Cov txiaj ntsig ntawm Kev Noj Qab Haus Huv Coenzyme Q10 Ntxiv NADH Ntxiv Rau Kev Pom Kev Nyuaj Siab Thiab Kev Noj Qab Haus Huv Txog Kev Noj Qab Haus Huv Zoo ntawm Lub Neej Hauv Cov Neeg Nrog Myalgic Encephalomyelitis / Chronic Fatigue Syndrome: Ib Lub Zeem Muag, Randomized, Ob-dig muag, Kev sim tshuaj placebo

Abstract:Myalgic encephalomyelitis / chronic fatigue syndrome (ME / CFS) yog ib qho nyuaj, ntau qhov system,thiab ua rau muaj kev nyuaj siab ntau yam kab mob neuroimmune, tej zaum ntawm post-viral multifactorial etiology.Hmoov tsis zoo, tsis muaj kev kuaj mob kom raug lossis kuaj sim tau raug tsim, lossis tsis muaj ib lub univer.sally zoo pom zoo tshuaj tam sim no muaj rau nws txoj kev kho mob. Txoj kev tshawb no yog tsom los tshuaj xyuas seb puas yogQhov ncauj coenzyme Q10 thiab NADH (txo daim ntawv ntawm nicotinamide adenine dinucleotide) co-supplementation tuaj yeem txhim kho pom kev qaug zog, pw tsis tsaug zog, thiab kev noj qab haus huv zoo ntawmlub neej hauv ME / CFS cov neeg mob. Ib 12-lub lim tiam yav tom ntej, randomized, ob-dig muag, kev sim tshuaj placebotau ua nyob rau hauv 207 cov neeg mob nrog ME / CFS, uas tau muab faib rau ib qho ntawm ob pawgkom tau txais 200 mg ntawm CoQ10 thiab 20 mg ntawm NADH (n = 104) los yog sib piv cov placebo (n = 103) ib hnub ib zaug. Cov ntsiab lus kawg tau raug ntsuas ib txhij ntawm qhov pib thiab tom qab ntawd rov ntsuas dua ntawm 4- thiab8-kev mus ntsib kws kho mob lub lim tiam thiab plaub lub lis piam tom qab kev kho mob, siv cov neeg mob uas muaj ntaub ntawv pov thawjntsuas qhov tshwm sim.

Ib qho kev txo qis hauv kev xav txog kev qaug zog thiab tag nrho FIS -40 qhab nia(p < 0.001="" and="">p = 0.022, ntsig txog) thiab kev txhim kho hauv HRQoL (kev noj qab haus huv ntsig txog lub neej zoo(SF-36)) (p <>) los ntawm cov hauv paus ntsiab lus tau pom nyob rau hauv pab pawg sim dhau sijhawm. Raws li kev txheeb cais,Qhov sib txawv tseem ceeb kuj tau pom rau lub sijhawm pw tsaug zog ntawm 4 lub lis piam thiab kev pw tsaug zog zoo li qubntawm 8 lub lis piam hauv kev rov qab mus xyuas los ntawm cov hauv paus hauv paus hauv pab pawg sim (p = 0.018 thiabp = 0.038, raws). Zuag qhia tag nrho, cov kev tshawb pom no txhawb nqa kev siv CoQ10 ntxiv rau NADH ntxiv raws liib qho kev xaiv kho mob uas muaj kev nyab xeeb rau kev txo qis kev paub txog kev qaug zog thiab txhim kho covKev noj qab haus huv ntsig txog lub neej nyob hauv ME / CFS cov neeg mob. Cov kev cuam tshuam yav tom ntej yog xav tau los txheeb xyuascov txiaj ntsig kev kho mob no thiab tseem tshawb nrhiav cov kab mob hauv qab ntawm CoQ10 thiab NADHkev tswj hwm hauv ME/CFS.

