失眠音乐调理证-乐匹配关系的科学研究

In order to solve the problem of selecting the music based on TCM syndrome differentiation in music therapy, this study take the insomniac with common TCM syndrome for an example and start with researching the music system formed two kinds of characteristics music (the mood characteristics music and the tonic characteristics music) and two kinds of therapeutic method (linstening method and vibroacoustic method). Applying a holistic strategy of integrating insomniac and TCM syndrome, integrating insomniac with common TCM syndrome and the music, effect of the music system on the insomniac with common TCM syndrome will be studied in clinic, mental state, neuropsychological state, neurophysiological state, neuroendocrine and coherent state. The results will reveal the complex correlation between. the response of mental state, neuropsychological state, neurophysiological state, neuroendocrinem coherent state in the insomniac with common TCM syndrome and different characteristics music. The information correlation based on the integrating insomniac and TCM syndrome, integrating insomniac with common TCM syndrome and the music is implemented. This study will provide the scientific assessment method for selecting the music corresponding to the insomniac with common TCM syndrome, the assessment criterion, the clinical evidence, the theoretical basis, a technological support and an exemplification for exploring a scientific way of selecting the music based on TCM syndrome differentiation in music therapy

为解决临床音乐调理中辨证施乐问题，本课题以失眠常见证候为例，从由音乐的两类特征（主音特征和情态特征）和两类干预方法（聆听法和体感振动法）构成的音乐干预系统研究入手，采用病-证-乐结合的整体研究模式，进行音乐干预系统对失眠常见证候的临床效果及多器官、多途径整体调节作用的研究。通过试验数据交互关系的整合分析，揭示音乐干预系统中主音特征音乐、情态特征音乐和干预方法的变化与人体情绪心理、神经心理、神经生理、神经内分泌和人体谐和态等心理-生物-物理系统应答的相关性，实现失眠常见证候的"病-证结合"和"病-证-乐结合"信息关联研究。本课题研究成果将为临床提供证-乐匹配关系的科学评估方法、评估标准及试验依据，为失眠证-乐匹配音乐调理提供理论基础、试验依据和技术支撑，为辨证施乐科学化研究提供范例。

为解决音乐调理中辨证施乐问题，本课题组研发出基于匹配度测评的音乐调理系统。该系统中的匹配度测评包括基于证候/体质测评结果的证候体质-调理音乐匹配测评、基于试听选曲结果的心理-调理音乐匹配测评和基于整体生理功能测评结果的生理功能-调理音乐匹配测评。应用该系统, 音乐调理师可以为被试遴选出高匹配度的调理音乐。临床研究结果表明，采用高匹配度调理音乐进行音乐调理的临床效果明显高于低匹配度调理音乐，圆满完成本课题研究目标。本课题组引入CPC睡眠质量测评分析技术对中国城市4515例成年志愿者人群( 44.14±14.48岁 )进行睡眠质量测评。测评结果显示睡眠质量良好者占测评总人数的24.94%；睡眠低质者占43.85%；睡眠质量差者占31.21%。采用本课题组研发的基于时辰的人体整体生理功能指数分析技术,对242例志愿者晚九点到次日早九点的12小时进行测评分析，结果显示，睡眠低质组子丑寅时熟睡比例和副交感神经强度明显低于睡眠质量良好组，明显高于睡眠质量差组。采用PSQI和中医体质量表对273例志愿者的睡眠质量和中医体质进行测评，结果显示睡眠低质组偏颇体质占比68.2%，低于睡眠质量差组80.1%, 但明显高于睡眠质量良好组37.5%。根据临床研究结果，本课题组建立睡眠健康综合测评方法，将睡眠亚健康定义为睡眠质量低质但未达到疾病诊断标准的一种亚健康状态,并开展睡眠亚健康评价标准临床研究，申报世界中医药联合会国际标准部《睡眠亚健康评价标准》新标准工作课题获批。此外，本课题组还开展原发性高血压病患者睡眠质量与血压节律之间相关性研究, 研究结果发现原发性高血压病患者中非杓形血压节律者的睡眠质量和夜间副交感神经强度低于杓形血压节律者。表明睡眠低质与夜间副交感神经强度上升不足是睡眠亚健康者和原发性高血压病患者共有特征，提示从改善睡眠质量和自主神经功能入手可有助于预防和治疗原发性高血压病。