가상 현실과 음악 치료를 이용한 고혈압 응급 치료

활성 비교기: Standard Pharmacological Treatment

Participants in this arm will receive standard oral antihypertensive treatment consisting of 25 mg captopril. Additional doses (25 mg at 30 minutes and 25 mg at 60 minutes, total 75 mg) will be administered if systolic blood pressure remains ≥180 mmHg or diastolic blood pressure remains ≥110 mmHg during follow-up. Rescue therapy with IV nitrate (0.1 mg/kg/min) will be used if blood pressure remains uncontrolled after 90 minutes, following routine emergency department protocol. No VR or music therapy is administered in this arm.

의약품: Captopril 25Mg Tab

This drug is administered to participants in both study arms. Standard oral antihypertensive treatment with 25 mg captopril is given at baseline, with additional doses administered during follow-up as needed according to the study protocol. Rescue therapy with IV nitrate (0.1 mg/kg/min) may be used if blood pressure remains uncontrolled after 90 minutes.

실험적: Standard Treatment + VR and Classical Music Therapy

Participants in this arm will receive standard oral antihypertensive treatment consisting of 25 mg captopril. Additional doses (25 mg at 30 minutes and 25 mg at 60 minutes, total 75 mg) will be administered if systolic blood pressure remains ≥180 mmHg or diastolic blood pressure remains ≥110 mmHg during follow-up. In addition to standard treatment, participants will receive virtual reality exposure combined with classical music therapy. Patients will view a calming VR environment while listening to a selected piece of classical music. VR and music therapy are administered concurrently in a quiet and dimly lit room. Rescue therapy with IV nitrate (0.1 mg/kg/min) will be used if blood pressure remains uncontrolled after 90 minutes, following the same emergency department protocol as the control group.

행동: 클래식 음악 치료

이 중재는 '표준 치료 + VR 및 클래식 음악 치료' 그룹에 속한 참가자에게만 투여됩니다. 참가자는 VR 노출 중에 편안한 음량(40-60 dB)으로 선택된 여러 클래식 음악 작품 중 하나를 듣습니다. 음악 치료는 이완을 지원하기 위해 표준 항고혈압 치료와 동시에 적용됩니다.

장치: 가상 현실 노출

이 중재는 '표준 치료 + VR 및 클래식 음악 요법' 그룹의 참가자에게만 투여됩니다. 참가자는 비전용 VR 헤드셋을 사용하여 선택한 차분한 가상 환경을 시청합니다. 이 세션은 조용하고 어둡게 조명된 방에서 표준 항고혈압 치료와 동시에 진행됩니다.

의약품: Captopril 25Mg Tab

This drug is administered to participants in both study arms. Standard oral antihypertensive treatment with 25 mg captopril is given at baseline, with additional doses administered during follow-up as needed according to the study protocol. Rescue therapy with IV nitrate (0.1 mg/kg/min) may be used if blood pressure remains uncontrolled after 90 minutes.

Change in Mean Arterial Pressure (MAP) at 30 Minutes

Mean arterial pressure will be measured at baseline (after 10 minutes of rest) and again at 30 minutes after the initial treatment. The primary endpoint is the percentage change in MAP at 30 minutes compared with baseline. Positive values indicate a reduction in MAP.

상태 불안 수준 변화 (상태 불안 척도 - Form I)

상태 불안은 검증된 20개 문항으로 구성된 척도인 상태 불안 목록 - Form I(STAI-I)를 사용하여 측정됩니다. 총 점수 범위는 20점에서 80점까지이며, 높은 점수는 높은 수준의 상태 불안을 나타냅니다. STAI-I는 관찰 기간 동안의 변화를 평가하기 위해 기준 시점과 120분에 시행됩니다.

부작용 발생률

항고혈압 약물 또는 VR/음악 치료와 관련된 부작용(예: 현기증, 메스꺼움, 저혈압)의 빈도와 유형은 전체 관찰 기간 동안 기록됩니다.