虚拟现实与音乐疗法在高血压急症中的应用

有源比较器：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.

药品：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.

实验性的：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.

行为的：经典音乐疗法

该干预措施仅对'标准治疗+虚拟现实与古典音乐疗法'组的参与者实施。 在虚拟现实暴露期间，参与者以舒适的音量（40-60分贝）聆听数首选定古典音乐作品中的一首。 音乐疗法与标准抗高血压治疗同时应用，以辅助放松。

设备：虚拟现实暴露疗法

该干预措施仅对'标准治疗+VR与古典音乐疗法'组的参与者进行。 参与者使用非专有VR头显观看自选的舒缓虚拟环境。该疗程与标准抗高血压治疗同时在安静、光线昏暗的房间内进行

药品：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.

状态焦虑水平变化（状态焦虑量表 - 表格 I）

状态焦虑将采用状态-特质焦虑量表状态分量表（STAI-I）进行测量，这是一个经过验证的20项量表，用于评估情境性焦虑。总分范围从20到80分，分数越高表示状态焦虑水平越高。STAI-I将在基线和120分钟时进行施测，以评估观察期间的变化。

不良事件发生率

在整个观察期间，将记录与抗高血压药物或VR/音乐疗法相关的不良事件（如头晕、恶心、低血压）的频率和类型。