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长期音乐疗法干预对接受蒽环类药物治疗的乳腺癌患者自主神经功能的影响。

Effect of long-term music therapy intervention on autonomic function in anthracycline-treated breast cancer patients.

机构信息

Institute of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan.

出版信息

Integr Cancer Ther. 2011 Dec;10(4):312-6. doi: 10.1177/1534735411400311. Epub 2011 Mar 7.

Abstract

Anthracyclines are potent antineoplastic agents associated with cardiotoxicity, which may lead to congestive heart failure, causing impairment of autonomic cardiovascular function as assessed by heart rate variability (HRV). This decreases survival rates. This study aimed to determine whether music therapy intervention improves autonomic function in anthracycline-treated breast cancer patients, and if so, whether such improvements persist after cessation of the intervention. Participants were 12 women with breast cancer who had undergone mastectomy or breast-conserving treatment and adjuvant chemotherapy; they attended 8 weekly music therapy sessions, each lasting 2 hours. Electrocardiogram traces (5 minutes) for HRV analysis were recorded 4 times: prior to the first music session, T1; after the fourth music session, T2; after the eighth music session, T3; and 4 weeks after the completion of music therapy, T4. HRV parameters were subjected to a nonparametric Friedman test on the differences between T1 and T2, T3, and T4. The standard deviation of normal intervals and the total power of HRV parameters, related to global autonomic function, were significantly higher at T3 than at T1. The root-mean-square differences of successive normal R-R intervals and high-frequency (HF) HRV parameters, related to parasympathetic activity, were significantly increased, but no change was seen in the LF/HF ratio of HRV parameters (which is related to sympathetic activity) during the music therapy. Global autonomic function and parasympathetic activity had not changed significantly at T4 relative to T1. The authors provide preliminary evidence of the benefits of music therapy for anthracycline-treated breast cancer survivors.

摘要

蒽环类药物是具有心脏毒性的有效抗肿瘤药物,可导致充血性心力衰竭,从而导致自主心血管功能障碍,如心率变异性(HRV)评估所示。这会降低生存率。本研究旨在确定音乐治疗干预是否能改善接受蒽环类药物治疗的乳腺癌患者的自主功能,如果可以,干预停止后这种改善是否仍然存在。参与者为 12 名接受过乳房切除术或保乳治疗和辅助化疗的乳腺癌女性;她们参加了 8 周的每周音乐治疗课程,每次持续 2 小时。共记录了 4 次用于 HRV 分析的心电图轨迹(5 分钟):在第一次音乐治疗前,T1;第四次音乐治疗后,T2;第八次音乐治疗后,T3;音乐治疗完成后 4 周,T4。对 T1 与 T2、T3 和 T4 之间 HRV 参数的差异进行非参数 Friedman 检验。与整体自主功能相关的正常间隔标准差和 HRV 参数总功率在 T3 时明显高于 T1。与副交感神经活动相关的连续正常 R-R 间隔均方根差和高频(HF)HRV 参数显著增加,但 HRV 参数的 LF/HF 比值(与交感神经活动相关)在音乐治疗期间没有变化。与 T1 相比,T4 时整体自主功能和副交感神经活动没有明显变化。作者提供了音乐治疗对接受蒽环类药物治疗的乳腺癌幸存者有益的初步证据。

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