东莨菪碱伍用纳曲酮和纳洛酮快速脱毒治疗海洛因依赖者临床分析  

The combined use of scopolamine, naltrexone and naloxone as a rapid, safe and effective detoxification treatment for heroin addicts

作　　者：杨国栋[1] 周文华[1] 徐坤[1] 李文惠[1] 江玲芬[1] 张建兵[1] 丁佩瑾[1] 金伟丽[1] 

机构地区：[1]宁波微循环与莨菪类药研究所宁波戒毒研究中心,315010

出　　处：《中华医学杂志》1999年第9期679-682,共4页National Medical Journal of China

摘　　要：目的　观察东莨菪碱伍用纳曲酮和纳洛酮对海洛因依赖者快速脱毒治疗的疗效及其安全性。方法　东莨菪碱伍用纳曲酮和纳洛酮对 84例海洛因依赖者快速脱毒治疗以及用动态心电观察其治疗期间的心率、血压、呼吸和血氧饱和度 ,纳洛酮催促试验和纳曲酮维持来评价快速脱毒的疗效。结果　 84例海洛因依赖者经快速脱毒治疗 ,在 6～ 8小时内控制戒断症状。在快速转入纳曲酮维持治疗时 ,均无痛苦的主观体验 ,其平均住院时间减少。疗程中 ,有 19例体温升高 ;口服纳曲酮和纳洛酮后出现轻度心率加快、血压升高、呼吸频率加快 ,而血氧饱和度均正常 ;另可观察到的主要并发症是胃内容物潜血阳性 ( 3例 ) ;84例海洛因依赖者脱毒后随访 6个月 ,其纳曲酮平均维持时间延长到2 6个月 ,操守 (drug free)时间明显延长。迄今 ,仍有 18例处于操守状态中。结论　东莨菪碱伍用纳曲酮、纳洛酮快速脱毒方法 ,可以明显缩短疗程 ,病人可快速顺利地转入纳曲酮维持 ,是安全、有效的脱毒方法。Objective To evaluate the efficacy of a rapid detoxification schedule for heroin addicts by scopolamine combined with opiate receptor antagonists.Methods The life signs such as temperature, blood pressure, ECG, heart rate, respiratory rate and blood oxygen saturation were monitored during the process of rapid detoxification treatment. The naloxone challenge test, withdrawal symptoms scale and naltrexone maintenance were used to evaluate the efficacy of the rapid detoxification. Results The withdrawal symptoms of 84 heroin addicts induced by naltrexone and naloxone were controlled completely under scopolamine administration in the 6 8 hours treatment period, although the naloxone challenge test was able to induce slight and transient withdrawal symptoms in the second day, and all patients were transferred rapidly to naltrexone maintenance. During treatment, the temperature in 19 cases elevated, and all patients showed increased heart rate, blood pressure and respiratory rate. However, the blood oxygen saturation was still stable after oral administration of naltrexone and continuous injection of naloxone during the detoxification. Blood test in gastric fluid was positive in 3 cases during the detoxification. The follow up data showed that the average maintenance time of naltrexone was 2.6 months, and the percentage of drug free was 21% in 6 months after the detoxification in 84 cases. Conclusion The combined use of scopolamine, naltrexone and naloxone is a rapid, safe and effective detoxification treatment protocol for heroin addicts.

关 键 词：东莨菪碱 海洛因依赖 纳曲酮 纳洛酮 治疗 

分 类 号：R595.505[医药卫生—内科学]