THERAPEUTIC EFFECT OF ABSTINENCE CAPSULE ON WITHDRAWAL SYMPTOMS OF HEROIN ADDICTS

435 heroin addicts were treated for 10 days to evaluate the therapeutic effectiveness ofabstinence capsule on heroin withdrawal symptoms and its main adverse actions.Lofexidine was applied in a control group of 48 addicts.The single blind method and somedetermination methods used internationally were employed to evaluate the therapeuticeffectiveness and adverse actions of the drugs.The results showed that the abstinence capsulehas better therapeutic effectiveness,with less adverse actions,wider safety range,longer timeof action and less cost than lofexidine.

Acupuncture with Methadone for heroin withdrawal syndrome: a meta-analysis of randomized controlled trials

Objective： To assess the efficacy of acupuncture plus Methadone in treating heroin withdrawal syndrome. Methods： According to the requirements of evidence-based medicine, the inclusion criteria, exclusion criteria and retrieval strategy were set for original documents. Randomized controlled trials（RCTs） involving acupuncture plus Methadone in treating heroin withdrawal syndrome were retrieved from China National Knowledge Infrastructure Database（CNKI）,Wanfang Academic Journal Full-text Database（Wanfang）, Chinese Biomedical Literature Database（CBM）, Chongqing VIP Database（CQVIP）, PubM ed, Cochrane Library and EMBASE. According to the Cochrane Handbook for Systematic Reviews of Interventions, each included trial was assessed strictly including risk of bias and quality evaluation. Meta-analysis and descriptive-analysis were conducted using the RevM an 5.3 software. Results： A total of 8 trials involving 931 patients were included. Meta-analysis showed that there was no statistical significance [RR=1.05; 95%CI（0.99, 1.11）; P=0.11] in comparing total effective rate between the acupuncture plus Methadone and Methadone alone; the cure rate of acupuncture plus Methadone was higher than that of Methadone alone[RR=1.45; 95%CI（1.19, 1.78）; P=0.0003]; the relapse rate of the acupuncture plus Methadone was lower [RR=0.691;95%CI（0.60, 0.80）; P〈0.00001]. On the basis of these results, the method recommended by the Grading of Recommendations Assessment, Development and Evaluation（GRADE） was taken to evaluate the quality of the evidence. It showed that the level of the evidence was low and it was weakly recommended. Conclusion： According to the included trials, acupuncture plus Methadone in treating heroin withdrawal syndrome is more effective and better than Methadone alone, but it still needs more high-quality, large sample, and polycentric researches to confirm it.

Brain-derived neurotrophic factor and Bcl-2 expression in rat brain areas following chronic morphine treatment

The ventral tegmental area and the locus coeruleus are associated with psychological and physical dependence of opioid addiction. To date, very little is known about brain-derived neurotrophic factor （BDNF） and Bcl-2 gene and protein changes following morphine addiction. The present study utilized immunohistochemistry and in situ hybridization techniques, which revealed that there were increased BDNF levels, but decreased Bcl-2 levels in the prefrontal cortex, locus coeruleus, hippocampus, and the ventral tegmental area during morphine-dependence formation and abstinence. However, the levels of BDNF remained unchanged, and Bcl-2 expression was increased in the nucleus accumbens. These results showed that BDNF and Bcl-2 are involved in the development of morphine dependence, and precipitation of abstinence syndrome.

Therapeutic Efficacy Observation on Acupuncture for Post-withdrawal Syndrome of Heroin Dependence

Obj ective： To observe and analyze the intervention effects of needling different points for post- withdrawal syndrome of heroin dependence, and thus provide clinical basis for screening specific points. Methods： A total of 60 males with heroin dependence were randomly allocated into 3 groups, the Neiguan （PC 6） group, the Shenmen （HT 7） group and the control group. The results were observed and evaluated before, during, and 3 weeks after treatment using the rating scale for post-withdrawal syndrome and Hamilton anxiety scale （HAMA）. Results： In regards to the control of post-withdrawal symptoms, the groups of Neiguan （PC 6） and Shenmen （HT 7） showed statistical difference when compared with the control group （P〈0.05, P〈0.01）; however, there was no statistical difference between the Neiguan （PC 6） group and Shenmen （HT 7） group （P〉0.05）. Conclusion： Acupuncture can alleviate the post-withdrawal syndrome and anxiety of heroin dependence. Although both Neiguan （PC 6） and Shenmen （HT 7） have equally remarkable effects, Shenmen （HT 7） have a better tendency for marked effect for heart-mind related symptoms.

