中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2014年
12期
831-835
,共5页
吕继辉%高天%李沫%谢丽娟%李文杰%靳玮叶%郝智慧%母海艳
呂繼輝%高天%李沫%謝麗娟%李文傑%靳瑋葉%郝智慧%母海豔
려계휘%고천%리말%사려연%리문걸%근위협%학지혜%모해염
阿尔茨海默病%音乐疗法%记忆%语言%神经行为学表现
阿爾茨海默病%音樂療法%記憶%語言%神經行為學錶現
아이자해묵병%음악요법%기억%어언%신경행위학표현
Alzheimer disease%Music therapy%Memory%Language%Neurobehavioral manifestations
目的 评价音乐治疗对轻度阿尔茨海默病(AD)患者记忆力、语言功能和精神症状的作用.方法 收集2012年1月至2014年4月就诊于北京老年医院记忆门诊的轻度AD患者93例,按照随机数字表法随机分为音乐治疗组(A组,32例)、歌词对照组(B组,31例)和空白对照组(C组,30例).A组在音乐治疗师指导下跟唱熟悉的老歌;B组朗读与音乐治疗组歌曲一致的歌词,无音乐.两组均每日1次,每次30 min,持续3个月,之后随访3个月.C组按常规诊疗,无特殊干预.所有受试者在基线期(t0)、3个月(t1)、6个月(t2)时接受相关神经心理学测验.结果 A组世界卫生组织-加利福尼亚听觉词语测试(WHO-UCLA AVLT)即刻回忆得分(分)t1(7.38±1.45)及t2(7.24±1.42)均高于t0(6.81±1.40),差异有统计学意义(t=3.79、t =3.62,P＜0.05).A组WHO-UCLAAVLT延迟回忆得分(分)t1高于t0(6.51±1.52与5.88±1.34,t=4.06,P＜0.05).词语流畅性测试得分(分)t1时A组(8.63±1.94)和B组(8.58±1.75)均高于C组(7.54±2.03),差异有统计学意义(t =5.57、t=2.48,P＜0.05);t2时A组(8.45±1.69)高于B组(7.89±1.74)和C组(7.43±1.52),差异有统计学意义(t=2.37、t =4.55,P＜0.05);A组t1(8.63±1.94)及t2(8.45±1.69)均高于t0 (7.62±1.70),差异有统计学意义(=3.92、t =3.65,P＜0.05);B组t1高于t0(8.58±1.75与7.68±1.76,t=3.31,P＜0.05).A组神经精神问卷评分(分)t1(13.52±11.63)及t2(13.01±11.72)均低于t0(16.37±11.72),差异有统计学意义(t=33.07、t=29.65,P＜0.05).A组照料者苦恼程度得分(分)t1(16.43±11.90)及t2(15.02±10.56)均低于t0 (21.72±12.88),差异有统计学意义(t=32.44、t =31.68,P＜0.05).结论 音乐治疗可增强轻度AD患者记忆能力和语言功能,减轻精神症状和照料者的苦恼程度.演唱歌曲效果优于朗读歌词.
目的 評價音樂治療對輕度阿爾茨海默病(AD)患者記憶力、語言功能和精神癥狀的作用.方法 收集2012年1月至2014年4月就診于北京老年醫院記憶門診的輕度AD患者93例,按照隨機數字錶法隨機分為音樂治療組(A組,32例)、歌詞對照組(B組,31例)和空白對照組(C組,30例).A組在音樂治療師指導下跟唱熟悉的老歌;B組朗讀與音樂治療組歌麯一緻的歌詞,無音樂.兩組均每日1次,每次30 min,持續3箇月,之後隨訪3箇月.C組按常規診療,無特殊榦預.所有受試者在基線期(t0)、3箇月(t1)、6箇月(t2)時接受相關神經心理學測驗.結果 A組世界衛生組織-加利福尼亞聽覺詞語測試(WHO-UCLA AVLT)即刻迴憶得分(分)t1(7.38±1.45)及t2(7.24±1.42)均高于t0(6.81±1.40),差異有統計學意義(t=3.79、t =3.62,P＜0.05).A組WHO-UCLAAVLT延遲迴憶得分(分)t1高于t0(6.51±1.52與5.88±1.34,t=4.06,P＜0.05).詞語流暢性測試得分(分)t1時A組(8.63±1.94)和B組(8.58±1.75)均高于C組(7.54±2.03),差異有統計學意義(t =5.57、t=2.48,P＜0.05);t2時A組(8.45±1.69)高于B組(7.89±1.74)和C組(7.43±1.52),差異有統計學意義(t=2.37、t =4.55,P＜0.05);A組t1(8.63±1.94)及t2(8.45±1.69)均高于t0 (7.62±1.70),差異有統計學意義(=3.92、t =3.65,P＜0.05);B組t1高于t0(8.58±1.75與7.68±1.76,t=3.31,P＜0.05).A組神經精神問捲評分(分)t1(13.52±11.63)及t2(13.01±11.72)均低于t0(16.37±11.72),差異有統計學意義(t=33.07、t=29.65,P＜0.05).A組照料者苦惱程度得分(分)t1(16.43±11.90)及t2(15.02±10.56)均低于t0 (21.72±12.88),差異有統計學意義(t=32.44、t =31.68,P＜0.05).結論 音樂治療可增彊輕度AD患者記憶能力和語言功能,減輕精神癥狀和照料者的苦惱程度.縯唱歌麯效果優于朗讀歌詞.
