音乐治疗对孤独症谱系障碍儿童干预效果的Meta分析

doi:10.3969/j.issn.1006-9771.2025.04.007

Abstract

Abstract:

Objective To explore the effect of music therapy on children with autism spectrum disorder (ASD).
Methods A systematic search was conducted in databases including CNKI, Wanfang data, VIP, PubMed, Elsevier Science Direct and Google Scholar for randomized controlled trials (RCT) on the effect of music therapy on children with ASD. The search period was from database inception to April, 2024. The control group received non-music therapy interventions, including medication, educational therapy, cognitive-behavioral therapy, and structured treatment. The observation group received music therapy. Studies were systematically reviewed following the Cochrane Handbook for Systematic Reviews, with two researchers independently screening literatures, extracting data, and assessing the risk of bias in the included studies. Statistic analysis was performed using Review Manager 5.4.
Results Nine RCTs were included, involving 828 patients from France, China, Norway, Iran, the United States and Australia. The intervention types mainly included music therapy, parent-child cooperative music therapy, Orff music therapy, group music therapy, improvisational music therapy, Orff-Schulwerk-based music therapy, music intervention and family-centered music therapy. The overall outcomes (SMD = -0.30, 95%CI -0.55 to -0.04, P = 0.02), language function (MD = -2.09, 95%CI -2.89 to -1.30, P < 0.001) and physical behavior (SMD = -0.27, 95%CI -0.53 to -0.01, P = 0.040) improved better in the observation group.
Conclusion Music therapy can improve the overall outcome of children with ASD, especially in language function and physical behavior.

Key words: autism spectrum disorder, children, music therapy, meta analysis

CLC Number:

R749.94

ZHANG Yong, CAI Zeng, XU Fengping, LIU Dan, CHANG Hongjuan. Effect of music therapy on children with autism spectrum disorder: a meta-analysis[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(4): 423-430.

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纳入文献	资格标准	随机分配	分配隐藏	基线相似	被试施盲	治疗师施盲	评估者施盲	被试流失率≤ 15%	意向性分析	组间统计比较	变异性测量	总分
Rabeyron等^[4](2020)	√	√	√	√	√		√	√	√	√	√	9
何迎霜等^[5](2022)	√	√	√	√	√		√		√	√	√	8
张玲等^[6](2023)	√	√	√	√			√	√	√	√	√	8
周青蕊等^[7](2017)	√	√		√			√	√	√	√	√	7
赵永红等^[8](2020)	√	√		√				√	√	√	√	6
Bieleninik等^[9](2017)	√	√							√	√	√	4
Ghasemtabar等^[10](2015)	√		√	√	√		√	√	√	√	√	8
LaGasse^[11](2014)	√	√	√	√			√	√	√	√	√	8
Thompson等^[12](2014)	√	√	√	√	√	√		√	√	√	√	9

纳入文献	国家	年龄/岁		样本量/n		对照组干预方法	观察组干预措施		结局指标
纳入文献	国家	对照组	观察组	对照组	观察组	对照组干预方法	内容	频率	结局指标
Rabeyron等^[4](2020)	法国	4~7	4~7	17	19	普通音乐聆听	音乐治疗	每次30 min，共25次，持续8个月	①②
何迎霜等^[5](2022)	中国	未提及	未提及	50	50	应用行为分析法	亲子合作式音乐治疗+应用行为分析法	每周60 min，持续8周	①②
张玲等^[6](2023)	中国	4.56±0.43	4.75±0.48	40	40	经颅磁刺激治疗	奥尔夫音乐治疗+经颅磁刺激	每次20~30 min，每3天1次，持续24周	①③
周青蕊等^[7](2017)	中国	3.72±1.08	3.79±1.12	55	53	常规教育康复(应用行为分析法、结构化教学）	音乐治疗+常规教育康复	每次30 min，每天1次，每周5次，持续6个月	①②
赵永红等^[8](2020)	中国	8.6±4.3	8.3±4.0	30	38	常规训练	组内音乐治疗+常规训练	每次60 min，每周2次，持续15周	①
Bieleninik等^[9](2017)	挪威	4~7	4~7	182	182	增强标准护理	即兴音乐治疗+增强标准护理	每次30 min，每周1次或3次，持续5个月	①
Ghasemtabar等^[10](2015)	伊朗	7~12	7~12	14	13	不进行干预	基于Orff-Schulwerk的音乐治疗	每次60 min，每周2次，持续45 d	②
LaGasse^[11](2014)	美国	6~9	6~9	12	10	社交技能	音乐疗法	每次50 min，每周2次，持续5周	③
Thompson等^[12](2014)	澳大利亚	3~5	3~5	11	12	早期干预	以家庭为中心的音乐治疗+早期干预	每次30~40 min，每周1次，持续16周	①③

结局指标	纳入研究数/n	异质性检验		效应模型	Meta分析结果
结局指标	纳入研究数/n	I²	P值	效应模型	MD/SMD (95%CI)	P值
总体治疗效果	7^{[4⇓⇓⇓⇓⇓-10]}	58	0.03	随机效应模型	-0.30(-0.55, -0.04)	0.020
语言功能^a	4^[4-5,7-8]	0	0.86	固定效应模型	-2.09(-2.89, -1.30)	< 0.001
社会交往	6^{[4-5,7⇓-9,12]}	0	0.68	固定效应模型	-0.09(-0.25, 0.07)	0.260
躯体行为	3^[5,7,11]	0	0.58	固定效应模型	-0.27(-0.53, -0.01)	0.040

干预类型	纳入研究数/n	样本量/n	异质性检验		效应模型	Meta分析结果
干预类型	纳入研究数/n	样本量/n	I²	P值	效应模型	MD(95%CI)	P值
治疗周期
≤ 12周	2	127	1	0.310	固定效应模型	-0.65(-2.62, 1.31)	0.510
> 12周	5	550	7	0.370	固定效应模型	-5.72(-8.08, -3.35)	< 0.001
治疗时长/min
≤ 45	4	482	0	0.550	固定效应模型	-6.67(-9.35, -3.98)	< 0.001
> 45	3	195	0	0.490	固定效应模型	-0.89(-2.71, 0.94)	0.340
治疗频次
≤ 3次/周	6	569	0	0.770	固定效应模型	-1.20(-2.92, 0.51)	0.170
> 3次/周	1	108	_	_	固定效应模型	-7.90(-11.08, -4.72)	< 0.001

干预类型	纳入研究数/n	样本量/n	异质性检验结果		效应模型	Meta分析结果
干预类型	纳入研究数/n	样本量/n	I²	P值	效应模型	MD(95%CI)	P值
治疗周期
≤ 12周	1	100				-0.90(-3.49,1.69)	0.500
> 12周	5	523	0	0.480	固定效应模型	-0.25(-0.80,0.30)	0.380
治疗时长
≤ 45 min/次	4	455	8	0.350	固定效应模型	-0.22(-0.78,0.34)	0.440
> 45 min/次	2	168	0	1.000	固定效应模型	-0.90(-2.79,0.99)	0.350
治疗频次
≤ 3次/周	5	515	0	0.760	固定效应模型	-0.08(-0.69,0.53)	0.790
> 3次/周	1	108				-1.00(-2.17,0.17)	0.090

Effect of music therapy on children with autism spectrum disorder: a meta-analysis

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