玛丽恩·谷德，凯斯西储大学护理专业教授，将音乐当作镇痛的处方。
Music for Pain
By Victor Limjoco 胡德良 译注
| A dose of music can be a prescription1 for pain relief. A new systematic study of music for pain finds that while music won’t replace painkillers, it can boost2 their effectiveness. | 一曲音乐可以作为镇痛处方。有关音乐止痛，一项最新的系统研究发现：尽管音乐不会替代止痛药物，却能够提高止痛药物的效果。 |
| Marion Good loves to play music in her spare time. But as a professor of nursing at Case Western Reserve University’s Frances Payne Bolton School of Nursing, she also prescribes it for pain relief. | 玛丽恩·谷德喜欢在业余时间弹奏音乐。然而，作为凯斯西储大学护理学院的教授，她也将音乐当作镇痛的处方。 |
| Her interest in researching music for pain began when as a nurse on a neurology3 unit she worked with patients suffering from back pain. “I would bring music into the room—soft quiet music. Their faces just relaxed ... pretty soon they fell asleep,” she says. “I had to tiptoe out of the room and come back an hour or two later to pick up my tape recorder.” | 在一个神经病学研究小组当护士时，她护理背部疼痛的病人，开始对研究音乐止痛感上了兴趣。“我总是将音乐—那种轻柔的音乐带到病房。病人的面部表情就放松了……很快，他们就睡着了，”她说，“我不得不蹑手蹑脚地走出病房，一两个小时后，再来取回我的磁带录音机。” |
| Good has been testing music with post-operative patients for more than 15 years. “I found that music does reduce pain up to about 31 percent in my studies in addition to medication4,” she says. | 十五六年以来，谷德一直用音乐对手术后病人做试验。“我在研究中发现：不考虑药物治疗的效果，音乐确实能够减轻高达约31%的疼痛。”她说。 |
| Now the conclusion of a systematic analysis combining 51 clinical studies is music to her ears5. The Cochrane Review of Evidence-Based Healthcare found that patients exposed to music rate their pain as6 less intense and even use lower doses of painkillers. | 现在，一项系统分析结合51项临床研究，所得出的结论对谷德来说是个好消息。从循证医疗保健中心的考科蓝评价资料中发现，听音乐的病人认为自己的疼痛程度减轻，甚至可以减少止痛用药的剂量。 |
| On a zero to 10 scale, patients reported an average .5 drop in their pain due to music. “It’s not a huge amount,” Good says, “but that’s an average and for some people, it will be more, and for some it will be less.” Since music has no side effects7, she points out, there’s no risk to trying it. | 若将止痛的效果用0至10成来表达，病人的报告说明，有5成的止痛效果来自音乐。“这个效果不算很好，”谷德说，“这不过是个平均值。对于一些病人来说，效果会更好；而对于另外的一些病人，效果会差些。”她指出，由于音乐没有副作用，试试无妨。 |
| The review found that it didn’t matter if patients chose their own music or were prescribed certain music. But Good thinks that for chronic pain like cancer pain, patients are more likely to keep using it if it’s music they like. | 评价资料显示，让患者自己选择乐曲，或者为他们开出某种乐曲处方都是无关紧要的。但是谷德认为，对于慢性疼痛—象癌症引起的疼痛，如果运用患者喜欢的音乐，他们就更有可能坚持听下去。 |
| Good’s latest study, conducted with Sandra Siedlecki of the Cleveland Clinic Foundation and published in The Journal of Advanced Nursing, found that patients with chronic pain who added music for pain relief got other benefits too. | 谷德的最新研究是伙同克里夫兰临床医学基金会的桑德拉·西德列基进行的，研究成果发表在《高级护理杂志》上。该成果发现，慢性疼痛病人接受外加的音乐疗法，还会在其他方面受益。 |
| “We found that music reduced pain, reduced anxiety, reduced depressive symptoms8 and reduced pain disability,” she says. | “我们发现音乐可以缓解疼痛、减轻焦虑、缓解抑郁症并减轻疼痛残障，”她说。 |
