࡀࢇ⏕Ꮡ⪅ࡢࠊ 㸦ஙࡀࢇక࠺㸧≧ࡸೃ⩌ ࡢⓎ⏕㢖ᗘࡑࡢ㔜ᗘࢆ᳨ウࡍࡿࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ⡿ᅜࣇࣟࣜࢲࡢࡀࢇࢭࣥࢱ࣮㸯タ ཧຍ⪅ ஙࡀࢇࢫࢸ࣮ࢪ Ϫ⨯ᝈࡋࠊ⒪ᡭ⾡ࠊᨺᑕ⥺ࠊᏛ⒪ἲᚋ ࣨ᭶௨ෆࡢ ྡ ධ 0%65 ᅇ 㛫㐌 ᅇ 㐌㛫 $UPධ⩌0%65 ⩌ ྡ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ᑐ↷⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ MDASI㸦M.D. Anderson Symptom InventoryࠊM. D. ࣥࢲ࣮ࢯࣥࡀࢇࢭࣥࢱ࣮∧≧ホ౯ ⚊ࠋࡀࢇᝈ⪅ࡢ」ᩘࡢ≧ࡢ㔜ᗘࢆホ౯ࡍࡿࡓࡵࡢ㉁ၥ⚊ࠋ19 㡯┠㸦≧ࡢᙉࡉ㸯3 㡯 ┠ࠊ≧ࡼࡿ⏕άࡢᨭ㞀 6 㡯┠㸧࡛ᵓᡂࡉࢀࠊ㺀ࡇࡢ 24 㛫ࡢ㺁13 ࡢ≧ࡢᙉࡉࠊ ⏕άࡢᨭ㞀ࢆホ౯ࡍࡿࠋ 㸧ࢆධ๓ࠊධᚋࡢ 2 ᅇ ᐃࠋ ࡞⤖ᯝ ࣚ࢞⩌ࡣࢥࣥࢺ࣮ࣟࣝ⩌ẚ㍑ࡋ࡚ࠊ⑂ປ࣭╧╀㞀ᐖࡢ᭷ព࡞ᨵၿ≧ࡼࡿ⏕άࡢ ᨭ㞀ࡢᨵၿࡀぢࡽࢀࡓ㸦Wilcoxon ࡢ㡰᳨ᐃࠊp<.01㸧 ࠋ ⤖ㄽ MBSR(BC)ࡣ⑂ປ╧╀㞀ᐖࡢᨵၿ✜ࡸ࡞㸦modestly㸧ຠᯝࡀ࠶ࡾࠊࡲࡓࠊࡀࢇక ࠺≧ࡀ᪥ᖖ⏕άࡶࡓࡽࡍᝏᙳ㡪ࢆ㍍ῶࡍࡿຠᯝࡀ࠶ࡿࡇࡽࠊஙࡀࢇ⏕Ꮡ⪅ᑐࡋ ࡚᭷ຠ࡛࠶ࡿࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ྡࡢཧຍ⪅ࡢ࠺ࡕ ྡࡀࢻࣟࢵࣉ࢘ࢺࠋ ⌮⏤ࡣ᫂ ࣚ࢞ࡢヲ⣽ 0%65%&ࡢෆᐜ㸸ࣜࣛࢡࢭ࣮ࢩࣙࣥࠊ▂ࠊᚰ㌟┦㛵ࡘ࠸࡚ࡢᏛ⩦㈨ᩱࢆ㓄ᕸࠋ 㸦ὀ㸧 0%65 ࠾ࡅࡿ▂ࡣࠊᗙࡗ࡚⾜࠺▂ࠊయࢆືࡋ࡞ࡀࡽ⾜࠺▂ࡢ᪉ࡀྵࡲࢀࡿࠋ ▂⦎⩦ࢆ㐌 ᅇࡢࢢ࣮ࣝࣉࢭࢵࢩࣙࣥ࡞ࡽࡧᐟ㢟ࡋ࡚ྛ⮬࡛ᐇࠋ ࢢ࣮ࣝࣉࢹࢫ ࢝ࢵࢩࣙࣥࠋࢸ࣮࣐㸸▂⦎⩦ࢆጉࡆࡿࡶࡢࡣఱࠋᬑẁࡢ⏕άࡢ࡞࡛࣐ࣥࢻࣇࣝࢿ ࢫࢆጉࡆࡿࡶࡢࡣఱࠋ ࢢ࣮ࣝࣉࡢ࣓ࣥࣂ࣮ྠኈࡢᨭⓗ࡞㛵ಀᵓ⠏ࠋ බᘧࡢ▂⦎⩦ࡣࠊ ᗙࡗ࡚ࡢ▂ࠊṌࡃ▂ࠊ࣎ࢹࢫ࢟ࣕࣥࠊඃࡋ࠸ࣁࢱࣚ࢞య᧯ࡢ ࡘࡀ࠶ࡾࠊ࠸ࡎࢀࡶ ྾ព㆑ࢆྥࡅ࡞ࡀࡽ⾜࠺ࠋ㠀බᘧࡢ▂⦎⩦ࡋ࡚ࡣࠊཧຍ⪅ᑐࡋ࡚᪥ᖖ⏕άࡢ࠶ ࡽࡺࡿሙ㠃㸦ᛌ࠸ฟ᮶ࡑ࠺࡛࡞࠸ฟ᮶ࠊ⩦័ⓗ࡞⾜ືࠊ᪥ᖖࡢฟ᮶㸧࠾࠸࡚࣐ ࣥࢻࣇࣝࢿࢫ࡛࠶ࡿࡇࢆᩍ࠼ࡿࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ⤫ィศᯒࡢ⤖ᯝゎ㔘ၥࡀṧࡿ㸦ᩘ್⤖ᯝᩥ❶⾲グࡢᕪ㸧 ࠋ࠼ࡤࠊゎ㔘ᗘDisturbed sleepࡢධ๓ᚋࡢኚࡣࠊMBSR⩌(P=.009)ࠊᚅᶵ⩌ࡶ(P=0.01)ࠊධࡢ⩌㛫ẚ㍑࡛(P=0.98) ࡞ࡢ࡛MBSR⩌ࡀᚅᶵ⩌ᑐࡋ࡚ᨵၿࡀ᭷ពゎ㔘ࡍࡿࡢࡣ㞴ࡋ࠸ࡢ࡛ࡣ࡞࠸ࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇ⏕Ꮡ⪅ 0%65 ࢆ່ࡵࡿ࠺ࡕࡽࡶゝ࠼࡞࠸ $EVWUDFWRUDQG'DWH ᮧୖ┿ ᒸᏕ − 49 − 㸰᪂⏕≀ 㸦&&ஙࡀࢇ㸧 ᩥ⊩ Pruthi S, et al. A Randomized Controlled Pilot Study Assessing Feasibility and Impact of Yoga Practice on Quality of Life, Mood, and Perceived Stress in Women With Newly Diagnosed Breast Cancer. Global Advances In Health and Medicine , 2012; 1(5), 30-35. ┠ⓗ ஙࡀࢇデ᩿ࡉࢀࡓ┤ᚋࡢᝈ⪅ࡢ 42/ࠊẼศࠊ⑂ປࠊཷࡅࡓࢫࢺࣞࢫ➼ࣚ࢞ࡀࡢࡼ࠺ ࡞ᙳ㡪ࢆཬࡰࡍࡢࠋ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ academic medical center breast clinic ཧຍ⪅ ዪᛶ ྡ ᖹᆒᖺ㱋㸦ࣚ࢞⩌ࠊࢥࣥࢺ࣮ࣟࣝ⩌㸧 ධ ศࢭࢵࢩࣙࣥ ᅇ㸦⾡๓࣭⾡ᚋ㸧㸩 ศ㐌 ᅇ 㐌㛫⮬Ꮿ࡛㐌୍ᅇ㸦'9' ᨭ⤥㸧 $UPධ⩌ࣚ࢞⩌ Q ࣚ࢞ ᅇ㸩⮬Ꮿ⏝ࡢ '9' ࡢᨭ⤥ $UPࢥࣥࢺ࣮ࣟࣝ⩌ ㏻ᖖ⒪⩌ Q ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ Functional Assessment of Cancer TreatmentࠊBreast