酒环境线索暴露对酒依赖者停止饮酒后心理渴求及生理活动的影响

The effect of exposure to alcohol-associated cues on the psychological craving and physiological changes after discontinuation of alcohol drinking in alcohol dependence patients

目的探讨酒环境暴露对酒依赖者心理渴求及生理活动的影响。方法选择停止饮酒40d的64例酒依赖患者和32名正常受试者（正常对照组）为研究对象，将患者分为试验组（暴露于酒环境）和患者对照组（暴露于牛奶环境），每组各32例，分别暴露于相关环境线索，于暴露前、暴露后的第1天、第1周和第4周测试三组的心理渴求以及心率、血压、血氢化可的松水平的变化。结果（1）患者试验组和患者对照组的血浆氢化可的松水平于暴露前[分别为（77±40）μg／L和（75±40）μg／L]、暴露后第1天[分别为（123±56）μg／L和（77±40）μg／L]均高于正常对照组[（47±26）μg／L和（47±31）μg／L；P〈0．05]。（2）患者试验组暴露于酒环境后，第1天的心理渴求程度及心率、收缩压、舒张压及血氢化可的松水平均较暴露前增高（P〈0．05），而第1周和第4周与暴露前比较的差异无统计学意义（P〉0．05）。结论酒环境暴露后酒依赖者的心理渴求及心率、血压、血氢化可的松水平增高，减少酒环境线索的暴露是降低复饮的重要因素。

Objective To explore the effects of exposure to alcohol-related environment on the psychological craving and physiological activities in alcohol dependent patients. Methods The 64 alcohol dependence patients with 40-day discontinuation of alcohol drinking were divided into patient experiment group （exposed to alcohol-related environment） and patient control group （exposed to milk）, and 32 healthy adults were involved as normal controls. After exposure to the alcohol-related clue, the craving index, heart rate ,blood pressure （BP） and serum hydrocortisone level were tested. Results The serum hydrocortisone level in the patient experiment group and the patient control group [（77±40） μg/L and. （75±40 ）μg/L respectively] were higher than that in healthy controls [（47±26）μg/L and （47±31 ）μg/L respectively] before and on the 1st day after exposure[（123±56）μg/L and （77±40）μg/L; P 〈 0.05]. On the 1st day after exposure to alcohol-related environment, the serum hydrocortisone level of the patient experiment group was significant higher than pre-exposure （P〈0.05 ）, with no differences between 7-, 28- day exposure and pre- exposure. Conclusion After exposure to alcohol-related environment, the craving index, heart rate, blood pressure and serum hydrocortisone level in the alcohol dependence patients are significant higher than pre-exposure, which indicates reducing the exposure to the alcohol-related clue is important for avoiding relapse.