音乐疗法联合药物对痴呆患者精神行为症状的疗效观察

Clinical efficacy of music therapy combined with drug on psychological symptoms in dementia patients

摘要:

目的 探讨音乐疗法联合奥氮平对阿尔茨海默病(AD)患者精神行为症状(BPSD)的疗效。方法 收集2014年2月至2016年2月期间在北京老年医院精神心理科住院的伴有BPSD的AD患者89例,按照随机数字表分为两组:音乐治疗组(n＝44)和对照组(n＝45)。音乐治疗组在服用奥氮平同时辅以跟唱老歌曲的音乐治疗,对照组仅口服奥氮平,观察8周。在治疗前后,用日常生活活动量表(ADL)来评定日常生活活动能力,采用AD病理行为评分表(BEHAVE-AD)评定BPSD。采用SPSS 18.0软件进行数据处理。计量资料以均数±标准差([AKx-D]±s)表示,组间比较采用t检验。结果 组内比较,与治疗前相比,音乐治疗组治疗后的ADL评分显著增加、BEHAVE-AD评分显著降低,对照组治疗后的BEHAVE-AD评分显著降低,差异均具有统计学意义(P<0.05)；组间比较,治疗后,音乐治疗组的ADL评分显著高于对照组,而BEHAVE-AD评分显著低于对照组,差异均具有统计学意义(P<0.05)。结论 奥氮平联合音乐疗法对AD的BPSD疗效优于单用奥氮平,且辅以音乐治疗还可在一定程度上提高患者日常生活能力。

Abstract:

Objective To investigate the curative effect of music therapy in combination with olanzapine on behavioral and psychological symptoms of dementia (BPSD) in the patients with Alzheimer’s disease (AD).Methods A total of 89 AD patients suffering from BPSD admitted in our department between February 2014 and February 2016 were enrolled in this study. The patients were randomly divided into 2 groups:music therapy group (n=44) and control group (n=45). The patients in the former group took olanzapine and sung old songs as music therapy for 8 weeks, while those of the latter group only received administration olanzapine for same period. Their activities of daily living were accessed with activity of daily living (ADL), and BPSD symptoms was evaluated with Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD) before and after treatment. SPPS 18.0 software package was used to perform the statistical analysis. Quantitative data were expressed as mean±SD, and compared with t-test. Results Intra-group comparison showed that 8 weeks’ treatment resulted in significant increased ADL score and lower BEHAVE-AD score in music group, and obviously lowered BEHAVE-AD score in the control group (P<0.05). Intergroup comparison indicated that after the treatment, BEHAVE-AD score was significantly lower, while ADL scores were remarkably higher in the music therapy group than the control group (P<0.05). Conclusion Olanzapine combined with music therapy is superior to the drug alone in the treatment of BPSD symptoms in AD patients, and music therapy is helpful to improve the ability of daily life in the patients.