社区美沙酮维持治疗结合社会心理综合干预研究  

A STUDY OF METHADONE MAINTAINANCE TREATMENT COMBINED WITH SOCIAL AND PSYCHOLOGICAL INTERVENTION

作　　者：王军[1] 张怀惠[1] 杜江[2] 董爱珍[1] 法金茂[1] 王建国[1] 陈圣祺[1] 

机构地区：[1]上海市杨浦区精神卫生中心,上海200090 [2]上海交通大学医学院附属精神卫生中心,上海200030

出　　处：《中国药物依赖性杂志》2014年第2期125-129,共5页Chinese Journal of Drug Dependence

摘　　要：目的獉獉:探索美沙酮维持治疗门诊开展社区强化及认知行为综合干预对海洛因依赖者的应用效果。方法獉獉:80名接受美沙酮维持治疗的海洛因依赖者被随机分为干预组(n=40)和对照组(n=40)。对干预组患者实施常规美沙酮维持治疗合并24周社区强化及认知行为综合干预,对照组仅给予常规美沙酮维持治疗。比较两组的心理健康状况、吗啡尿检结果、维持治疗情况。结果獉獉:经24周社区强化及认知行为综合干预后,干预组的心理健康状况显著优于对照组(P<0.05)。治疗第12周末两组比较心理健康状况调查在躯体化、强迫症状、恐怖、偏执及精神病性5个因子分上存在显著统计学差异(P<0.05),表明干预组经12周社区强化及认知行为综合干预后心理健康状况优于对照组。贝克抑郁量表调查在BDI总分在第12周末两组比较无显著差异。干预组尿检阳性率为10.5%,对照组阳性率16.1%,干预组尿检阳性率显著低于对照组(P<0.01)。第24周末,干预组的维持率为72.5%,对照组的维持率为40%,干预组的治疗维持率显著高于对照组(P<0.05)。结论獉獉:社区强化及认知行为综合干预有助于美沙酮维持治疗门诊的海洛因依赖者改善心理健康状况、减少毒品使用,有助于提高治疗维持率。Objective： To explore the effect of community enhancement and cognitive behavior intervention on heroin addicts in methadone maintenance treatment clinic. Methods：Eighty heroin addicts in methadone maintenance treatment were randomly divided into intervention group （ n = 40） and control group （n = 40）. The implementation of routine methadone maintenance therapy for patients in the trial group with intensive 24 weeks community and cognitive behavior intervention, the control group only received routine methadone maintenance treatment. The mental health status, morphine urine test results, and the maintenance treatment situation were compared between the two groups. Results ： After 24 weeks of community and cognitive behavior intervention, mental health status of intervention group was significantly better than the control group （P 〈0. 05）. After 12 weeks treatment, there were statistically significant differences between the two groups in five factors of somatization, obsessive - compulsive, phobia, paranoid and psychotic symptoms （P 〈 0. 05 ）. It showed that the mental health status of 12 week intensive community and cognitive behavior intervention of the intervention group was better than that of control group. There was no significant difference in two groups with Beck depression scale survey in BDI by the end of the 12 weeks. The positive rate of urine was 10.5% in trial group, 16. 1% in control group, the positive rate was significantly lower in intervention group than that in control group （P 〈0. 01 ）. By the end of 24 weeks, the retention rate of the trial group was 72. 5%, the control group was 40%. There were statistically significant differences between the two groups （P 〈 0. 05 ）. Conclsion： The community reinforcement and cognitive behavior intervention can help heroin addicts in methadone maintenance treatment to improve the psychological health, reduce drug use, and improve the retention rate of maintainence treatment.

关 键 词：社区强化及认知行为综合干预 社区美沙酮维持治疗 海洛因依赖者 

分 类 号：R512.91[医药卫生—内科学]