Shen's Experience in Application of the Drugs for Tonifying the Kidney to.Reduce and Withdraw Adrenocortical Hormone

Adrenocortical hormone (ACH) has antiinflammatory and antiallergic actions, changes stress state and controls the attack of some severe and obstinate diseases. The treatment of chronic diseases with ACH often leads to its dependence; especially oral administration of ACH for a long time is liable to inhibit the function of hypothalamus-pituitary-adrenocortical-thymic axis (HPAT), and results in the hypo-reservation of adrenal cortex. Hence, sudden ACH withdrawal or decrease often causes the disease recurrence, even adrenocortical crisis. Academician Shen Ziyin has a wealth of clinical experience in both the withdrawal and reduction of ACH and the keeping of therapeutical effectiveness to form his unique remedy in the application of drugs. Shen's rich experience is described as follows.

Clinical Observation on Improvement of Heroin Withdrawal Syndrome by Acupuncture plus Methadone

Purpose： To observe therapeutic effect of acupuncture plus Methadone on improvement of heroin withdrawal syndrome. Methods： Sixty cases of heroin dependence patients were divided into the treatment group and the control group. The treatment group was given acupuncture plus Methadone, and the control group was treated with Methadone. Results： The score of the withdrawal symptoms was lower in the treatment group than in the control group （P〈 0.05）. The improvement of withdrawal symptoms was significantly better in the treatment group than in the control group （P〈 0.05）. Conclusion： Acupuncture plus Methadone can significantly improve heroin withdrawal syndrome.

Dopaminergic system does not play a major role in the precipitated cannabinoid withdrawal syndrome

AIM:To determine the dopaminergic system involvement in precipitated cannabinoid withdrawal syndrome.METHODS:The dopamine D_(1)receptor antagonist SCH23390 or the dopamine D_(2)receptor antagonist sulphide was administered to rats chronically treated with either△^(9)-tetrahydrocannabinol(THC)or vehicle.Subjects were then injected with either SR141716A or vehicle and behavior was observed for 1 h.RESULTS:Administration of the cannabinoid receptor antagonist SR141716A to animals chronically treated with THC as described by Tsou et al(1995)produced a profound withdrawal syndrome.Treatment with dopamine antagonists did not attenuate cannabinoid precipitated withdrawal syndrome in THC tolerant animals while the agonists increased the syndrome.CONCLUSION:It is unlikely that the dopaminergic system plays a major role in mediating the behavioral aspects of the cannabinoid withdrawal syndrome.

Clinical Observation of Electroacupuncture in Treating Withdrawal Anxiety in Heroin-dependent Patients

Objective： To observe the effects of electroacupuncture on withdrawal anxiety in heroin-dependent patients. Methods： Sixty heroin-withdrawal subjects with negative urine morphine were digitally randomized into two groups： acupuncture group in which 30 cases were treated by electroacupuncture and control group in which 30 cases were given no treatment. The patients were assessed by Hamilton anxiety scale before treatment and one week, two weeks and three weeks after treatment. Results： After treatment, the anxiety symptoms of heroin-dependent patients were improved more significantly in the acupuncture group than in the control group （P〈0.01）. Conclusion： Electroacupuncture has good effects on anxiety symptoms and emotions of heroin-dependent patients.

