Yu Haibo, Liu Yongfeng, Li Shuzhen, Ma Xiaoming
Department of Acupuncture and Moxibustion, Traditional Chinese Medicine Hospital of Shenzhen, No. 1, Fu-hua Road, Fu-tian District, Shenzhen 518000, Guangdong Province, China.
Int J Nurs Stud. 2009 Nov;46(11):1423-30. doi: 10.1016/j.ijnurstu.2009.05.007. Epub 2009 Jun 3.
To study the effects of music on anxiety and pain in children with cerebral palsy receiving acupuncture daily in a clinical setting.
A randomized controlled trial.
Acupuncture Unit at Shenzhen Hospital of Traditional Chinese Medicine in Shenzhen City of China.
Sixty children with cerebral palsy undergoing acupuncture.
Children listened to their favorite music or a blank disc for 30 min.
(1) the modified Yale preoperative anxiety scale for children's anxiety (mYPAS); (2) children's hospital of eastern Ontario pain scale (CHEOPS) and Wong-Baker faces pain rating scale (FACES) for pain intensity; (3) vital signs including mean arterial blood pressure (MAP), heart rate (HR) and respiratory rate (RR).
An independent sample t-test showed significantly lower mYPAS scores in the music group 30 min after the intervention compared with the control group (t=4.72, P=0.00). Significant differences between groups were found in mYPAS scores (F=4.270, d.f.=1, P=0.043, Partial eta(2)=0.069) and over treatment duration (F=143.421, d.f.=1.521, P=0.000, Partial eta(2)=0.712). A significant interaction was also found (F=4.298, d.f.=1.521, P=0.025, Partial eta(2)=0.069). LSD's post hoc testing confirmed that the mYPAS scores significantly increased from the baseline to 1 min (P=0.000, 95% CI 14.913, 20.257) and then gradually decreased from 1 to 30min (P=0.000, 95% CI -18.952, -13.714). For pain intensity scores, a highly significant time effect was found in both the CHEOPS (F=87.347, d.f.=2, P=0.000, Partial eta(2)=0.601) and FACES (F=225.871, d.f.=1.822, P=0.000, Partial eta(2)=0.796), and a significant interaction effect was found as well (F=4.369, d.f.=2, P=0.015, Partial eta(2)=0.070; F=5.859, d.f.=1.822, P=0.005, Partial eta(2)=0.092). However, no significant difference between groups was present (F=2.343, d.f.=1, P=0.131, Partial eta(2)=0.039; F=3.738, d.f.=1, P=0.058, Partial eta(2)=0.061). Significant differences between groups were found in MAP and HR (P<0.05) and over time (P<0.05), but no significant effects in RR were apparent (P>0.05). A significant interaction effect was found in HR (P<0.05), but not in MAP or RR (P>0.05).
This study demonstrates that listening to music while receiving acupuncture can relieve anxiety among children with cerebral palsy; however, no effect was observed in terms of pain reduction. Further research is needed to explore the types of music which best impact an individual's treatment. Whether music results in fewer accidents and side effects of acupuncture should be investigated. Music can be considered as adjunctive therapy in clinical situations that may be anxiety-provoking for children.
研究在临床环境中，音乐对每日接受针灸治疗的脑瘫患儿焦虑和疼痛的影响。
随机对照试验。
中国深圳市中医院针灸科。
60名接受针灸治疗的脑瘫患儿。
患儿听30分钟自己喜欢的音乐或空白光盘。
（1）用于评估儿童焦虑的改良耶鲁术前焦虑量表（mYPAS）；（2）用于评估疼痛强度的东安大略儿童医院疼痛量表（CHEOPS）和面部表情疼痛评分量表（FACES）；（3）生命体征，包括平均动脉血压（MAP）、心率（HR）和呼吸频率（RR）。
独立样本t检验显示，干预后30分钟，音乐组的mYPAS得分显著低于对照组（t = 4.72，P = 0.00）。组间在mYPAS得分（F = 4.270，自由度 = 1，P = 0.043，偏 eta 方 = 0.069）和整个治疗期间（F = 143.421，自由度 = 1.521，P = 0.000，偏 eta 方 = 0.712）存在显著差异。还发现了显著的交互作用（F = 4.298，自由度 = 1.521，P = 0.025，偏 eta 方 = 0.069）。LSD事后检验证实，mYPAS得分从基线到1分钟显著增加（P = 0.000，95%置信区间14.913，20.257），然后从1分钟到30分钟逐渐下降（P = 0.000，95%置信区间 - 18.952， - 13.714）。对于疼痛强度得分，在CHEOPS（F = 87.347，自由度 = 2，P = 0.000，偏 eta 方 = 0.601）和FACES（F = 225.871，自由度 = 1.822，P = 0.000，偏 eta 方 = 0.796）中均发现了高度显著的时间效应，并且也发现了显著的交互作用效应（F = 4.369，自由度 = 2，P = 0.015，偏 eta 方 = 0.070；F = 5.859，自由度 = 1.822，P = 0.005，偏 eta 方 = 其092）。然而，组间无显著差异（F = 2.343，自由度 = 1，P = 0.131，偏 eta 方 = 0.039；F = 3.738，自由度 = 1，P = 0.058，偏 eta 方 = 0.061）。组间在MAP和HR方面存在显著差异（P < 0.05）且随时间变化存在显著差异（P < 0.05），但RR方面无明显显著效应（P > 0.05）。在HR方面发现了显著的交互作用效应（P < 0.05），但在MAP或RR方面未发现（P > 0.05）。
本研究表明，在接受针灸治疗时听音乐可缓解脑瘫患儿的焦虑；然而，在减轻疼痛方面未观察到效果。需要进一步研究以探索对个体治疗影响最佳的音乐类型。应研究音乐是否能减少针灸的意外和副作用。在可能引起儿童焦虑的临床情况下，音乐可被视为辅助治疗。