1. Taw qhia

Myalgic encephalomyelitis, feem ntau hu ua chronic fatigue syndrome (ME/CFS),yog ib qho mob hnyav, nyuaj, thiab mob ntau yam kab mob uas tsis paub txog etiology, feem ntau tshwm simlos ntawm tus kab mob tsis tu ncua (vim li no, nws tseem hu ua post-viral fatigue syndrome). Nws yog characterized los ntawm unexplained thiab persistent post-exertional qaug zog, uasyog unrelieved los ntawm so thiab ua phem los ntawm lub cev thiab lub hlwb kev rau siab, nrog rau lwm yamCov tsos mob tseem ceeb xws li kev cuam tshuam ntawm kev paub, immunometabolic, autonomic, thiabneuroendocrine txoj kev [1]. Nws cuam tshuam txog li 17 txog 24 lab tus tib neeg thoob ntiaj teb,thiab nws qhov kev nthuav dav yuav tsum muaj ntau dua ob npaug los ntawm 2030 [2]. Kev nthuav qhia kho mobthiab cov tsos mob zaus thiab qhov hnyav yuav txawv ntawm cov neeg mob, tab sis feem ntau, qhov mobtxo tag nrho lub neej zoo thiab kev sib raug zoo, kev ua haujlwm, thiab kev ua haujlwm ntawm tus kheej; tseeb tiag,Qee tus neeg mob txawm pw hauv txaj lossis pw hauv tsev [3]. Kev kuaj mob ntawm ME / CFS yog nyob ntawmCov neeg mob cov tsos mob tseem ceeb raws li kev pom zoo ntawm plaub qhov xwm txheej tau tsim dua25 xyoo dhau los, uas tau siv ob qho tib si hauv kev tshawb fawb thiab hauv kev kho mob: lub1994 CDC/Fukuda txhais [4], 2003 Canadian Consensus Criteria (tseem hu uaCCC) [52011 International Consensus Criteria (ICC) [6], thiab, tsis ntev los no, xyoo 2015IOM Tus Kws Lij Choj Tus Txheej Txheem rau Kev Ua Haujlwm Tsis Txaus Siab (SEID) [7]. Hauv kev kho mobKev kuaj mob ntawm ME / CFS, nws yog ib qho tseem ceeb rau kev ntsuam xyuas qhov kev xav tsis zoo ntawm kev qaug zog, pw tsaug zogteeb meem, thiab kev noj qab haus huv ntsig txog lub neej siv cov lus nug uas muaj tseeb xws li covFatigue impact scale (FIS-40) [8], Pittsburg pw tsaug zog zoo Performance index (PSQI) [9], thiab Short-FormHealth Survey (SF-36) [10]. Hmoov tsis zoo, tam sim no, tsis muaj kev muag khoomKev tshuaj ntsuam xyuas, tsis muaj ib qho chaw kuaj biomarkers, thiab tsis muaj hom tshuaj FDA pom zoo rauME/CFS [11]. Coenzyme Q10 (CoQ10) thiab txo daim ntawv ntawm nicotinamide adenine dinucleotide(NADH) yog cov khoom tseem ceeb ntawm cov saw hlau thauj hluav taws xob ua lub luag haujlwm rau mitochondrialATP ntau lawm, uas txo cov dawb radical tiam, thiab, nyob rau hauv lawv cov ntaub ntawv txo, lawvua raws li muaj zog antioxidants. CoQ10 thiab NADH qib thiab cov xwm txheej redox tau pomkom muaj kev ntxhov siab hauv ME/CFS. Cov pov thawj muaj zog tau tshwm sim tias mitochondrial tsis ua haujlwm,cuam ​​tshuam immunometabolism, thiab nce oxidative kev nyuaj siab ua lub luag haujlwm tseem ceeb hauv lub cevpathogenesis ntawm ntau yam mob, muab ib tug robust scientific rational rau kev kuajmuaj peev xwm "nutraceuticals" uas tsom cov txheej txheem no [12]. Raws limob nkeesyog ib qho kev kuaj mob tseem ceeb rau ME / CFS, nws tau pom zoo tiasLub zog metabolism tuaj yeem cuam tshuam rau hauv cov neeg mob me / CFS. Mitochondrialkev ua haujlwm tsis zoo tau suav tias yog qhov ua tau hauv qab pathomechanism ntawm tus mob,raws li kev hloov pauv ntawm cov qauv thiab kev ua haujlwm tau tshaj tawm vis-a-vis kev noj qab haus huv tswj [12]. Ntev-chain polyunsaturated fatty acid, prostaglandin thiab amino acid metabolism, thiabATP biosynthesis tsis muaj txiaj ntsig tau pom tias yog qhov tshwm sim ntawm ME / CFS vim yogKev cuam tshuam ntawm mitochondrial bioenergetic metabolism [13]. Vim lub luag hauj lwm muaj peev xwm ntawm lubmitochondria hauv ME / CFS, mitochondrial-targeting nutraceutical cuam tshuam tausiv los pab txhim kho cov txiaj ntsig ntawm tus neeg mob xws li qaug zog thiab lawv cov kev noj qab haus huv zoontawm lub neej [14], suav nrog CoQ10, NADH, thiab n-Acetyl-L-carnitine ua ib feem ntawm lawv cov kev kho mobkev tswj hwm [15–18]. Cov kev kho mob no yog siv ib leeg lossis ua ke nrog acocktail ntawm lwm yam nutraceutical thiab / los yog tshuaj raws li cov khoom.Hauv kaum xyoo dhau los, lub cev loj hlob ntawm cov ntaub ntawv tau txhawb nqa kev siv tshuaj kho mobntawm kev noj haus CoQ10 supplementation nyob rau hauv kev noj qab haus huv thiab mob ntev [13,19–25]. Yav dhau los, hauv kev tshawb fawb pov thawj-ntawm-lub tswv yim, peb pab pawg tau pom muaj qhov sib txawv ntawm kev txhim khodhau sijhawm hauvqaug zogkev xaav, teb rau kev tawm dag zog lub cev, thiab biochemical tsisoxidative kev nyuaj siab thiab mitochondrial metabolism (ATP cov ntsiab lus, lipid peroxidation, citrate)synthase kev ua, theem ntawm CoQ10 thiab NADH) hauv peripheral ntshav mononuclear hlwb tom qabCoQ10 plus NADH kev tswj hwm [26–28]. Muaj pov thawj ntawm kev txhim kho mitochondrialUa pa tom qab ntev CoQ10 supplementation [29,30], los ntawm cov txheej txheem koom nroglub upregulation ntawm enzymes uas tswj fatty acid thauj mus rau organelles thiab kujstimulation ntawm mitochondrial biogenesis [31,32]. Ntawm cov tib neeg raug kev txom nyem los ntawm antau yam mob, cov kws tshawb fawb kuj tau tshaj tawm txog kev txo qis hauv cov pa oxygen reactive thiabnitrogen hom theem (ROS / RNS), protein carboxylation, DNA puas, protein nitration,thiab lipid peroxidation tom qab CoQ10 supplementation [33,34]. Lwm cov pov thawj hauv vivoKev txo qis ntawm oxidative thiab nitrosative kev nyuaj siab tom qab CoQ10 supplementationsuav nrog downregulation ntawm iNOS enzyme thiab NF-kB [35,36]. Coenzyme Q10 tau uapom tias txo cov cim ntawm cov kab mob hauv lub cev hauv ntau yam metabolic, autoimmune, thiabneurological mob [37,38]. Raws li rau NADH, nws yog lub npe hu los pab txhawb cov tiam ntawmIntracellular ATP [39], thiab nyob rau hauv ntau txoj kev tshawb fawb, nws tau qhia ntau dua cov lus teb thaum lub sij hawmthawj peb lub hlis twg ntawm kev kho mob piv rau cov kev tswj hwm [40]. Nyob rau hauv lwm yam pov thawj-ntawm-lub tswv yimkev tshawb fawb ntawm pawg, peb pab pawg tau pom tias NADH tau tswj hwm los txhim kho kev ntxhov siab / kev nyuaj siabCov tsos mob thiab lub plawv dhia siab tshaj plaws hauv ME / CFS tom qab kev sib tw ob hnub sib law liagkuaj (2-hnub CPET), kev tshawb pom uas yuav ua rau muaj kev txhim kho hauv cov pa oxygen mus rauCov leeg pob txha thiab rau lub hlwb hauv cov tib neeg nrog ME / CFS [41]. Cov ntaub ntawv hais txog qhov muaj peev xwm kho tau ntawm CoQ10 thiab NADH co-supplementation ntawmqaug zog, mob, thiab pw tsaug zog tsis zoo rau cov tib neeg uas muaj ME / CFS tsis tshua muaj. Tam sim noKev tshawb fawb tau ua los soj ntsuam cov teebmeem ntawm CoQ10 ntxiv rau NADH supplementationntawm kev xav qaug zog, teeb meem pw tsis tsaug zog, thiab HRQoL hauv cov neeg uas muaj ME / CFS,vim qhov kev tshawb nrhiav yav dhau los uas tsis muaj qhov sib txawv tseem ceeb tau pom rau ntevmob thiab pw tsaug zog zoo hauv ME/CFS.

2. Cov ntaub ntawv thiab cov txheej txheem

2.1. Cov neeg koom nrog

Ib 12-lub lim tiam, ib qho chaw, randomized, ob qhov muag tsis pom kev, kev sim tshuaj placebo yogua nyob rau hauv 242 Caucasian ME / CFS cov neeg mob sib law liag los ntawm ib tus neeg mob sab nraudtertiary referral center (ME/CFS Clinical Unit, Vall d'Hebron University Hospital,Barcelona, ​​Spain) txij lub Ib Hlis 2018 txog Lub Kaum Ob Hlis 2019. Daim duab1 qhia flflowchart ntawmcov neeg koom ua ntej kev txheeb xyuas. Cov neeg mob tsim nyog tau txais kev kawm yog tias lawv yog poj niam, hnub nyoog 18 xyoo lossis tshaj saud, muaj kev kuaj pom tseeb ntawm ME / CFS raws li xyoo 1994CDC/Fukuda case definition [4], thiab tau kos npe sau ntawv tso cai pom zoo. Kev cais tawmCov txheej txheem suav nrog txhua yam kev mob tshwm sim uas piav qhia txog kev qaug zog ntev (tsis khohypothyroidism, pw tsaug zog apnea, narcolepsy, tshuaj phiv tshuaj, thiab hlau deficiency anemia), kev kuaj mob yav dhau los tsis daws qhov tseeb (hloov kab mob siab, mob malignancy), yav dhau loslos yog cov kab mob neuropsychiatric tam sim no (kev nyuaj siab loj nrog kev puas siab puas ntsws lossis melancholicnta, kev puas siab puas ntsws bipolar, schizophrenia, delusional tsis meej, dementia, anorexianervosa, bulimia nervosa), thiab kev koom tes hauv lwm qhov kev sim tshuaj ntawm tib yam lossis txawvxwm nyob rau hauv 30 hnub ua ntej kev kawm suav nrog; tsis muaj peev xwm (hauv kev xav ntawm tus neeg tshawb xyuas)ua raws li cov lus qhia lossis ua kom tiav cov kev kho mob txaus siab; tsis ua hauj lwm muabkos npe rau kev pom zoo; noj tej yam tshuaj/siv ntxiv uas yuav cuam tshuamCov txiaj ntsig tau ntsuas hauv 90 hnub dhau los lossis nws qhov kev tshem tawm yuav yog qhov teeb meem cuam tshuam,Kev kho mob anticoagulant, cev xeeb tub lossis pub niam mis, haus luam yeeb, haus dej cawv lossis khoom sivKev tsim txom, rog rog (BMI> 30 kg / m2 ), thiab hypersensitivity rau CoQ10 lossis NADH. Cov neeg mob nrogcov ntaub ntawv uas ploj lawm los ntawm kev rov qab mus rau qhov chaw hauv paus tau suav tias tau tso tseg.

