Is There Any Change in Inflammatory Markers in Medical Students after Participating in a Mind-Body Program?

ABSTRACT Introduction Medical students are exposed to high stress levels, triggered by having to deal with their illness and death of their patients, extensive workloads, sleep deprivation, competition, having to fulfil demanding duties, responsibility, and fear of making mistakes, among other factors. Some techniques and practices, such as meditation, are used in medical schools to help manage and reduce stress. Stress can activate components of the inflammatory system, triggering a series of pathologies. The disorders caused by stress can be measured by means of serological markers, with biological markers being the main ones used. Objective. To evaluate the effects of a program of mind-body practices, Reduction of Stress and Development of Empathy in Medicine (REDEMED ©), on pro- and anti-inflammatory markers of medical students. Methodology This is a quasi-experimental study, composed of 86 students: 44 in the intervention group, who participated in the REDMED© program with eight-weekly meetings that included meditation techniques and exercises of interpersonal experiences, and 42 students in the control group. Before and after the course, blood was collected from both groups for analysis of the markers: C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL06) and interleukin-10 (IL10). Results No statistically significant changes were observed in the proinflammatory cytokines CRP, TNF-α and IL06. However, IL-10, an anti-inflammatory cytokine, showed a positive and statistically significant variation (p: 0.009). It has been used in studies with integrative and complementary practices to demonstrate its benefits. Conclusion The REDEMED© program seems to benefit medical students through inflammatory modulation and as a group that provides a forum to share their stress and receive coaching in coping strategies. This study, even though it did not find a statistically significant difference in the markers studied, with the exception of IL10, raises the important theme of the high levels of stress that medical students experience, and the need for medical schools to take greater care of their students, addressing stress in order better manage it in their own lives.

摘要
引言：医学生面临较高的压力水平，诱因涵盖处理患者的疾病与死亡事件、繁重的学业与工作负荷、睡眠不足、竞争压力、需履行严苛职责与承担责任，以及害怕犯错等诸多因素。目前已有部分技术与实践方法（如冥想）在医学院校中应用，用于帮助医学生管理并缓解压力。压力可激活炎症系统的相关组分，进而引发一系列病理状态。压力相关的机体紊乱可通过血清学标志物进行检测，其中生物标志物是当前主流的检测手段。
目的：评估心身干预项目「医学生压力缓解与共情培养计划（REDEMED ©）」对医学生促炎与抗炎血清标志物的影响。
研究方法：本研究为类实验性研究，共纳入86名医学生：其中干预组44名，参与为期8周、每周开展一次的REDEMED©项目，课程包含冥想技巧训练与人际体验练习；对照组42名。于项目实施前后分别采集两组受试者的静脉血样，用于检测以下标志物：C反应蛋白（C-reactive protein, CRP）、肿瘤坏死因子-α（tumor necrosis factor-alpha, TNF-α）、白细胞介素-6（interleukin-6, IL-6，原文标注为IL06）及白细胞介素-10（interleukin-10, IL-10，原文标注为IL10）。
研究结果：促炎细胞因子CRP、TNF-α及IL-6未观察到具有统计学意义的变化。然而，抗炎细胞因子IL-10呈现出具有统计学意义的正向变化（p=0.009）。此类抗炎标志物已在整合与补充医学实践相关研究中被用于验证干预手段的获益效果。
研究结论：REDEMED©项目似乎可通过调控炎症状态对医学生产生获益，同时作为团体交流平台，为医学生提供了分享压力体验、学习压力应对策略的渠道。尽管本研究仅在IL-10这一指标上发现具有统计学意义的差异，其余检测标志物未观察到显著变化，但本研究凸显了医学生普遍承受高压力水平这一重要议题，同时呼吁医学院校应更加关注学生的身心健康，重视压力管理教育，以助力学生更好地应对自身生活中的压力。