米氮平治疗海洛因依赖患者稽延性戒断症状的疗效观察

Curative effects of mirtazapine in protracted withdrawal syndrome of patients with heroin dependence

目的探讨米氮平治疗海洛因依赖患者稽延性戒断症状的疗效。方法将120例海洛因依赖患者随机分为米氮平治疗组(研究组)55例,康复欣治疗组(对照组)65例。两组在急性期均选用美沙酮脱毒治疗10d,尿液检查呈阴性患者分别服用米氮平和康复欣治疗。米氮平15～30mg·d-1,康复欣4粒·d-1,疗程均为4w。于治疗前及治疗第1、2、3、4w末采用稽延性戒断症状评定量表评定临床疗效,并进行对比分析。结果稽延性戒断症状量表评定两组治疗第4w末总分及各因子分显著低于治疗前;躯体症状因子分在治疗第1、2、3w末研究组显著高于对照组;情绪因子分在治疗第1、2、3、4w末对照组显著高于研究组;渴求因子分在治疗第1、2、3、4w末研究组显著高于对照组;睡眠因子分在治疗第1、2w末对照组显著高于研究组。结论米氮平对稽延性戒断症状有良好的疗效,特别是对情绪和睡眠障碍有显著改善。

Objective To explore the curative effect of mirtazapine in protracted withdrawal syndrome of patients with heroin dependence. Methods 120 patients with heroin dependence were randomly assigned into research(took mirtazapine,n=55) and control(did Kangfuxin capsule ,n=65) group. All patients were treated with methadone on acute stage for 10 days, ones whose urine examination became negative were given mirtazapine 15~30mg/d and Kangfuxin capsule 4 grains for 4 weeks respectively. Curative effects were assessed and compared with the Scale for Assessment of Protracted Withdrawal Symptoms(SAPWS)before treatment and at the ends of 1st, 2 nd , 3 rd and 4 th week during treatment. Results At the end of 4th week, the total scores and all factors' scores were obviously lower than those before tre atment in both the 2 groups; in the first 3 weeks, the score of somatic symptoms was obviously higher in the research than in the control group; during treatment, the score of emotion was significantly higher and that of craving lower in the control than in the research group; at the ends of 1 st and 2 nd week, the score of sleep was obviously higher in the control than in the research group. Conclusion Mirtazapine is effective in the treatment of heroine protracted withdrawal symptoms, especially in improving emotion and sleep disorders.