Daim duab 1.Consolidated Standards of Reporting Trials (CONSORT) ua raws li daim duab qhia txog cov kauj ruamntawm kev tshuaj xyuas, kev tso npe kawm, ua haujlwm, thiab ua raws li cov neeg koom nrog kev kawm.

2.2. Kev cuam tshuam

Ntawm 242 tus neeg koom nrog ME / CFS tau soj ntsuam, 35 raug cais tawm (yim leej twgtsis tau raws li cov txheej txheem suav nrog, thiab 27 leej twg tsis kam koom). Qhov seem207 tus neeg koom tau muab faib rau kev kho mob los ntawm tus kws tshawb nrhiav ywj pheej tsis yog lwm yamkoom nrog hauv kev cuam tshuam, siv cov txiaj ntsig ntawm cov npe ntawm cov lej random tsim los ntawm acomputer program. Cov neeg koom tau random muab tso rau hauv ob qhov muag tsis pom kev hauv1: 1 piv kom tau txais 200 mg ntawm CoQ10 ntxiv rau 20 mg ntawm NADH (n = 72) los yog kev sib twcov placebo (n = 72), nyob rau hauv plaub capsules txhua hnub rau yim lub lis piam; txhua tus neeg koom kuj tau txais lawvstandard kho rau tus kab mob. CoQ10 tau siv ua ke nrog NADH, hauvLub teeb ntawm cov lus ceeb toom tias lawv yuav muaj kev sib koom ua ke ntawm cov teebmeem antioxidant thiab uas NADH tuaj yeemTxhim kho CoQ10 absorption [26,27]. Cov ntaub ntawv kev nyab xeeb tau txais ntawm txhua qhov kev mus ntsib suav nrog cov ntaub ntawv ntawm cov xwm txheej tsis zoo, cov ntaub ntawvlos ntawm kev soj ntsuam kuaj mob, cov cim tseem ceeb, nrog rau cov txiaj ntsig ntawm lub cev dav davkev tshuaj xyuas. Cov xwm txheej tsis zoo, suav nrog cov teeb meem loj, raug tshuaj xyuas thoob plaws hauv kev simlos ntawm kev saib xyuas kev kho mob ywj pheej, pawg tswj hwm, thiab cov ntaub ntawv ywj pheejthiab pawg saib xyuas kev nyab xeeb. Kev npaj tau tsim rau tus neeg tshawb xyuas-pib ib ntus lossistxo koob tshuaj tas mus li los yog ncua vim muaj kev phom sij.Thaum lub sij hawm txoj kev tshawb no, 19 cov ntsiab lus poob tawm vim muaj kev phiv: yim nyob rau hauv lub activepab pawg (tsib epigastralgias, thiab peb kiv taub hau), thiab 11 hauv pawg placebo (plaub epigastralgias),gastralgias, tsib kiv taub hau, ib tug raws plab, thiab ib leeg spasm). Nees nkaum plaub tus neeg mobpoob rau kev soj ntsuam (13 hauv pawg sim thiab 11 hauv pawg placebo). Plaubtxiav tawm txoj kev tshawb no vim muaj cov txheej txheem sib txuam (ib kis ntawm hypotensivekev kho mob hauv txhua pab pawg, ib kis mob ntshav qab zib hauv pawg sim, thiab ib kis ntawm ko tawkev raug mob hauv pawg placebo). Thaum kawg, 16 tus neeg mob tau thim ntawm lawv tus kheej qhov kev thov (cuaj kishauv pawg sim thiab xya hauv pawg placebo). Qhov seem 144 kisntawm ME / CFS (70 feem pua, 72 tus neeg mob hauv txhua pab pawg kho mob) ua tiav tag nrho cov txheej txheem kawmcov txheej txheem thiab tau suav nrog hauv kev tshuaj xyuas tag nrho ntawm cov txiaj ntsig ntsuas (saib daim duab1). 2.3. Khoom kuajCov neeg mob randomized rau CoQ10 ntxiv rau NADH kev sim pab pawg tau txais plaubenteric-coated ntsiav tshuaj txhua hnub muaj cov khoom xyaw nquag (50 mg ntawm CoQ10 thiab 5 mg ntawmNADH) thiab excipients (20 mg ntawm phosphatidylserine thiab 40 mg ntawm vitamin C). Cov neeg mobrandomized rau cov placebo tau txais cov tshuaj ntxiv suav nrog plaub lub ntsiav tshuaj enteric-coated txhua hnubtsuas muaj excipients. Ob qho kev sim thiab cov tshuaj placebo tau zoo ib yam hauvloj, xim, opacity, puab, nthuav qhia, thiab ntim. Tag nrho cov ntsiav tshuaj tau tsimthiab pub dawb los ntawm Vitae Health Innovation, SL (Montmeló, Barcelona, ​​Spain). Txoj kev kawmtus kws muag tshuaj tau sau tag nrho cov kev kho mob uas muab rau hauv daim ntawv muab tshuaj raunrog tus thawj tsab ntawv.2.4. Kawm Tsim thiab Cov Txheej TxheemQhov no Unicenter, randomized, ob-dig muag, placebo-tswj pab pawg kawm tsim qauvtau ua los ntsuas cov txiaj ntsig kho mob ntawm qhov ncauj CoQ10 ntxiv rau NADH kev tswj hwmntawm kev xav qaug zog, thiab teeb meem pw tsaug zog tsis zoo, thiab HRQoL hauv ME / CFS. Kev mus ntsib kws kho mobthoob plaws hauv txoj kev tshawb fawb tau piav qhia hauv daim duab2, uas kuj piav qhia txog kev sim tsim hauvob pawg. Tom qab hais lus piav qhia ntawm txoj kev tshawb no, txhua tus neeg koom tau sau ntawv tso caiua ntej pib thiab tsis tau txais nyiaj them rau lawv txoj kev koom tes. Cov neeg mobtau soj ntsuam ntawm lub hauv paus, thiab tom qab ntawd ntawm plaub thiab yim lub lis piam ntawm kev kho mob, thiab thaum kawgplaub lub lis piam tom qab qhov kawg ntawm kev kho mob los ntawm qhov chaw soj ntsuam. Hloov cov tsos mobtau raug soj ntsuam los ntawm validated daim ntawv nug tus kheej-daim ntawv qhia ua tiav los ntawm cov neeg koomnyob rau hauv kev saib xyuas ntawm ob tug kws tshawb fawb (JC-M. thiab JA-M.). Ua rawstau tshuaj xyuas los ntawm cov ntawv teev tshuaj. Kev siv cov tshuaj sib xyaw ua ke tau taug qabntawm txhua qhov kev mus ntsib tom qab. Cov txheej txheem kev kawm tau raug tshuaj xyuas thiab pom zoo los ntawm lub zoslub koom haum tshuaj xyuas pawg thawj coj ntawm lub koom haum koom nrog (Clinical Research Ethics Committee,Tsev Kho Mob Vall d'Hebron University, Barcelona, ​​Spain; raws tu qauv code: VITAE-2015, pom zoo24 April 2015). Txoj kev kawm raws tu qauv tau ua raws li cov lus qhia ntawmTshaj tawm ntawm Helsinki thiab nrog cov kev cai Spanish tam sim no ntawm kev tshawb fawb soj ntsuamthiab cov qauv ntawm kev kho mob zoo ntawm European Union. Nws kuj ua raws liConsolidated Standards of Reporting Trials (CONSORT) cov lus qhia.

