盐酸二氢埃托啡身体依赖性潜力的临床评价

CLINICAL ASSESSMENT OF PHYSICAL DEPENDENCE POTENTIAL OF DIHYDROETORPHINE HYDROCHLORIDE(DHE)

报道了盐酸二氢埃托啡（ＤＨＥ）临床替代３８例海洛因成瘾者的替代抑制试验，并应用ＣＩＮＡ量表评价海洛因成瘾者的身体依赖性程度（１）。结果表明：盐酸二氢埃托啡可与那洛酮竞争阿片受体，对戒断症状的１００％替代抑制量与海洛因成瘾者的身体依赖性强度呈正相关，剂量反应关系良好。本研究同时对啡盐酸二氢埃托啡的身体依赖性潜力进行了讨论（３，７）。

This paper reports the DHE substitution clinical trial in 38 heroin addicts. TheCINA(Clinical Institute Narcortic Assessment)scale was used to assess physical dependence potential.The CINA scale contains 10 opioid withdrawal signs(nausea ,vomiting ,gooseflesh,sweating,restless-ness , tremor , larcrimation , nasal congestion ,yawning ,changes in heart rate and systolic blood pres-sure)and 3 opiate withdrawal symptoms(abdominal pain , muscle pain and feeling hot or cold). For each subject admitted to the Drug Detoxification and Treatment Center his(her ) status oneach of the 13 items of CINA were immediately rated.Then ,naloxone 0.4 mg was injected iv toprecipitate withdrawal symptoms and at 5 ,10 ,15 min after the naloxone injection,the CINA scoreof each patient was rated again. The differences among the scores of pre-and post-naloxone injectionis a measurement of the degree of withdrawal symptoms.Then,a single dose of DHE wasadministered sublingually to each patient , all withdrawal symptoms disappeared. These results show that DHE can compete with naloxone for opioid receptors.A good Dose-response relationship was found between the 100%suppressive withdrawal sign doses of DHE and thedegree of withdrawal sign in heroin addicts.The physical dependence potential of DHE given to heroinaddicts sublingually was probably more than that of methadone given to heroin addicts orally by making reference to the report of Dr.Peachy(3).