儿童牙科畏惧症临床治疗中音乐疗法应用研究

Clinical study of music therapy for children with dental fear

目的探讨音乐疗法缓解儿童牙科畏惧症(CDF)的适用范围和疗效。方法选择2015年12月至2016年9月在中国人民解放军总医院儿童口腔科就诊的需行根管治疗患儿作为研究对象。筛选其中经儿童畏惧调查-牙科分量表(CFSS-DS)确定具有CDF的4~10岁患儿128例,随机分为两组:音乐疗法组(64例)进行音乐辅助治疗和行为诱导,行为诱导组(64例)仅进行行为诱导。在初次治疗前、治疗中、治疗后及复诊前分别测量两组患儿心率、血压、血氧饱和度等生理指标,并在诊疗过程中采用Venham焦虑与合作行为量表评价患儿畏惧焦虑程度。结果音乐疗法组60例(93.75%)完成治疗,4例因畏惧无法缓解中止治疗;行为诱导组56例(87.50%)完成治疗,8例中止治疗。诊疗过程中,音乐疗法组患儿心率变化幅度显著小于行为诱导组(P<0.05)。音乐疗法组治疗中心率与治疗前相比无明显升高,治疗后心率显著降低(P<0.05);行为诱导组治疗中心率较治疗前明显增快(P<0.05)。音乐疗法组Venham 2、3级患儿根管治疗各阶段心率、收缩压无明显增高,复诊前则明显降低(P<0.05)。结论音乐疗法可有效缓解CDF患儿的畏惧紧张情绪,提高患儿口腔诊疗依从性,是一种有效、简便、易接受的行为管理辅助方法。

Objective To explore the application and curative effect of music therapy in relieving children dental fear （CDF）.Methods A total of 128 first-visit-dental children（aged 4-10 years）,who were classified as CDF by children＇s fear survey schedule-dental subscale （CFSS-DS）,were included in the study.The children were randomly selected to accept music therapy and behavior management （64 children,experiment group）,and behavior management only （64 children,control group）.Heart rate,blood pressure and oxygen saturation were recorded before,during and after treatment as well as before return visit,and anxiety level was evaluated by Venham anxiety and cooperative behavior scale.Results Sixty planned treatments were completed satisfactorily in experimental group,but only 56 children completed treatment in control group.In the process of treatment,heart rate variation in experimental group was significantly less than the control group.In the experimental group,the heart rate in operation was not significantly increased,but the postoperative rate was significantly lower than that before treatment;the intraoperative and postoperative heart rate was significantly faster than preoperative rate in the experiment group.Except for children with Venham grade of 4,other children＇s heart rate decreased significantly after initial visits and before subsequent visits in experiment group.Systolic pressure also showed similar trends.Conclusion Music therapy is a safe and acceptable way to relieve children dental fear with higher compliance of children.