五音具象催眠技术治疗中风后阈下抑郁疗效  

Effect of Five Elements Music Concrete Hypnosis Technique on Subthreshold Depression after Stroke

作　　者：张佳乐 周霞[2] 刘建宪[2] 钱前[2] 王芹[2] 王振松[2] ZHANG Jiale;ZHOU Xia;LIU Jianxian;QIAN Qian;WANG Qin;WANG Zhensong(The First Affiliated Hospital,Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250014,China;The Second Affiliated Hospital,Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250001,China)

机构地区：[1]山东中医药大学第一临床学院,山东济南250014 [2]山东中医药大学第二附属医院,山东济南250001

出　　处：《康复学报》2022年第6期482-488,共7页Rehabilitation Medicine

基　　金：国家重点研发计划中医药现代化研究项目(2018YFC1706005);山东中医药大学院级课题(2021Y-08)。

摘　　要：目的:观察五音具象催眠技术对中风后阈下抑郁患者抑郁心境状态、躯体运动功能、日常生活活动能力的影响。方法:选择在山东中医药大学第二附属医院就诊的78例中风后阈下抑郁患者,采用随机数字表法分为对照组和观察组,每组39例。治疗过程中,对照组、观察组分别脱落/中止3例、1例,最终对照组纳入36例,观察组纳入38例。对照组在常规治疗基础上由未经心理专业培训的医护人员给予个体化的情感支持。观察组在常规治疗基础上给予“五音具象催眠技术”干预,由专业心理技术人员录制角调五行音乐背景中的催眠放松及动作引导语,在音乐情境中由治疗师引导患者进行运动想象训练。2组均治疗30 min/次,1次/d,每周6次,共持续治疗4周。分别于治疗前、治疗4周后采用汉密尔顿抑郁量表17项(HAMD-17)和流行病学研究中心抑郁量表(CES-D)评价患者抑郁心境状态;采用Fugl-Meyer运动功能评分量表(FMA)评价躯体运动功能;采用改良巴氏指数(MBI)量表评价日常生活活动能力。另纳入观察组12例患者接受静息态功能磁共振(rs-fMRI)检查,观察脑区激活范围。结果:与治疗前比较,2组治疗后HAMD-17、CES-D评分均明显降低,FMA和MBI评分均明显提高,差异均具有统计学意义(P<0.05)。与对照组比较,观察组治疗后HAMD-17、CES-D评分均明显降低,FMA、MBI评分均明显升高,差异均具有统计学意义(P<0.05)。与治疗前比较,观察组治疗后枕叶视皮质、扣带回后部、皮质区等周围脑区(Brodman分区18,30,31)处于激活状态。结论:五音具象催眠技术可有效改善中风后阈下抑郁患者的抑郁心境状态、躯体运动功能及日常生活活动能力,这可能与枕叶视皮质、扣带回后部、皮质区激活有关。Objective:To observe the effect of five elements music concrete hypnosis technique on depressive mood state,somatic motor function and activities of daily living of patients with subthreshold depression after stroke.Methods:A total of 78 patients with subthreshold depression after stroke in the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control group and observation group,with 39 cases in each group.During the treatment,a total of 3,1 case fell off/stopped in the control group and the observation group respectively.Finally,a total of 36,38 cases were included in the control group and the observation group respectively.The control group received individualized emotional support from medical staff with no professional psychological training an conventional treatment.The observation group received five elements music concrete hypnosis technique intervention on the basis of conventional treatment.The hypnotic relaxation and movement guidance language in the background of Jue tune of five element music were recorded by professional psychological technicians,and the patients received motor imagination training in the music background under the guidance of therapists.Both groups were treated for 30minutes a time,once a day,six times a week,lasting for four weeks.Before treatment and four weeks after treatment,the Hamilton depression scale 17(HAMD-17) and the center for epidemiologic studies depression scale(CES-D) were used to evaluate the depressive mood state of patients;the Fugl-Meyer assessment(FMA) was used to evaluate somatic motor function;the modified Barthel index(MBI) scale was used to evaluate the ability of activities of daily living.In addition,12 patients in the observation group underwent resting-state functional magnetic resonance imaging(rs-fMRI) to observe the activation range of brain regions.Results:Compared with those before treatment,the scores of HAMD-17 and CES-D of both groups decreased significantly after treatment,and the scores

关 键 词：中风 脑卒中 阈下抑郁 五行音乐 具象思维 想象运动 催眠 角调 

分 类 号：R255.2[医药卫生—中医内科学] R277.7[医药卫生—中医学]