美沙酮维持治疗6个月后随访效果评价

Six months follow-up study of the effects of methadone maintenance treatment

目的：探讨6个月的综合干预对美沙酮维持治疗（MMT）者的疗效,为进一步完善MMT提供参考依据。方法：收集2007年1月~2014年11月广州市荔湾区惠爱医院MMT门诊收治的海洛因依赖患者,进行治疗前和治疗6个月后的问卷调查,比较治疗前后患者在药物滥用、性行为等方面的改变情况。结果：治疗后,过去1个月使用过毒品的人数、有注射吸毒行为的人数、注射吸毒次数、共针吸毒人数和共针总人数都较治疗前显著减少,其中使用过毒品人数由100%降至26%,有注射行为人数比例由88.5%降至77.7%,注射吸毒次数由以≥61次组为主（68.7%）转变成以1~30次组为主（85.5%）,共针总人数由最多20人减少到0。过去3个月的性伴人数超过1人的由5.2%升至12.3%,最近1次性行为安全套的使用率（12.5%）较治疗前（17.7%）有所减少;患者自我感觉目前与家人关系良好（52.6%）、过去1个月内没有或较少与吸毒朋友交往（69.3%）及目前有工作的人数（37.2%）都较治疗前（43.7%、22.6%和25.3%）显著提高。以上数据均有统计学意义（P〈0.05）。结论：MMT可明显减少毒品的使用,有利于恢复其各项社会功能,但对减少高危性行为,仍需加强系统社会心理综合干预进一步提高治疗效果。

Objective： To explore the effects of methadone maintenance treatment （MMT） in heroin addicts after 6 months treat- ment, and to provide basis for improving MMT. Methods ： Heroin abusers enrolled in MMT program in outpatient clinics of Guangzhou Huiai Hospital from January 2007 to Nov Z014 were included. Questionnaire of drug use and sexual behavior etc, were conducted before and after six months treatment. Results： After six months MMT treatment, past month total drug use, injecting drug use, and needle sharing were significantly reduced; total drug use declined from 100% to 26% ; injecting drug use declined from 88.5% to 77.7% ; the frequency of drug injection declined from over 61 times to 1 - 30 times; needle sharing declined from 20 persons to 0. Past three month more than one sexual partners increased from 5.2% to 12.3% ; last econdom use rate declined from 17.7% to 12.5% ） ; good family relationship increased from 43.7% to 52.6% ; past month away from drug-friends increased from 22.6% to 69.3% ; employment increase from 25.3% to 37.2%. All the above data were statistically significant （P 〈0. 05 ）. Conclusion： MMT could significantly reduce the use of drugs, and restore patients＇ social functions. However, we still need to strengthen the system of social psychology comprehensive intervention to improve therapeutic effect, and reduce high-risk sexual behavior.