音乐治疗辅助肺康复训练对COPD患者康复治疗的研究
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摘要
目的:探讨音乐治疗辅助肺康复训练对COPD患者的心肺功能、生活质量、情绪状况及睡眠质量的影响。方法:将COPD的患者共30例随机数字表法分为研究组和对照组,每组15例。2组均予以正规内科治疗及康复专科护理,研究组予以音乐治疗辅助常规肺康复训练干预,对照组予以常规肺康复训练干预,2组治疗时间每次45min,每日1次,5次/周,持续12周。比较2组干预前后肺功能、生活质量、情绪状况、睡眠质量。结果:干预12周后,2组第一秒用力呼气容积(FEV1)与用力肺活量(FVC)的比值(FEV1/FVC)(%)、FEV1占预计值百分比(FEV1%pred)、无氧阈(AT)、二氧化碳通气当量斜率(VE/VCO_2)、6min步行距离及健康调查简表(SF-36)指数明显高于治疗前(均P<0.05),2组改良气短(Borg)指数均明显低于治疗前(P<0.05),且研究组的各项评定均明显高于对照组(均P<0.05);治疗后,2组汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)均明显低于治疗前(均P<0.05),且研究组各项指标均低于对照组(均P<0.05)。结论:音乐治疗辅助肺康复训练与常规肺康复训练相比,能更好地改善COPD患者的肺功能,提高患者的运动耐力、生活质量,改善患者的心理、情绪及睡眠状况。
Objective: To explore the effects of music therapy on cardiopulmonary function, quality of life, emotional state and sleep quality of patients with chronic obstructive pulmonary disease(COPD). Methods: From Jan. 1, 2016 to Dec. 31, 2017, 30 COPD patients admitted in our hospital were divided into the experimental group and control group according to the random number table method, 15 cases in each group. Both groups were given regular medical treatment and rehabilitation specialist nursing, and the experimental group was treated with music therapy for assisted pulmonary rehabilitation training intervention, and the control group was given routine pulmonary rehabilitation training. The treatment time of the two groups was 45 min each time' 5 times/week for 12 weeks. The cardiopulmonary function before and after the intervention, the quality of life, emotional state and the sleep quality were compared between two groups. Results: After 12 weeks of intervention, forced expiratory volume in one second(FEV1)/forced vital capacity(FVC)(%), FEV1% pred, anerobic threshold(AT), ventilation relative to carbon dioxide production(VE/VCO2) in both groups were significantly higher, and the Borg index significantly lower than pretreatment(all P<0.05), more significant in the experimental group than in control group(P<0.05). The 6-minute walking distance in the experimental group was significantly longer than in the control group(P<0.05). The SF-36(the MOS item short from health survey) index scores in both groups were significantly higher than pretreatment(P<0.05), more significant in the experimental group than in the control group(P<0.05). After 12 weeks of intervention, the scores of Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD) and Pittsburgh Sleep Quality Index(PSQI) in both groups were significantly lower than pretreatment, more significant in the experimental group than in the control group(all P<0.05). Conclusion: Music therapy for assisted pulmonary rehabilitation training can more significantly improve the pulmonary function, the quality of life, the mental, emotional, and sleep status, and enhance the endurance of the movement in COPD patients than the routine pulmonary rehabilitation.
Objective: To explore the effects of music therapy on cardiopulmonary function, quality of life, emotional state and sleep quality of patients with chronic obstructive pulmonary disease(COPD). Methods: From Jan. 1, 2016 to Dec. 31, 2017, 30 COPD patients admitted in our hospital were divided into the experimental group and control group according to the random number table method, 15 cases in each group. Both groups were given regular medical treatment and rehabilitation specialist nursing, and the experimental group was treated with music therapy for assisted pulmonary rehabilitation training intervention, and the control group was given routine pulmonary rehabilitation training. The treatment time of the two groups was 45 min each time' 5 times/week for 12 weeks. The cardiopulmonary function before and after the intervention, the quality of life, emotional state and the sleep quality were compared between two groups. Results: After 12 weeks of intervention, forced expiratory volume in one second(FEV1)/forced vital capacity(FVC)(%), FEV1% pred, anerobic threshold(AT), ventilation relative to carbon dioxide production(VE/VCO2) in both groups were significantly higher, and the Borg index significantly lower than pretreatment(all P<0.05), more significant in the experimental group than in control group(P<0.05). The 6-minute walking distance in the experimental group was significantly longer than in the control group(P<0.05). The SF-36(the MOS item short from health survey) index scores in both groups were significantly higher than pretreatment(P<0.05), more significant in the experimental group than in the control group(P<0.05). After 12 weeks of intervention, the scores of Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD) and Pittsburgh Sleep Quality Index(PSQI) in both groups were significantly lower than pretreatment, more significant in the experimental group than in the control group(all P<0.05). Conclusion: Music therapy for assisted pulmonary rehabilitation training can more significantly improve the pulmonary function, the quality of life, the mental, emotional, and sleep status, and enhance the endurance of the movement in COPD patients than the routine pulmonary rehabilitation.
