美沙酮与丁丙诺啡联合梯度递减治疗海洛因依赖者疗效观察

Clinical study of methadone hydrochloride combined with buprenorphine hydrochloride in the treatment with gradually reducing dosage of heroin addicts, compared with ordinary dosage of buprenorphine hydrochloride

目的 对比研究美沙酮和丁丙诺啡联合梯度递减疗法与单纯丁丙诺啡梯度递减疗法治疗海洛因依赖的临床效果。方法 对 14 44例海洛因依赖者采用 10d递减疗法进行戒毒治疗 ,随机分为两组 ,A组 :10 2 8例 ,联合应用美沙酮与丁丙诺啡治疗 ;B组 :416例 ,应用丁丙诺啡治疗。结果 治疗后两组轻、中、重度积分均明显降低 ,治疗前 5dA组比B组戒断症状积分要低得多 ,A组治疗期间戒断症状控制平稳 ,效果确切 ,总体临床脱瘾率为 96.89% ,与单用丁丙诺啡治疗脱瘾率 94.71%比 ,差异显著 (P<0 .0 5 )。结论 美沙酮与丁丙诺啡联合梯度治疗海洛因依赖的替代递减疗法联用合理安全 ,效果好 ,递减迅速 ,副作用轻微 。

Objective To investigate practicability of methadone hydrochloride combined with buprenorphine hydrochloride was used in the treatment of mild, moderate and severe heroin addiction patients, compared with ordinary dosage of buprenorphine hydrochloride.Methods 1 444 patients were randomly divided into two groups, group A(n=1028):patients received methadone hydrochloride combined with buprenorphine hydrochloride; group B (n=416):patients received buprenorphine hydrochloride. Medications were given with the dosage gradually decreasing in ten day course.Results The effective in controlling the symptoms in the mild group was better than the moderate and the severe heroin addictive groups. The detoxification rate in group A(96.89%) was higher than the group B(94.71%)(P<0.05).Conclusions Methadone hydrochloride combined with buprenorphine hydrochloride therapy showed the advantage of rapid on set of effect, well control of symptoms, smooth course of detoxification without rebound phenomena after treatment.