Effect of reward alteration following acupuncture for morphine withdrawal rats on neuronal discharges in the ventral medial prefrontal cortex

Objective：To observe the effect of reward alteration following acupuncture for morphine withdrawal rats on the behavior and neuronal discharges in the medial prefrontal cortex （mPFC）. Methods：The Sprague-Dawley （SD） rats were randomly allocated into a model group, a confinement group, an electroacupuncture （EA） group, and a control group. Rats with morphine addiction were made by intraperitoneal injection of naloxone （same dose injection of saline for rats in the control group）, followed by a 2-week morphine withdrawal. Acupuncture and confinement were completed during the morphine withdrawal period. Upon withdrawal, the rats received conditioned place preference （CPP） training and open field test. The multi-channel neural signal processor was used in the electrophysiological experiment to measure the neuronal discharges in different subareas of prefrontal cortex in CPP box and aversion box. Results：Rats in the model group and the confinement group spent longer period of time in CPP box than those in the EA group and the control group （allP〈0.01）; there was no statistically significant difference between the EA group and the control group. The total distances of movement by rats in the model group and the confinement group were longer than those in the EA group and the control group （allP〈0.01）. The mPFC neuronal discharge frequencies were compared between morphine preference box and aversion box. The mPFC neuronal discharge frequencies in the model group and the confinement group were higher than those in the EA group and the control group （allP〈0.05）; there was no statistically significant difference between the EA group and the control group. Conclusion：Acupuncture can effectively interfere with the reward alteration following morphine withdrawal, possibly because of its involvement with the mPFC neuronal discharges.

Sex differences in morphine dependence and plasma levels of morphine and morphine-3-glucuronide in rats

To examine whether there are sex differences in morphine dependence and its metabolism. Naloxone-precipitated withdrawal study was performed. Twenty rats were induced by naloxone 1 h after a single dose of morphine injection. The withdrawal syndromes were recorded and an HPLC-UV method was set up to quantify the plasma levels of morphine and morphine-3-glucuronide（M3G）. In the spontaneous withdrawal study, 97 rats were treated with progressive morphine for 28 d to develop physical dependence. The spontaneous withdrawal syndromes were recorded and plasma levels of morphine and M3G were determined after the last injection. No significant differences were observed in withdrawal syndrome of naloxone precipitating. More severe spontaneous withdrawal syndromes were produced by chronic morphine injection in male rats than in female rats（P0.05）. Higher maximum plasma concentration（Cmax） of morphine was measured in male rats than female rats, while female rats had higher Cmax of M3G than male rats in both acute and chronic morphine administration. Our results indicated that sex differences existed in withdrawal syndrome of morphine-dependent rats, and the pharmacokinetics of morphine showed sex difference by both acute and chronic administration. There might be a relationship between the severity of withdrawal syndrome and the plasma concentrations of morphine, M3G, and the ratio of morphine to M3G（M3G/MOR）.

Effect of acupuncture in intervening heroin-induced brain damage via regulating ubiquitin-proteasome pathway

Objective：To observe the effect of acupuncture in regulating ubiquitin-proteasome pathway （UPP）,and discuss the action of acupuncture in intervening heroin-induced brain damage.Methods：Thirty male Sprague-Dawley （SD） rats were divided into a control group,a model group and an acupuncture group by using the random number table.Rats in the model and acupuncture groups received intramuscular heroin injection for successive 8 d at a progressively increased dose.Afterwards,the injection was suspended for 5 d for withdrawal.The heroin relapse rat model was established by repeating the drug addiction and withdrawal process for 3 times.The control group followed the step of the model establishment,but was given intramuscular injection of normal saline at the stage of addiction and no intervention at the stage of withdrawal;the model group was given intramuscular heroin injection at a progressively increased dose at the addiction stage and no intervention at the withdrawal stage;the acupuncture group was dealt in the same way as the model group at the addiction stage,but received acupuncture at Baihui （GV 20） and Dazhui （GV 14） at the withdrawal stage,with the needles retained for 30 min each time,1 session a day,for successive 5 d.On the 39th day,brain tissues were extracted from the hippocampus and ventral tegmental area （VTA） of the three groups of rats.The apoptosis of brain nerve cells was detected by using terminal deoxynucleotidyl transferase-mediated nick and labeling （TUNEL）.The mRNA and protein expressions of ubiquitin （Ub）,ubiquitin protein ligase （E3） and 26S were examined by immunohistochemistry and quantitative real-time polymerase chain reaction （RT-qPCR）.Results：Compared with the model group,rat＇s hippocampus and VTA in the acupuncture group showed significantly fewer cells positively stained by TUNEL staining （P〈0.01）,and its mRNA and protein expressions of Ub,E3,26S were significantly lower （P〈0.01）.Conclusion：Reducing nerve cell apoptosis and regulating the mRNA and protein expressions of Ub,E3 and 26S in rat＇s hippocampus and VTA are possibly one of the action mechanisms of acupuncture in intervening heroin-induced brain damage.

