| Theoretical ResearchResearch One:TCM literature review on mental fatigueObjective:To retrospect the history of the development of mental fatigue by collecting TCM terminology on mental fatigue. Methods:Sequential search was applied to checking Chinese Medical Dictionary (Zhong Hua Yi Dian) (5th edition) without time limitation. Results:There were 79 588 TCM relative literatures on mental fatigue coming out after preliminary screening. By reading the full text of all the literatures,12 119 were in the category of TCM theory,12 694 in the category of clinical research,20 570 belonging to comprehensive reviews and 32 699 were in the category of health preservation. According to the inclusion criteria,4442 literatures were finally selected for this study. Conclusions:In TCM, mental fatigue was recognized as ’pi’,’lao’ and ’juan’.’lao’ was most frequently used. At the meantime, the occurrence of ’pi’,’lao’ and ’juan’ was most closely related with the spleen. They were high affected by emotions and were related with work stress. These were in accordance with modern research.Research Two:Study on modern literatures of mental fatigueObjects:To study the types of literatures to develop the TCM treatment on mental fatigue by collecting relative modern literatures on mental fatigue. Methods:Chinese database and Western database were searched without time limitation. Results:There were 29 585 TCM relative mental fatigue literatures coming out in preliminary screening.1736 were finally recruited according to inclusion criteria. Therein, there were 318 theoretical research,422 case reports,375 Chinese medicines reports,173 expert’s experience reports,160 for other therapies,64 mental fatigue mechanism research,104 pharmaceutical mechanism research and 120 reviews. Conclusions:Over-tiredness was the main cause of mental fatigue, including both long time of heavy mental work and continuous emotions changes or depression after suffering from severe mental damage. According to TCM, this was closely related with the spleen, liver and heart. Meanwhile, in the research of mental fatigue mechanism, there were personal differences in the occurrence of mental fatigue, which means people with nervousness and introversion more likely suffer mental fatigue. Clinical researchResearch One:Post-voyage marines fatigue evaluationObjective:To study the relationship between sleep quality and fatigue. Methods:Evaluate fatigue with General Burnout Questionnaire and Fatigue Self-assessment Scale (FSAS). PSQI was filled to evaluate the sleep quality. Results:According to fatigue grading, there were 97 cases of mental fatigue while only 13 marines were healthy. In the scores of every factor in FSAS in mental fatigue group, there was no significant difference in the factor of fatigue situation compared with non-fatigue group. In the factors of sleep quality, sleep efficiency, sleep disorder, daytime functional disorder and sleep index, the mental fatigue group was found to have significant differences compared with non-fatigue group (P<0.05). There was no remarkable difference in the factor of sleep latency, sleep time and hypnotic (P>0.05).Conclusions:The mental fatigue of post-voyage marines was affected by factors such as physical fatigue, fatigue consequences, general fatigue, and fatigue which could not relieve by sleep and rest. Especially, the sleep factors were closely related with mental fatigue. Therefore, sleep condition should be moderated to eliminate the mental fatigue among marines.Research Two:Post-voyage marines’physical fitness evaluationObjective:To understand preliminarily the physical fitness condition of post-voyage marines and to provide reliable evidence and support on preventing and treating relative diseases. Methods:118 post-voyage marines were recruited. Height and weight measurement instrument, electronic vital capacity measurement instrument, heart rate measurement instrument, ear-point detecting instrument and visual stroboscope were used to complete the measurement. Results:The average height was 74.84±5.00 cm. The average weight was 71.50±9.20kg. The average value of Quetlet Index was 408.7±46.5. The average heart rate was 80.34±10.44 times/min. The average vital capacity was 4970.20±1361.59 mL. Kou, pi zhi xia, e xue, shenmen xue, and shenshuai qu were selected for detecting resistance value in this research. The values were all significantly lower than standard values (P<0.01-0.05) The value of shenmen xue was lowest. The value of shen shuai dian was invalid (P>0.05). The minimum value of visual flicker-fusion was 27.15 Hz, and the maximum was 39.5 Hz. The average value was 32.78±1.90 Hz. Conclusions:The occurrence and development of mental fatigue were closely related with height, weight, physical functions and mental intelligence. In TCM, the liver and spleen are considered to be related with mental fatigue. The spleen dominates muscles. Dysfuction of spleen-qi leads to malnutrition of muscles. The lack of acquired origine results in insufficient essence and marrow, causing the slow development of