丁丙诺啡舌下片维持治疗预防海洛因成瘾复发的临床效果

EFFICACY OF MAINTENANCE TREATMENT WITH BUPRENORPHINE SUBLINGUAL TABLETS FOR RELAPSE PREVENTION AMONG HEROIN ADDICTS

目的:探讨丁丙诺啡舌下片维持治疗预防海洛因成瘾复发的临床效果。方法:观察组海洛因成瘾维持治疗71例,对照组没有维持治疗的51例。观察组在脱毒治疗后进行3个月丁丙诺啡舌下片维持治疗,递减停药后3个月再回访。对照组同样在脱毒治疗后3个月回访。对两组治疗前、治疗中和回访时的心理渴求(VAS)进行比较。对观察组的用药剂量和维持时间等进行统计分析。结果:观察组71例海洛因成瘾者中51例(71.83%)完成了3个月的丁丙诺啡舌下片维持治疗,脱失20例(28.17%)。停药后3个月回访有17例继续维持操守,34例复发。对照组51例中有9例继续操守。观察组的操守时间显著高于对照组(中位6.0∶0.8月,P<0.001);维持治疗中的心理渴求VAS值最低,回访时的渴求比治疗中有升高,但比对照组降低明显,两组比较差异有显著性(P<0.001)。结论:丁丙诺啡舌下片有抑制心理渴求、维持操守的作用,是海洛因成瘾者防复发的有效治疗方法之一。

Objective： To explore the efficacy of maintenance treatment with buprenorphine sublingual tablets for relapse prevention among heroin addicts. Methods：Patients were divided into two groups, observation group （n = 71 ） and control group （n = 51 ）. After heroin detoxification, the observation group was treated with buprenorphine for three months as maintenance treatment while the control group did not do buprenorphine maintenance treatment. A followed -up was conducted three months later in both groups after the dose of buprenorphine administered by the observation group decreased gradually until eventually terminated. Comparison focused on psychological craving （VAS）of the addicts in two groups before treatment, in the course of the treatment and follow -up time. Statistics and analysis were conducted on the observation group of the dose of buprenorphine applied, and duration of buprenorphine maintenance..Results： In the observation group, 51 heroin addicts （71.83%） completed the three months buprenorphine maintenance treatment, and 20 dropped off （28. 17% ）. Three months later after the termination of buprenorphine, at follow - up time, 17 clients in the observation group kept abstinence from heroin, 34 clients relapsed. In the control group, 9 out of 51 clients kept drug free. The observation group kept abstinence longer than the control group （the medium data was 6. 0：0. 8 months, P 〈 0. 001 ） ; the psychological craving（VAS） in the observation group was the lowest in the course of treatment, while psychological craving（VAS） grew hieher at follow -up time but still lower compared with the control group, showing significant difference （ P 〈 0. 001 ）.Conclusion： Buprenorphine sublingual tablets can effectively mitigate psychological craving for drugs and prevent drug relapse, which shows that it can be an effective treatment for heroin addicts.