音乐疗法在产程中应用效果的Meta分析

The Effect of Music Therapy for Childbirth:A Meta-analysis

目的系统评价音乐疗法在产程中的应用效果。方法计算机检索Cochrane图书馆、PubMed、EMbase、EBSCO host、SpringerLINK Online Journals、CBM和万方学术会议论文全文数据库中关于音乐疗法在产程中应用的随机对照试验,检索时间为2000年1月至2010年12月。按照纳入与排除标准选择文献、评价文献质量和提取资料,而后采用RevMan 5.02软件进行Meta分析。结果共纳入9个RCT。其中有5个研究表明音乐疗法可缓解产妇的疼痛感;有5个研究表明音乐疗法可降低临产后经阴道试产失败转为剖宫产的事件发生风险;有3个研究表明音乐疗法可缩短第一产程时间;有2篇研究表明音乐疗法能稳定宫口开全时的收缩压和心率;还有3个研究表明音乐疗法能缓解产妇的焦虑情绪。此外,音乐疗法对新生儿Apgar评分无明显影响;经敏感性分析,音乐疗法对产后出血量影响的Meta分析结果不稳定。结论在产程中应用音乐疗法能缓解产妇的疼痛感和焦虑,稳定宫口开全时的心率和收缩压,并且降低临产后经阴道试产失败转为剖宫产的事件发生风险,缩短第一产程的时间,对产妇的身心具有良好的效果。

Objective To evaluate the effect of music therapy for childbirth.Methods Such databases as The Cochrane Library,PubMed,EMbase,EBSCO host,SpringerLINK Online Journals,CBM and WanFang Data were searched from January of 2000 to December of 2010 to collect randomized controlled trials（RCTs） of music therapy for childbirth.The quality of RCTs was appraised and the data were extracted.Meta-analyses were conducted with RevMan5.02 software for the standarded RCTs.Results A total of nine RCTs were included.Five RCTs indicated the music therapy could alleviate the labor pain;five RCTs indicated the music therapy could reduce the event risk of cesarean section due to the failure of transvaginal trial labor;three RCTs indicated the music therapy could shorten the first stage of labor;two RCTs indicated the music therapy could stabilize the systolic pressure and heart rate when complete cervical dilation was done,and three RCTs indicated the music therapy could relieve anxiety.In addition,music therapy had no influence on neonate Apgar＇s score;and the result of meta-analyses on postpartum hemorrhage was not reliable through sensitivity analyses.Conclusion The music therapy applied during childbirth can relieve the labor pain and anxiety,stabilize the heart rate and systolic pressure when complete cervical dilation is done,reduce the event risk of cesarean section due to the failure of transvaginal trial labor,shorten the first stage of labor,and is beneficial to the mind and body of parturient.