曲唑酮联合心理治疗对海洛因依赖者脱毒期的疗效观察

Effects of trazodone combined with psychological on treatment of heroin addicts during detoxification

目的:观察曲唑酮联合心理治疗对海洛因依赖者脱毒期间的临床疗效,探讨其在改善成瘾者心理状况、防复吸等方面的作用。方法:120例接受丁丙诺非维持治疗(BMT)的海洛因依赖者随机分为对照组、曲唑酮组、心理治疗组、曲唑酮+心理治疗组,每组30例。治疗前后,采用稽延性症状评定量表、汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、海洛因渴求评定量表、自我控制量表分别对患者进行问卷调查。结果:曲唑酮和心理治疗均能改善海洛因依赖者脱毒期间的焦虑、抑郁症状;与曲唑酮组、心理治疗组比较,曲唑酮联合心理治疗在改善焦虑、抑郁症状方面疗效更显著。心理治疗还可降低渴求、增加自我控制能力,而曲唑酮在降低渴求、增加自我控制能力方面则无明显疗效。结论:曲唑酮联合心理治疗可有效控制海洛因依赖者脱毒期间焦虑、抑郁症状,并能增加海洛因依赖者自我控制能力,降低渴求,对预防复吸具有积极作用。

AIM： To observe the effect of trazodone combined with psychotherapy for heroin addicts after detoxification, and to evaluate their effects in improving the psychological state and reducing relapse. METHODS： 120 heroin addicts receiving buprenorphine maintenance treatment（ BMT）were randomly divided into control group（ n = 30cases）,trazodone group（ n = 30 cases）,psychotherapy group（ n = 30 cases）,and trazodone combined with psychotherapy group（ n = 30 cases）. Patients in the respective groups were questionnaire surveyed by using Hamilton Anxiety Scale（ HAMA）,Hamilton Depression Scale（ HAMD）,heroin craving rating scale,and self control scale before and after treatment. The course of treatment was 3months. RESULTS： The single trazodone and the single psychotherapy could all reduce the anxiety and depression for heroin addicts after detoxification. Compared with the single trazodone group and the single psychotherapy group,the trazodone combined with psychotherapy group could reduce the anxiety and depression better. However,psychotherapy could significantly reduce the craving for heroin and improve self-control ability of addicts. The single trazodone also was effective in reducing craving for heroin and improving the self-control ability.CONCLUSION： Trazodone combined with psychotherapy is effective in reducing anxiety and depression for heroin addicts after detoxification. It can significantly reduce the craving for heroin and improve the self-control ability of addicts.