从脑神经递质到情绪调节：音乐疗法缓解失眠的研究进展

From Brain Neurotransmitters to Emotional Regulation: A Review of Music Therapy in Alleviating Insomnia

摘要: 目的：系统综述音乐疗法(Music Therapy, MT)缓解失眠的潜在生物学机制与临床研究进展，为该疗法的深入研究和临床应用提供理论参考。方法：通过系统梳理近年来国内外关于音乐疗法治疗失眠及相关精神心理障碍的临床研究和基础实验文献，从神经递质调节、自主神经系统功能调控及大脑功能活动改变三个层面，总结其作用机制；并从单独应用、联合中医疗法、联合现代医学技术三个方面，归纳其临床应用现状。结果：音乐疗法主要通过三条核心通路缓解失眠：一是调节脑内5-羟色胺(5-HT)、去甲肾上腺素(NE)、γ-氨基丁酸(GABA)等关键神经递质的水平；二是激活副交感神经，降低心率、血压和皮质醇，诱导身心放松；三是影响前额叶皮层、海马体等脑区的功能连接，改善脑功能网络。临床研究表明，无论是单独使用还是与针刺、药物等疗法联合，音乐疗法均能有效改善患者的睡眠质量(PSQI评分)、缩短入睡时间、延长睡眠时长，并减轻焦虑、抑郁等负性情绪。结论：音乐疗法是一种安全、有效的非药物干预手段，其作用机制涉及神经–内分泌–免疫网络的多层次调节。未来研究应致力于建立标准化干预方案，并结合多模态神经科学技术，深入探索其作用靶点与分子机制。

Abstract: Objective: To systematically review the potential biological mechanisms and clinical research progress of music therapy (MT) in alleviating insomnia, providing theoretical references for its further research and clinical application. Methods: By systematically reviewing recent domestic and international clinical studies and basic experimental literature on music therapy for insomnia and related mental disorders, we summarize its mechanisms of action from three aspects: regulation of neurotransmitters, modulation of autonomic nervous system function, and alterations in brain activity. Additionally, we synthesize the current clinical applications from three perspectives: standalone use, integration with traditional Chinese medicine (TCM) therapies, and combination with modern medical technologies. Results: Music therapy primarily alleviates insomnia through three core pathways: first, by regulating the levels of key neurotransmitters in the brain such as 5-hydroxytryptamine (5-HT), norepinephrine (NE), and γ-aminobutyric acid (GABA); second, by activating the parasympathetic nervous system, reducing heart rate, blood pressure, and cortisol levels, thereby inducing physical and mental relaxation; third, by influencing functional connectivity in brain regions such as the prefrontal cortex and hippocampus, improving brain functional networks. Clinical studies indicate that whether used alone or in combination with acupuncture, medication, or other therapies, music therapy can effectively improve patients’ sleep quality (PSQI scores), shorten sleep onset latency, prolong sleep duration, and alleviate negative emotions such as anxiety and depression. Conclusion: Music therapy is a safe and effective non-pharmacological intervention, with mechanisms involving multi-level regulation of the neuro-endocrine-immune network. Future research should focus on establishing standardized intervention protocols and utilizing multimodal neuroimaging technologies to deeply explore its specific targets and molecular mechanisms.