목적 평개음악치료대경도아이자해묵병(AD)환자기억력、어언공능화정신증상적작용.방법 수집2012년1월지2014년4월취진우북경노년의원기억문진적경도AD환자93례,안조수궤수자표법수궤분위음악치료조(A조,32례)、가사대조조(B조,31례)화공백대조조(C조,30례).A조재음악치료사지도하근창숙실적로가;B조랑독여음악치료조가곡일치적가사,무음악.량조균매일1차,매차30 min,지속3개월,지후수방3개월.C조안상규진료,무특수간예.소유수시자재기선기(t0)、3개월(t1)、6개월(t2)시접수상관신경심이학측험.결과 A조세계위생조직-가리복니아은각사어측시(WHO-UCLA AVLT)즉각회억득분(분)t1(7.38±1.45)급t2(7.24±1.42)균고우t0(6.81±1.40),차이유통계학의의(t=3.79、t =3.62,P＜0.05).A조WHO-UCLAAVLT연지회억득분(분)t1고우t0(6.51±1.52여5.88±1.34,t=4.06,P＜0.05).사어류창성측시득분(분)t1시A조(8.63±1.94)화B조(8.58±1.75)균고우C조(7.54±2.03),차이유통계학의의(t =5.57、t=2.48,P＜0.05);t2시A조(8.45±1.69)고우B조(7.89±1.74)화C조(7.43±1.52),차이유통계학의의(t=2.37、t =4.55,P＜0.05);A조t1(8.63±1.94)급t2(8.45±1.69)균고우t0 (7.62±1.70),차이유통계학의의(=3.92、t =3.65,P＜0.05);B조t1고우t0(8.58±1.75여7.68±1.76,t=3.31,P＜0.05).A조신경정신문권평분(분)t1(13.52±11.63)급t2(13.01±11.72)균저우t0(16.37±11.72),차이유통계학의의(t=33.07、t=29.65,P＜0.05).A조조료자고뇌정도득분(분)t1(16.43±11.90)급t2(15.02±10.56)균저우t0 (21.72±12.88),차이유통계학의의(t=32.44、t =31.68,P＜0.05).결론 음악치료가증강경도AD환자기억능력화어언공능,감경정신증상화조료자적고뇌정도.연창가곡효과우우랑독가사.
Objective To explore the effect of music therapy on memory,language,and psychological symptoms of patients with mild Alzheimer' s disease (AD).Methods Ninety-three patients with mild AD from Beijing Geriatric Hospital between January 2012 and April 2014 were recruited and divided randomly into three groups:music therapy group (group A,n =32),lyrics control group (group B,n =31),and blank control group (group C,n =30).Patients in group A sung familiar lyrics,while patients in group B read the same lyrics without music,supervised by music therapist for 30 minutes every day over a period of three months.All participants were followed up for another three months.Patients in group C received no special intervention except routine treatment.All participants completed scheduled neuropsychological tests on baseline (t0),three months later (t1),and six months later (t2).Results The World Health Organization-University of California Los Angeles Auditory Verbal Learning Test (WHO-UCLA AVLT) scores of immediate recall at t1 (7.38 ± 1.45) and t2 (7.24 ± 1.42) were both higher than that at t0 (6.81 ± 1.40) in group A (t =3.79,t =3.62,P ＜ 0.05).WHO-UCLA AVLT score of delayed recall at t1 was higher than that at t0 in group A (6.51 ± 1.52 vs 5.88 ± 1.34,t =4.06,P ＜ 0.05).In verbal fluency test,group A (8.63 ± 1.94) and group B (8.58 ± 1.75) scored higher than group C (7.54 ± 2.03) at t1 (t =5.57,t =2.48,P ＜ 0.05) ; Group A (8.45 ± 1.69) scored higher than group B (7.89 ± 1.74) and group C (7.43 ± 1.52) at t2 (t =2.37,t =4.55,P ＜ 0.05) ; Group A scored higher at t1(8.63±1.94) andt2(8.45±1.69),compared with that at t0(7.62±1.70,t=3.92,t=3.65,P＜0.05) ; Group B scored higher at t1 compared with that at t0 (8.58 ± 1.75 vs 7.68 ± 1.76,t =3.31,P ＜0.05).Group A scored lower at t1 (13.52 ± 11.63) and t2 (13.01 ± 11.72),compared with that at t0 (16.37 ± 11.72) in neuropsychiatric inventory score (t =33.07,t =29.65,P ＜ 0.05).Group A scored lower at t1 (16.43 ± 11.90) and t2 (15.02 ± 10.56),compared with that at t0 (21.72 ± 12.88) in Caregiver Distress Scale (t =32.44,t =31.68,P ＜ 0.05).Conclusions Music therapy significantly enhances memory and language ability of patients with mild AD.It relieves the psychological symptoms and reduces caregiver distress.Training of singing lyrics is superior to reading lyrics.
