音乐疗法对心力衰竭患者的干预效果:系统评价和Meta分析  

Effectiveness of music therapy intervention in patients with heart failure:systematic review and Meta analysis

作　　者：李姗 马超 张超[2] 王楠[2] 李佳雪 LI Shan;MA Chao;ZHANG Chao;WANG Nan;LI Jiaxue(Nursing School of Xinjiang Second Medical College,Kelamayi 834000,China;Xinjiang Kelamayi Central Hospital,Kelamayi 834000,China)

机构地区：[1]新疆第二医学院护理学院,新疆维吾尔自治区克拉玛依市834000 [2]新疆克拉玛依市中心医院,新疆维吾尔自治区克拉玛依市834000

出　　处：《护理实践与研究》2025年第3期414-422,共9页Nursing Practice and Research

基　　金：克拉玛依市科技局创新环境建设计划(创新人才)基金资助项目(编号:20212022hjcxrc0046)。

摘　　要：目的评价音乐疗法对心力衰竭患者心功能、负性情绪、生活质量和疲乏的影响。方法计算机检索PubMed、Embase、CINAHL、Web of Science、中国知网、万方数据库等9个中英文数据库和临床试验注册平台,检索时限为从建库至2023年6月12日。纳入音乐疗法对心力衰竭患者心功能、生活质量和负性情绪等干预效果的随机对照试验。由2名研究者独立进行文献筛选、资料提取、使用Cochrane手册最新推荐偏倚风险评估工具2.0对纳入研究进行质量评价,采用RevMan 5.4进行Meta分析。结果共纳入12篇文献,包括931例患者。Meta分析结果显示,音乐疗法有助于改善心力衰竭患者的左室射血分数[SMD=6.46,95%CI(1.81,11.10),P=0.006]、峰值摄氧量[SMD=3.94,95%CI(2.45,5.42),P<0.001]、生活质量[SMD=-6.61,95%CI(-8.74,-4.47),P<0.001]、焦虑情绪[SMD=-2.25,95%CI(-3.55,-0.95),P<0.001]和抑郁情绪[SMD=-1.80,95%CI(-2.75,-0.86),P<0.001],但在疲乏症状[SMD=-1.18,95%CI(-2.85,0.49),P=0.170]方面差异无统计学意义(P>0.05),对疲劳的干预效果尚不明确。结论音乐疗法可改善心力衰竭患者的心脏功能、负性情绪,提高患者的生活质量。因此,护士可建议患者接受音乐疗法,也可将音乐疗法与运动训练、中医疗法相结合使用。由于研究数量较少,干预措施具有较大的异质性,还需更多大样本且高质量的研究进行验证。Objective To evaluate the effects of music therapy on cardiac function,negative emotions,quality of life and fatigue in patients with heart failure.Methods Nice Chinese and English databases including PubMed,Embase,CINAHL,Web of Science,China National Knowledge Infrastructure,Wanfang database and clinical trial registration platforms,with a search timeframe from the time of database construction to 12 June 2023 by computer.Randomised controlled trials on the intervention effects of music therapy on cardiac function,quality of life and negative mood in patients with heart failure were included.Literature screening,data extraction,quality assessment of the included studies using the Cochrane Handbook's latest recommended risk of bias assessment tool 2.0,and Metaanalysis operated by RevMan 5.4 were performed independently by 2 researchers.Results A total of 12 papers,including 931 patients,were included.Meta analysis showed that music therapy helped to improve left ventricular ejection fraction[SMD=6.46,95%CI(1.81,11.10),P=0.006],peak oxygen uptake[SMD=3.94,95%CI(2.45,5.42),P<0.001],quality of life[SMD=-3.94,95%CI(2.45,5.42),P<0.001],and quality of life[SMD=-3.94,95%CI(2.45,5.42),P<0.001]in heart failure patients,quality of life[SMD=-6.61,95%CI(-8.74,-4.47),P<0.001],anxiety[SMD=-2.25,95%CI(-3.55,-0.95),P<0.001]and depression[SMD=-1.80,95%CI(-2.75,-0.86),P<0.001].However,the difference in fatigue symptoms[SMD=-1.18,95%CI(-2.85,0.49),P=0.170]was not statistically significant(P>0.05),and the effect of the intervention on fatigue is unclear.Conclusion Music therapy can improve cardiac function,negative emotions,and quality of life in patients with heart failure.Therefore,nurses may recommend that patients receive music therapy,or music therapy may be used in combination with exercise training and Chinese medicine.Due to the small number of studies and the large heterogeneity of interventions,more large-sample and high-quality studies are needed for validation.

关 键 词：音乐疗法 心力衰竭 心功能 生活质量 负性情绪 

分 类 号：R473.54[医药卫生—护理学]