美沙酮维持患者重返社会程式训练的一年随访研究

Improvement of Symptom and Social Function in Methadone Maintenance Treatment Patients Receiving Community Re-entry Program:a One-year Follow-up Study

目的:探讨重返社会技能训练程式对于社区美沙酮维持患者康复的作用。方法:将100例社区美沙酮维持患者随机分为技能训练组(以下简称训练组,50例,其中脱失5例)和对照组(50例,其中脱失2例)。在药物维持治疗的同时,对训练组进行重返社会技能训练,对照组接受门诊一般咨询辅导,对两组患者干预1年。采用戒断症状量表、稽延性戒断症状量表和Momingside康复状态量表(MRSS),在干预前、后第1、3、6、9、12个月时对患者进行评估;同时监测尿吗啡检查阳性率、脱失率、就业率。结果:⑴入组时与干预末次评分减分值的比较,训练组戒断症状量表0.51±3.36分,稽延性戒断症状量表3.14±5.27分,MRSS总分13.92±21.08分,均优于对照组(分别为-2.93±7.16分、-1.23±7.27分和-10.09±30.93分,P<0.05～0.01);⑵训练组尿吗啡检查阳性率(8%)和脱失率(2%)低于对照组(分别为40%和19%,P<0.05);⑶训练组的就业率(51%)高于对照组(23%),P<0.01。结论:在药物维持治疗的基础上,重返社会程式可以有效帮助海洛因依赖者维持在治疗项目中,尽早重返社会。

Objective： To examine the effects of community re-entry program on relieving the symptoms and improving the social functions in methadone maintenance patients. Methods： A total of 100 patients with methadone maintenance were randomly assigned into two groups. The patients in the study group were given scheduled skill-training course; the patients in the control group were given traditional rehabilitation training. All the subjects were followed up for one year, and assessed with anxiety disorder and protracted abstinence （PA） and Morning side Rehabilitation Status Scale （MRSS） before the study and at the 1st, 3rd, 6th, 9th and 12th months, respectively. Results： Ninety three subjects completed the one year follow-up. According to the reduction scores of anxiety disorder, PA and MRSS, the study group demonstrated better improvement than the control group （0.51 ±3.36 vs.-2.93 ±7.16, 3.14 ± 5.27 vs. -1.237.27 ±7.27, 13.92 ±21.08 vs. -10.09 ±30.93, respectively; P〈 0.005-0.01） The rates of relapse and re-hospitalization were significantly lower （20% vs. 40%, 2% vs. 19%; P〈 0.05） than that in control group. Conclusion： Combining with pharmacotherapy, the community re-entry program is helpful in relieving symptoms and improving social function in patients with methadone maintenance.