中西医结合治疗酒依赖急性戒断期的半随机对照试验

Quasi-Randomized Controlled Trial of Integrated Traditional Chinese with Western Medicine for Acute Episodes of Withdrawal in Alcoholism

目的 比较中西医结合治疗与单纯西医治疗酒依赖患者急性戒断期的疗效。方法 将符合DSM IV酒依赖及急性酒戒断综合征标准的 6 2例患者按入院顺序随机分成两组 ,奇数为观察组 ,共 31例 (4例因提前出院而排除 ) ,偶数为对照组 ,共 31例。观察组根据中医四诊资料辨证分为四型。观察组予安定替代、凯西来、输液支持治疗及中药汤剂每日一剂 ;对照组除不服中药外其余治疗与观察组相同。结果 观察组患者的肝功能恢复优于对照组 ,其中两组治疗前后GOT、γ GT差值比较有统计学差异 (P分别为 0 0 4 6和0 0 0 1)。焦虑抑郁量表测查减分 ,观察组均优于对照组 ,其中HAMD减分差异有统计学意义 (t =3 16 5 ,P =0 0 0 3)。平均安定治疗天数 ,观察组明显少于对照组 (t =- 2 6 6 6 ,P =0 0 1) ,安定平均使用总量 ,观察组亦少于对照组 ,但差异无统计学意义 (P =0 4 34)。

Objective To compare the effectiveness of integrated traditional Chinese medicine (TCM) with Western medicine and Western medicine alone for acute episodes of withdrawal in alcoholism.Methods According to the criteria of alcohol dependence and acute alcochol withdrawal syndrome of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) , 62 consecutive patients were divided into two groups: 31 patients with odd numbers were allocated to the treatment group (4 patients were excluded because they left hospital early), 31 patients with even numbers were allocated to the control group. According to the four diagnostic methods of TCM, all patients in the treatment group were further divided into 4 types. The treatment group received valium, tiopronin, transfusion therapy and herbs (potion per day). The control group received the same therapy as the treatment group did but without oral herbs. Results Liver function, especially the difference between before and after treatment of GOT and γ-GT,the treatment group showed more improvement than the control group (P=0.046 and 0.001). The scores of anxiety and depression test, especially the HAMD, the treatment group showed more improvement than the control group (t=3.165, P=0.003). The treatment group used significantly less time than the control group (P=0.01), but no statistically significant difference was seen in the dosage of valium between the two groups (P=0.434). Conclusions The efficacy of integrated TCM with Western medicine is better than Western medicine alone for acute episodes of withdrawal in alcoholism.