摘要:

[背景]森林療養(yǎng)的健康效應(yīng)得到了廣泛認(rèn)可，但既往研究多采用森林中行走的單一活動(dòng)方式，缺乏對(duì)不同類型森林療養(yǎng)活動(dòng)療愈效果的研究。

[目的]探討短期森林療養(yǎng)對(duì)人群心肺健康、心理情緒和睡眠質(zhì)量指標(biāo)的影響，并進(jìn)一步探究不同類型療養(yǎng)活動(dòng)的健康效應(yīng)，以期為森林療養(yǎng)的深入開展提供人群實(shí)證研究數(shù)據(jù)。

[方法]采用自身前后對(duì)照的研究設(shè)計(jì)，于2018年8—9月間，以北京市郊區(qū)某國(guó)家森林公園為研究地點(diǎn)，以31名健康大學(xué)生為研究對(duì)象，探討森林中停留3天2夜前后研究對(duì)象身心健康變化情況。研究期間每位研究對(duì)象均先后體驗(yàn)漫步療法、靜坐療法配合五感體驗(yàn)（簡(jiǎn)稱靜坐療法）以及作業(yè)療法3種森林療養(yǎng)活動(dòng)，每種活動(dòng)均持續(xù)約2 h。測(cè)量研究對(duì)象進(jìn)入森林前后的血壓、血氧飽和度（SpO2）、肺功能和呼出氣一氧化氮（FeNO），分別采用簡(jiǎn)明心境狀態(tài)量表和匹茲堡睡眠質(zhì)量指數(shù)量表對(duì)研究對(duì)象的心理情緒和睡眠質(zhì)量指標(biāo)變化進(jìn)行評(píng)估，并分析不同類型森林療養(yǎng)活動(dòng)對(duì)研究對(duì)象上述心肺健康和心理情緒指標(biāo)的影響。采用混合效應(yīng)模型分析短期森林療養(yǎng)及不同類型森林療養(yǎng)活動(dòng)前后研究對(duì)象健康指標(biāo)的改變。

[結(jié)果]本次研究對(duì)象的平均年齡為（24.5±2.6）歲，平均體重指數(shù)為（20.7±1.7）kg·m?2。短期森林療養(yǎng)后，研究對(duì)象心肺健康、心理情緒和睡眠質(zhì)量均有所改善。研究對(duì)象的脈壓差（PP）和FeNO分別下降3.02 mmHg和1.10 ppb，SpO2和呼氣流量峰值（PEF）分別提高0.65%和0.50 L·s?1，負(fù)向情緒得分和睡眠質(zhì)量量表總得分均呈明顯的積極改變（均P<0.05）。不同療養(yǎng)方式對(duì)不同健康指標(biāo)的影響有所不同。漫步療法對(duì)SpO2、肺功能和慌亂（CON）情緒指標(biāo)呈明顯的改善作用，其中SpO2提高0.48%，第1秒用力呼氣量（FEV1）上升0.14 L，用力肺活量（FVC）上升0.12 L，CON指標(biāo)降低0.97分（均P<0.05）。靜坐療法可以降低研究對(duì)象血壓和緊張（TEN）情緒得分，其中收縮壓（SBP）下降4.45 mmHg，PP下降4.19 mmHg，TEN指標(biāo)下降0.84分（均P<0.05）。作業(yè)療法后舒張壓（DBP）小幅度上升（ΔDBP=2.44 mmHg，P=0.016），其他指標(biāo)改變無(wú)統(tǒng)計(jì)學(xué)意義。

[結(jié)論]短期森林療養(yǎng)可有效改善年輕健康個(gè)體的心肺健康，舒緩心理情緒并提升睡眠質(zhì)量，不同類型森林療養(yǎng)活動(dòng)具有不同的健康改善效果。

Abstract:

[Background]The health effects of forest therapy have been widely recognized, while the previous studies mostly focused on a single activity mode of forest walks. The effects of different types of forest therapy activities remain unclear.

[Objective]To explore the effects of short-term forest therapy on cardiopulmonary health, psychological health, and sleep quality, and the health effects of different types of forest therapy activities, aiming to provide population empirical study data for the development of forest therapy.