Cancer (FACT-B, QoL)ࠊPerceived Stress Scale (PSSࠊ⮬ぬࢫࢺࣞࢫ)ࠊPOMS㸦Ẽศ㸧ࠊBrief Fatigue Inventry㸦BFI, ⑂ປ㸧ࠊၚᾮࢥࣝࢳࢰ ್࣮ࣝ ࢆධ๓ࠊධᚋࡢ 2 ᅇ ᐃࠋ ࡞⤖ᯝ ୧⩌ࡶධᚋ QOL ࡢᨵၿࡀㄆࡵࡽࢀࠊࣚ࢞⩌ࢥࣥࢺ࣮ࣟࣝ⩌࡛ࡣ᭷ពᕪࡣㄆࡵ ࡽࢀ࡞ࡗࡓࠋឤ㠃ࠊ࠺ࡘࠊᏳࠊΰ≧ែࠊ࡞࡛ࡶ୧⩌࡛ᨵၿࡀㄆࡵࡽࢀࠊࢥࣝࢳ ࢰ್࣮ࣝࡣࡶῶᑡࢆ♧ࡋࡓࠋ୧⩌࡛ᕪࡣ࡞ࡗࡓࠋࡓࡔࡋࠊFACT-B ࡢ♫㸭ᐙ᪘ࡢ ᖾ⚟ࡢ㡯┠࡛ࡣࠊࢥࣥࢺ࣮ࣟࣝ⩌ࡢ᪉ࡀࡼࡃᨵၿࡋࡓࠋ ⤖ㄽ ங⒴デ᩿ࡉࢀࡓ┤ᚋࡢᝈ⪅࠾ࡅࡿࣚ࢞ࡼࡿධࡢᐇྍ⬟ᛶࡣⰋዲ࡛࠶ࡗࡓࠋධ ⩌ࢥࣥࢺ࣮ࣟࣝ⩌ࠊ୧⩌࡛ឤ㠃ࠊᏳࠊ࠺ࡘࠊΰ≧ែࡢᨵၿࡀㄆࡵࡽࢀࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ධ⩌Q ࢥࣥࢺ࣮ࣟࣝ⩌Q ࣚ࢞ࡢヲ⣽ ࢭࢵࢩࣙࣥ ㄝ᫂ࠊ3UDQD\DPD ࢭࢵࢩࣙࣥ ࠊ+DWKD\RJDSUDQD\DPDࠊ᳔Ꮚࡶࡋࡃࡣ࣐ࢵࢺ≧࡛ࡢᅄ⫥ࡢඃࡋ࠸ືࡁ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ࣚ࢞ࡢධࡼࡗ࡚ங⒴ᝈ⪅ࡢ⾡ᚋከࡃࡢⅬ࡛ᨵၿࡀㄆࡵࡽࢀࡓࠋᚋࡣලయⓗࡢ ࡼ࠺࡞ධࡀ≉᭷ຠࢆㄪࡿᚲせࡀ࠶ࡾࠊᵝࠎ࡞ᣦᶆࢆ⏝࠸ࡓ◊✲ࡀᮇᚅࡉࢀࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ஙࡀࢇデ᩿┤ᚋࡢᝈ⪅ࡢ 4R/ࠊẼศࠊࢫࢺࣞࢫࢆᨵၿࡍࡿ┠ⓗ࡛ࣚ࢞ࢆ⾜࡞ࡗ࡚ࡶࡼ࠸㸦≉ ᭷ᐖ㇟ࡣ࡞࠸㸧ࡀࠊ㏻ᖖ⒪⩌ࡢ㛫ᕪࡣ࡞࠸ࠋ $EVWUDFWRUDQG'DWH ᒸభ ᒸᏕ − 50 − 㸰᪂⏕≀㸦& ஙࡀࢇ⏕Ꮡ⪅ၚᾮ୰ࢥࣝࢳࢰ࣮ࣝ⃰ᗘ㸧 ᩥ⊩ Banasik J, et al. .Effect of Iyengar yoga practice on fatigue and diurnal salivary cortisol concentration in breast cancer survivors. J Am Acad Nurse Pract, 2011; 23:135-142. Pubmed