盐酸曲唑酮和舒必利缓解海洛因依赖者的稽延性戒断症状  

TRAZODONE AND SULPIRIDE FOR THE PROLONGED WITHDRAWAL SYMPTOMS

作　　者：李静[1] 康林[1] 宋萍[1] 黄明生[1] 

机构地区：[1]四川大学华西医院心理卫生中心,成都610041

出　　处：《中国药物依赖性杂志》2006年第5期367-372,共6页Chinese Journal of Drug Dependence

摘　　要：目的:观察盐酸曲唑酮和舒必利控制海洛因依赖者稽延性戒断症状的临床疗效以及探讨稽延性戒断症状产生的神经生物学机制。方法:对象为成都市强制戒毒所的60例戒毒者;采用随机双盲的方法将戒毒者分为3组,分别给与舒必利、盐酸曲唑酮和安慰剂,按时评定稽延性戒断症状、焦虑和药物不良反应,并检测吸毒者体重、肝肾功能、心电图和尿吗啡定性的变化,对血液中5-羟色胺(5-HT)和去甲肾上腺素(NE)递质系统定时测定。结果:有45例完成治疗,有15例因犯罪而脱失。舒必利组(18例),盐酸曲唑酮组(14例)的稽延性戒断症状治疗前与治疗后比较,总分值逐渐下降,第4周后两组评分与安慰剂组(13例)评分比较有统计学差异(q舒=0·238,q曲=0·218,P<0·05);5-HT测定值盐酸曲唑酮组与安慰剂组在第三次测定时有统计学差异(q=3·890,P<0·05);NE测定值治疗组与安慰剂组不存在统计意义的差别(P>0·05)。结论:舒必利和盐酸曲唑酮可以改善吸毒者的稽延性戒断症状。未发现药物不良反应,安全性高。血清中5-HT与稽延性戒断症状产生有关,血清中5-HT浓度的改变可作为观测稽延性戒断症状程度的客观指标,其降低的程度可作为疗效的评定参考,戒断后血清中NE趋向稳定。Objective： To investigate the therapeutic effects of sulpride and trazodone on the prolonged withdrawal symptoms, and discuss the mechanism of the prolonged withdrawal symptoms. Methods：Sixty patients recruited from Chengdu Compulsory Treatment Center were randomly divided into three groups and treated with sulpride, trazodone and placebo, respectively. The prolonged withdrawal symptoms, such as craving, anxiety and adverse effects were assessed with a standard measuring scale, and the function of liver and kidney, blood cell count and Hb, ECG, TLC and the concentration of 5 - HT and NE were examined. Results： Forty -five patients completed the treatment and 15 dropped out because of committing crimes. The total scores in sulpride （18 cases）and trazodone （14 cases）treatment groups were reduced greatly, and showed significant difference at four weeks, compared with the placebo group（qs = 0. 238, qT = 0. 218; P 〈 0.05）. There was a difference between trazodone and placebo groups in 5 - HT value examined at the third time （ q = 3. 890, P 〈 0.05 ）, no difference was observed among the three groups in NE value（P 〉 0.05 ）. Conclusion：Sulpride and trazadone have definite effects on the control of prolonged withdrawal symptoms and no obvious adverse reactions are found. The concentration of 5 - HT in serum can be an index to the prolonged withdrawal symptoms, and the concentration of NE tends to be stable.

关 键 词：舒必利 盐酸曲唑酮 稽延性戒断症状 5-羟色胺 去甲肾上二腺素 

分 类 号：R595.5[医药卫生—内科学]