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音乐诱导镇痛在慢性疼痛病症中的应用:系统评价和荟萃分析。

Music-Induced Analgesia in Chronic Pain Conditions: A Systematic Review and Meta-Analysis.

机构信息

Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramon de la Fuente Muñíz", Mexico City, Mexico; Universidad Nacional Autónoma de México, Mexico City, Mexico.

Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramon de la Fuente Muñíz", Mexico City, Mexico; Universidad Nacional Autónoma de México, Mexico City, Mexico; Instituto de Neurobiología, Universidad Nacional Autónoma de México, Juriquilla, Queretaro, Mexico.

出版信息

Pain Physician. 2017 Nov;20(7):597-610.

Abstract

BACKGROUND

Music is increasingly used as an adjuvant for the management of chronic pain (CP), as it is non-invasive, inexpensive, and patients usually report positive experiences with it. However, little is known about its clinical efficacy in chronic pain patients.

OBJECTIVES

We aimed to determine the effect of music as an adjuvant for chronic pain, as well as to identify characteristics of music interventions associated with positive clinical outcomes.

STUDY DESIGN

In this systematic review and meta-analysis, we investigated randomized controlled trials (RCTs) of adult patients that reported any type of music intervention for chronic pain, chosen by the researcher or patient, lasting for any duration. Searches were performed using PsycINFO, Scopus, and PubMed for RCTs published until the end of May 2016. The primary outcome was reduction in self-reported pain using a standardized pain measurement instrument, reported post-intervention. The secondary outcomes were: quality of life measures, depression, anxiety, and related measures.

METHODS

The study was pre-registered with PROSPERO (CRD42016039837), and the meta-analysis was performed using RevMan 5.3 (The Nordic Cochrane Centre for The Cochrane Collaboration, Copenhagen, Denmark). We identified 768 titles and abstracts, and we included 14 RTCs that fulfilled our criteria. The sample size of the studies varied between 25 and 200 patients.

RESULTS

We found that music reduced self-reported chronic pain and depressive symptoms. We also found that music had a greater effect when the patient chose the music, compared to when the researcher chose it.

LIMITATIONS

The sample size of RCTs was small and sometimes with different outcome measures. There was high heterogeneity associated with pooled estimates.

CONCLUSIONS

Our analysis suggests that music may be beneficial as an adjuvant for chronic pain patients, as it reduces self-reported pain and its common comorbidities. Importantly, the analgesic effect of music appears higher with self-chosen over researcher-chosen music.

KEY WORDS

Pain, music, analgesia, music-induced analgesia, chronic pain, meta-analysis, systematic review, therapy.

摘要

背景

音乐作为慢性疼痛(CP)管理的辅助手段越来越受到重视,因为它是非侵入性的、廉价的,而且患者通常对其有积极的体验。然而,对于音乐在慢性疼痛患者中的临床疗效知之甚少。

目的

我们旨在确定音乐作为慢性疼痛辅助手段的效果,并确定与积极临床结果相关的音乐干预特征。

研究设计

在这项系统评价和荟萃分析中,我们调查了研究人员或患者选择的任何类型的音乐干预慢性疼痛的成人患者的随机对照试验(RCT),持续时间不限。使用 PsycINFO、Scopus 和 PubMed 进行了研究,检索截止到 2016 年 5 月底发表的 RCT。主要结果是使用标准化疼痛测量工具报告的干预后自我报告疼痛的减少。次要结果是:生活质量指标、抑郁、焦虑和相关指标。

方法

该研究在 PROSPERO(CRD42016039837)上进行了预先注册,荟萃分析使用 RevMan 5.3(丹麦哥本哈根的北欧 Cochrane 中心 Cochrane 协作组)进行。我们确定了 768 个标题和摘要,并纳入了符合我们标准的 14 项 RCT。研究的样本量在 25 到 200 名患者之间不等。

结果

我们发现音乐可以减轻自我报告的慢性疼痛和抑郁症状。我们还发现,当患者选择音乐时,音乐的效果比研究人员选择音乐时更大。

局限性

RCT 的样本量较小,有时使用不同的结果测量方法。汇总估计值存在高度异质性。

结论

我们的分析表明,音乐可能对慢性疼痛患者有益,因为它可以减轻自我报告的疼痛及其常见的合并症。重要的是,与研究人员选择的音乐相比,自我选择的音乐具有更高的镇痛效果。

关键词

疼痛、音乐、镇痛、音乐诱导镇痛、慢性疼痛、荟萃分析、系统评价、治疗。

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