ID:21355946 ┠ⓗ ࣮ࣥ࢞ࣚ࢞ࢆᐃᮇⓗᐇ㊶ࡋࠊ⮬ぬⓗᚰ⌮♫ⓗᶵ⬟࠾ࡼࡧ᪥୰ၚᾮ୰ࢥࣝࢳࢰ࣮ࣝ ⃰ᗘᑐࡍࡿຠᯝࢆホ౯ࡍࡿ ◊✲ࢹࢨࣥ ࣛࣥࢲ࣒ẚ㍑ヨ㦂㸦5&7㸧 ࢭࢵࢸࣥࢢ ࣡ࢩࣥࢺࣥᕞ❧Ꮫᙜヱタ ཧຍ⪅ ⒪ᚋ 2 ࣧ᭶௨ୖ⤒㐣ࡋࡓ II㹼IV ᮇங⒴ዪᛶᝈ⪅ 18 ྡ ධ $UPධ⩌࣮ࣥ࢞ࣚ࢞⩌ ྡ ᅇ ศ㐌 ᅇ 㐌㛫 $UPࢥࣥࢺ࣮ࣟࣝ⩌ 㠀ධ⩌ ྡ ࡞࢘ࢺ࣒࢝ホ౯ᣦᩘ ၚᾮ୰ࢥࣝࢳࢰ࣮ࣝ ᐃ 1 ᪥ 4 ᅇ㸦ᮅࠊṇ༗ࠊ5 pmࠊ10 pm㸧 Cella’s FACT B Qualit㹷of Life Breast Cancer Specific Questionnaire(ங⒴ᝈ⪅ࡢ⮬ぬⓗ QOL)ࠊ ⑂ປࢫࢣ࣮ࣝࠊ8 㐌㛫ࡢࣚ࢞ࣉࣟࢢ࣒ࣛධ TI(ヨ㦂㛤ጞ)࠾ࡼࡧ T2(ࣚ࢞ࣉࣟࢢ࣒ࣛ) ࡞⤖ᯝ ධ⩌࡛ࡣࠊධᚋᮅ㸦p=.018㸧࠾ࡼࡧࠊ༗ᚋ 5 㸦p=.028㸧ࡢၚᾮ୰ࢥࣝࢳࢰ࣮ࣝ⃰ᗘ ࡀ᭷ពపୗࡋࡓࠋ⥴ⓗᗣᗘࡣ᭷ពᨵၿࡋ㸦p=.042㸧ᛰឤᚓⅬࡣ᭷ពపୗࡋࡓ (p=.046)ࠋࢥࣥࢺ࣮ࣟࣝ⩌࡛ࡣࠊ࠸ࡎࢀࡢࣃ࣓࣮ࣛࢱ࣮ࡶධ๓ᚋ࡛ኚࡋ࡞ࡗࡓࠋ ⤖ㄽ ங⒴⏕Ꮡ⪅ࡀ 1 ᅇ 90 ศࠊ㐌 2 ᅇࡢ࣮ࣥ࢞ࣚ࢞ࢡࣛࢫ 8 㐌㛫ཧຍࡍࡿࠊᛰឤࡀ㍍ ῶࡋࠊ⥴ⓗᗣᗘࡀᨵၿࡋࡓࠋࡲࡓᮅ༗ᚋ㸳ࡢၚᾮ୰ࢥࣝࢳࢰ࣮ࣝศἪࡀపୗࡋࡓࠋ Ᏻᛶ㛵ࡍࡿゝཬ ࡞ࡋ ࢻࣟࢵࣉ࢘ࢺ⋡ࢻࣟࢵࣉ࢘ࢺ⩌ࡢ≉ᚩ ධ⩌㸣⌮⏤㸸ࢫࢣࢪ࣮ࣗࣝࡀྜࢃ࡞࠸ ࣚ࢞ࡢヲ⣽ ࣮ࣥ࢞ࡢึᚰ⪅ࢡࣛࢫ࡛ᚑ᮶ᐇࡍࡿ࣏࣮ࢬ࡛࠶ࡿࠋࣜࢫࢺࣛࢸࣈࣚ࢞ࡸࢪ࢙ࣥࢺ ࣝࣚ࢞ࡼࡾࡶ㌟యⓗᙉᗘࡀᙉࡃࠊྛᝈ⪅ࡢ⬟ຊࡀᨵၿࡍࡿࡘࢀ࡚⭎࡛య㔜ࢆᨭ࠼ࡿ㛫ࡀ 㛗ࡃ࡞ࡿ࡞ḟ➨࣏࣮ࢬࡢ㞴ᗘࡀ㧗ࡃ࡞ࡿࡶࡢ࡛࠶ࡗࡓࠋࣚ࢞ᐇ㊶ࡢ↔Ⅼࡣࢺ࣮ࣞࢽࣥࢢ ㌟యⓗᙧࡢ㟂せ࠶ࡾࠊ▂ࡢせ⣲ࡣ≉࡞ࡗࡓࠋ $EVWUDFWRU ࡢࢥ࣓ࣥࢺ ங⒴ᝈ⪅ᑐࡍࡿࣚ࢞ࡢຠᯝࢆၚᾮ୰ࢥࣝࢳࢰ࣮ࣝ ᐃཬࡧங⒴ᝈ⪅⏝42/ᑻᗘ࡛࠶ࡿ&(//$ ࡢ)$&7%࡛ẚ㍑ࡋࡓⅬࡣ◊✲ࡀẚ㍑ⓗ⾜࠸᫆࠸ࠋᚋከࡃࡢࢹ࣮ࢱࡀቑࡏࡤࡼࡾ࢚ࣅࢹࣥࢫ ࡶቑ࠼ࡿᛮࢃࢀࡿࡢ࡛ᮇᚅ࡛ࡁࡿࠋ $EVWUDFWRU ࡢ᥎ዡᗘ ங⒴ᝈ⪅ࡢ⑂ປᨵၿࡢࡓࡵ࣮ࣥ࢞ࣚ࢞ࢆ᮲௳ࡁ່࡛ࡵࡿࠋ᮲௳ࡁࡋࡓࡢࡣ ᩘࡀᑡ࡞࠸ࡓࡵࠋ $EVWUDFWRUDQG'DWH ᮌಙஅ ᒸᏕ − 51 −