叙事护理联合五行音乐之角调式乐曲干预肝气郁结型维持性血液透析患者焦虑、抑郁的效果  

The Effect of Narrative Nursing Combined with Jue Tone of TCM Five-Element Music Therapy on Anxiety and depression status in maintenance hemodialysis patients of liver qi stagnation syndrome

作　　者：金敏燕 张巧萍 储媛媛 李慧敏 范军芬[1] JIN Min-Yan;ZHANG Qiao-Ping;CHU Yuan-Yuan(The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310018,Zhejiang,China)

机构地区：[1]浙江中医药大学附属第一医院浙江省中医院,浙江杭州310018

出　　处：《吉林医学》2025年第2期463-468,共6页Jilin Medical Journal

基　　金：浙江省中医药科技计划项目[项目编号:2022ZB139]。

摘　　要：目的:探讨叙事护理联合五行音乐之角调式乐曲干预肝气郁结型维持性血液透析(MHD)患者焦虑、抑郁的临床效果。方法:选取浙江中医药大学附属第一医院2021年1月~2023年1月收治的90例肝气郁结型MHD患者为研究对象,随机分为对照组、五行音乐组与联合组各30例,对照组实施常规护理干预,五行音乐组在对照组基础上增加五行音乐之角调式乐曲干预,联合组在五行音乐组基础上增加叙事护理干预。比较三组干预前后焦虑情绪、抑郁情绪、睡眠质量及中医症状评分变化。结果:干预6周、12周后,联合组汉密尔顿焦虑量表(HAMA)评分低于五行音乐组和对照组,五行音乐组低于对照组(P<0.05)。干预6周、12周后,联合组汉密尔顿抑郁量表(HAMD)评分低于五行音乐组与对照组,五行音乐组低于对照组(P<0.05)。干预6周、12周后,联合组匹兹堡睡眠质量指数量表(PSQI)评分低于五行音乐组与对照组,五行音乐组低于对照组(P<0.05)。干预12周后,联合组失眠多梦、沉默寡言、善太息中医症状评分均低于五行音乐组和对照组,五行音乐组均低于对照组(P<0.05)。结论:叙事护理联合五行音乐之角调式乐曲能有效改善肝气郁结型MHD患者焦虑、抑郁情绪及睡眠质量,减轻中医症状。Objective To explore the effect of narrative nursing combined with Jue tone of TCM five-element music therapy on anxiety and depression in maintenance hemodialysis(MHD)patients of liver Qi stagnation syndrome.Method Ninety MHD patients of liver Qi stagnation syndrome in our hospital from January 2021 to January 2023 were selected as research object,and randomly assigned into the control group 30 cases,the music group 30 cases and the combined group 30 cases.Control group adopted routine nursing intervention,based on this,music group was given Jue tone of TCM five-element music therapy,while combined group received Jue tone of TCM five-element music therapy plus narrative nursing.Then the anxiety,depression,sleep quality,and TCM syndrome scores before and after intervention were compared among three groups.Results After 6 weeks and 12 weeks of intervention,Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Rating Scale(HAMA)and Pittsburgh Sleep Quality Index(PSQI)among the three groups were the lowest in combined group,followed by music group,and were the highest in control group,with statistical difference(P<0.05).After 12 weeks of intervention,TCM syndrome scores including insomnia,dreaminess,reticence and frequent sighing were the lowest in combined group,followed by music group,and were the highest in control group,with statistical difference(P<0.05).Conclusion Application of narrative nursing combined with Jue tone of TCM five-element music therapy in MHD patients of liver Qi stagnation syndrome can effectively alleviate the anxiety and depression,improve the sleep quality and ameliorate the TCM syndromes,which is worthy of recommendation.

关 键 词：维持性血液透析 叙事护理 五行音乐 角调式乐曲 肝气郁结型 焦虑抑郁 

分 类 号：R459.5[医药卫生—治疗学]