[Methods]A self-control study was conducted in a national forest park in suburb of Beijing from August to September 2018. A total of 31 healthy college students were recruited as the study subjects, with a total forest stay for 3 days and 2 nights. During the period of study, each subject practiced walking therapy, sitting therapy with five senses experience (sitting therapy thereafter), and handmade work therapy, successively. Each type of forest therapy lasted about 2 h. Changes of blood pressure, oxygen saturation (SpO2), lung function, and fractional exhaled nitric oxide (FeNO) were estimated by measuring corresponding indicators before and after the forest therapy. Psychological health and sleep quality were assessed by Profile of Mood States and Pittsburgh Sleep Quality Index respectively at the same time. Mixed effects models were used to analyze the changes of these health indicators. The health effects of different types of forest therapy activities were further analyzed.

[Results]The average age and body mass index of subjects in this study were (24.5±2.6) years and (20.7±1.7) kg·m?2, respectively. After a short-term forest therapy, the selected indicators of cardiopulmonary health, psychological health, and sleep quality of subjects were all improved. In particular, the pulse pressure (PP) and FeNO decreased by 3.02 mmHg and 1.10 ppb, respectively, while the SpO2 and peak expiratory flow (PEF) increased by 0.65% and 0.50 L·s?1, respectively, and the negative emotion and global sleep quality also presented significant positive changes (all P<0.05). Furthermore, different therapy activities presented differential effects in the health indicators. Walking therapy significantly improved pulmonary function, SpO2, and confusion (CON) emotion, in which the SpO2, forced expiratory volume in the first second (FEV1), and forced vital capacity (FVC) increased by 0.48%, 0.14 L, and 0.12 L, respectively, and the score of CON decreased by 0.97 (all P<0.05). Sitting therapy significantly reduced blood pressure and tension (TEN) emotion of subjects, including a decrease of the systolic blood pressure (4.45 mmHg), PP (4.19 mmHg), and the score of TEN (0.84) (allP<0.05). The diastolic blood pressure (DBP) increased slightly after handmade work therapy (ΔDBP=2.44 mmHg,P=0.016), but there were no significant changes in other indicators.

[Conclusion]Short-term forest therapy could significantly improve cardiopulmonary health, psychological health, and sleep quality of young healthy individuals, and different types of forest therapy activities may have differential health effects.

圖  1  

研究對(duì)象研究期間活動(dòng)安排

Figure  1.  

Activity arrangements of subjects during the study

圖  2  

研究對(duì)象進(jìn)行短期森林療養(yǎng)前后心理情緒指標(biāo)的變化（n=31）

采用混合效應(yīng)模型進(jìn)行分析，對(duì)研究對(duì)象性別、年齡和BMI進(jìn)行控制。排除缺失值后，療養(yǎng)后樣本量為30。*：P < 0.05；**：P < 0.01；（?）表示負(fù)向情緒；（+）表示正向情緒。A和B分別為POMS分指標(biāo)和TMD得分。TEN：緊張；ANG：憤怒；FAT：疲勞；DEP：抑郁；CON：慌亂；VIG：精力；ERA：自尊感；TMD：情緒紊亂總值。

Figure  2.  

Changes of emotional indicators before and after short-term forest therapy (n=31)

Mixed effects models are conducted, and sex, age, and BMI of subjects are adjusted as covariates. After forest therapy, the sample size is 30 excluding missing values. *: P < 0.05; **: P < 0.01; (?): Negative emotion; (+): Positive emotion. A and B are component and TMD scores of POMS. TEN: Tension; ANG: Anger; FAT: Fatigue; DEP: Depression; CON: Confusion; VIG: Vigor; ERA: Esteem-related affect; TME: Total mood disturbance.

圖  3  

研究對(duì)象進(jìn)行短期森林療養(yǎng)前后睡眠質(zhì)量指標(biāo)的變化（n=31）

采用混合效應(yīng)模型進(jìn)行分析，對(duì)研究對(duì)象性別、年齡和BMI進(jìn)行控制。*：P < 0.05；**：P < 0.01。A和B為PSQI分指標(biāo)和總量表得分。

Figure  3.  

Changes of sleep quality indicators before and after short-term forest therapy (n=31)

Mixed effects models are constructed, and sex, age, and BMI of subjects are adjusted. *: P < 0.05; **: P < 0.01. A and B are component and total scores of PSQI.

