美沙酮联合氯氮平治疗海洛因依赖的疗效观察

Curative effects of methadone combined with clozapine in the treatment of patients with heroin dependence

目的探讨美沙酮联合氯氮平治疗海洛因依赖的疗效及安全性.方法将60例自愿戒毒的海洛因依赖者随机分为美沙酮联合氯氮平治疗组28例和美沙酮治疗组32例.两组美沙酮起始量20～40mg·d-1,氯氮平起始剂量为12.5mg·d-1·Qn,平均剂量68.25±22.75mg·d-1.分别于治疗前及治疗后采用汉密尔顿焦虑量表和副反应量表评定临床疗效和不良反应,并进行比较分析.结果两组治疗前后汉密尔顿焦虑量表评分比较有极显著性差异(P＜0.01),副反应量表,除睡眠因子有极显著差异外(P＜0.01),其它因子均无显著性差异(P＞0.05).结论美沙酮联合氯氮平治疗海洛因依赖疗效肯定,安全性高.

Objective To explore the curative effect and safety of methadone combined with clozapine in the treatment of patients with heroin dependence . Methods 60 patients with heroin-dependence were randomly divide into combination group（methadone combined with clozapine, n=28） and methadone group（n=32）. Initial dosage of methadone was 20-40mg/d for both 2 groups and that of clozapine 12.5mg/d, Qn , mean dosage 68.25±2275mg/d. Clinical effectiveness and side effects were assessed with the Hamilton Anxiety Scale（HAMA） and Treatment Emergent Symptom Scale（TESS） before and after treatment. Results Before treatment ,there was most significant difference in the score of the HAMA between the 2 groups（P〈0.01）; sleep factor of the TESS had the most significant difference （P〈0.01） and the other factors no （P〉0.05） between the 2 groups. Conclusion Combination of clozapine and methadone has precise effectiveness and higher safety in the treatment of heroin dependence.