美沙酮维持治疗效量关系及患者依从性分析

Analysis of dose-effect relationship and compliance for methadone maintenance treatment

目的:分析美沙酮维持治疗用量与保持率的量效关系、常见不良反应及影响病人依从性的原因。方法:对符合纳入要求的研究对象,连续记录12个月内每人每天美沙酮维持治疗用量及其维持治疗的持续时间,常见的不良反应、以其保持率评价美沙酮维持治疗的效果。并就病人社会人口学特征、药物依赖及治疗剂量保持率的变化分析影响美沙酮维持治疗依从性的因素。结果:1.剂量与保持率两变量相关系数为0.076,绝对值<0.3,P概率值为0.098,P>0.05,服药剂量与维持率之间,二者无明显相关性;2.美沙酮维持治疗主要副作用为胃肠道反应,给与对症治疗或减量后大部分有所好转;3.吸毒时间较长、吸毒频率高、无业、无家人支持、多药物滥用者是影响美沙酮维持治疗依从性的危险因素。结论:药量增加在初期不能提高患者的保持率,但随时间延长,剂量增加有提高患者保持率的趋势。

Objective：To analyze the dose-effect relationship of methadone maintenance treatment （MMT）, methadone side effects, and the factors influencing curative effects. Methods： With national MMT guideline for heroine addicted drug users, local heroine-dependent people were admitted to community based MMT program af- filiated to XIAN MMT clinic. Data on outpatients＇ social-demo characteristics, baseline behaviors on drug use and daily stabilized dose drugs were entered to MMT datable-Results. Results：There was no association between the dose and retentionr（r--0.076, P〈0.05）. The most side effect is constipation. Long for heroine, the high frequency of heroine ,sole and more drug addicts and no family help men cannot have methadone on schedule. Conclusion： There is no association between the dose and retention in one year.