圖  4  

研究對(duì)象進(jìn)行不同森林療養(yǎng)活動(dòng)前后各健康指標(biāo)的變化（n=31）

采用混合效應(yīng)模型進(jìn)行分析，對(duì)研究對(duì)象性別、年齡和BMI進(jìn)行控制。SBP：收縮壓；DBP：舒張壓；PP：脈壓差；SpO2：血氧飽和度；FEV1：第1秒用力呼氣量；FVC：用力肺活量；PEF：呼氣流量峰值；TEN：緊張；ANG：憤怒；FAT：疲勞；DEP：抑郁；CON：慌亂；VIG：精力；ERA：自尊感；TMD：情緒狀態(tài)的總評(píng)分。圖E中（+）表示正向情緒，（?）表示負(fù)向情緒。C和D：排除缺失值后漫步療法后FEV1、FVC和PEF指標(biāo)樣本量為30。A~E分別為不同療法下的血壓、SpO2、FEV1和FVC、PEF及心理情緒指標(biāo)得分改變情況。

Figure  4.  

Changes of health indicators before and after different forest therapies (n=31)

Mixed effects models are constructed, and sex, age, and BMI of subjects are adjusted as covariates. SBP: Systolic blood pressure; DBP: Diastolic blood pressure; PP: Pulse pressure; SpO2: Oxygen saturation; FEV1: Forced expiratory volume in the first second; FVC: Forced vital capacity; PEF: Peak expiratory flow; TEN: Tension; ANG: Anger; FAT: Fatigue; DEP: Depression; CON: Confusion; VIG: Vigor; ERA: Esteem-related affect; TME: Total mood disturbance. Fig. E: (?) Negative emotion; (+) Positive emotion. C and D: After walking therapy, the sample sizes of FEV1, FVC, and PEF are all 30 excluding missing values. A-E are the changes of blood pressure, SpO2, FEV1 and FVC, PEF and scores of emotional indicators under different therapy, respectively.

表  1  

研究對(duì)象進(jìn)行短期森林療養(yǎng)前后心肺健康指標(biāo)的變化（n=31）

Table  1  

Changes of cardiopulmonary health indicators before and after short-term forest therapy (n=31)

心肺指標(biāo)
Cardiopulmonary indicator療養(yǎng)前
Before therapy
($ bar{x}pm s $)療養(yǎng)后
After therapy
($bar x pm s$)變化量
VariationPa收縮壓(SBP)/mmHg110.74±11.57108.25±11.21?2.490.080舒張壓(DBP)/mmHg67.78±8.6968.31±8.110.530.639脈壓差(PP)/mmHg42.96±7.9839.94±7.36?3.020.017血氧飽和度(SpO2)/%97.87±0.8598.52±0.770.650.002第1秒用力呼氣量(FEV1)/L3.19±0.773.28±0.74b0.06c0.172用力肺活量(FVC)/L3.57±0.913.62±0.87b<0.01c0.903呼氣流量峰值(PEF)/(L·s?1)5.64±2.236.21±2.07b0.50c0.035呼出氣一氧化氮(FeNO)/ppb13.13±7.3612.03±7.15?1.100.042[注] a：采用混合效應(yīng)模型進(jìn)行分析，對(duì)研究對(duì)象性別、年齡和BMI進(jìn)行控制。b：排除缺失值后，該指標(biāo)樣本量為30。c：根據(jù)排除缺失值后的數(shù)據(jù)進(jìn)行計(jì)算。為便于與同類研究比較，根據(jù)文獻(xiàn)[7]，F(xiàn)eNO水平表示方式為ppb。[Note] a: Mixed effects models are conducted, and sex, age, and BMI of subjects are adjusted. b: The sample size of this indicator is 30 excluding missing values. c: This variation is calculated by the data excluding missing values. To facilitate comparison with other studies, according to the reference [7], the level of FeNO is expressed in ppb. [1]

PARK B J, TSUNETSUGU Y, KASETANI T, et al. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan[J]. Environ Health Prev Med, 2010, 15(1): 18-26.

doi: 10.1007/s12199-009-0086-9 [2]

ZHANG Z, WANG P, GAO Y, et al. Current development status of forest therapy in China[J]. Healthcare (Basel), 2020, 8(1): 61.

[3]

李晨, 劉珊, 郭新彪, 等. 森林覆蓋率與中老年人群肥胖的關(guān)聯(lián)及其中介因素分析[J]. 環(huán)境與健康雜志, 2020, 37(6): 471-475.

LI C, LIU S, GUO X B, et al. The association between forest coverage and obesity of middle-aged and elderly and its mediating factors[J]. J Environ Health, 2020, 37(6): 471-475.