Lub zeem muag tau txiav txim siab qhov txiaj ntsig tseem ceeb yog qhov hloov pauv ntawm tus kheej tshaj tawmCov qhab nia qaug zog raug soj ntsuam los ntawm kev siv qhov kev siv tau Fatigue Impact Scale (FIS-40) los ntawm qhov pib mus rauqhov kev mus ntsib zaum kawg tau tuav peb lub hlis tom qab. Txoj kev tshawb no tau siv los txheeb xyuas qhov 3-pointQhov sib txawv ntawm pawg kho mob nquag thiab cov placebo. FIS-40 muaj 40 yam khoommuab faib ua peb yam uas piav qhia txog qhov pom tias qaug zog cuam tshuam li cas rau kev paub(10 yam), lub cev (10 yam), thiab kev puas siab puas ntsws ua haujlwm (20 yam) dhau losplaub lub lis piam. Txhua yam tau qhab nia los ntawm 0 (tsis muaj zog) mus rau 4 ( qaug zog hnyav). Tag nrho FIS-40qhab nias yog xam los ntawm kev ntxiv ua ke cov lus teb los ntawm 40 cov lus nugpacts ntawm kev txawj ntse(10 yam), lub cev (10 yam), thiab psychosocial ua haujlwm (20 yam khoom)

2.6. Secondary Endpoints

Cov txiaj ntsig thib ob ntsuas suav nrog kev hloov pauv ntawm kev pw tsaug zog tsis zoo thiab cuam tshuam txog kev noj qab haus huvKev ua neej zoo los ntawm kev lees paub tus kheej tshaj tawm PSQI thiab HRQoL cov lus nug,raws.

2.6.1. Pittsburgh Pw tsaug zog zoo Index

Kev pw tsaug zog cuam tshuam tau raug soj ntsuam los ntawm tus kheej tswj hwm 19- yam PittsburghPw tsaug zog zoo Index (PSQI) nug. Cov qhab nia tau txais ntawm txhua ntawm xya lub npe ntawmpw tsaug zog zoo: subjective pw zoo, pw tsaug zog latency, pw tsaug zog ntev, ib txwm pw tsaug zog efficiency,pw tsaug zog perturbations, siv tshuaj tsaug zog, thiab kev ua haujlwm nruab hnub. Txhua yamtau qhab nia ntawm 0 mus rau 3 (0=tsis muaj teeb meem pw tsaug zog thiab 3=teeb meem pw tsaug zog hnyav). Lub ntiaj teb noPSQI cov qhab nia txawv ntawm 0 mus rau 21 cov ntsiab lus, nrog cov qhab nia ntawmNtau dua lossis sib npaug5 qhia tias pw tsaug zog tsis zoo [9]. 

2.6.2. Qhov 36-Kev Tshawb Fawb Txog Kev Noj Qab Haus Huv Short-FormDaim ntawv qhia 36-Tej yam luv luv-Form Health Survey (SF-36) tau siv los ntsuas kev noj qab haus huv zoontawm lub neej. SF-36 yog ib daim ntawv ntsuam xyuas tus kheej qhia dav dav ntawm kev noj qab haus huv ntsig txog lub cev thiabKev puas siab puas ntsws ua haujlwm hauv ME / CFS thiab lwm yam mob. Nws ntsuas kev ua haujlwmntawm yim subscales suav nrog cov haujlwm ntawm lub cev ua haujlwm, lub luag haujlwm ntawm lub cev, mob lub cev,kev noj qab haus huv dav dav, kev ua haujlwm hauv zej zog, kev loj hlob, lub luag haujlwm ntawm kev xav, thiab kev noj qab haus huv ntawm lub hlwb, thiab obntxiv cov subscales uas npog lub cev thiab lub hlwb noj qab haus huv domains, nyob rau ntawm antsuas los ntawm 0 mus rau 100. Cov qhab nias qis qhia tias muaj kev cuam tshuam ntau dua ntawm tus neeg noj qab haus huvntawm kev ua haujlwm [10]. 

2.7. Fais fab thiab Sample Size kwv yees

Tus qauv loj yog kwv yees raws li cov ntaub ntawv los ntawm kev sim tshuaj xyuas dhau los ntawm CoQ10thiab NADH ntxiv rau cov neeg nrog ME / CFS [28]. Tso cai rau kwv yees thaum ntxovtso tawm tus nqi ntawm 20 feem pua ​​​​, thiab lees txais qhov pheej hmoo alpha ntawm 5 feem pua ​​​​thiab beta pheej hmoo ntawm 20 feem pua ​​(ob togxeem), tag nrho ntawm 121 cov ntsiab lus hauv txhua pab pawg tau suav tias tsim nyog los nrhiav kev txheeb caisqhov sib txawv tseem ceeb ntawm cov pab pawg, xav tias yuav yog 10 feem pua ​​​​ntawm cov placebo pawg thiab25 feem pua ​​​​hauv pawg sim, nkag mus rau 12 Lub Rau Hli 2018).

