五行音乐对卒中后抑郁患者干预效果的系统评价  

Five elements of music therapy for post-stroke depression:a systematic review

作　　者：戴晓凤[1] 陈剑明[2] 方凤贞 罗宝英[1] 李壮苗[1] 

机构地区：[1]福建中医药大学护理学院,福建福州350122 [2]福州市第二医院马尾分院内科

出　　处：《护理学杂志》2015年第15期97-101,共5页

基　　金：福建中医药大学重点学科专项(X2014068-学科)

摘　　要：目的系统评价五行音乐对卒中后抑郁(PSD)患者的干预效果。方法以The Cochrane Library、Pubmed、Web of Science、Science Direct、CNKI、VIP和WanFang Data等数据库为主要数据来源,检索有关五行音乐干预卒中后抑郁的随机对照试验及临床对照试验,检索时限均为从建库至2015年3月15日。由2名研究员按照纳入和排除标准筛选文献、提取资料、评价质量,采用RevMan 5.1软件进行Meta分析。结果最终纳入9项研究,共777例患者。Meta分析结果显示:与对照组相比,五行音乐组在总有效率、生活自理能力Barthel指数(BI)评分及降低汉密尔顿抑郁量表(HAMD)17项评分方面优于对照组,其差异有统计学意义(均P<0.05);在降低患者HAMD 24项评分及血浆5-羟色胺(5-HT)水平方面,差异无统计学意义(均P>0.05)。结论五行音乐对减轻PSD患者抑郁症状的严重程度有辅助作用,在一定程度上提高患者生活自理能力,但不能改善PSD患者抑郁的病理症状;此外,关于血浆5-HT是否可作为衡量PSD程度的有效生化指标,有待考证。受纳入研究质量和数量的限制,上述结论尚需更多大样本、多中心、高质量的随机对照试验加以验证。Objective To systematically review the intervention of Five elements of music therapy in patients with post-stroke depression （PSD）. Methods Literature search was conducted in such databases as The Coehrane Library, PubMed, Web of Science, Science Direct, CNKI, VIP and WanFang Data, etc. from the dates of establishment to March 15,2015. Randomized controlled trials （RCTs） and clinical controlled trials（CCTs） on Five elements music therapy for patients with PSD were included. Then, me- ta-analysis was performed using RevMan 5.1 software. Results A total of 9 studies involving 777 patients were included. The results of meta-analysis showed that, the Five elements music group was superior to the control group in total effective rate, Barthel Index（BI） score, the score of 17-item Hamilton＇s Depression Scale, with significant differences （P〈0.05 for all）. However,there was no statistical difference in reducing the score of 24-item Hamiltonr s Depression Scale and the level of Plasma 5 hydroxytryptamine（5-HT） between the two groups （P〉0.05 for all）. Conclusion Five elements of music therapy could reduce the severity of depression in PSD patients, to a certain extent, improve the patientsr self-care ability, but cannot improve the pathological symptoms of PSD. In addition, whether plasma 5-HT can be used as an effective biochemical indicators to measure the degree of PSD, remains to be proven. However, due to the limitation of quantity and quality of the included studies, this aforementioned conclusion should be further confirmed by conducting more large-scale high quality RCTs.

关 键 词：五行音乐 卒中后抑郁 生活自理能力 5-羟色胺 系统评价 

分 类 号：R473.74[医药卫生—护理学] R195.1[医药卫生—临床医学]