Effect Of Five-element Music Therapy On Decompensated Patients With Post-hepatitis B Cirrhosis Due To Liver Depression And Spleen Deficiency Type

ObjectiveObserving the clinical effect of five-element music therapy in decompensated patients with post-hepatitis B cirrhosis due to liver depression and spleen deficiency type,which could provide an effective basis for TCM characteristic nursing intervention methods in patients with post-hepatitis B cirrhosis due to liver depression and spleen deficiency type.MethodsThis study was used to select 76 patients with post-hepatitis B cirrhosis who met the criteria for inclusion and divided into observation groups(38 cases)and control groups(38 cases)randomly.The two groups of patients were on the basis of standardized treatment and routine nursing of post-hepatitis B cirrhosis.Ordinary music therapy was applied to the control group,meanwhile the five-element music therapy was applied to the observation group,20 days for a course of treatment.The general condition questionnaire was used to collect basic data before intervention.The CLDQ and the PSQI were used to collect information of quality of life and sleep respectively at 3 time points which including preintervention,intervention 21st day and intervention 42st day.The patient’s compliance was investigated by the music therapy compliance questionnaire.The TCM syndrome score of liver disease,laboratory indicators of liver function and coagulation function were used to investigate overall efficacy.SPSS 23.0 statistical software was applied for statistical analysis.The balance analysis was used to baseline data of 2 groups.The differences of the CLDQ and PSQI at three time points were compared by generalized estimating equations.The influencing factors of the CLDQ were explored by multiple linear regression analysis.Comprehensive efficacy was explored by the non-parametric Mann-Whitney U test.ResultsThere were 71 effective cases collected in this study,35 cases in the observation group and 36 cases in the control group.1.There was no significant difference(P>0.05)in baseline value,which indicated that the good balance and comparable between 2 groups.2.The CLDQ score was analyzed by generalized estimating equation analysis.There were significant differences(P<0.05)between 2 groups and at 3 time points in total score of the scale,WO,EF,and FA.There were no significant difference(P>0.05)in AS,SS and AC between 2 groups;while the comparison at 3 time points was statistically significant(P<0.05).The CLDQ score was analyzed by multiple linear regression analysis.The total score of CLDQ were most affected by the daytime dysfunction(F=6.996,P=0.002<0.05,R~2=0.171).WO were most affected by the age(F=8.164,P=0.001,R~2=0.194);the correlations were not close.FA were most affected by the daytime dysfunction(F=8.469,P=0.000<0.05,R~2=0.275).AS were most affected by the subjective sleep quality(F=8.694,P=0.000,R~2=0.345).SS were affected by the total score of PSQI(F=14.148,P=0.000,R~2=0.170).AC were affected by the daytime dysfunction(F=7.851,P=0.007,R~2=0.102)。3.The PSQI score was analyzed by generalized estimating equation analysis.There were significant differences(P<0.05)between 2 groups and at 3 time points in total scores of the PSQI,sleep latency,sleep disturbances and daytime dysfunction.There were significant differences(P<0.05)in subjective sleep quality and use of sleeping medication between 2 groups;while there was no significant difference(P>0.05)at 3time points.There was no significant difference(P>0.05)between 2 groups in habitual sleep efficiency,while the difference was statistically significant at 3 time points(P<0.05).There was no significant difference(P>0.05)between 2 groups and at 3 time points in sleep duration.4.There was no significant difference(P>0.05)in overall efficacy between 2 groups.5.There was no significant difference(P>0.05)in music therapy compliance between 2groups.6.There was no significant difference(P>0.05)in laboratory indicators of liver function(GGT excluded)and coagulation function between 2 groups,which were non-affected by the number of days in hospital(F=0.810,P=0.603,R~2=0.276).Conclusion1.Five-element music therapy could effectively improve the overall QOL,WO,EF and FA to the decompensated patients with post-hepatitis B cirrhosis;but interventions in AS,SS,AC were not strong enough,which may be related to insufficient intervention.2.Five-element music therapy could effectively improve the overall sleep quality,sleep latency,sleep disturbances,daytime dysfunction,use of sleeping medication and subjective sleep quality,but non-affect in sleep efficiency and sleep duration.3.Five-element music therapy had little influencese in overall efficacy,liver function and coagulation function to the decompensated patients with post-hepatitis B cirrhosis;which may be related to insufficient intervention.4.There were good compliance of music therapy in 2 groups and no significant difference(P>0.05)between 2 groups.