音乐干预对维持性血液透析患者心理和生理状态影响的Meta分析

A Meta-analysis of effects of music intervention on psychological and physiological responses of patients receiving maintenance hemodialysis

目的评价音乐干预对维持性血液透析(MHD)患者心理和生理状态的影响。方法计算机检索The Cochrane Library、Pub Med、EMbase、EBSCO、CBM、中国知网和万方数据库中关于音乐干预对维持性血液透析患者心理和生理状态影响的随机对照试验文献。采用Rev Man 5.3软件进行Meta分析。结果共纳入17篇随机对照试验文献,包括1326例研究对象。Meta分析结果显示:音乐干预可缓解MHD患者的焦虑(SMD=-1.22,95%CI:-1.82^-0.62,P<0.01)和抑郁(WMD=-6.73,95%CI:-8.33^-5.12,P<0.01),降低心率(WMD=-6.24,95%CI:-10.42^-2.05,P<0.01)、收缩压(SMD=-0.47,95%CI:-0.75^-0.19,P<0.01)及舒张压(SMD=-0.46,95%CI:-0.71^-0.20,P<0.01),同时减少透析并发症的发生(RR=0.41,95%CI:0.17~1.01,P=0.05)。结论音乐干预能改善MHD患者的焦虑和抑郁情绪,稳定患者在透析中的心率和血压水平,减少并发症。鉴于本研究纳入文献的质量相对较低,结论尚需大样本、高质量的随机对照试验予以验证。

Objective To evaluate the effects of music intervention on psychological and physiological responses of pa- tients receiving maintenance hemodialysis. Methods Databases including The Coehrane Library, PubMed, Embase, E- BCCO, CBM, CNKI and Wanfang data were searched to collect references about randomized controlled trials related with the effectiveness of music intervention on psychological and physiological responses of patients receiving mainte- nance hemodialysis. RevMan 5.3 software was used for statistical analysis. Results A total of 17 literatures were in- eluded, which involved 1326 patients. The results of Meta-analysis showed that listening to music was able to relieve anxiety （SMD = -1.22, 95%CI： -1.82 - -0.62, P 〈 0.01） and depression （WMD = -6.73, 95%CI： -8.33 - -5.12, P 〈 0.01） of MHD patients, and reduce heart rate （WMD = -6.24, 95%CI：-10.42 - -2.05, P = 0.003）, systolic pressure （SMD = -0.47, 95%CI： -0.75 - -0.19, P 〈 0.01）, diastolic pressure （SMD = -0.46, 95%CI：-0.71 - -0.20, P 〈 0.01） and the incidence of complications （RR = 0.41, 95%CI： 0.17-1.01, P = 0.05）. Conclusion Music intervention can re- duce the anxiety and depression of MHD patients, stabilize the heart rate and blood pressure, decrease the complica- tions rate. However, because of the quality of studies included in the current research is relative low, further research with larger sample and higher quality is needed to confirm our conclusion.