bones. With the concept of eye as the window of the liver and ear as the end of liver meridian, the eyes and ears are dysfunctional if the liver has disturbance in ascending and descending.Research Three:The comparative research on marines’fatigue before and after long-term voyageObjective:This study compared demography characteristics, physical indexes, fatigue self-assessment and mental fatigue degree to provide epidemiological evidence for future research on mental fatigue treatment. Methods:Physical Fitness Investigation Form ans FSAS were used to investigate 258 marines from one navy in 2015. Results:There was no significant difference in the age, length of military service, education, marital status before and after voyage (P>0.05). The weight, Quetlet Index, heart rate and vital capacity were all significantly lower after voyage than before voyage, especially heart rate. The resistance values in kou xue, pi zhi xia, e xue, shenmen xue and shenshuai qu were also remarkably lower after voyage (P,0.01-0.05). The visual flicker-fusion rate was significantly lower after voyage (P<0.01-0.05). Compared with before voyage, the differences between each factor of FSAS were significant (P<0.05) after voyage. The mental fatigue degree was remarkably higher after voyage (P<0.05). Conclusions:The weight, Quetlet Index and vital capacity of marines after voyage were significantly lower than before voyage. The mental fatigue was more severe after voyage. This suggested the special environment of long-term voyage led to the differences in physical fitness and mental condition. The long-term voyage was one of the causes of mental fatigue. The pathological changes were in the spleen, liver, heart and lung. This reflects the idea of’the mutual corresponding of the heaven and the human’.Research Four:Post-voyage marines’TCM patterns evaluationObjective:To lay the foundation for future study on mental fatigue of long-term voyage marines through discussing the mechanism characteristics of mental fatigue with pattern research and investigation of pattern elements. Methods:Investigate 118 marines with TCM Pattern Investigation Form. Results:110 investigation forms were received with the valid recovery rate of 93.22%. Common TCM symptoms in investigated marines were:vexation and anxiety, difficult to fall asleep, edginess and easy anger, lassitude, somnolence, disinclination to talk due to lack of qi, dreamfulness, arthralgia, muscular strength reducing, amnesia, stomach fullness after eating, lumba pain, early awaking, diarrhea, back pain, heavy body, arms and legs muscle pain, poor appetite, thirsty, abdominal distension. For tongue texture, pale and red were most commonly seen. For tongue coating, thin and white coating and little coating were most common. Wiry pulse and thin and rapid pulse were most frequently seen. There were 26 TCM patterns among long-term voyage marines in this study. The most common two were liver stagnation and spleen deficiency pattern and spleen-heart deficiency pattern. Other patterns over the frequency of 3% were blazing of heart-liver fire, spleen-yin deficiency, and liver-stomach disharmony. Conclusions:The most common patterns in long-term voyage marines were pattern of liver stagnation and spleen deficiency. This was concerned with long-term voyage, special training and living environment. At the same time, long-term voyage and the changes of emotions can cause the dysfunction of the liver and spleen.Research Five:The correlation between mental fatigue and symptoms and physical fitness among marinesObjective:To understand the changing characteristics of mental fatigue among marines during voyage and to provide evidence for future treatments. Methods:Physical Fitness Investigation Form, General Burnout Questionnaire (MBI-GS), and TCM Pattern Investigation Form were used to evaluate the mental fatigue, TCM patterns and pgysical fitness situation of 118 marines. Results:In TCM symptoms among marines, only’diarrhea’ was related with mental fatigue. Although there was no significant correlation between other symtoms and mental fatigue, the tendency of correlation can be detected. There was no significant correlation between physical fitness indexes and mental fatigue. However, the tendency of correlation can be seen. Conclusions:There was internal cause-effect relationship between symptoms, physical fitness indexes and mental fatigue. This relationship was established by the circulation system of’Human (physical fitness) - exterior representations (symptoms)-Heaven (environment)’, closely related to TCM theory of ’the corresponding between Human and Heaven’. The mental fatigue among long-term voyage marines was closely related with ’physical fitness and environment’. In TCM, the liver and spleen are considered to be easily affected by the environment. The occurrence of mental fatigue was involved with the disorder of the liver and spleen. This relationship was presented by the external symptoms through ’physical fitness-environment’. |
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