Effect of Electroacupuncture on Anxiety and Craving in Heroin Addicts During Detoxification

Objective:To observe the effect of electroacupuncture at Jiaji (EX-B 2) points for anxiety and craving in heroin addicts during detoxification. Methods:A total of 60 cases were randomized into an electro-acupuncture group and a control group, 30 in each group. Cases in the electroacupuncture group were treated with electroacupuncture at Jiaji (EX-B 2) points, whereas cases in the control group were treated with Methadone and Doxepin. Then scores were graded using Zung self-rating anxiety score (SAS) and self-made visual analogue scale (VAS). The assessment was conducted once a day to record the adverse reactions. Results:After treatment, the SAS and VAS scores in the electro-acupuncture group were significantly lower than that in the control group (P<0.01). Conclusion:Electroacupuncture at Jiaji (EX-B 2) points can effectively alleviate anxiety and craving intensity in heroin addicts during detoxification.

Effect of Acupuncture on Contents of Tyrosine Hydroxylase and Glial Fibrillary Acidic Protein in Ventral Tegmental Area of Heroin Self-administrating Rats

Objective： This present study is to investigate the biochemical adaptations in the rdated brain regions of the mesolimbic dopamine system, such as the ventral tegmental area （VFA）, nucleus accumbens （NAc）, amygdale （Amy）, prefrontal cortex （PFC） , substantia nigra （SN） and caudateputamen （CPu） in response to heroin self-administration in rats and observe the effect of electroacupuncture on them. Methods. Thirty rats were trained by nose-poking response to establish stable intravenous heroin self-administration within 14 days, and then divided randomly into model group （group B） including 6 rats, withdrawal group which were withdrawn from heroin for 1 week （group C, n = 6） and for 2 weeks （group D, n= 6）, during which time they only lived in their individual home cages, and dectrtyacupuncture group which were also withdrawn from heroin for 1 week （group E, n= 6） and for 2 weeks （group F, n = 6）, during which time they were given electro-acupuncture treatment for 20 min daily and then returned to their individual home cages; in the meantime, another 6 rats were trained by nose-poking response with saline for 14 days as control （group A）; Then the leeds of tyrosine hydroxylase （TH） and glial fibrillary acidic protein （GFAP） in VFA, NAc, Amy, PFC, SN, CPu were detected with immunohistochemistry method. Results. The leeds of TH and GFAP in VFA of the heroin self administrating rats were obviously increased, and the leeds of TH and GFAP in NAc were also decreased, and these changes were not found in SN, CPu, Amy and PFC; Electro-acupuncture could promote the up regulation of TH and GFAP in VTA and down-regulation of TH and GFAP in NAc to return to the normal leeel. Conclusions： The chronic heroin self administration produced some biochemical adaptations in the related brain regions of the mesolimbic dopamine system and electroacupuncture could promote the repair of the ＂injured＂ DA neurons in VTA of heroin addicted rats and their functional recovery.

Comparison of the Detoxification Chinese Herbs and Acupuncture Plus Addiction Effects of Acupuncture, Chinese Herbs on Heroin

Heroin addicts were treated with acupuncture, Chinese herbs, and acupuncture plus Chinese herbs respectively, their effects were compared with that of Western medicine. The scores of withdrawal symptoms were observed continuously for 20 days. The effect of acupuncture was better than that of Western medicine 48 hours after the withdrawal treatment （P〈 0.05）, and better than that of other three methods 72 hours after the withdrawal treatment, （P〈 0.01）. Acupuncture, Chinese herbs, and acupuncture plus Chinese herbs have the detoxification effects of varying degrees, in particular acupuncture＇ effect was the best. But all the therapies could not completely improve the withdrawal symptoms in the first 3 days of treatment, and acupuncture plus Chinese herbs had no synergetic effect in treating withdrawal symptoms.

