音乐疗法对卒中后认知障碍的临床疗效

Clinical effect of music therapy on post-stroke cognitive impairment

目的探讨音乐疗法对缺血性卒中后认知障碍的临床疗效和相关作用机制。方法选取80例韦氏记忆量表测量值在40-55分之间的缺血性卒中后认知障碍患者分为常规肢体康复治疗组和音乐治疗组,2组分别进行8周常规肢体康复治疗和常规肢体康复治疗合并音乐治疗,并在治疗前后分别予以MoCA量表、Stroop色词测验,以及血清BDNF的测量。结果经过8周康复训练后,常规肢体康复治疗组患者总体认知功能得到显著改善,MoCA量表成绩有显著性提高（P〈0.05）;反映执行功能的Stroop色词测验成绩的改善情况不明显（P〉0.05）;血清BDNF蛋白含量有显著性增高（P〈0.05）;常规肢体康复治疗合并音乐治疗组患者MoCA量表和Stroop色词测验成绩以及血清BDNF的含量均较治疗前显著改善（P〈0.01）,与同期常规肢体康复治疗组比较,这些指标也有显著性改善（P〈0.05）。结论音乐疗法可以改善卒中后认知障碍患者的总体认知功能和执行功能,与神经缺损功能的改善有一定相关性,并能够促进该类患者血清BDNF表达的上调。

Objective To explore the clinical effect and its mechanism of music therapy on post-stroke cognitive impairment.Methods 80 cognitive impairment patients after ischemic stroke applying wechsler memory scale measurements between 40 to 55points were divided into conventional physical rehabilitation group and musical treatment group,and the two groups were respectively given conventional physical rehabilitation and conventional physical rehabilitation combined with music therapy,and the treatment lasted for 8weeks.Level of serum BDNF,the measurement MoCA scale and the Stroop colour word test before and after treatment were compared.Results After 8weeks of training,the overall cognitive function of patients in conventional physical rehabilitation group was improved significantly,the MoCA scale scores improved obviously（P〈0.05）.At the same time the result of Stroop colour word test revealed that there was no significant difference of executive function（P〉0.05）,but the level of serum BDNF protein content significantly increased（P〈0.05）.The scores of MoCA scale and the Stroop colour word test consequence,and the level of serum BDNF of patients in the musical treatment group improved significantly compared with conventional physical rehabilitation therapy group（P〈0.01）.Conclusion Music therapy can improve the overall cognitive function and executive function of patients with cognitive impairment after stroke,indicate a correlation with the improvement nerve defect function and promote the expression of serum BDNF in patients who accepted the music therapy.