Zhang Jingyi, Zhang Liping, Qiu Yifang, Wu Wenmin, Zhou Sujin, Ye Xuanying, Zeng Huiping, Gao Yun
School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China.
Department of Nephrology, The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Complement Ther Med. 2025 Sep;92:103199. doi: 10.1016/j.ctim.2025.103199. Epub 2025 Jun 14.
Due to the intricate interplay between music and culture, the comparative effectiveness of Western music therapy and five-element music therapy for Chinese patients undergoing maintenance hemodialysis warrants further investigation.
In this randomized controlled trial, 87 patients receiving maintenance hemodialysis were recruited and randomly assigned to the five-element music group (n = 29), Western music group (n = 29), and control group (n = 29) in a 1:1:1 ratio. Participants in the five-element music group and Western music group received eight weeks of five-element music therapy and Western music therapy, respectively, for 60 min per session, three times per week. The primary outcome indicator was the Hospital Anxiety and Depression Scale score. The secondary outcome indicators were the Pittsburgh Sleep Quality Index, Dialysis Symptom Index, and Positive and Negative Emotions Scale scores. All outcome indicators were measured at baseline, on the day of the end of week 4 of the intervention, on the day of the end of week 8 of the intervention, and at the one-month follow-up after the end of the intervention.
The results of the generalized estimating equations indicated that both five-element music therapy and Western music therapy were effective in alleviating anxiety, depression, sleep disturbances, and both positive and negative emotions among patients undergoing maintenance hemodialysis. However, patients in the five-element music group showed significantly greater relief from anxiety (mean difference = -1.76 ± 0.672, 95 % CI: 3.37, -0.15, p = 0.027), depression (mean difference = -1.79 ± 0.647, 95 % CI: -3.34, -0.24, p = 0.017), and both positive (mean difference = -3.00 ± 1.062, 95 % CI: 0.46, 5.54, p = 0.014) and negative emotions (mean difference = -3.38 ± 1.084, 95 % CI: -5.97, -0.78, p = 0.005) compared to those in the Western music group. Conversely, no significant differences were observed in sleep quality (mean difference = -1.07 ± 0.776, 95 % CI: -2.93, 0.79, p = 0.505) or symptom-related distress (mean difference = 3.62 ± 3.124, 95 % CI: -3.86, 11.10, p = 0.739) between the five-element music and Western music groups.
The significant benefits of five-element music therapy in improving emotions in Chinese patients undergoing maintenance hemodialysis highlight the importance of culturally tailored interventions.
由于音乐与文化之间存在复杂的相互作用，西方音乐疗法与五音疗法对接受维持性血液透析的中国患者的相对疗效值得进一步研究。
在这项随机对照试验中，招募了87名接受维持性血液透析的患者，并以1:1:1的比例随机分配到五音组（n = 29）、西方音乐组（n = 29）和对照组（n = 29）。五音组和西方音乐组的参与者分别接受为期八周的五音疗法和西方音乐疗法，每次治疗60分钟，每周三次。主要结局指标为医院焦虑抑郁量表得分。次要结局指标为匹兹堡睡眠质量指数、透析症状指数以及正负情绪量表得分。所有结局指标均在基线时、干预第4周结束当天、干预第8周结束当天以及干预结束后1个月随访时进行测量。
广义估计方程的结果表明，五音疗法和西方音乐疗法均能有效缓解维持性血液透析患者的焦虑、抑郁、睡眠障碍以及正负情绪。然而，与西方音乐组相比，五音组患者在焦虑（平均差异=-1.76±0.672，95%CI：-3.37，-0.15，p = 0.027）、抑郁（平均差异=-1.79±0.647，95%CI：-3.34，-0.24，p = 0.017）以及正性（平均差异=-3.00±1.062，95%CI：-5.54，-0.46，p = 0.014）和负性情绪（平均差异=-3.38±1.084，95%CI：-5.97，-0.78，p = 0.005）方面的缓解程度明显更大。相反，五音组与西方音乐组在睡眠质量（平均差异=-1.07±0.776，95%CI：-2.93，0.79，p = 0.505）或症状相关困扰（平均差异=3.62±3.124，95%CI：-3.86，11.10，p = 0.739）方面未观察到显著差异。
五音疗法对改善接受维持性血液透析的中国患者情绪具有显著益处，凸显了文化适应性干预的重要性。