2.8. Kev soj ntsuam kev ua raws cai thiab cov xwm txheej tsis zoo

Txhua tus neeg koom tau raug hais kom rov qab los ntawm cov khoom kawm uas tseem tshuav tom qab kev cuam tshuam. Kev ua raws li tau ntsuas los ntawm kev suav tag nrho cov ntsiav tshuaj ntxiv. Cov neeg koom nrog uas tau uatsis txhob noj cov tshuaj ntxiv rau ntau tshaj ob hnub tsis sib law liag lossis hnub sib law liagsuav tias yog tsis ua raws (n = 0). Tag nrho cov xwm txheej tsis zoo tom qab kev tswj hwm kev kawmcov khoom noj tau raug saib xyuas kom txog thaum kawg ntawm txoj kev tshawb fawb. Tsis muaj teeb meem loj los yogxav tias tsis zoo tshwm sim (piv txwv li, cov xwm txheej ua rau tuag, tam sim ntawd txoj sia yuav hemcov xwm txheej, cov xwm txheej tseem ceeb ntawm kev kho mob rau ib qho laj thawj, cov xwm txheej xav tau lossis ncua mus pw hauv tsev kho moblos yog ua rau muaj kev tsis taus / tsis muaj peev xwm tsis tu ncua) tau tshaj tawmthaum lub sij hawm los yog tom qab qhov kawg ntawm txoj kev kawm.2.9. Kev txheeb caisKev piav qhia statistical tsom xam tau ua tiav rau txhua qhov kev kawm sib txawv. Cov txiaj ntsig yogqhia li txhais tau tias± standard deviation (SD). Kev xeem Kolmogorov-Smirnov tau siv los uatxiav txim siab qhov kev faib tawm thiab normality ntawm cov ntaub ntawv rau ob pawg. Kev hloov pauv tsis tu ncuatau txhais los ntawm tus naj npawb ntawm cov teeb meem siv tau thiab qhia tias txhais tau tias± SD. CategoricalCov kev hloov pauv tau piav qhia siv qhov tseeb thiab txheeb ze ntawm txhua pawg dhautag nrho cov nqi siv tau. Qhov sib txawv ntawm kev sib piv ntawm ob pawgraug soj ntsuam los ntawm cov tub ntxhais kawmt-test (paired cov ntaub ntawvt-test siv tus nqi ntawm tus neeg mob likev tswj) rau qhov sib txawv tsis tu ncua thiab Chi-square test rau categorical variables. Rautag nrho cov kev sib piv, ib theem ob sab ntawm qhov tseem ceeb ntawm cov lej ntawm 0.05 raug txiav txim siab. Tag nrhokev soj ntsuam tau ua tiav ntawm cov ntaub ntawv teeb tsa siv tag nrho cov ntaub ntawv muaj nrog kev xav-rau-kho (ITT) cov txheej txheem. Kev ntsuam xyuas ntawm kev sib txawv (ib-txoj kev ANCOVA) tau ua los ntawm kev sivcov kev hloov pauv hauv tag nrho FIS-40 cov qhab nia los ntawm qhov pib mus rau qhov kawg rov qab mus saib ntawm txoj kev tshawb noqhov kev ntsuas thawj zaug, thiab nkag mus rau tag nrho FIS-40, PSQI, thiab HRQoL cov qhab nia ntawmlub hauv paus raws li qhov kev kwv yees tas mus li thiab tus neeg soj ntsuam thiab kev kho mob tau muab raucategorical kwv yees. Kev txheeb xyuas txheeb cais tau soj ntsuam ICH-E9 cov lus qhia thiab txhua yamcov cai ntawm kev kho mob zoo. Tag nrho cov ntaub ntawv tau txheeb xyuas siv SAS program, version9.4 (Statistical Analysis System Institute Inc., Cary, NC, USA).

3. Cov txiaj ntsig

3.1. Cov neeg koom nrog cov yam ntxwv ntawm Baseline

Rooj1 qhia txog cov pej xeem thiab cov yam ntxwv kho mob ntawm cov neeg koom nrog kev kawm.Tsis muaj qhov sib txawv tseem ceeb hauv statistics tau pom nyob rau hauv cov ntsiab lus ntawm pej xeem thiab kev kho mobparameters ntawm cov pab pawg kawm ntawm lub hauv paus. Tsis muaj qhov sib txawv tseem ceebtau pom nyob rau hauv cov txheej txheem kev kho tshuaj siv nyob rau hauv cov neeg koom cov pab pawg kho mob.Cov hauv qab no yog cov tshuaj sib xyaw ua ke ntau tshaj plaws (ntau dua 90 feem pua) uas kawmtau noj thaum lub sij hawm kawm: anticonvulsants (gabapentin), tricyclic antidepressants(duloxetine), anxiolytics / hypnotics (benzodiazepines ntawm kev thov), NSAIDs (ibuprofen ntawmxav tau), thiab opioids (tramadol).

Cov ntaub ntawv raug nthuav tawm raws li txoj kev± standard deviation (SD) rau qhov sib txawv tsis tu ncua thiab muab piv los ntawm Tub Kawm Ntawvt-test, thiab raws li tus naj npawb ntawm cov neeg koom nrog feem pua ​​(feem pua) rau categorical variables thiab muab piv los ntawm Chi-squaredxeem. Cov ntawv luv: BMI, lub cev qhov hnyav; BP, ntshav siab; HR, lub plawv dhia; NSAIDs, non-steroidaltshuaj tiv thaiv kab mob.

3.2. Cov kev hloov pauv hauv kev qaug zog ntawm cov neeg koom nrog

Rooj2 qhia cov neeg koom nrog cov qhab nia rau kev qaug zog kev xav dhau ntawm chav kho mobkawm. Kev nkag siab ntawm kev txawj ntse qaug zog (raws li qhia los ntawm kev hloov pauv hauv kev txawj ntselos ntawm FIS-40) txhim kho tau zoo ntawm 4- thiab 8- lub limtiam mus ntsib los ntawm qhov pib hauvactive pab pawg (p = 0.005 thiabp = 0.010, ntsig). Psychosocial domain qhia ibkev txhim kho nominal nyob rau hauv pab pawg neeg nquag ntawm 4-lub lim tiam mus ntsib, txawm tias tsis ncav cuagstatistical tseem ceeb (p = 0.053).

Rooj 2.Kev qaug zog hnyav (FIS-40 daim ntawv nug) cov qhab nia ntawm cov neeg koom ua tiav qhov kawgkev soj ntsuam.

Cov ntaub ntawv yog muab raws li txoj kev± SD thiab muab piv los ntawm Paired Student'st-test rau kev sib piv hauv pab pawg thiablos ntawm Tub Kawm Ntawvt-test rau cov ntaub ntawv ywj pheej rau kev sib piv ntawm pab pawg. Qib tseem ceeb tau teeb tsa ntawm* p < 0.05="" and="" **="">p < 0.01.="" statistically,="" significant="" differences="" were="" found="" in="" the="" overall="" fis-40="" score="" at="" 4="" weeks="">los ntawm lub hauv paus (p = 0.022) hauv pawg sim. Cov ntawv luv: FIS-40, 40-khoom qaug zog cuam tshuam. qisFIS-40 cov qhab nia qhia txog kev txhim kho ntawm kev qaug zog ntawm cov neeg koom.1 p-nqirau nruab nrab-pab pawgkev sib piv.Hauv pawg CoQ10 ntxiv rau NADH, tag nrho FIS-40 qhab nia tau poob qis ntawm4- mus xyuas lub limtiam los ntawm lub hauv paus (p = 0.022). Txawm li cas los xij, qhov kev txhim kho no tsis tseem ceebntawm qhov kev mus ntsib tom qab los ntawm qhov pib (8 lub lis piam thiab 4 lub lis piam tom qab kev kho mob;p = 0.089 thiabp = 0.071, raws). FIS-40 domain cov qhab nia hloov zuj zus nyob rau hauv qhov sib npaug ntawm cov pab pawg dhau ntawmchav kawm ntawm kev kawm.3.3. Kev hloov pauv hauv Pw tsaug zog zoo thiab kev noj qab haus huv ntsig txog lub neej tom qab CoQ10 Plus NADHSupplementation nyob rau hauv Kev Tshawb Fawb Cov Neeg3.3.1. Pittsburgh Pw tsaug zog zoo IndexRooj3 qhia cov neeg koom nrog cov qhab nia pw tsaug zog zoo tau soj ntsuam siv daim ntawv nug PSQI. Hauv kev txheeb xyuas kev sib piv ntawm pab pawg, txheeb cais, qhov sib txawv tseem ceeb yogtso tawm rau lub sijhawm pw tsaug zog ntawm 4-lub lim tiam tom qab mus ntsib los ntawm qhov pib hauv qhov kev simpab pawg (p = 0.018). Tsis tas li ntawd, nyob rau hauv kev sib piv ntawm pab pawg sib piv, pebpom muaj qhov sib txawv tseem ceeb rau PSQI domains los ntawm lub hauv paus hauv lub sijhawm (tag nrhop-values ​​< 0.05).

