美沙酮维持治疗与丁丙诺啡维持治疗对海洛因依赖疗效评估  

Effective evaluation of MMT and BMT for heroin addicts

作　　者：刘悦[1] 张亚海[1] 周文华[1] 王清[2] 张建兵[2] 

机构地区：[1]宁波市微循环与莨菪类药研究所,宁波315010 [2]宁波戒毒研究中心,宁波315010

出　　处：《中国药物滥用防治杂志》2012年第5期252-255,共4页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：国家"十一五"支撑项目(2007BA107B03)资助;宁波市科技计划项目(2009C50024)资助

摘　　要：目的:观察美沙酮维持治疗(MMT)和丁丙诺啡维持治疗(BMT)对海洛因依赖的疗效,探讨二者在提高成瘾者生活质量、降低渴求等方面的作用。方法:采用海洛因渴求评定表和药物成瘾者生命质量测定量表分别对接受MMT与BMT的患者进行问卷调查,对1个月、3个月、6个月、12个月维持治疗时间段的量表的测定结果进行对比研究。结果:与未治疗组比较,MMT 1个月、3个月渴求量表得分无显著变化;MMT 6个月、12个月、BMT 12个月,渴求量表得分明显降低;MMT 12个月渴求量表得分低于BMT 12个月,二者比较有统计学差异。与未治疗组比较,MMT 1个月生命质量得分无显著变化;在MMT 3个月、6个月、12个月时,患者生命质量量表四个领域的得分及生命质量总体评分均明显提高,差异有统计学意义;MMT 3个月组、6个月组、12个月组,各组之间生命质量得分均有显著性差异。与未治疗组相比,在BMT 1个月时患者生命质量无改善;BMT 3个月时,除心理功能领域无显著改善外,生命质量量表其它领域的得分及生命质量总体评分均明显提高;在BMT 6个月、12个月时,患者生命质量量表四个领域的得分及生命质量总体评分均明显提高,差异有统计学意义。BMT 3个月组、6个月组、12个月组,各组之间生命质量得分均有统计学差异。MMT组与BMT组在3个月、6个月、12个月这三个时段,生命质量量表评分均无统计学差异。结论:MMT和BMT均可减少成瘾者对海洛因的渴求,改善成瘾者生命质量,MMT减少渴求的程度高于BMT。另外,二者各有优缺点,成瘾者可根据个人具体情况加以选择。Objective：To explore the effect of methadone maintenance treatment（MMT） and buprenorphine maintenance treatment（BMT） for heroin addicts,and evaluate their effects in improving quality of life and reducing craving for heroin.Methods：QOL-DA and craving for heroin scale were used as the tool of assessment for obtaining the patient＇s quality of life and craving for heroin.Results：Compared with control group,it was found that MMT for 6 months,MMT for 12 months and BMT for 12 months can all reduce the craving for heroin.Compared with BMT for12 months group,MMT for 12 months group can reduce craving more.When MMT for 3 months,6 months and 12 months,the scores of the four domains of the quality of life and the total scores of the quality of life were all increased.Compared with control group,the difference were statistically significant.There were significant difference between MMT for 3 months group,6 months group and 12 months group.When BMT for 3 months,except that the score of the psychological domain was unchanged,scores of the other three domains and the total scores of quality of life were all increased.When BMT for 6 months and 12 months,the scores of four domains of quality of life and the total scores of quality of life were all increased.Compared with control group,the difference were statistically significant.There were all significant difference between BMT for 3 months group,6 months group and 12 months group.There were not marked difference in the scores of the quality of life scale between MMT and BMT groups at 3 months,6 months and 12 months respectively.Conclusion：MMT and BMT can all reduce craving for heroin and improving quality of life.In contrast with BMT,MMT can reduce craving even more.MMT and BMT,each has its own advantages.And heroin addicts should choose one of them in the light of their own actual situation.

关 键 词：美沙酮维持治疗 丁丙诺啡维持治疗 生命质量 渴求 

分 类 号：R749.6[医药卫生—神经病学与精神病学]