引文
[1] Yohannes A M, Alexopoulos G S. Depression and anxiety in patients with COPD[J]. European Respiratory Review An Official Journal of the European Respiratory Society, 2014, 23(133):345-349.
[2] 李红梅,高欢玲,刘爱梅,等.老年慢性阻塞性肺疾病患者生活质量质性研究[J]. 中国老年学杂志, 2017, 37(5):1244-1246.
[3] 徐灵彬,马苗,孙莉.老年慢性阻塞性肺疾病患者稳定期健康相关生活质量评价[J]. 中华老年医学杂志, 2015, 34(9):972-975.
[4] Cullen K, Talbot D, Gillmor J, et al. Effect of Baseline Anxiety and Depression Symptoms on Selected Outcomes Following Pulmonary Rehabilitation.[J]. Journal of Cardiopulmonary Rehabilitation & Prevention, 2017, 37(4):279.
[5] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)(一)[J]. 中华结核和呼吸杂志, 2013, 36(4):484-491.
[6] 吴海燕,钱钧,郝建,等.康复训练对稳定期COPD患者肺功能的影响[J]. 临床肺科杂志, 2014(10):1787-1789.
[7] Mcnaughton A, Aldington S, Williams G, et al. Sing Your Lungs Out: a qualitative study of a community singing group for people with chronic obstructive pulmonary disease (COPD)[J]. Bmj Open, 2016, 6(9):e012521.
[8] 张利娟.心肺康复治疗对冠心病心肺功能及生活质量的影响分析[J]. 中国伤残医学, 2016, 24(9):127-128.
[9] Wasterlain E, Reychler G, Caty G. Occupational therapy (OT) and pulmonary rehabilitation (PR) of COPD patients[J]. Annals of Physical & Rehabilitation Medicine, 2013, 56(Suppl 1):e173-e174.
[10] Bonilha A G, Onofre F, Vieira M L, et al. Effects of singing classes on pulmonary function and quality of life of COPD patients.[J]. International Journal of Copd, 2008, 2009(default):1-8.
[11] Thaut M H, Gardiner J C, Holmberg D, et al. Neurologic Music Therapy Improves Executive Function and Emotional Adjustment in Traumatic Brain Injury Rehabilitation [J]. Ann N Y Acad Sci, 2010, 1169(1):406-416.
[12] Beaumont M, Mialon P, Le C B, et al. Effects of inspiratory muscle training on dyspnoea in severe COPD patients during pulmonary rehabilitation: controlled randomised trial.[C]. Ers International Congress. 2018:OA2924.
[13] Horuz D, Kurcer M A, Erdo an Z. The Effect of Music Therapy on Anxiety and Various Physical Findings in Patients With COPD in a Pulmonology Service[J]. Holistic Nursing Practice, 2017, 31(6):378.
[14] 姜力,韦莉萍.音乐治疗与临床的研究进展[J]. 护士进修杂志, 2005, 20(9):809-811.
[15] Troosters T,Casaburi R,Gosselink R. Pulmonary rehabilitation in chronic obstructive pulmonary disease[J]. American Journal of respiratory and critical care medicine,2005,172(1):19.
[16] 吴浩,孙兴国,顾文超,等.心肺运动试验计算个体化目标心率指导男性慢性阻塞性肺疾病患者运动康复的效果观察[J]. 中国全科医学, 2016, 19(35):4323-4327.
[17] 谢斌, 鲍晓, 李伟玲,等. 康复训练对稳定期慢阻肺患者生活质量和运动功能的影响[J]. 中国康复, 2016, 31(4):277-279.
[18] Je D L R O, Garcíapardo M P, Cabaňés I C, et al. Does Music Therapy Improve Anxiety and Depression in Alzheimer's Patients[J]. J Altern Complement Med,2017, 24(1):33-36.