Cov ntaub ntawv yog muab raws li txoj kev± SD thiab muab piv los ntawm Paired Student'st-test rau kev sib piv hauv pab pawgthiab los ntawm Student'st-test rau cov ntaub ntawv ywj pheej nyob rau hauv nruab nrab-pab pawg kev txheeb xyuas. Qhov tseem ceeb theem tau teem rau* p <>. Tsis muaj qhov sib txawv tseem ceeb tau tshwm sim hauv cov khoom PSQI ntawm pawg. Cov ntawv luv:PSQI, Pittsburgh pw tsaug zog zoo Performance index. Cov qhab nia PSQI qis qhia tau tias muaj kev txhim kho hauv kev nkag siab ntawm kev pw tsaug zogzoo ntawm cov neeg koom.1 p-nqirau kev txheeb xyuas qhov sib piv ntawm pab pawg.

3.3.2. Daim Ntawv Qhia luv luv 36-Kev Tshawb Fawb Txog Kev Noj Qab Haus HuvRooj4 qhia cov neeg koom nrog cov qhab nia ntawm SF-36 daim ntawv nug. Lub cev lub luag haujlwm ua haujlwm, kev paub txog kev noj qab haus huv, kev loj hlob, kev ua haujlwm hauv zej zog, kev xav lub luag haujlwm,thiab cov xwm txheej ntawm kev puas siab puas ntsws tsis tau qhia qhov sib txawv ntawm cov pab pawgkev sib piv.

Cov ntaub ntawv yog muab raws li txoj kev± SD thiab muab piv los ntawm Paired Student'st-test rau kev sib piv hauv pab pawg thiablos ntawm Tub Kawm Ntawvt-test rau cov ntaub ntawv ywj pheej rau kev sib piv ntawm pab pawg. Qib tseem ceeb tau teeb tsa ntawm* p < 0.05,="">thiab **p < 0.01.="" no="" statistically="" significant="" differences="" were="" found="" in="" any="" sf-36="" items="" in="" the="" between-group="">kev sib piv ntawm lub sijhawm. Cov ntawv luv: SF-36, 36-cov ntawv tshawb fawb txog kev noj qab haus huv. Siab dua SF-36 cov qhab nia qhia tau zoo duakev noj qab haus huv ntsig txog lub neej zoo ntawm cov neeg koom.1 p-tus nqi rau kev txheeb xyuas qhov sib piv ntawm pab pawg.Lub cev ua haujlwm tau pom cov qhab nia zoo dua hauv CoQ10 ntxiv rau NADH pawg;Raws li kev txheeb cais, kev txhim kho tseem ceeb tau pom ntawm ob qho kev mus ntsib los ntawm lub hauv paus hauv pauskev kho mob (4-lub lim tiam thiab 8-lub lim tiam mus ntsib;p = 0.036 thiabp = 0.001, ntsig). Mob lub cevdomain txhim kho nyob rau ntawm 4-lub lim tiam mus ntsib los ntawm lub hauv paus (p = 0.043). Hauv pawg placebo, aKev txo qis hauv qhov tseem ceeb tau pom 4 lub lis piam tom qab kev kho mob tsis tu ncua (p = 0.042). 

3.4. Kev soj ntsuam kev nyab xeeb thiab kev ua siab ntev

Hais txog cov ntaub ntawv kev nyab xeeb, qee qhov kev tsis zoo tau cuam tshuam nrog CoQ10 thiabNADH supplementation [18,39] hauv lwm haiv neeg. Hauv peb txoj kev tshawb fawb ntawm ME / CFS cov neeg mob,Tsis muaj cov xwm txheej cuam tshuam txog kev kho mob cuam tshuam tau raug kaw. Peb fifindings qhiatias qhov ncauj CoQ10 ntxiv rau NADH ntxiv rau yim lub lis piam tau nyab xeeb thiab muaj peev xwmzoo zam los ntawm cov neeg koom.

4. Kev sib tham

Kev siv cov khoom noj khoom haus zoo li cov tshuaj antioxidant kom txo taunce oxidative kev nyuaj siab hauv ME / CFS cov neeg mob tseem muaj teeb meem tsis sib haum xeeb [14]. CoQ 10thiab NADH yog ob tus neeg sib tw tau los siv rau hauv kev kho mob ntawm ME / CFS, thiab tej zaumnyob rau hauv lwm yam mob uas muaj xws li mob nkees nyob rau hauv uas oxidative kev nyuaj siab plays lub luag hauj lwm tseem ceeb,tsawg kawg yog peb lub laj thawj.

Ua ntej, CoQ10 thiab NADH yog bioenergetic cofactors nrog raumuaj peev xwm los txhawb kev ua haujlwm mitochondrial. Thib ob, CoQ10 thiab NADH muaj zog dawbradical scavengers uas tuaj yeem txo cov lipid peroxidation thiab DNA puas los ntawmoxidative kev nyuaj siab; thib peb, lawv muaj zog antioxidant zog [17]. Rau qhov zoo tshaj plaws ntawm peb txoj kev paub, qhov no yog thawj RCT los tshawb xyuas cov txiaj ntsig zoontawm qhov ncauj CoQ10 ntxiv rau NADH supplementation ntawm perceived qaug zog, teeb meem nonrestorative, thiab HRQoL hauv ntau tus neeg nrog ME / CFS. Peb cov txiaj ntsig tau tshwm simtias kev sib xyaw ua ke ntawm CoQ10 ntxiv rau NADH tau muaj txiaj ntsig zoo rau kev nkag siab ntawmqaug zog, pw tsaug zog zoo, thiab HRQoL hauv ME / CFS. Qhov no tau hais txog qhov kev txhim khonyob rau hauv cov qhab nia pom nyob rau hauv intragroup tsom xam, txawm hais tias tsis muaj qhov sib txawv nyob rau hauv lubkev tsom xam ntawm pab pawg.Coenzyme Q10 thiab NADH tsis txaus kuj tau piav qhia hauv tib neegnrog ME / CFS thiab fibromyalgia [26,42], thiab nws tau raug pom zoo tias qib ntshav NADHyog ncaj qha cuam tshuam nrog cov ntshav CoQ10 concentrations hauv cov neeg mob no. CoQ10, ibhu ua ubiquinone, yog cov rog-soluble, vitamin zoo li benzoquinone compound uas yog endogenouslysynthesized los ntawm tyrosine nyob rau hauv tib neeg lub cev.

Nws yog ib feem tseem ceebnyob rau hauv cov metabolism ntawm tag nrho cov hlwb, thiab ib tug tsis txaus CoQ10 yog txuas mus rau lub pathogenesis ntawm antau yam ntawm cov kab mob ntev. Nws yog ib tug muaj zog antioxidant tus neeg sawv cev uas confers kuj mus rau lubmitochondrial kev puas tsuaj tshwm sim los ntawm oxidative thiab nitrosative kev nyuaj siab, thiab nws kuj pab raws liib qho tshuaj tiv thaiv kab mob, cuam tshuam rau ATP synthesis thiab nitric oxide preservation [14]. Cov tshuaj tiv thaiv kab mob ntev ntev thiab cov tshuaj nitrosative thiab oxidative kev nyuaj siab hauv ME / CFSCov neeg mob ua rau muaj teeb meem xws li lub hlwb hypoperfusion / hypometabolism, neuroinflamMation, DNA puas, mitochondrial tsis ua hauj lwm, theem nrab autoimmune tebqhia tawm tsam cuam tshuam cov proteins thiab lipid daim nyias nyias, thiab ua haujlwm tsis zoointracellular signaling pathways [15]. Kev tswj hwm ntawm NADH ib leeg [43] thiab ua ke nrog CoQ10 [27,28] muajtau pom tias txo kev qaug zog ntawm cov neeg uas muaj ME / CFS. Txawm li cas los xij, txawm tias cov kev tshawb fawb notau tshaj tawm cov txiaj ntsig zoo, tsis muaj leej twg tau tshaj tawm txog cov yam ntxwv ntawm kev noj zaub mov kom tsawg,thiab qhov no tej zaum yuav cuam tshuam cov txiaj ntsig.