[4]

CHEN C, LU F C. The guidelines for prevention and control of overweight and obesity in Chinese adults[J]. Biomed Environ Sci, 2004, 17 Suppl: 1-36.

[5]

MILLER M R, HANKINSON J, BRUSASCO V, et al. Standardisation of spirometry[J]. Eur Respir J, 2005, 26(2): 319-338.

doi: 10.1183/09031936.05.00034805 [6]

American Thoracic Society, European Respiratory Society. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005[J]. Am J Respir Crit Care Med, 2005, 171(8): 912-930.

doi: 10.1164/rccm.200406-710ST [7]

DWEIK R A, BOGGS P B, ERZURUM S C, et al. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications[J]. Am J Respir Crit Care Med, 2011, 184(5): 602-615.

doi: 10.1164/rccm.9120-11ST [8]

祝蓓里. POMS量表及簡(jiǎn)式中國(guó)常模簡(jiǎn)介[J]. 天津體育學(xué)院學(xué)報(bào), 1995, 10(1): 35-37.

ZHU B L. Brief introduction of POMS scale and its model for China[J]. J Tianjin Inst Phys Educ, 1995, 10(1): 35-37.

[9]

鄭棒, 李曼, 王凱路, 等. 匹茲堡睡眠質(zhì)量指數(shù)在某高校醫(yī)學(xué)生中的信度與效度評(píng)價(jià)[J]. 北京大學(xué)學(xué)報(bào)(醫(yī)學(xué)版), 2016, 48(3): 424-428.

ZHENG B, LI M, WANG K L, et al. Analysis of the reliability and validity of the Chinese version of Pittsburgh sleep quality index among medical college students[J]. J Peking Univ (Health Sci), 2016, 48(3): 424-428.

[10]

LEE J, PARK B J, TSUNETSUGU Y, et al. Effect of forest bathing on physiological and psychological responses in young Japanese male subjects[J]. Public Health, 2011, 125(2): 93-100.

doi: 10.1016/j.puhe.2010.09.005 [11]

LANKI T, SIPONEN T, OJALA A, et al. Acute effects of visits to urban green environments on cardiovascular physiology in women: a field experiment[J]. Environ Res, 2017, 159: 176-185.

doi: 10.1016/j.envres.2017.07.039 [12]

楚夢(mèng)天, 南海龍, 馬瑩, 等. 北京市城市森林環(huán)境中人群心肺功能及心理情緒相關(guān)指標(biāo)的短期變化[J]. 環(huán)境與職業(yè)醫(yī)學(xué), 2020, 37(2): 162-167, 180.

CHU M T, NAN H L, MA Y, et al. Short-term changes of cardiopulmonary functions and psycho-emotional indicators of general population in urban forest environment in Beijing[J]. J Environ Occup Med, 2020, 37(2): 162-167, 180.

[13]

ZENG C, LYU B, DENG S, et al. Benefits of a three-day bamboo forest therapy session on the physiological responses of university students[J]. Int J Environ Res Public Health, 2020, 17(9): 3238.

doi: 10.3390/ijerph17093238 [14]

LEE J Y, LEE D C. Cardiac and pulmonary benefits of forest walking versus city walking in elderly women: a randomised, controlled, open-label trial[J]. Eur J Integr Med, 2014, 6(1): 5-11.

doi: 10.1016/j.eujim.2013.10.006 [15]

YU C P, LIN C M, TSAI M J, et al. Effects of short forest bathing program on autonomic nervous system activity and mood states in middle-aged and elderly individuals[J]. Int J Environ Res Public Health, 2017, 14(8): 897.

doi: 10.3390/ijerph14080897 [16]

KIM H, LEE Y W, JU H J, et al. An exploratory study on the effects of forest therapy on sleep quality in patients with gastrointestinal tract cancers[J]. Int J Environ Res Public Health, 2019, 16(14): 2449.

doi: 10.3390/ijerph16142449 [17]

POLKEY M I, QIU Z H, ZHOU L, et al. Tai chi and pulmonary rehabilitation compared for treatment-naive patients with COPD: a randomized controlled trial[J]. Chest, 2018, 153(5): 1116-1124.

doi: 10.1016/j.chest.2018.01.053 [18]

OOI S L, GIOVINO M, PAK S C. Transcendental meditation for lowering blood pressure: an overview of systematic reviews and meta-analyses[J]. Complement Ther Med, 2017, 34: 26-34.

doi: 10.1016/j.ctim.2017.07.008

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