135例苯二氮类药物依赖5年后的随访

Five-year follow-up of 135 cases with Benzodiazepine dependence

目的:了解苯二氮类药物依赖后患者用药情况及对药物的态度。方法:对5年前进行调查的,符合CCMD-Ⅲ精神活性物质所致精神障碍中镇静催眠药或抗焦虑药依赖综合征的诊断标准患者进行5年后的随访,采用自制的调查表进行调查评估。结果:15年后随访时已有4例患者死亡,死亡原因全部为躯体疾病。2在这5年中发生宿醉摔伤者6例,其中5例有不同程度的骨折,1例无骨折。3与5年前相比单一用药从37.78%下降到21.37%。而2种以上药物合并使用从62.22%上升到78.63%。45年后用药量增加者88例,占67.18%,而用药量减少者21例,占16.03%。55年后用药频次增加者55例,占41.98%。而频次减少者11例,占8.40%。65年后就诊2家以上医院者120例,占91.60%。其中就诊于3家以上医院者92例,占70.23%。7有意愿减少用药量者84例,占64.12%;但真正实施减少用药量行为者只有21例,占有意愿者中的25.00%;减量后100.00%出现躯体不舒适;担忧减量后存在隐患92例,占70.23%;担忧用药对健康不利者86例,占65.65%。结论:随着时间的延长,患者对该类药物的用药量、用药频次、同类药物的合并应用等情况都在增加;患者就诊于多家医院可能与药物的不易得性及患者有躯体不适有关;有意愿减少用药量与真正实施行动者之间差距较大,可能与该类药物治疗效果相对比较满意致使患者长期用药、药物对患者的躯体及心理都产生了依赖、少有的药物替代等因素有关。

To understand the conditions of patients＇ medications after Benzodiazepine （BDZ） dependence and atti-tudes to the drugs. Methods： The cases diagnosed as the dependence syndrome of sedative-hypnotic or antianxiety drug in which men-tal disorders being due to use of psychoactive substances according to the CCMD-Ⅲfive years before were researched, and investigatedand estimated employing the self-made table. Results： （1） Four patients died because of physical disease when the five-year followupwas performed. （2） There were six patients who had a hangover fell down, in which five patients had broken their bones varying de-grees and a patient had not broken any bones during these five years. （3） The rate of taking the single medicine was reduced from 37.78% to 21. 37% compared with that five years before, however the rate of taking more than two medicines increased from 62. 22% to78. 63%. （4） There were 88 patients （67. 18%） who increased the dose five years later, however 21 patients （16. 03%） decreasedthe dose. （5） There were 55 patients （41. 98%） who increased the frequency of taking medicines five years later, however 11 patients（8. 40%） decreased the frequency. （6） There were 120 patients （91. 60%） who visited more than two hospitals five years later, inwhich 92 patients （70. 23%） visited more than three hospitals. （7） There were 84 patients （64. 12%） who wished to decrease thedose, but only 21 patients （25. 00%） really decreased the dose. After decreasing the dose, all patients appear somatic discomfort.There were 92 patients （70. 23%） who were afraid of existing hidden troubles, and 86 patients （65. 65%） were afraid that takingmedicines was bad for their health. Conclusions： As time goes on, the dose, the frequency and the condition of taking similar medi-cines together are all raising. The patients visit many hospitals due to getting this type of medicines difficultly and patients＇somatic dis-comfort. The gap between wishing to decrease the dose and decreasing the dose really is biggish, which maybe have ties with the factorsof long-term taking medicines because of being satisfied with the treatment result and physical and psychological dependence on themedicines and less medicines to be surreal.