米氮平与硝西泮治疗海洛因依赖者戒断后失眠、焦虑的对照研究  

A Controlled Study of Mirtazapine and Nitrazepam in the Treatment of Insomnia and Anxiety of Heroin Addicts after Detoxification

作　　者：曹长安[1] 张建军 

机构地区：[1]深圳市康宁医院,深圳518020 [2]深圳市戒毒所,深圳518020

出　　处：《中国心理卫生杂志》2006年第6期416-417,419,共3页Chinese Mental Health Journal

摘　　要：目的比较米氮平与硝西泮治疗海洛因依赖者戒断后失眠、焦虑的疗效及安全性。方法将66例海洛因依赖者随机分为两组,分别予米氮平和硝西泮治疗4周。在治疗前及后1、2、4周以汉密顿焦虑量表(HAMA)、稽延性戒断症状评定量表(PWSRS)和精神药物副反应量表(TESS)评定疗效及副反应。结果米氮平组在治疗后1、2、4周HAMA评分(21.6±3.5,16.3±4.5,10.5±2.4)及PWSRS评分(4.3±3.7,3.7±3.0,3.2±2.3)均低于治疗前(28.8±4.2,7.4±5.1)和硝西泮组治疗后1、2、4周HAMA评分(26.2±3.5,20.6±4.3,14.1±2.5,t=2.26,3.15,2.83,P<0.05)及PWSRS评分(6.6±4.1,5.9±3.3,5.2±2.4,t=3.02,2.24,1.93,P<0.05),硝西泮组在治疗后4周HAMA(14.1±2.5)和PWSRS(5.2±2.4)评分均低于治疗前(29.2±4.3,7.5±5.3)。两组不良反应的发生率差异无统计学意义。结论米氮平和硝西泮均可改善海洛因依赖者脱毒后的失眠及焦虑,但前者起效快,疗效较好。Objective：To compare the efficacy and safety of mirtazapine and nitrazepam in the treatment of insomnia and anxiety of heroin addicts after detoxification. Methods：66 heroin addicts were randomized to mirtazapine or nitrazepam treatment for 4 weeks. The Hamilton Anxiety Scale （ HAMA ）, Prolonged Withdrawal Symptom Rating Scale （PWSRS）, and the Treatment Emergent Symptom Scale （TESS） were administered to evaluate efficacy and side effect. Results： At week 1,2 and 4, the HAMA total scoreand insomnia score of PWSRS were statistically lower than those at baseline in each group （28. 8±4. 2, 7.4±5.1） （29.2±4. 3, 7. 5±5.3）, and those of mirtazapine group （ 21.6±3.5,16. 3±4. 5,10. 5±2. 4） （ 4. 3± 3.7,3.7±3.0,3.2±2. 3） were significantly lower than those of nitrazepam group （26.2±3.5,20.6±4.3, 14. 1±2.5,t =2.26, 3.15, 2.83, P〈0.05; PWSRS 6.6±4. 1,5.9±3.3, 5.2±2. 4,t = 3.02,2. 24,1.93, P 〈 0. 05 ）. The incidences of side effects between two groups were not statistically significant. Conclusion：Both mirtazapine and nitrazepam are effective in the treatment of insomnia and anxiety of heroin addicts after detoxification, hut mirtazapine is more effective and quicker than nitrazepam. The safety profile of the two medications is similar.

关 键 词：海洛因依赖 稽延性戒断症状 米氮平 硝西泮 临床试验 

分 类 号：R749.6[医药卫生—神经病学与精神病学]