苯二氮类负荷剂量法与逐日递减法治疗戒酒综合征的对照研究

COMPARISON OF LOAD DOSAGE AND TAPERED DOSAGE BENZODIAZEPINE IN THE TREATMENT OF ALCOHOLWITHDRAWAL

目的 :比较苯二氮 艹卓 类负荷剂量法与逐日递减法治疗戒酒综合征的有效性和安全性。方法 :111例AWS总分≥ 7分、符合CCWD - 2 -R戒酒综合征诊断标准的患者 ,随机分为两组进行对照研究 ,分别采用负荷剂量法和逐日递减法治疗 ,以AWS减分率为疗效评定指标 ,以TESS为评价不反应指标。结果 :苯二氮 艹卓 类负荷剂量法治疗戒酒综合征 ,2周末有效率 96 % ,与逐日递减法比较 ,无显著性差异 (P >0 0 5 )。但负荷剂量法在治疗d1、d2就能较全面控制戒断症状 ,其AWS的减分率较逐日递减法有非常显著性差异 (P <0 0 1) ,并且负荷剂量法能较快改善震颤、焦虑、激越、幻觉、定向力等症状 ,AWS上述各因子分明显低于逐日递减法 (P <0 0 5 ,P <0 0 1)。 2周后负荷剂量法的不良反应的发生率明显低于逐日递减法 (P <0 0 5 ,P <0 0 1) ,其不良反应的程度亦明显较低 (P <0 0 1)。结论 :苯二氮 艹卓 类负荷剂量法治疗戒酒综合征简便、有效、安全 。

Objective: To evaluate the efficacy and safety of load dosage benzodiazepines on alcohol withdrawal syndromes. Methods: A double-blind randomized study was carried out to compare the treatments of load dosage and tapered dosage benzodiazepines; Alcohol Withdrawal Scale (AWS) and Treatment Emergent Symptom Scale (TESS) were used. Results: 56 patients were treated with load dosage of benzodiazepines, 55 patients were treated with tapered dosage of benzodiazepines. Both groups showed significant reduction of AWS scores. The treatment of withdrawal symptoms with load dosage was overall and faster than that with tapered dosage(P<0.05,P<0.01), and the group of load dosage showed lower score of side effects. Conclusion: Load dosage benzodiazepines are effective in the treatment of withdrawal syndromes of alcohol dependence and has fewer and mild adverse reactions.