美沙酮递减法联合糖皮质激素治疗重度海洛因依赖的临床研究

Methadone withdrawal method combined with glucocorticoids in detoxification of heroin abusers

目的 观察重度海洛因依赖者戒毒初期加用糖皮质激素后对美沙酮抑制海洛因依赖戒断反应的影响。方法 将基本情况相似的 2 0 0例重度海洛因依赖者随机分为治疗组和对照组 ,各 10 0例 ,治疗组在服用美沙酮递减法的同时 ,入院初期 3d服用泼尼松片 2 0mg/次 ,3/d ,对照组单纯用美沙酮递减疗法。结果 治疗组在每日美沙酮需要量及整个疗程中的总需要量均明显低于对照组 (P <0 0 1) ,且治疗组使用美沙酮时间也明显少于对照组 (P <0 0 1)。结论 海洛因依赖者戒断初期伴有明显戒断反应 ,重度海洛因依赖者应激能力明显低下 ,戒毒初期适当补充糖皮质激素 ,有利于提高重度海洛因依赖者的应激能力 ,减轻戒断反应 ,减少美沙酮用量 。

Objective To explore the effticacy of methadone combined with glucocorticoids in detoxification of heavy heroin abusers.Methods 200 heavy herion abusers were randomly assingned to treatment group and control group,100 cases each.The treatment group was treated by methadone withdrawal method and with cortisone(20 mg,tid) in the early 3 days after admission to the hospital,whereas the control group was treated by methadone withdrawal method alone.Results The dosage of methadone used in the treatment group was significomtly lower than that in the control group(P<0.01),and the period of methadone administration in the treatment group was significantly shorter than that in the control ptoup (P<0.01).Conclusions Stress reaction is related to abstinence reaction in early stage of detoxification,and the stress ability of heavy herion abusers is low.Glucocorticoid properly administered to heroin abusers in the early stage of detoxification facilitates enhancement of stress ability,alleviation of abstinence reaction,diminution of the amount of methadone used,and prevention of side effects due to large doses of methadone.