正念减压疗法和音乐治疗对种植牙牙科焦虑症患者焦虑及疼痛的影响

摘要

目的 探讨正念减压疗法、音乐治疗缓解种植牙牙科焦虑症患者焦虑及疼痛的作用以及减轻焦虑的远期效果.方法 2016年1月至2017年4月,便利抽样法选取在我院口腔科植入美国3i种植系统的70例患者为研究对象.按就诊时间先后顺序,将2016年1-8月就诊的患者设为正念减压组,2016年9月至2017年4月就诊患者设为音乐治疗组,各35例.正念减压组患者采用正念减压疗法,音乐治疗组患者采用音乐治疗,分别在初诊、种植体植入术后以及二期术前,采用改良牙科焦虑量表对患者的焦虑程度进行评价;比较一期术前、种植体植入时、术后5 min患者的脉搏、收缩压和舒张压的变化;在术后6 、24 、48 h采用视觉模拟量表评估患者的疼痛程度.结果 正念减压组干预4周后MDAS评分低于音乐治疗组患者,其主效应差异有统计学意义(P＜0 .001) ,测量前后与处理存在交互作用(P＜0 .001).两组患者在治疗前后疼痛评分变化程度相同,均呈现下降趋势,测量前后与处理不存在交互作用(P＞0 .05) ,时间差异有统计学意义(P＜0 .05).两组患者脉搏、收缩压、舒张压的差异均无统计学意义(均 P＞0 .05) ,测量前后与处理均不存在交互作用(均 P＞0 .05).结论 正念减压疗法和音乐治疗均可减轻种植牙牙科焦虑症患者的焦虑和疼痛,保持生命体征稳定.正念减压疗法降低焦虑远期效果较好.%Objective To explore the effects of mindfulness -based stress reduction and music therapy on relief the dental anxiety and pain in patients with implant denture .Methods Total 70 patients with dental anxiety of implant teeth were selected by using convenience sampling method ,and divided into two groups according to appointment time ,35 cases with appointments between January 2016 to August 2016 were se-lected in mindfulness -based stress reduction group ,and another 35 cases with appointments between Sep-tember 2016 to April 2017 were selected in music therapy group .The observation group was applied with mindfulness -based stress reduction ,while control group received music therapy .Using modified dental anxiety scale (MDAS) to evaluate the degree of patient's anxiety at the first visit ,post -operation and fur-ther consultation of the second surgery .Comparison of the changes of the pulse ,systolic and diastolic blood pressure of the patients in the preoperative ,at the moment of implantation and 5 minutes after the operation .The level of pain was assessed by using a visual analogue scale at 6 ,24 ,48 hours after surgery . Results Four weeks after intervention ,the MDAS score in mindfulness -based stress reduction group was lower than that of music therapy group ,the statistical significance of main effect was found between two groups (P＜0 .001) ,and it had interactive effect between before and after interventions (P＜0 .001) . The pain score in two groups were both decreased after treatment ,no interactive effect was found (P＞0 . 05) ,the time difference was statistically significant (P＜0 .05) .There was no statistically significance in pulse ,systolic and diastolic pressure between two groups (all P＞ 0 .05) ,and no interactive effect was found (all P＞0 .05) .Conclusions Mindfulness -based stress reduction and music therapy can reduce anx-iety and pain in dental anxiety patients with implant denture and keep the vital signs stable .The mindful-ness-based stress reduction has better long -term effect on reduce patient's anxiety .