音乐干预对小细胞肺癌患者抑郁状态及Th1／Th2免疫状态的影响

目的：探讨音乐干预对小细胞肺癌并发抑郁患者抑郁状态的疗效及对辅助性T细胞亚群（Th1／Th2）免疫反应状态的影响。方法：小细胞肺癌并发抑郁患者72例，随机分为音乐组和常规组各36例，并另设正常组36例。音乐组和常规组均给予常规化疗和口服阿米替林片治疗，音乐组同时配合音乐干预。治疗前后采用汉密尔顿抑郁量表（HAMD）作为抑郁评价工具，用酶联免疫吸附法检测外周血中Th1型细胞因子白细胞介素2（IL-2）、7-干扰素（IFN-7）和Th2型细胞因子白细胞介素4（IL-4）、白细胞介素10（IL-10）的浓度及评价I临床疗效。结果：治疗6及12周时音乐组和常规组与治疗前比较，患者HAMD评分及血中IL-4、IL-10浓度持续下降，IL-2、IFN-7浓度明显升高，音乐组表现更明显；12周时音乐组IL-2和IL-4浓度均接近正常组，常规组与正常组比较差异仍有统计学意义（P〈0.05）。临床疗效比较，音乐组治愈、显效率及总有效率均明显高于正常组（P〈0.01）。结论：音乐干预能减轻或消除小细胞肺癌并发抑郁患者的不良心理反应，调节和改善Th1／Th2细胞因子失衡的免疫状态。

Effect of Music Therapy on Depression and the Immunological Reaction State of Th1/Th2 Cytokines in the Patients with Small-cell Lung Cancer

Objective：To investigate the effects of music therapy on the depression and the immunological reaction state of Th1/Th2 cytokines in the patients with small-cell lung cancer. Methods： Seventy-two patients were divided into two groups： a treatment group, in which 36 patients were treated with both music therapy and regular treatment; and a control group, in which 36 patients were treated with only regular treatment （chemotherapy and amitriptyline）. Clinical symptoms and signs were recorded, and the serum samples were obtained before and after treatment. Hamilton depression scale （HAMD） was used for evaluating each patient in both groups. The levels of interleukin 2（IL-2）, interferon-γ（IFN-γ）, interleukin 4（IL-4） and interleukin 10 （IL-10） in serum were determined by enzyme-linked immunosorbent assay （ELISA）. Results：Compared with those before treatment and those in control group, the depression was eliminated, the HAMD marks were decreased, the levels of IL-2 and IFN-γ were increased, and the levels of IL-4 and IL-10 were reduced more significantly after the treatment with music therapy. Conclusion： Music therapy is effective for eliminating the depression and regulating the secretion of Th1/Th2 cytokines of patients with small-cell lung cancer.