| The study focused on people with chronic non-malignant9 pain or CNMP, which typically does not go away with traditional treatments. According to the study, the pain can mix with depression, disability, and feelings of powerlessness. “Although frequently prescribed, the usefulness of medications such as opioids, non-steroidal anti-inflammatory agents, muscle relaxants, neuroleptics and antidepressants, is limited by the adverse side effects,” Good and Seidlecki write in the study. | 本次研究是集中针对非癌症慢性疼痛（CNMP）患者进行的，他们的疼痛往往不会因传统的治疗而结束。该研究显示，此类患者在疼痛的同时还会伴有压抑、残障和乏力的感觉。谷德和西德列基在研究报告中写到：“尽管鸦片类镇痛剂、非固醇类抗炎剂、肌肉弛缓剂、神经安定剂和抗抑郁剂等经常作为止痛处方，但由于此类药物的毒副作用而使得药物治疗的效果受到限制。” |
| While the Cochrane review cautions10 that music should not replace traditional primary treatments for pain, Good hopes this evidence will get other healthcare providers to think of music therapy as a complement to traditional treatment. | 虽然考科蓝评价资料中告诫，音乐止痛不应代替主要的传统止痛治疗，但是谷德还是希望，这一证据会使其他的医疗保健机构把音乐疗法当作传统治疗的一种补充。 |
| Aware of Good’s findings, her colleague Jane Suresky added music to her own care for her knee replacement surgeries. She says it’s helped her to wean off11 her pain medication and cope with physical therapy. For her first knee replacement, in 2004, she used Good’s prescribed music, while for her recent second knee, she purchased an MP3 player and programmed it with her own music. “Having that experience, I was better able to be a more active participant in terms of my own recovery this time,” says Suresky. She even listened to her digital music player on the way to the hospital. “I had to give it up once I got to the pre-operative area,” she says, “and I barely turned it over12 because I wanted it when I was finished.” | 谷德的同事简·苏雷斯基做了膝关节置换手术，了解到这些研究成果之后，将音乐纳入自己的护理之中。她说这有助于撤掉止痛药物，实施物理疗法。2004年第一次置换膝关节时，她运用了谷德为她开出的音乐处方；而今她的另一个膝关节做了置换手术，她买了一个MP3播放器，往里面输入了自己的音乐。苏雷斯基说：“通过那次经历，我具备了较高的能力，这次可以更积极地参与到自我康复中来。”她甚至在去医院的路上也听数字播放器里的音乐。“我一进入手术等侯区就不得不停止播放，”她说，“我不情愿地将播放器上交，因为我手术结束后还想听。” |
| Both Good and Suresky teach their nursing students about the benefits of music, relaxation and other complementary therapies. “This will be consumer-driven13 in the future,” Good says. “People will start asking for complementary therapies such as music to relieve their pain.” | 谷德和苏雷斯基都给学护理的学生讲授音乐、放松和其他补充疗发的益处。“这在将来会成为消费者驱动型，”谷德说，“人们将开始要求利用补充疗法（象音乐疗法）来缓解疼痛。” |
| Or like Suresky, they’ll just bring their own. Suresky says that the music she uses to treat her pain fits her mood. “If I’m really stressed, I’ll probably listen to some classical music ... If I’m going out walking with the walker14, and I want to move a little bit more, I put my Cuban music on.” | 或者就象苏雷斯基，人们会带上自己的音乐。苏雷斯基说她用来治疗疼痛的音乐适合她的心情：“如果确实很紧张，我很可能会听古典音乐；如果我要推着助步车出去散步，想多活动活动，就播放古巴音乐。” |
Notes:
1. 处方
2. 提高，增进
3. 神经病学
4. 药物治疗
5. music to one’s ears 佳音，好消息
6. rate… as… 认为……是
7. side effect 副作用
8. depressive symptom 抑郁症状
9. 非恶性的，非癌的
10. caution警告，告诫
11. 戒掉，断掉
12. 上交，递交
13. 消费者驱动的，消费者主导的
14. 助步车，扶车
译自：美国《科学中心网》
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