五行音乐辅助治疗双相障碍的临床疗效观察

Clinical efficacy of five-element music therapy in the treatment of bipolar disorder

目的:观察五行音乐辅助治疗双相障碍的临床效果。方法:选取山东省精神卫生中心2018年1月至2019年12月住院治疗的双相障碍患者80例,采用随机数字表法分为研究组、对照组各40例,对照组进行常规药物治疗,研究组在对照组基础上给予五行音乐疗法。治疗前、恢复期、治疗结束后对其躁狂、抑郁情况进行评估,完成症状自评及《中医五态情志问卷》调查,进行疗效评估,电话随访1年,记录患者治疗后3个月、6个月、12个月的复发情况。结果:治疗前,两组患者贝克-拉范森躁狂量表(BRMs)、汉密尔顿抑郁量表(HAMD)、中医五态情志问卷、症状自评量表(SCL-90)评分差异均无统计学意义(均P>0.05)。恢复期及治疗结束时,两组患者BRMs、HAMD、中医五态情志问卷、SCL-90评分均明显下降[对照组恢复期、治疗结束时BRMs评分:(11.52±1.57)分、(9.43±1.05)分,HAMD评分:(16.75±3.05)分、(13.61±2.51)分,中医五态情志问卷评分:情绪词汇(67.25±5.7)分、(56.38±4.97)分,躯体症状(29.52±3.94)分、(24.19±3.05)分,SCL-90评分:(100.52±10.26)分、(68.85±7.33)分;研究组恢复期、治疗结束时BRMs评分:(9.33±1.09)分、(7.85±0.82)分,HAMD评分:(13.74±2.54)分、(10.17±1.97)分,中医五态情志问卷评分:情绪词汇(58.19±5.06)分、(46.85±4.06)分,躯体症状(25.14±3.54)分、(20.11±2.57)分,SCL-90评分:(90.85±8.97)分、(56.87±5.81)分],且研究组4项评分均明显低于对照组(t=3.77、7.01、4.48、6.99、8.78、4.89、6.05、4.19、7.57,均P<0.05)。研究组总有效率为90.0%,高于对照组的72.5%(χ^(2)=4.02,P<0.05)。研究组治疗后3个月、6个月、12个月复发率分别为2.5%、15.0%、30.0%,均低于对照组的17.5%、35.0%、52.5%,差异均有统计学意义(χ^(2)=5.00、4.26、4.17,均P<0.05)。结论:五行音乐疗法用于辅助治疗双相障碍,可显著改善患者抑郁、躁狂情况,恢复患者情志状态,提高临床疗效,降低复发率。

Objective:To investigate the clinical efficacy of five-element music therapy in the treatment of bipolar disorder.Methods:Eighty patients with bipolar disorder admitted to Shandong Mental Health Center from January 2018 to December 2019 were included in this study.They were randomly divided into a study group and a control group(n=40/group).The control group was treated with conventional drug treatment.The study group was treated with five-element music therapy based on conventional drug treatment.Before,during and after treatment,mania and depression were evaluated.Symptom self-evaluation scale and the Traditional Chinese Medicine Five State Emotion Questionnaire were completed to evaluate the curative effect.Patients were followed up by telephone call.Recurrence at 3,6 and 12 months was recorded.Results:Before treatment,there were no significant differences in the scores of the Bech-Rafaelsen Mania Rating Scale(BRMs),Hamilton Depression Rating Scale(HAMD),Traditional Chinese Medicine Five State Emotion Questionnaire,Symptom Checklist-90(SCL-90)between the two groups(all P>0.05).During and after treatment,BRMs,HAMD,Traditional Chinese Medicine Five State Emotion Questionnaire,and SCL-90 scores were significantly decreased in each group compared with before treatment[Control group:BRMs score during and after treatment:(11.52±1.57)points,(9.43±1.05)points;HAMD score during and after treatment:(16.75±3.05)points,(13.61±2.51)points;Traditional Chinese Medicine Five State Emotion Questionnaire:emotional vocabulary(67.25±5.7)points,(56.38±4.97)points,physical symptoms(29.52±3.94)points,(24.19±3.05)points,SCL-90 score:(100.52±10.26)points,(68.85±7.33)points.Study group:BRMs score during and after treatment:(9.33±1.09)points,(7.85±0.82)points;HAMD score:(13.74±2.54)points,(10.17±1.97)points;Traditional Chinese Medicine Five State Emotion Questionnaire:emotional vocabulary:(58.19±5.06)points,(46.85±4.06)points,physical symptoms(25.14±3.54)points,(20.11±2.57)points;SCL-90 scores:(90.85±8.97)points,(56.87±5.81)points].During and after treatment,scores of BRMs,HAMD,Traditional Chinese Medicine Five State Emotion Questionnaire and SCL-90 in the study group were significantly lower than those in the control group(t=3.77,7.01,4.48,6.99,8.78,4.89,6.05,4.19,7.57,all P<0.05).Total response rate in the study group was significantly higher than that in the control group(90.0%vs.72.5%,χ^(2)=4.02,P<0.05).At 3,6 and 12 months after treatment,recurrence rate in the study group was 2.5%,15.0%and 30.0%,respectively,which were significantly lower than 17.5%,35.0%,and 52.5%in the control group(χ^(2)=5.00,4.26,4.17,all P<0.05).Conclusion:Five-element music therapy for the treatment of bipolar disorder can markedly alleviate depression and mania,restore patient's emotional state,improve clinical efficacy,and decrease recurrence rate.