非营养性吸吮联合音乐治疗对新生儿疼痛的缓解作用

目的观察非营养性吸吮（NNS）、音乐治疗（MT）及非营养性吸吮联合音乐治疗（NNS＋MT）在缓解新生儿疼痛中的作用。方法收集2008年1～6月在南京医科大学附属南京儿童医院新生儿医学中心普通新生儿病房收治的新生儿作为研究对象,对符合纳入和排除标准的新生儿按照住院号从小到大顺序分为干预组（NNS亚组、MT亚组、NNS＋MT亚组）和空白对照组,干预措施在新生儿足后跟采血前2min开始持续至研究结束,共15min,空白对照组不予干预措施。通过观察新生儿的心率、经皮氧饱和度（SpO2）及新生儿疼痛行为（NIPS）评分,采集采血针刺前1min、针刺时和针刺后13min过程中的每一分种数据,比较各种干预措施缓解新生儿疼痛的临床效果。采用SPSS11.0软件进行多变量方差分析,ANOVA方差检验,同时应用PostHoc进行组间比较。结果纳入住院新生儿80例,男54例,女26例;各亚组和空白对照组各20例。疼痛刺激后各组的心率均显著加快,于刺激后0～2min达峰值,之后逐渐减慢;NNS亚组与空白对照组心率差异无统计学意义,MT、NNS＋MT亚组与空白对照组心率差异均有统计学意义,MT亚组和NNS＋MT亚组心率差异无统计学意义。疼痛刺激后各亚组SpO2均显著降低,于刺激后2～4min降至最低值,之后逐渐升高;NNS亚组与对照组SpO2差异无统计学意义,MT、NNS＋MT亚组与空白对照组SpO2差异均有统计学意义,MT亚组和NNS＋MT亚组SpO2差异无统计学意义。疼痛刺激后各组NIPS评分均显著提高,于0～1min达峰值,之后逐渐降低,各亚组NIPS评分差异均无统计学意义。与空白对照组比较,MT、NNS＋MT干预措施均可缓解疼痛刺激引起的心率、SpO2和NIPS评分变化。结论新生儿临床医护人员可通过使用MT和NNS＋MT可缓解新生儿疼痛。     

The effect of musical experience on emotional self‐reports and psychophysiological responses to dissonance

To study the influence of musical education on emotional reactions to dissonance, we examined self‐reports and physiological responses to dissonant and consonant musical excerpts in listeners with low (LE: n=15) and high (HE: n=13) musical experience. The results show that dissonance induces more unpleasant feelings and stronger physiological responses in HE than in LE participants, suggesting that musical education reinforces aversion to dissonance. Skin conductance (SCR) and electromyographic (EMG) signals were analyzed according to a defense cascade model, which takes into account two successive time windows corresponding to orienting and defense responses. These analyses suggest that musical experience can influence the defense response to dissonance and demonstrate a powerful role of musical experience not only in autonomic but also in expressive responses to music.     

音乐疗法配合心理激励对初产妇心理和分娩结局的影响

目的:观察音乐疗法与心理激励措施在初产妇中应用效果,进一步分析初产妇心理现状、分娩结局的情况。方法:选取2013年1月-2015年12月笔者单位的100例初产妇为研究受试者,根据护理措施的差异分成了观察组及对照组,各50例产妇。对照组产妇采取常规的产科护理措施,观察组则在对照组的基础上加音乐疗法、心理激励措施。对患者心理情绪指标、分娩结局等进行评价。结果:观察组患者汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分均显著低于对照组(t=-14.1567,-106329,-9.4004,-10.3742;P0.01)。观察组产妇的第一产程、第二产程、第三产程以及总产程均低于对照组(t=-6.6420,-12.3747,-27.2876,-6.8092;P0.01)。观察组顺产例数高于对照组(χ~2=6.8501,P0.05);观察组产褥期感染例数低于对照组(χ~2=4.3956,P0.05);观察组新生儿Apgar评分高于对照组(t=5.4727,P0.01),观察组产妇的产后出血量低于对照组(t=-35.0457,P0.01)。结论:音乐疗法联合心理激励措施能够显著改善初产妇的心理负性情绪,产程时间缩短,剖宫产风险降低,出血量减少。     

Untangling syntactic and sensory processing: an ERP study of music perception

The present study investigated music-syntactic processing with chord sequences that ended on either regular or irregular chord functions. Sequences were composed such that perceived differences in the cognitive processing between syntactically regular and irregular chords could not be due to the sensory processing of acoustic factors like pitch repetition, pitch commonality (the major component of "sensory dissonance"), or roughness. Three experiments with independent groups of subjects were conducted: a behavioral experiment and two experiments using electroencephalography. Irregular chords elicited an early right anterior negativity (ERAN) in the event-related brain potentials (ERPs) under both task-relevant and task-irrelevant conditions. Behaviorally, participants detected around 75% of the irregular chords, indicating that these chords were only moderately salient. Nevertheless, the irregular chords reliably elicited clear ERP effects. Amateur musicians were slightly more sensitive to musical irregularities than nonmusicians, supporting previous studies demonstrating effects of musical training on music-syntactic processing. The findings indicate that the ERAN is an index of music-syntactic processing and that the ERAN can be elicited even when irregular chords are not detectable based on acoustical factors such as pitch repetition, sensory dissonance, or roughness.     