Clinical Study on Combined Acupuncture and Psychological Desensitization Therapy for Anxiety due to Heroin Addiction

Objective： To observe the clinical efficacy of combined acupuncture and psychological desensitization therapy for anxiety in those with heroin addiction. Methods： All 90 cases were randomly allocated into a treatment group （45 cases） and a control group （45 cases）. Cases in the treatment group received 30 min of combined acupuncture and psychological desensitization therapy for each treatment, twice a week and 8 weeks in total, whereas cases in the control group received no treatment. After that, the anxiety score and state were observed. In addition, the mental state prior to and after cue-elicited heroin craving was evaluated. Results： The total and standard scores of anxiety in the treatment group were significantly reduced compared to the control group （P〈0.05）, coupled with a significant reduction of heroin craving （P〈0.01）. Conclusion： Combined acupuncture and psychological desensitization can alleviate anxiety and inhibit the short-term heroin craving.

Influence of Acupuncture on Sleep Disorders and Anxiety in Patients with Heroin Dependence

Objective： To observe the influence of acupuncture on sleep disorders and anxiety in patients with heroin dependence. Methods： Sixty-two male patients with heroin dependence were divided into two groups by random number table. Thirty-five cases in the acupuncture group were treated by puncturing Baihui （GV 20）, Neiguan （PC 6）, and Shenmen （HT 7） and moxibustion at Zusanli （ST 36）. Twenty-seven cases in the control group did not receive any therapeutic measures. The therapeutic effects were summarized after observation of 8 weeks. Results： After treatment, the global scores and standard scores of anxiety declined in comparison with those before the treatment in both two groups, but there was statistical difference only in the acupuncture group （P〈0.05）. There were no statistical differences in the global score and the standard score of anxiety between the two groups, but the standard scores in the acupuncture group reached the normal level. After treatment, only the sleep latency was obviously improved in the control group （P〈0.05）. The syndromes of sleep disorder were improved noticeable in the acupuncture group （P〈0.05）, and the actual sleep time was improved better than those in the control group （P〈0.05）, and PSQI global scores decreased below the normal level. Conclusion： Acupuncture has the effects to improve sleep disorders and anxious emotion in the patients with heroin dependence.

Mind-regulating Needling plus Psychological Guidance for Internet Addiction:A Report of 38 Cases

Internet addiction disorder （IAD） refers to impulsive internet use, which does not involve using any addictive drugs. It includes psychiatric symptoms such as substance withdrawal symptoms, emotional disorders and loss of social relationship, as well as a group of syndromes of subhealth and autonomic nervous dysfunction. Patients with IAD usually have a strong emotional reliance on the internet. They feel delighted and content in on-line activities, and often go on to use internet because of the withdrawal symptoms such as irritability, anxiety and insomnia. We used acupuncture and psychological guidance in treating 38 cases. The report is now given as follows.

Effect of Electro-acupuncture on Drug-seeking Behavior of the Heroin Self-administrating Rat

Objective： This present study is to establish a rat model of intravenous heroin self-administration and observe the effect of electro-acupuncture on the heroin seeking behavior of the heroin self-administrating rat. Methods： Six Male Wistar rats were surgically implanted with an intra jugular intravenous catheters under sodium pentobarbital anesthesia, following a minimum recovery of 7 days, the rats were trained by nose-poke response with one daily 4-hour session for 14 consecutive days to self administer heroin （50 μg /kg / per injection）, the session ended after 25 infusions were earned or 4 hours had passed, whichever came first, the reinforcement schedule was fixed ratio 1 （FR1） that the rat received a heroin injection for each nose poke response. And then the rats were given electro-acupuncture treatment daily 30min prior to each session and then were trained with one daily 4-h session for 7 consecutive days. Results： Stable intravenous heroin self-administration behavior of rats was established after 7-8 days＇ drug training, electro-acupuncture given to the stable heroin self-administrating rat 30 min prior to each session could reduce the drug self-administration behavior, namely the total heroin intake in each session was reduced, especially the 1^th hour heroin intake, the initiation of first nose-poke response in each session was relayed, and the haste heroin-seeking behavior also became slower. Conclusions： The above results suggested that the electro-acupuncture had better detoxification effect.