| Background: Leukemia is a malignant disease of hematopoetic system. The etiology and pathogenesis is unclear. Recently studies showed that people's emotion can influence occurrence and development of the disease. Conversely, disease can influence patient's emotion. Psychologists believe that, emotion involved in a wide range of physiological activities of neurons, including the central nervous system, the body nervous system, autonomic nervous system and endocrine system. Substantial results prove the occurrence of leukemia is closely related to the emotion. Tension, anxiety and fear is the typically emotion features of leukemia patients. Adverse emotional reactions can enhance the excitability of sympathetic nerve of cerebral cortex, and increase the releasing of catecholamines substances such as norepinephrine adrenaline, the secreting of enkephaline,β-endorphine. This lead to a series of physiological changes, such as faster heart rate, elevated blood pressure, respiration rate increases, and poor sleep. Repeated chemotherapy, and chemotherapy-induced nausea and vomiting, patients, both physically and psychologically, have to suffering the painful experience This will not only increase the patient's anxiety, fear, but also increased the burden on the patients and lower the quality of life. Some patients even gave up the treatment at last as these reasons. It is not conducive to the resumption of the disease, and lost the opportunity of rehabilitation. How to improve theemotional response of patients becomes an urgent issue need to be resolved in the nursing care.Music therapy is a simple, economical, non-invasive method of psychological intervention. Currently it has been widely used in abroad. Recent years it was used in many fields in our country, such as clinical nursing care. Research shows that music primarily through the central nervous system to regulate the body. Music caused emotional regulation and integration role in the central nervous system, also lead to peripheral tissue's physiological responses dominated by central nervous system, autonomic nervous system. Music can stimulate the brain through auditory nerve, so that promote nerve cell's excitability. Through neural and neuro-humoral regulation, the brain can make some wholesome human secretion such as hormones, enzymes, acetylcholine, enkephaline,β-endorphine and other substances, through excitation vagous-nerve, it can lower heart rate, blood pressure, and respiration rate, regulate blood flow, improve blood circulation, strengthen the intestinal motility, improve cancer patients immune function, alleviate nausea and vomiting, ease anxiety, tension and depression, and improve the quality of life. Modern medical science has proved: music can act as an effective method to relax, alleviate the ache, tension, anxiety and fear of the patient, lower the heart rate, respiratory rate and blood pressure, decrease the nausea and vomit. It can promote patients'recovery and improve the life quality of patient's, increase the confidence of winning paroxysm. However,the effect of music on tension, anxiety and fear in leukemia patients receiving chemotherapy has not investigated.Objective: This study was to evaluate the effect of music therapy on leukemia patients receiving chemotherapy both in anxiety level and physiological responses, as assessed by objective parameters and a subjective validated anxiety scale. Seeking for a simple, safe, economic and effective nursing intervention for leukemia patients receiving chemotherapy which can alleviate patient's physiological and psychological suffering, increase the confidence of winning paroxysm, help patient to pull through the chemotherapy period, enhance the life quality of patient's, promote health and well-being.Methods: A randomized controlled clinical trial was carried out with 80 leukemia patients aged 16-65. They were randomly assigned to undergo either 1 hour of music intervention (experiment group, n=40) or a rest period (control group, n=40). Patients in two groups have accepted same chemotherapy protocol, and same drugs. Patients in experiment group listen to the music two times a day, each time thirty minutes. At the same time patient in control group rest in bed. Nursing care was same in control group except listening to the music. Anxiety was measured with the State Trait Anxiety Inventory(S-AI) when patients admitted to the department .The patient was asked to answer the S-AI scale and their blood for NE test was taken before the first and after the last chemotherapy treatment. Physiological indices, such as heart rate, respiratory rate, systolic blood pressure anddiastolic blood pressure were recorded before and after the studying period. And the side-effects related with chemo-drugs, such as nausea and vomiting also need to be recorded during the studying period.Results:⑴There are no statistical difference in age, gender, occupation, education, and S-AI score in admission in two groups.⑵Compare in two groups (pre-chemotherapy -post-chemotherapy). The S-AI score in two groups has evidence difference (t=10.82, p=0.001<0.01), S-AI score obviously decreased in experiment group compared with control group. HR in two groups has evidence difference (t=8.09, p=0.001<0.01), SBp in two groups has evidence difference(t=10.77, p=0.001<0.05), DBp in two groups has evidence difference(t=12.22, p=0.001<0.01), NE in two groups has evidence difference(t=2.87, p=0.005<0.01). All changes were found to be statistically significant. HR, SBp, DBp, NE are obviously lowered in experiment group comparing with control group. RR in two groups has no evidence difference(t=0.42, p=0.678>0.05).⑶Compare the anxiety level and physiological responses of pre-chemotherapy and post-chemotherapy within experiment group and control group. S-AI score is statistical difference after chemotherapy compared with before chemotherapy (experiment group t=16.92, p=0.001<0.01, control group t=2.25, p=0.030<0.05), S-AI score in two groups decreased after chemotherapy compared with before chemotherapy. Either HR is significant difference afterchemotherapy compared with before chemotherapy (experiment group t=10.45, p=0.001<0.01,control group t=3.07, p=0.004<0.01), NE is prominent difference after chemotherapy compared with before chemotherapy (experiment group t=8.71, p=0.001< 0.01, control group t=2.43, p=0.020<0.05), HR and NE within two groups were decreased post-chemotherapy compared with pre- chemotherapy. SBp and DBp were compared pre-chemotherapy with post-chemotherapy in experiment group. There are statistical difference after chemotherapy compared with before chemotherapy(SBp t=12.38,p=0.001<0.05,DBp t=14.71,p=0.001<0.05),SBp and DBp were decreased post-chemotherapy compared with pre- chemotherapy. SBp and DBp were compared pre-chemotherapy with post-chemotherapy in control group. There are no statistical difference after chemotherapy compared with before chemotherapy(SBp t=1.09,p=0.281>0.05;DBp t=0.07,p=0.943>0.05);RR in two groups were no significantly difference after chemotherapy compared with before chemotherapy (experiment group t=1.52, p=0.137>0.05, control group t=0.73, p=0.470>0.05).⑷Patient's hospitalized duration in experiment group is 26.18±6.21d, while those in control group is 30.78±13.21d, this difference were statistically significant (t=1.99, p=0.05), the hospitalized days is obviously shorter in experiment group compared with control group.⑸The rate of nausea and vomiting occurred is 7.5% inexperiment group, and 25% in control group, it is obviously difference (p=0.034<0.05, X~2=4.50).Conclusion: Music therapy can allay anxiety and promote patients recovery. It can lower patients'heart rate, respiratory rate and blood pressure. It can also reduce NE's level in blood, reduce side-effects caused by chemo-drugs, and decreased hospitalized duration. It successfully help patient to pull through the chemotherapy period, and reduced patients cost in the period of hospitalization.
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