音乐疗法对脑瘫患儿针灸治疗中焦虑和疼痛的影响

A study of effects of music therapy on anxiety and pain in the treatment of children with cerebral palsy with acupuncture

目的探讨音乐疗法对脑瘫患儿针灸治疗中焦虑和疼痛的影响。方法将46例脑瘫患儿随机分成两组：A组为音乐干预治疗组，B组为对照组。A组患儿在针刺过程中予聆听音乐，乐曲为患儿所喜爱的儿歌。对照组只予针灸治疗，不予聆听音乐。留针30min，期间不转针。分别记录46名患儿针刺前和针后1min、15min及拔针后的BP、HR、RR和SPO2。同时，以mYPAS评估针刺前和针后1min、15min及拔针后患儿的焦虑状态，以CHEOPS和FACES评估患儿的针灸后疼痛情况。结果针刺后1min两组间MAP、HR升高比较无明显差异性（P〉0．05）；针刺15rainA组的HR较针刺前差异无显著性（P〉0．05），对照组的HR较针刺前非常显著升高（P〈0．01）；拔针后两组MAP、HR均非常显著升高（P〈0．01），但A组MAP、HR升高不如对照组明显。两组患儿针刺后1minmYPAS评分均非常明显高于针刺前（P〈0．01），两组比较差异无显著性（P〉0．05）；针刺15rainA组mYPAS评分与针刺前差异无显著性（P〉0．05），与B组比较差异有非常显著性（P〈0．01）；两组拔针后mYPAS评分非常明显高于针刺前（P〈0．01），但B组升高明显（P〈0．05）。A组CHEOPS评分或FACES评分基本满意率均高于对照组。结论音乐疗法不能短时间内缓解患儿的焦虑、疼痛感，但能在患儿停止哭闹后经音乐治疗师的引导开始专心聆听音乐，从而明显缓解其紧张焦虑情绪和疼痛感。试验还观察到音乐疗法干预脑瘫患儿针灸时的焦虑情绪和疼痛感可能与音乐治疗能降低脑瘫患儿的血压和心率有关。但由于本试验是小样本型，音乐疗法干预脑瘫患儿针灸时的焦虑情绪和疼痛感的效果还需要大样本试验去验证，而且此效果对临床针灸治疗脑瘫患儿效果的影响还有待于我们下一步的试验去研究。

Objective To study the effects of music therapy on anxiety and pain in the treatment of children with cerebral palsy with acupuncture. Methods Forty - six patients were divided into two groups on random： group A with acupuncture and music therapy, and Group B only with acupuncture. The needles kept still for 30 minutes. Then recorded BP, HR, RR, SPO2 before and at 1 min, 15 rain, 30 min after acupuncture. The mYPAS were tested children＇s anxiety before and at 1 min, 15 min, 30 min after acupuncture. The CHEOPS and FACES were tested children＇s pain before and at 1 rain, 15 min, 30 min after acupuncture. Results MAP and HR were increasing in both group A and B at 1 min after acupuncture, with no significant difference between them （P 〉0. 05） . HR in group A was similar to that before acupuncture at 15min after acupuncture （P 〉 0. 05 ）, but HR in group B was significantly increasing （ P 〈 0. 01 ） . MAP and HR in group A increased less than group B after acupuncture （P 〈0. 01 ） . The mYPAS in both groups increased significantly at 1rain after acupuncture, with significant difference between two groups （ P 〉 0. 05） . The mYPAS in group A at 15min after acupuncture was similar to that before acupuncture （P 〉 0. 05 ）, but there was significant difference between group A and B （ P 〈 0.01 ） . The mYPAS in two groups after acupuncture both significantly increased （ P 〈 0. 01 ）, but group B was more obviously than group A. The CHEOPS and FACES in group A were higher than group B. Conclusion The music therapy can not reduce anxiety and pain in children with cerebral palsy in short time, but can do it after stopping crying. This is because that music therapy can reduce the MAP and HR in childrenwith cerebral palsy. But this trim is a small model, the effects of music therapy on anxiety and pain in the treat- ment of children with cerebral palsy with acupuncture need to be testified in large model. And we will next study the effects of music therapy reducing anxiety and pain of children with cerebral palsy with acupuncture on the treatment.