摘要
背景 阿尔茨海默病(AD)作为一种神经系统退行性疾病,发病率高,病情发展快,严重影响着患者的生活质量.近年来,音乐治疗干预AD的研究逐渐增多,但缺乏有效的系统评估与分析.目的 对音乐治疗AD患者认知、情绪、生活能力、睡眠障碍等方面的干预效果进行Meta分析.方法 计算机检索中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普网(VIP)、Medline、Elsevier Science Direct、PubMed、Embase中关于音乐治疗方法对AD患者干预效果的随机对照试验(RCT),检索时限为建库至 2023 年 2 月,采用RevMan 5.3 软件进行数据分析.结果 研究纳入15篇RCT文献,共1 077例患者.Meta分析结果显示:音乐干预组对AD患者认知功能(MD=4.35,95％CI=1.64～7.05,Z=3.15,P=0.002)、负性情绪(SMD=-0.71,95％CI=-1.26～-0.15,Z=2.51,P=0.01)、生活能力(SMD=-0.91,95％CI=-1.55～-0.27,Z=2.77,P=0.006)干预效果优于对照组;两组在睡眠障碍干预效果方面比较,差异无统计学意义(MD=-1.04,95％CI=-3.10～1.02,Z=0.99,P=0.32).亚组分析结果显示,治疗周期<12周(P=0.01)、治疗时长<45 min/次(P=0.02)、治疗频次≥3次/周(P<0.001)、实施方式为个体(P<0.001)、实施方式为个体+团体(P=0.002)、干预措施为接收式音乐治疗(P<0.001)的音乐干预组对认知功能的干预效果优于对照组.治疗周期≥12 周(P=0.004)、治疗频次<3 次/周(P=0.01)、实施方式为个体+团体(P=0.02)、干预措施为接收式音乐治疗(P=0.002)、干预措施为主动式音乐治疗(P=0.002)的音乐干预组对负面情绪的干预效果优于对照组.结论 音乐治疗能够改善AD患者认知功能、精神状况,提升患者日常生活能力.但由于纳入研究质量不高,仍需要借助更多大样本、高质量的循证研究加以验证.
Abstract
Background As a neurodegenerative disease,Alzheimer's disease(AD)has a high incidence rate and rapid development,which seriously affects the quality of life of patients.In recent years,research on music therapy intervention in AD has gradually increased,lacking effective systematic evaluation and analysis.Objective A meta-analysis was conducted on the intervention effects of music in the treatment of cognition,emotion,living ability and sleep disorders in AD patients.Methods Randomized controlled trials(RCT)on the intervention effect of music therapy methods on Alzheimer's patients were searched by computer in CNKI,Wanfang Data,VIP,Medline,Elsevier Science Direct,PubMed,and Embase from inception to February 2023,and the data was analyzed using RevMan 5.3 software.Results The study included 15 RCTs with a total of 1 077 patients.The results of Meta-analysis showed that the intervention effects of music therapy on cognitive function(MD=4.35,95％CI=1.64 to 7.05,Z=3.15,P=0.002),negative emotion(SMD=-0.71,95％CI=-1.26 to-0.15,Z=2.51,P=0.01),life ability(SMD=-0.91,95％CI=-1.55 to-0.27,Z=2.77,P=0.006)in the music therapy group was better than that of control group.There was no significant difference in sleep disorder intervention between the two groups(MD=-1.04,95％CI=-3.10 to 1.02,Z=0.99,P=0.32).Subgroup analysis showed that the music therapy groups with treatment period was<12 weeks(P=0.01),treatment duration<45 min/time(P=0.02),treatment frequency≥3 times/week(P<0.001),individual implementation method(P<0.001),individual+group implementation method(P=0.002),receiving music therapy as the intervention method(P<0.001)had better intervention effect on cognitive function than the control group;the music therapy groups with treatment period≥12 weeks(P=0.004),treatment frequency<3 times/week(P=0.01),implementation method of individual+group(P=0.02),intervention measure of receiving music therapy(P=0.002),intervention measure of active music therapy(P=0.002),had better intervention effect on negative emotions than the control group.Conclusion Music therapy can improve the cognitive function,mental state,and daily self activity of AD patients.However,due to the low quality of case studies included,more large-scale and high-quality evidence-based studies are still needed to verify.
基金项目
国家自然科学基金面上项目(71774127)
教育部人文社科规划基金项目(17YJAZH122)
国家科技期刊平台
NSTL
万方数据