音乐疗法对卒中后失语患者干预效果的Meta分析

doi:10.3761/j.issn.0254-1769.2024.15.017

摘要/Abstract

摘要：

目的评价音乐疗法对卒中后失语患者的干预效果。方法检索中国知网、万方数据库、PubMed等9个数据库中关于音乐疗法治疗卒中后失语患者的随机对照试验，检索时限为建库至2023年7月。由2名研究者按照纳入和排除标准筛选文献、提取资料，使用Cochrane 5.1.0手册评估文献质量，采用RevMan 5.3软件进行Meta分析。结果共纳入22篇研究，包括827例患者。Meta分析结果表明：音乐疗法显著改善了卒中后失语患者的自发言语[SMD=0.60，95%CI（0.40，0.80），P<0.01]、听理解能力[SMD=0.49，95%CI（0.32，0.67），P<0.01]、复述能力[SMD=0.77，95%CI（0.60，0.94），P<0.01]、命名能力[SMD=0.54，95%CI（0.29，0.78），P<0.01]、沟通交流能力[SMD=0.40，95%CI（0.02， 0.78），P<0.01]、抑郁情绪[SMD=-0.75，95%CI（-1.10，-0.40），P<0.01]，在改善失语严重程度方面差异无统计学意义[SMD=0.82，95%CI（-0.26，1.90），P=0.14]。结论音乐疗法有助于改善卒中后失语患者的自发言语、听理解能力、复述能力、命名能力、沟通交流能力及抑郁情绪，但未能改善患者的失语严重程度。

关键词: 音乐疗法, 卒中, 失语, Meta分析, 循证护理学

Abstract:

Objective To investigate the effectiveness of music therapy on patients with post-stroke aphasia. Methods Randomized controlled trials of music therapy for patients with post-stroke aphasia were systematically searched from 9 databases，such as CNKI，WanFang，PubMed，etc. The search time was from the inception of databases to July 2023. The literature was screened and extracted by 2 researchers according to the inclusion criteria，and the quality of the literature was assessed using Cochrane Manual 5.1.0. Revman 5.3 software was used for meta-analysis. Results We selected 22 studies comprising 827 participants comparing with control conditions. The meta-analysis demonstrated that music therapy significantly improved spontaneous speech[SMD=0.60，95%CI（0.40~0.80），P<0.01]，listening comprehension[SMD=0.49，95%CI（0.32~0.67），P<0.01]，repetition[SMD=0.77，95%CI（0.60~0.94），P<0.01]，naming[SMD=0.54，95%CI（0.29~0.78），P<0.01]，communication ability[SMD=0.40，95%CI（0.02~0.78），P<0.01]，depression[SMD=-0.75，95%CI（-1.10~-0.40），P<0.01]，but had no significant effect on the severity of aphasia[SMD=0.82，95%CI（-0.26，1.90），P=0.14]. Conclusion Music therapy significantly improved language expres-sion and understanding ability，but there was no clear evidence for the improvement of aphasia severity.

Key words: Music Therapy, Stroke, Aphasia, Meta-Analysis, Evidence-Based Nursing

杨玲虹, 贾瑞英, 魏慧, 柳妙妙, 高杨琴, 杨红燕. 音乐疗法对卒中后失语患者干预效果的Meta分析[J]. 中华护理杂志, 2024, 59(15): 1908-1917.

YANG Linghong, JIA Ruiying, WEI Hui, LIU Miaomiao, GAO Yangqin, YANG Hongyan. The effects of music therapy on patients with post-stroke aphasia：a Meta-analysis[J]. Chinese Journal of Nursing, 2024, 59(15): 1908-1917.

图/表 3

图1 文献筛选流程

Figure 1 Flow chart of literature screening

表3 音乐疗法对卒中后失语患者自发言语干预效果的亚组分析（n=11）

Table 3 Subgroup analysis of the effect of music therapy on spontaneous speech in patients with PSA（n=11）

图3 音乐疗法对卒中后失语患者听理解能力的影响

Figure 3 Effect of music therapy on listening comprehension in patients with PSA

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