植入型长效纳曲酮缓释剂治疗海洛因依赖者心理渴求的临床价值

Study of the curative effect on heroin craving among heroin dependence treated with long-term sustained release naltrexone （LSRNTX） implants

目的研究植入型长效纳曲酮缓释剂（Long—term sustained release nahrexone，LSRNTX）对海洛因依赖者心理渴求的疗效。方法对接受植入型LSRNTX治疗的108例海洛因依赖患者，进行治疗前后的海洛因渴求量表分析，同步进行治疗后尿液吗啡、美沙酮和丁丙诺啡突击性定性检测。结果（1）108例患者接受植入型LSRNTX治疗后海洛因渴求量表总分及用药意向、用药渴望、效果期待、自我控制4个因子得分均显著低于治疗前得分，差异具有统计学意义。（2）治疗后的108例患者中，95例（87．96％）尿吗啡、美沙酮、丁丙诺啡检测结果为全阴性，阳性结果者13例（12．04％）。（3）治疗后尿液检测阴性结果者海洛因渴求量表得分较治疗前得分减低幅度高于阳性结果者得分减低幅度。结论植入型LSRNTX对海洛因依赖患者具有降低心理渴求的良好疗效，有利于防治海洛因依赖患者复吸。

Objective To investigate heroin craving changes among heroin dependence treated with longterm sustained release nahrexone （LSRNTX） implants. Methods Before and after the treatment of LSRNTX implants, the levels of heroin craving were evaluated with Rating Scale for Heroin Craving among 108 heroin addicts, and urine analysis for morphine, methadone, and buprenorphine were performed among them without prior notification. Results （1）After the treatment of LSRNTX implants,the total scores of Rating Scale for Heroin Craving and the scores of the four factors of abusing intent , abusing spiration, expect effect, and self-control among the 108 heroin addicts were much less lower than those before the treatment, and the differences are statistically significant. （2） After the treatment, the outcomes of urine analysis for morphine, methadone, and buprenorphine were completely negative among 95 subjects （87.96%） ,the positive outcomes were found in 13 （12.04%） subjects. （3）After the treatment ,the scores of Rating Scale for Heroin Craving among the subjects with negative outcome of urine analysis decreased much more significantly than those of the subjects with positive outcome. Conclusion The LSRNTX implants are effective on palliating or eliminating heroin craving,and belp to prevent the heroin addicts from relapsing.