2/100 Hz 跨皮电刺激(多导HANS仪)对海洛因成瘾的治疗作用

Treatment on heroin addicts by four channel Han's acupoint nerve stimulator (HANS)

目的：观察多导韩氏穴位神经刺激仪（Ｈａｎ’ｓａｃｕｐｏｉｎｔｎｅｒｖｅｓｔｉｍｕｌａｔｏｒ，ＨＡＮＳ）对海洛因成瘾戒断症状、海洛因注射疤痕综合征及脱毒后复吸率的影响。方法：２８例自愿戒毒者随机分为丁丙诺啡（ｂｕｐｒｅｎｏｒｐｈｉｎｅ，ＢＰＮ）组或ＨＡＮＳ（选用４对穴位，每天刺激２～４次）加低剂量ＢＰＮ组（简称ＨＡＮＳ组）。两组所用的ＢＰＮ剂量均以患者不出现戒断症状为标准，连续治疗１４ｄ。结果：（１）１４ｄ后，２组患者尿样吗啡分析、纳络酮催瘾试验均呈阴性。（２）在１４ｄ脱毒期内，ＢＰＮ组每人对ＢＰＮ的平均总需要量为（１２．９０±１．３４）ｍｇ，而ＨＡＮＳ组为（１．０１±０．１１）ｍｇ，比ＢＰＮ组的平均总需求量降低了９２．１８％（Ｐ＜０．００１）。（３）ＢＰＮ组患者的注射疤痕综合征（静脉壁纤维性增厚、静脉干疤痕、静脉塌陷等）总评分治疗后降低了２２．０％，与治疗前无显著性差异；ＨＡＮＳ组注射疤痕综合征总评分治疗后降低６２．８％，与该组治疗前相比有显著性差异（２７±１１ｖｓ７３±７，Ｐ＜０．０５）。（４）在脱毒期结束后，对患者进行了跟踪追访。第１、第２和第３个月，ＢＰＮ组的复吸率分别为９２％、１００％和１００％；而?

Objective: To evaluate the efficacy of a 4 channel HANS in the treatment of heroin addicts and the heroin related injection mark syndrome. Methods: 28 heroin addicts were randomly divided into 2 groups ( n =14 in each group) to receive either buprenorphine (BPN) or HANS plus low dose of BPN for 14 days. The doses of BPN were chosen according to individual requirement for abolishing withdrawal syndrome. The frequency of HANS was 2 Hz and 100 Hz shifting automatically, each lasting for 3 seconds (D D mode). Results: (1) The urine analysis for morphine and the naloxone tests were negative in both the BPN and HANS groups. (2) The total average dose of BPN per person used in the BPN group was (12.90±1.34) mg (100%) in the 14 day period whereas that of the HANS group in the same period was only (1.01±0.11) mg (7.82%, P <0.001). (3) Heroin related injection mark syndrome (fibrotic thickening of the vein, thrombosis or induration, superficial venous stasis, scarred mainlines , venous collapse) was scored before and after the 14 days treatment. No significant change was observed in the BPN group ( 71±7 vs 56±8, P >0.05 ) , whereas in the HANS group there was a significant reduction of the scoring ( 73±7 vs 27± 11 , P <0.05 ) . (4) Follow up survey revealed that in BPN group the relapse rate was 98% in the 1st month and 100% in the 2 nd and 3rd months, whereas in HANS group the corresponding relapse rate was 57% ( P <0.05), 71%( P < 0.05 ) and 78% ( P <0.05), respectively. Conclusion: The use of 4 channel HANS for heroin detoxification resulted in a 92.3% reduction of BPN consumption, a marked reduction of the injection mark syndrome and a significant lowering of the relapse rate, at least in the first 3 months of convalescence.