Nrog rau kev qaug zog ntev, cov tsos mob tseem ceeb tshaj plaws ntawm ME / CFS yog intolerance raukev tawm dag zog lub cev / lub hlwb (tom qab ua haujlwm tsis zoo), kev hloov pauv hauv kev xav / nco,pw tsaug zog nonrestorative, orthostatic intolerance, thiab generalized mob ntev [1]. Muab rauCov chav kawm ntuj rau kev mob ntev hauv ME / CFS, peb xav txog cov txiaj ntsig tau txais hauv peb txoj kev kawmua qhov tseem ceeb. Peb lees paub tias CoQ10 ntxiv rau NADH supplementation muaj txiaj ntsig zoontawm kev nkag siab ntawm kev txawj ntse qaug zog, nrog kev txhim kho tseem ceeb ntawm 4- thiab 8- mus ntsib(p < 0.001)="" compared="" to="" baseline.="" likewise,="" our="" dietary="" nutraceutical="" combination="" may="" have="">cuam ​​tshuam rau tag nrho FIS-40 tus qhab nia sau npe—txo nws ntawm 4-lub lim tiam mus ntsib los ntawm qhov pib(p = 0.022), txawm hais tias qhov sib txawv tsis tseem ceeb thaum kawg ntawm kev mus ntsib (8-lis vs. baseline,p = 0.08)—thiab tseem muaj lub siab lub ntsws, uas qhia tau tias muaj cimkev txhim kho ntawm 4-lub limtiam mus ntsib (txawm tias tseem tsis tau ncav cuag qhov tseem ceeb piv rau qhov pib,p = 0.05) nyob rau hauv pab pawg sim.

Hauv kev tshawb fawb yav dhau los ua los ntawm peb pab pawg thiablwm tus, nrog rau kev cuam tshuam nutraceutical los ntsuas mitochondrial tsis ua haujlwm hauv ME / CFS,qaug zog yog qhov kawg ntawm yim ntawm cuaj txoj kev tshawb fawb [28,43–49]. Ntawm cov kev tshawb fawb no,tsib pom qhov sib txawv tseem ceeb hauvQhov tsis sib xws ntawm cov kev tshawb fawb no yuav yog vim muaj qhov sib txawv ntawm ME / CFSpej xeem (piv txwv li, sociodemographic thiab kev kho mob yam ntxwv ntawm cov neeg mob, diagnosticCov txheej txheem siv, muaj kev sib txawv ntawm kev noj qab haus huv comorbid, thiab pharmacological thiabCov kev kho mob uas tsis yog tshuaj kho mob), cov qauv me me, thiab kev kawm luv luvntev, ntawm lwm yam.Hauv kev sim ntawm cov nas, kev kho CoQ10 txhim kho kev paub tsis meej los ntawm kev hloov khomitochondrial kev ua haujlwm thiab tau txais txiaj ntsig zoo hauv kev tiv thaiv kev puas hlwbthiab neurodegeneration hauv kev sim tsiaj qauv [50,51]. Fukuda et al. [44] xavuas ubiquinol-10 supplementation tuaj yeem txhim kho kev puas hlwb los ntawm kev hloov pauvlub zog reserves hauv ME/CFS, thiab Dumont li al. [52] tau tshaj tawm tias kev tswj hwm CoQ10txhim kho kev txawj ntse nyob rau hauv ib tug transgenic nas qauv ntawm Alzheimer tus kab mob.Cov kev sim tshuaj ntsuam xyuas tau pom tias cov tshuaj hloov qhov ncauj ntawm CoQ10 ntxiv / lossisNADH txo qis kev xav qaug zog thiab lwm yam tsos mob cuam tshuam nrog mob ntevkab mob. Ntau cov kev tshawb fawb hauv cov neeg mob fibromyalgia [42] tau tshaj tawm txog kev txhim khohauv kev mob ntev, qaug zog, thiab HRQoL, thiab kev tshawb fawb hauv lwm yam kab mob neuroimmune xws liRaws li remitting-relapsing ntau yam sclerosis tau pom qhov ua tau zoo ntawm CoQ10kev tswj hwm hauv kev txo qishauv vivoo thiab oxidative kev nyuaj siab, thiab nyob rau hauv kev txhim khoqaug zog thiab ntxhov siab vim / kev nyuaj siab cov tsos mob [52,53]. Raws li cov kev tshawb pom no, muaj peev xwm tshiabCov tswv yim kho mob tam sim no xav tau sai sai [54].

Peb qhov kev sib piv sib piv hauv pab pawg pom tau tias ME / CFS cov neeg mob ntxivnrog CoQ10 ntxiv rau NADH tau pom tias muaj kev nce ntxiv hauv lub cev ua haujlwmntawm SF-36 ntawm ob qhov kev mus ntsib. Cov txiaj ntsig no yog qhov txaus siab, vim tias peb qhov kev tshuaj xyuas ntawm covCov ntaub ntawv tshawb fawb tau qhia txog kev txhim kho hauv kev noj qab haus huv ntsig txog lub neej tom qab CoQ10kev tswj hwm hauv lwm yam mob ntev xws li fibromyalgia thiab Gulf WarSyndrome [55,56], tab sis tsis nyob hauv ME / CFS.Nyob rau hauv pawg dav ntawm neurological manifestations ntawm ME / CFS, cov khoom ntawmQhov mob dav dav sawv tawm, ob qho tib si hauv cov ntsiab lus ntawm ME / CFS thiab nyob rau hauv cov ntaub ntawv ntawm comorbidfibromyalgia [57]. Hauv peb txoj kev tshawb fawb, CoQ10 ntxiv rau NADH supplementation induced antxhim kho qhov mob ntawm lub cev ntawm SF-36 daim ntawv nug ntawm 4-lub lim tiamkev kho mob los ntawm lub hauv paus hauv paus hauv cov neeg koom nrog kev kawm. Kev kawm yav dhau los los ntawm peb pawg rausoj ntsuam qhov mob ntev siv daim ntawv nug McGill Pain pom tsis muaj kev hloov pauv hauv qhov mobME/CFS cov neeg koom [28].

Hauv cov neeg mob nrog ME / CFS, kev pw tsaug zog tsis zoo ua rau muaj kev hloov pauv tseem ceeb hauv kev pw tsaug zogzoo [58]. Peb cov txiaj ntsig tau pom tias CoQ10 ntxiv rau NADH kev tswj hwm tau txhim khokev nkag siab ntawm kev pw tsaug zog zoo, ua kom pom cov kev tshawb pom tshiab uas txawv ntawm qhov tau hais tsegkev kawm ua ntej los ntawm peb pawg [28], uas kuj siv tib daim ntawv nug PSQI validated.Ntawm qhov tsis sib xws, kev kawm hauv cov qub tub rog nrog Gulf War Syndrome, uas muaj qhov sib xwsrau ME/CFS, pom tias tsuas yog CoQ10 supplementation txhim kho cov tsos mob ntawm lub cevua haujlwm tab sis tsis muaj txiaj ntsig zoo rau kev pw tsaug zog zoo [55]. Cov kev tshawb fawb yav dhau los tshawb xyuas cov txiaj ntsig kho mob tau zoo ntawm CoQ10 supplementationnyob rau hauv lub plawv tsis ua hauj lwm (HF) tau ua nyob rau hauv ob peb xyoos dhau los. Cov kev tshawb pom muajqhia txog kev txhim kho hauv bioenergetic thiab kev ua haujlwm qib thiab endothelial muaj nuj nqi hauvcov neeg mob HF no [59,60]. Cov ntawv tshaj tawm yav dhau los tau qhia tias kev noj zaub mov zoo xws li CoQ10 lossis NADHmuaj kev nyab xeeb thiab zoo zam [18]. Peb cov txiaj ntsig tau lees paub cov kev soj ntsuam no thiab qhia tiasCov koob tshuaj nruab nrab ntawm cov molecules no tuaj yeem muaj kev nyab xeeb ntxiv rau kev kho cov pa hauv ME / CFSqaug zog theem tom qab muaj kev cuam tshuam [28,46–49]; Txawm li cas los xij, lwm tus kws sau ntawv tau tshaj tawm tsis muaj kev hloov pauv tseem ceeb hauv qib qaug zog hauv ME / CFS [44,45].

