海洛因依赖躯体脱毒治疗方案的比较

COMPARISON OF DIFFERENT TREATMENT SCHEMES FOR SOMATIC SYMPTOMS INDUCED BY HEROIN DEPENDENCE

目的··:寻找一种相对较佳的躯体脱毒治疗方案。方法·· :对符合DSM -Ⅲ -R药物依赖及阿片类戒断反应诊断标准的90例海洛因依赖者随机分成3组 ,即美沙酮替代递减法 (A组 )、阶梯治疗法 (美沙酮口服液 ,盐酸丁丙诺啡注射液和盐酸洛非西定片 ,B组 )、盐酸洛非西定递减治疗 (C组 )3组。采用双盲双模拟的给药方法 ,进行为期15d的治疗比较。戒断症状采用《戒断症状评定量表》、《汉密顿焦虑量表》和《不良反应观察量表》进行评定。结果··:A、B两组d2 -8戒断症状分值无显著性差异(P>0.05) ,C组与A、B两组d2 -8戒断症状分值有显著性差异(P<0.05)。A组后期戒断症状减分缓慢 ;C组头晕、恶心等不良反应出现较多。结论·· :阶梯治疗法 (B组 )

Objective: To select out a better treatment scheme for somatic symptoms induced by heroin dependence. Method: 90 patients with heroin dependence were randomly assigned to double-blind groups treated by methadone with dosage successively decreased(Group A), methadone, buprenorphine (Bup), lofexidine hydrochloride in steps (Group B) and lofexidine hydrochloride(Group C). All the subjects were treated for 15 days. Withdrawal symptoms and adverse drug reactions were recorded daily. Result: Withdrawal symptoms in Group A and B were well controlled with a few adverse reactions produced in the 2nd day to 8th day and there was no significant difference between the two groups (P>0.05). However, significant difference was found(P<0.05) compared with Group C in which there were more patients producing adverse reactions such as dizziness, nausea.Group A was slower in reducing scale scores during the late part of the treatment.Conclusion: Combination of three medications administered in steps (Group C) is comparatively ideal in the treatment of heroin dependence.