[19] Kenny D T, Faunce G. The impact of group singing on mood, coping, and perceived pain in chronic pain patients attending a multidisciplinary pain clinic[J]. J Music Ther,2004, 41(3):241-58.
[20] Steinhoff N, Heine A M, Vogl J, et al. A pilot study into the effects of music therapy on different areas of the brain of individuals with unresponsive wakefulness syndrome[J]. Frontiers in Neurology,2015, 9(291):291.本刊办刊方向
[2] 李红梅,高欢玲,刘爱梅,等.老年慢性阻塞性肺疾病患者生活质量质性研究[J]. 中国老年学杂志, 2017, 37(5):1244-1246.
[3] 徐灵彬,马苗,孙莉.老年慢性阻塞性肺疾病患者稳定期健康相关生活质量评价[J]. 中华老年医学杂志, 2015, 34(9):972-975.
[4] Cullen K, Talbot D, Gillmor J, et al. Effect of Baseline Anxiety and Depression Symptoms on Selected Outcomes Following Pulmonary Rehabilitation.[J]. Journal of Cardiopulmonary Rehabilitation & Prevention, 2017, 37(4):279.
[5] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)(一)[J]. 中华结核和呼吸杂志, 2013, 36(4):484-491.
[6] 吴海燕,钱钧,郝建,等.康复训练对稳定期COPD患者肺功能的影响[J]. 临床肺科杂志, 2014(10):1787-1789.
[7] Mcnaughton A, Aldington S, Williams G, et al. Sing Your Lungs Out: a qualitative study of a community singing group for people with chronic obstructive pulmonary disease (COPD)[J]. Bmj Open, 2016, 6(9):e012521.
[8] 张利娟.心肺康复治疗对冠心病心肺功能及生活质量的影响分析[J]. 中国伤残医学, 2016, 24(9):127-128.
[9] Wasterlain E, Reychler G, Caty G. Occupational therapy (OT) and pulmonary rehabilitation (PR) of COPD patients[J]. Annals of Physical & Rehabilitation Medicine, 2013, 56(Suppl 1):e173-e174.
[10] Bonilha A G, Onofre F, Vieira M L, et al. Effects of singing classes on pulmonary function and quality of life of COPD patients.[J]. International Journal of Copd, 2008, 2009(default):1-8.
[11] Thaut M H, Gardiner J C, Holmberg D, et al. Neurologic Music Therapy Improves Executive Function and Emotional Adjustment in Traumatic Brain Injury Rehabilitation [J]. Ann N Y Acad Sci, 2010, 1169(1):406-416.
[12] Beaumont M, Mialon P, Le C B, et al. Effects of inspiratory muscle training on dyspnoea in severe COPD patients during pulmonary rehabilitation: controlled randomised trial.[C]. Ers International Congress. 2018:OA2924.
[13] Horuz D, Kurcer M A, Erdo an Z. The Effect of Music Therapy on Anxiety and Various Physical Findings in Patients With COPD in a Pulmonology Service[J]. Holistic Nursing Practice, 2017, 31(6):378.
[14] 姜力,韦莉萍.音乐治疗与临床的研究进展[J]. 护士进修杂志, 2005, 20(9):809-811.
[15] Troosters T,Casaburi R,Gosselink R. Pulmonary rehabilitation in chronic obstructive pulmonary disease[J]. American Journal of respiratory and critical care medicine,2005,172(1):19.
[16] 吴浩,孙兴国,顾文超,等.心肺运动试验计算个体化目标心率指导男性慢性阻塞性肺疾病患者运动康复的效果观察[J]. 中国全科医学, 2016, 19(35):4323-4327.
[17] 谢斌, 鲍晓, 李伟玲,等. 康复训练对稳定期慢阻肺患者生活质量和运动功能的影响[J]. 中国康复, 2016, 31(4):277-279.
[18] Je D L R O, Garcíapardo M P, Cabaňés I C, et al. Does Music Therapy Improve Anxiety and Depression in Alzheimer's Patients[J]. J Altern Complement Med,2017, 24(1):33-36.
[19] Kenny D T, Faunce G. The impact of group singing on mood, coping, and perceived pain in chronic pain patients attending a multidisciplinary pain clinic[J]. J Music Ther,2004, 41(3):241-58.
[20] Steinhoff N, Heine A M, Vogl J, et al. A pilot study into the effects of music therapy on different areas of the brain of individuals with unresponsive wakefulness syndrome[J]. Frontiers in Neurology,2015, 9(291):291.本刊办刊方向