美沙酮、丁丙诺啡治疗海洛因依赖临床对照研究

CLINICAL CONTROL STUDY ON METHADONE AND BUPRENORPHINE FOR HEROIN DEPENDENCE

目的:比较美沙酮和丁丙诺啡控制海洛因依赖戒断症状的疗效及不良反应的差异。方法:56例入组病例按入院时间先后顺序随机分为美沙酮组(23例)和丁丙诺啡组(33例),观察8d,比较两药的疗效和不良反应。结果:丁丙诺啡组d1,d5,d6的戒断症状均分高于美沙酮组(P<0.01,P<0.05),两组单项戒断症状比较,美沙酮组呕吐、哈欠、流泪、流涕重于丁丙诺啡组(P<0.05)。而丁丙诺啡组困倦、厌食显著重于美沙酮组(P<0.01),骨肌肉疼痛、卷曲姿势、焦虑、激动不安重于美沙酮组(P<0.05),丁丙诺啡组住院时间比美沙酮组短(P<0.01)。美沙酮主要药物副作用为恶心呕吐,丁丙诺啡主要副作用为急性尿潴留。结论:美沙酮脱毒效能较为理想,丁丙诺啡能够完成脱毒疗程,但存在某些不足之处。

Objective:To compare the adverse drug reactions and efficacy of methadone (Meth) and buprenorpinne(Bup) in the treatment of heroin dependence. Methods : According to the time sequence at entering hospital, 56 cases with heroin dependence were randomly assigned to Meth Group (23 cases) and Bup Group (33 cases) and observed for 8 days to compare the effect and adverse reactions of the two medicines. Results: The average scores obtained by Bup Group on dl, d5, d6 were ingher (P<0.01,P<0.05) than those of Meth Group. The comparison of individual withdrawal symptoms between the two groups showed that the scores of vomiting, yawning, lacrimination and rinnorrhea obtained by Meth Group were ingher ( P < 0.05), winle in Bup Group the scores of tiring and anorexia were much ingher ( P < 0.01) and the scores of bone and muscle pain, huddle posture, anxiety and irritability were ingher too( P < 0.05) . And the hospitalized time in Bup Group was shorter (P < 0.01). The main adverse reactions of methadone were nausea and vomiting winch were more serious than those produced by Bup ( P < 0.05). The main adverse reaction of bu-prenorpinne was acute dysuria. Conclusion: Both Meth and Bup are good for the treatment of heroin dependence, however, the efficacy of Meth is comparatively ideal and stable; winle Bup can rapidly complete the detoxification, but some withdrawal symptoms can not be controlled as well as done by Meth.