曲唑酮对甲基苯丙胺滥用者焦虑情绪和心理渴求的临床治疗对照研究

A controlled clinical intervention study on the treatment of anxiety and psychological craving in methamphetamine addicts by using trazodone

目的观察曲唑酮对甲基苯丙胺滥用者中出现的焦虑情绪和心理渴求的临床疗效并予以分析。方法选取2017年2-12月本院收治的60例甲基苯丙胺依赖者作为研究对象,将其以随机抽签法分成治疗组与对照组两组,每组各30例。对照组予以常规安慰剂治疗,观察组则予以曲唑酮治疗。比较两组治疗前后焦虑情绪以及心理渴求变化情况,不良反应发生情况。结果治疗前,治疗组与对照组的HAMA评分对比不明显(P>0.05);治疗组与对照组治疗2周后、4周后的HAMA评分均低于本组治疗前(均P<0.05);且治疗2周后、4周后治疗组的HAMA评分分别为(14.23±2.25)分、(13.64±1.75)分,低于对照组的(21.56±1.87)分、(20.66±1.54)分(均P<0.05)。治疗前治疗组与对照组的VAS总分对比不明显(P>0.05);治疗组与对照组治疗2周后、4周后的VAS总分均低于本组治疗前(均P<0.05);且治疗2周后、4周后治疗组的VAS总分分别为(4.16±0.85)分、(2.72±0.67)分,低于对照组的(5.86±1.01)分、(5.12±0.85)分(均P<0.05)。观察组嗜睡、头昏、疲乏、口干、轻度便秘发生率分别为16.67%、13.33%、10.00%、3.33%、3.33%,与对照组的13.33%、10.00%、13.33%、6.67%、6.67%相比,差异不明显(均P>0.05)。结论曲唑酮应用于甲基苯丙胺滥用者中,可明显改善患者的焦虑情绪及心理渴求,且不会增加不良反应的发生,安全性较佳,对减少复吸的临床治疗手段具有指导意义。

Objective To observe and analyze the clinical effect of trazodone on anxiety and psychological craving in methamphetamine abusers.Methods 60 cases of methamphetamine addicts admitted to our hospital from February 2017 to December 2017 were selected as research objects.They were divided into treatment group and control group by random lottery method,with 30 cases in each group.The control group received conventional placebo for treatment and the observation group received trazodone for treatment.The changes of anxiety,psychological desire and adverse reactions before and after treatment were compared between the two groups.Results The difference of HAMA scores between the treatment group and the control group was not statistically significant before treatment(P>0.05).HAMA scores of the treatment group and the control group decreased significantly at the 2 nd and 4 th week after treatment(all P<0.05).In addition,2 weeks and 4 weeks after treatment,HAMA scores of the treatment group(14.23± 2.25 and 13.64± 1.75) were lower than those of the control group(21.56±1.87 and 20.66± 1.54)(all P<0.05).Before treatment,the differences of total VAS scores between the treatment group and the control group were not statistically significant(P>0.05).The VAS scores of both groups decreased significantly at 2 weeks and 4 weeks after treatment(all P<0.05).In addition,2 weeks and 4 weeks after treatment,VAS scores of the treatment group(4.16±0.85 and 2.72±0.67) were lower than those of the control group(5.86±1.01 and 5.12±0.85)(all P<0.05).The incidence of lethargy,dizziness,fatigue,dry mouth and mild constipation in the observation group was 16.67%,13.33%,10.00%,3.33% and 3.33%respectively,there were no statistically significant compared with that of 13.33%,10.00%,13.33%,6.67%,6.67% in the control group(all P>0.05).Conclusions The application of trazodone in methamphetamine abusers could significantly improve patients ’ anxiety and psychological desire,and will not increase the occurrence of adverse reactions,presents well safety.It provides guidance for the clinical treatment of reducing relapse.