神奇的医嘱：冥想

Doctor's Orders:

20 Minutes Of Meditation Twice A Day

神奇的医嘱：

冥想

At Beth Israel Deaconess Medical Center in Boston, doctor's orders can include an unlikely prescription:

meditation.

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.

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 O'Boyle, 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.

'Here's a cardiologist telling me to go and meditate,' said Ms. O'Boyle. 'I'm thinking, does shethink I'm crazy?'

Ms. O'Boyle 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. O'Boyle meditates every day for 20 to 45 minutes. 'The pain is not gone, but it helps me cope with it,' she said.

Murali Doraiswamy, a professor of psychiatry at Duke University Medical Center in Durham,N.C., says it isn't clearly understood how meditation works on the body. Some forms of meditation have been found to activate the parasympathetic nervous system, which stimulates the body's 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.

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 isn't known whether there is an optimal amount of time for meditating that is most effective. And, it hasn't 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 Alzheimer's disease.

In a study published last year in the American Heart Association journal Circulation:

Government-funded research also is exploring meditation's 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 forComplementary 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 O'Boyle)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、恐慌症、焦虑症、长期饱受压力折磨的人，以及那些注重大脑养生与心血管健康的人都推荐冥想疗法。

多雷斯瓦米说，成千上万种针对冥想的研究成果都已发表。这其中，约有500项研究针对各种疾病进行了冥想疗法的临床试验，但仅仅只有约40例试验经过了长期的研究。目前还不清楚多长时间的冥想活动效果最佳。而对于此类活动能否延长人们的寿命或使人们远离某些慢性病，至今仍尚无定论。

多雷斯瓦米还称，有些短期研究已发现，冥想能提高如注意力和记忆力这样的认知能力。科学家利用成像技术发现，冥想能改善人们大脑中某些特定回路的功能特性，还可能减少随着年龄增长而出现的大脑中枢萎缩状况，特别是对于那些容易患上老年痴呆症(Alzheimer's disease，又称阿兹海默症)等病症的人更是如此。

最近的研究发现，冥想能引起影响端粒长度的分子变化。端粒是染色体末端的一种保护覆盖物，它会随着人的年事增高而变得越来越短。这项研究涉及

40名照料痴呆症患者的家庭医护人员。有一半的参与者每天都会进行简短的冥想，而另一半的人则会每天聆听12分钟放松身心的音乐。这项持续了八周的研究发现，那些冥想者的端粒──端粒是一种修复端粒长度的──活性提高了43%，而听音乐的那组人只提高了3.7%。与实验对照组相比，参与冥想的人还表现出更强的心理和认知功能、更低的抑郁程度。这项试验性研究于一月份发表在《国际老年精神病学杂志》(International Journal of Geriatric Psychiatry)上。

由政府资助的研究也正在探索冥想对节食和抑郁的影响。