Musically induced arousal affects pain perception in females but not in males: a psychophysiological examination

The present study investigated affective and physiological responses to changes of tempo and mode in classical music and their effects on heat pain perception. Thirty-eight healthy non-musicians (17 female) listened to sequences of 24 music stimuli which were variations of 4 pieces of classical music. Tempo (46, 60, and 95 beats/min) and mode (major and minor) were manipulated digitally, all other musical elements were held constant. Participants rated valence, arousal, happiness and sadness of the musical stimuli as well as the intensity and the unpleasantness of heat pain stimuli which were applied during music listening. Heart rate, respiratory rate and end-tidal PCO(2) were recorded. Pain ratings were highest for the fastest tempo. Also, participants' arousal ratings, their respiratory rate and heart rate were accelerated by the fastest tempo. The modulation of pain perception by the tempo of music seems to be mediated by the listener's arousal.     

Sight-reading of violinists: eye movements anticipate the musical flow

When sight-reading a piece of music the eyes constantly scan the score slightly ahead of music execution. This separation between reading and acting is commonly termed eye-hand span and can be expressed in two ways: as anticipation in notes or in time. Previous research, predominantly in piano players, found skill-dependent differences of eye-hand span. To date no study has explored visual anticipation in violinists. The present study investigated how structural properties of a piece of music affect the eye-hand span in a group of violinists. To this end eye movements and bow reversals were recorded synchronously while musicians sight-read a piece of music. The results suggest that structural differences of the score are reflected in the eye-hand span in a way similar to skill level. Specifically, the piece with higher complexity was associated with lower anticipation in notes, longer fixation duration and a tendency for more regressive fixations. Anticipation in time, however, remained the same (~1 s) independently of the score played but was correlated with playing tempo. We conclude that the eye-hand span is not only influenced by the experience of the musician, but also by the structure of the score to be played.     

音乐系统脱敏治疗大学生交流恐惧效果分析

目的探讨音乐系统脱敏疗法对消除或缓解大学生交流恐惧的有效性和可行性，为有效干预大学生交流恐惧提供方法学资料。方法将24名高交流恐惧者在校大学生随机等分为实验组和对照组，对12名实验组成员进行音乐系统脱敏；实验前后分别测量交流恐惧自陈量表（PRCA-24）、演讲者信心自评量表（PRCS）、惧怕否定评价量表（FNE）和羞怯量表（Shyness Scale），并对实验前后实验组、对照组的各项评定结果进行比较；采用自编主观评价问卷检验实验组成员对音乐系统脱敏疗法的满意程度。结果经音乐系统脱敏后，实验组成员除FNE量表平均分实验前后差异无统计学意义外，其余各测量指标差异均有统计学意义（P〈0．05），音乐系统脱敏自我评价呈满意趋势。结论音乐系统脱敏疗法对消除或缓解大学生交流恐惧是有效的、可行的；     

音乐疗法在神经外科昏迷病人中的疗效观察

目的：研究音乐疗法在促进神经外科昏迷病人功能恢复中的作用。方法：2005年1月～2007年12月我院收治130例重型颅脑损伤的昏迷病人,随机分为两组,对照组采取常规治疗方法,治疗组在常规治疗的基础上进行音乐疗法。结果：通过治疗,治疗组清醒病人25例（38.5%）,改善31例（47.7%）,无效9例（13.8%）;对照组清醒病人49例（75.2%）,改善12例（18.5%）,无效4例（6.3%）。经过统计分析,两组的治疗效果有非常显著性差异（P〈0.01）。通过治疗,对照组10d后清醒6例（24%）,20d后清醒7例（28%）,30d后清醒12例（48%）;治疗组10d后清醒19例（38.8%）,20d后清醒17例（34.7%）,30d后清醒13例（26.5%）。结论：通过早期合理的药物治疗与音乐治疗可以促进神经细胞的修复及神经功能的恢复,可以将音乐疗法贯穿于昏迷病人的治疗过程中,促进昏迷病人的恢复。     

音乐行为干预在糖尿病治疗中的探索

目的:探讨音乐、行为干预对2型糖尿病(DM)综合治疗的疗效.方法:对180例DM患者进行代谢指标测定、抑郁自评量表(SDS)、焦虑自评量表(SAS)、糖尿病控制状况评价量表(CSSD70)、DM生活质量测评量表(DQOL)评定,随机分为治疗组(A),对照组(B),两组均给予DM常规治疗,A组辅以音乐治疗,3月后与对照组比较血糖、糖化血红蛋白(GH b A1c)、血压、量表等变化.结果:DM患者抑郁发生率45.2%,音乐治疗3个月后血糖谱、GHAIc、血压、糖尿病控制状况、生活质量较对照组有显著差异.结论:音乐、行为干预有益于DM的综合治疗.     

音乐疗法在围手术期护理中的应用研究

目的：探讨音乐疗法在围手术期护理中的作用。方法：选择在我院实施局麻手术患者120例，随机分为观察组和对照组，两组均进行常规护理，观察组同时在术前、术中、术后收听自己喜欢的音乐。对两组焦虑水平、术中麻醉药用量和术后疼痛程度进行比较。结果：观察组术前SAS评分和焦虑发生率均明显低于对照组（P〈0．05），而术后两组无显著性差异（P〉0．05）；观察组术中咪唑安定使用量明显少于对照组（P〈0．05），利多卡因使用量也少于对照组，但无显著性差异（P〉0．05）；观察组术后疼痛分级明显低于对照组（P〈0．01）。结论：在同手术期护理中应用音乐疗法，可以减轻患者焦虑、减少麻醉药用量，缓解疼痛，促进康复。