音乐疗法对机械通气患者生理与焦虑状态影响的Meta分析

Effect of music therapy on physiology and anxiety state in the mechanical ventilation patients：a Meta-analysis

目的：系统评价音乐疗法对机械通气患者生理因素及焦虑状况的影响。方法计算机检索PubMed、Cochrane图书馆、EMbase、Google、CBM、VIP、CNKI和WanFangData数据库，检索时间均为1998年1月-2013年6月。纳入有关音乐疗法对机械通气患者生理以及焦虑状态影响的随机对照实验（RCT），同时追溯文献中的参考文献。按照所确定标准选择文献，根据GRADE系统推荐分级方法应用GRADEprofiler3．6评价文献质量并提取资料，采用Revman5．2软件进行Meta分析。结果共纳入7篇文献，分析显示实验组机械通气患者的心率、呼吸、收缩压及焦虑状态干预后变化与对照组相比差异有统计学意义[WMD（95％CI）分别为-4．08（-5．36，-2．79），-2．50（-3．06，-1．94），-5．45（-9．52，-1．38），-0．66（-1．24，-0．07）]，而干预后患者的舒张压以及血氧饱和度变化与对照组相比差异无统计学意义[WMD（95％CI）分别为-1．76（-5．65，2．13），-0．01（-3．53，3．51）]。结论音乐疗法能有效改善患者的心率、呼吸、收缩压以及焦虑状态，但对舒张压和血氧饱和度的影响却不明显。但由于所纳文献中部分文献方法学质量偏低，尚有待于开展更多大样本、高质量、规范的随机对照试验来进一步证实音乐疗法的效果。

Objective To systematically review the effect of the music therapy on physiology and anxiety state in the mechanical ventilation patients .Methods The databases including the PubMed , Cochrane Library, EMbase, Google, CBM, VIP, CNKI, EMbase and WanFang Data were searched from January 1998 to June 2013.The randomized controlled trails （RCTs） of the music therapy on physiology and anxiety state in the mechanical ventilation patients were chosen , and at the same time the related references in the literatures were also searched .The literatures were chosen according to the determined criteria , and the literature quality was assessed by the GRADEprofiler3.6 recommended by the GRADE system.The data was collected, and the Meta-analysis was carried out through the RevMan 5.2.Results A total of seven studies were included in this analysis.The analysis showed that the differences were found in the heart rate , respiration, systolic blood pressure and anxiety state between two groups after the intervention [WMD（95%CI） =-4.08（ -5.36,-2.79）,-2.50（-3.06,-1.94）,-5.45（ -9.52,-1.38）,-0.66（ -1.24,-0.07）, respectively], and no differences were found in the diastolic blood pressure and blood oxygen saturation [WMD（95%CI） =-1.76（-5.65,2.13）,-0.01 （ -3.53,3.51）, respectively].Conclusions The music therapy can effectively improve the heart rate , respiration, systolic blood pressure and anxiety state in the patients , and the effects on diastolic blood pressure and blood oxygen saturation in the patients are not significant .The large-sample, high-quality and standard RCTs should be further carry out so as to test the effect of music therapy in view of the low methodological quality in some included studies .