Conrad Claudius, Niess Hanno, Jauch Karl-Walter, Bruns Christiane J, Hartl Wolfgang, Welker Lorenz
Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Crit Care Med. 2007 Dec;35(12):2709-13. doi: 10.1097/01.ccm.0000291648.99043.b9.
Music has been used for therapeutic purposes since the beginning of cultural history. However, despite numerous descriptions of beneficial effects, the precise mechanisms by which music may improve human well-being remain unclear.
We conducted a randomized study in ten critically ill patients to identify mechanisms of music-induced relaxation using a special selection of slow movements of Mozart's piano sonatas. These sonatas were analyzed for compositional elements of relaxation. We measured circulatory variables, brain electrical activity, serum levels of stress hormones and cytokines, requirements for sedative drugs, and level of sedation before and at the end of a 1-hr therapeutic session.
Compared with controls, we found that music application significantly reduced the amount of sedative drugs needed to achieve a comparable degree of sedation. Simultaneously, among those receiving the music intervention, plasma concentrations of growth hormone increased, whereas those of interleukin-6 and epinephrine decreased. The reduction in systemic stress hormone levels was associated with a significantly lower blood pressure and heart rate.
Based on the effects of slow movements of Mozart's piano sonatas, we propose a neurohumoral pathway by which music might exert its sedative action. This model includes an interaction of the hypothalamic-pituitary axis with the adrenal medulla via mediators of the unspecific immune system
自文化史开端以来，音乐就被用于治疗目的。然而，尽管有诸多关于其有益效果的描述，但音乐改善人类福祉的确切机制仍不清楚。
我们对十名重症患者进行了一项随机研究，通过特别挑选莫扎特钢琴奏鸣曲的慢板乐章来确定音乐诱导放松的机制。对这些奏鸣曲进行了放松的作曲元素分析。我们在1小时治疗疗程开始前和结束时测量了循环变量、脑电活动、应激激素和细胞因子的血清水平、镇静药物需求以及镇静程度。
与对照组相比，我们发现音乐应用显著减少了达到可比镇静程度所需的镇静药物量。同时，在接受音乐干预的患者中，生长激素的血浆浓度升高，而白细胞介素-6和肾上腺素的血浆浓度降低。全身应激激素水平的降低与显著更低的血压和心率相关。
基于莫扎特钢琴奏鸣曲慢板乐章的效果，我们提出了一条神经体液途径，通过该途径音乐可能发挥其镇静作用。该模型包括下丘脑-垂体轴通过非特异性免疫系统的介质与肾上腺髓质的相互作用。