Txoj kev tshawb no muaj qee qhov kev txwv uas yuav tsum tau xav txog. Ua ntej, thawj qhov kawg, kev xaav ntawm kev qaug zog sau tseg los ntawm FIS-40 daim ntawv nug, yog cov ntsiab lusparameter. Hauv kev ua haujlwm yav tom ntej, lub hom phiaj physiological thiab biological tsis muaj peev xwm yuav yogsiv, xws li qhov siab tshaj plaws oxygen noj thiab lactate/glucose qib thaum lub sij hawm thiabtom qab ua qhov kev sim cardiopulmonary challenge (2-hnub sib law liag CPET).

Thib ob,muaj kev txwv cuam tshuam nrog kev tsim qauv, kev tshawb fawb, thiab cov neeg koom nrogxaiv. Qhov tseeb tias txhua tus neeg mob yog Caucasian ME / CFS cov poj niam thiab raug xaivlos ntawm ib lub chaw xa mus rau tertiary tej zaum yuav tau nce qhov feem ntawm cov mob hnyavcov neeg mob, thiab peb yuav tsum ceev faj thaum muab cov txiaj ntsig no rau lwm tus neeghauv lwm qhov chaw kho mob xws li kev saib xyuas thawj zaug lossis cov pej xeem.

Thib peb, qhov tsis muajntawm qhov sib txawv ntawm kev txheeb cais pom ntawm cov pab pawg tuaj yeem yog vim cov placebocov nyhuv (phosphatidylserine thiab vitamin C li excipients). Thaum kawg, cov koob tshuaj thiab ua rawsLub sij hawm ntawm kev cuam tshuam tau tsim ua ntej, yog li qhov kev siv tshuaj tiv thaiv tsis tuaj yeemraug saib xyuas thiab sau tseg ntawm cov neeg koom nrog kev kawm.

Txawm li cas los xij, peb txoj kev tshawb fawb kuj muaj qee qhov tseem ceeb ntawm lub zog:

(1) Analysis ntawm combiLub teb chaws ntawm CoQ10 ntxiv rau NADH ua cov khoom noj khoom haus ntxiv hauv ME / CFS, nrog rau kev suav nrogntawm ib tug loj tus naj npawb ntawm cov neeg koom

(2) kev txhim kho hauv kev xaav ntawm cognitiv thaiv kev qaug zog thiab kev noj qab haus huv ntsig txog lub neej ua tiav los ntawm kev sib xyaw ntawm CoQ10 ntxivNADH

(3) homogeneous inclusion qauv los ntawm 1994 CDC/Fukuda txhais,

subgroups, raws li cov kev kuaj mob, cov tsos mob ntawm neurological, comorbid noj qab haus huv tej yam kev mob, thiab pharmacological thiab non-pharmacological kev kho mob), thiab nrogcov lus pom zoo kom noj zaub mov zoo. Peb kuj txhawb cov kev tshawb fawb mus sij hawm ntev nrog rauLub hom phiaj physiological thiab lom cov cim qhia, xws li kev noj cov pa oxygen(VO2 raws li "tus qauv kub" ntsuas) thiab lactate / glucose ratio tom qab ergospirometryprovocation xeem, thiab kev ntsuam xyuas ntawm cov ntaub ntawv ceev ceev siv computerizedKev ntsuam xyuas neuropsychological txhawm rau txheeb xyuas cov txiaj ntsig zoo ntawm kev kho antioxidant hauvcov neeg nrog ME / CFS.

Rau qhov zoo tshaj plaws ntawm peb txoj kev paub, qhov no yog thawj txoj kev tshawb fawb los ntsuas qhov cuam tshuam ntawm qhov ncaujCoQ10 ntxiv rau NADH supplementation muab rau ntau tus lej ntawm ME / CFScov neeg mob (n = 207). Peb qhov kev tshawb pom qhia tias, dhau ob lub hlis, qhov kev sib xyaw no yogmuaj peev xwm ua tau zoo hauv kev txo qis kev qaug zog (tseem hu ua "pob hlwb") thiab tag nrhokev xav qaug zog, yog li txhim kho HRQoL hauv ME / CFS.

Txoj kev tshawb no qhia tias CoQ10thiab NADH tuaj yeem koom nrog kev tswj hwm zoo rau ME / CFS cov neeg mob thiab feem ntau zoo-tolerated ntawm cov koob tshuaj qhia. Ib qho kev kho mob kuj tshwm sim thaum pw tsaug zogzoo nyob rau hauv pawg sim. Lub sijhawm ntev RCTs nyob rau hauv loj dua ME / CFS pawg yuav tsum

tam sim no tau ua kom paub meej tias qhov ua tau zoo ntawm CoQ10 thiab NADH co-supplementationnyob rau hauv kev kho cov tsos mob ntawm tus mob tom qab exertional malaise siv ob hnub sib law liagKev kuaj mob plawv (2-hnub CPET).

Nrhiav qhov zoo tshaj plaws BOTANICAL HOLISTIC CARE rau Nerve Pain

Peb ua tib zoo xuas tes ua Neuro Regen mis muaj xws li tshuaj ntsuab tshawb fawb zoo tshaj plaws. Txhua qhov qhia tau hais tias muaj peev xwm zoo rau kev tswj cov hlab ntsha, ntxiv rau cov paj hlwb thiab cov neuron txhawb nqa tag nrho.

Xws li:

Flavonoidsyog ib hom tshuaj suav tshuaj ntsuab hauv peb lub neej txhua hnub.Flavonoids, tshwj xeeb tshaj yog dihydromyricetin, tswj lub cev lub zog thiab txhim kho lub cev tiv thaiv kab mob.Flavonoidstuaj yeem tshem tawm cov khib nyiab thiab cov dawb radicals hauv cov hlab plawv, tshem tawm cov kab mob thiab cov kab mob cab, Kho cov ntaub so ntswg ua pa thiab cov ntaub so ntswg puas, thiab induce qog cell apoptosis, thiab cov ntsiab lus siab.flavonoidstuaj yeem kho cov ntaub so ntswg hauv lub cev, thiab txhawb cov metabolism, tswj cov hluas, thiab kev noj zaub mov zoo hauv lub cev. Nyob rau tib lub sijhawm, flavonoids tuaj yeem tshem tawm cov kev tawm dag zog hnyav los ntawm kev ua haujlwm dhau sijhawm nyob lig. Dawb radicals, yog li tshem tawm lub cev qaug zog thiab txhim kho lub cevtiv thaiv kab mob.