经皮穴位电刺激治疗海洛因滥用患者的戒断症状  

TRANSCUTANEOUS ELECTRICAL ACUPOINT STIMULATION FOR THE TREATMENT OF WITHDRAWAL SYNDROME IN HEROIN ADDICTS

作　　者：马达[1,2] 韩济生[1,2] 刁洤恒 邓桂发 平星杰[1,2] 靳伟杰[1,2] 吴鎏帧 崔彩莲[1,2] 李晓东 

机构地区：[1]北京大学神经科学研究所,北京100191 [2]国家教育部、卫计委重点实验室,北京100191 [3]广东省中山市戒毒所,中山528400 [4]广东珠海金鼎自愿戒毒医院,珠海519085

出　　处：《中国疼痛医学杂志》2014年第10期696-703,共8页Chinese Journal of Pain Medicine

基　　金：国家十一五科技支撑计划项目(2007BAI07B03)资助

摘　　要：目的：评价2/100 Hz经皮穴位电刺激（TEAS）治疗海洛因依赖者脱毒期戒断症状的疗效.方法：对海洛因依赖男性患者测定其戒断症状评分,将评分等于或大于20患者63例采用随机数字表随机分为2组：①TEAS组31人,在双侧上肢4个穴位（一侧合谷-劳宫,另一侧内关-外关）上贴电极,采用2/100 Hz交替的疏密波,刺激强度7～15mA,每次持续30 min,每天2～3次.②对照组32人,在同样穴位上贴电极,但无电流输出.每个病人连续治疗10天.测评并记录治疗前一天及治疗期每天戒断症状评分.在治疗期的头两天,给予每个病人0.5～1.0 mg丁丙诺啡,此后当病人出现戒断症状超过20分时起,还可以增加0.5～1.0 mg.结果：治疗前两组戒断症状评分无显著性差别.TEAS组从治疗第2天评分开始明显下降,10天治疗期内TEAS组“戒断症状评分”总分较对照组减少60％ （P＜ 0.001）;患者主动要求的丁丙诺啡药量较对照组少90％.未见明显副作用.结论：TEAS治疗10天可显著降低海洛因滥用者的戒断症状,并显著减少丁丙诺啡需求量.Objective： To assess the therapeutic effect of transcutaneous electric acupoint stimulation （TEAS） for the treatment of withdrawal syndrome in heroin addicts. Methods： A total of 63 male heroin addicts with withdrawal score higher than 20 were recruited in the Detoxification Center of Zhongshan city, Guangdong province, China. They were randomly distributed into 2 groups： TEAS group （n = 31） received TEAS produced by two channeled HANS 200A stimulator, 2×3 sessions per day, 30 min per session for 10 consecutive days. Rectangular electrical stimulation of alternating frequency shifting between 2 Hz and 100 Hz with intensity of 10 - 15 mA was applied on Hegu and Laogong points on one hand, and Neiguan and Waiguan points on the other forearm via electroconductive skin pads of 4 cm ~ 4 cm size. Control group （n = 32） was treated with the same procedure except that the output of the stimulator was disconnected. Assessments of withdrawal syndrome were conducted one day before and continued for the whole treatment period of 10 days. Buprenorphin of 1 mg per day sublingually was provided for all subjects in the first 2 days, and then for those with withdrawal score over 20 in the following days. Results： No significant difference was found for the withdrawal scores between the two groups at the beginning of the observation. The scoresshowed a more marked drop in TEAS group than the control, starting from the second day and remained for the whole course of treatment. The area under the curve of TEAS group was only 40% of that of the control （P 〈 0.001, two way RM ANOVA）, and the requirement of buprenorphine was only 10% of that of the control. No adverse side effects were observed in both groups. Conclusion： TEAS of 2/100 Hz for 10 days in abrupt abstinence of the heroin addicts resulted in a marked reduction of the withdrawal syndrome as well as a reduced requirement for rescue opioids.

关 键 词：针刺 电针 经皮穴位电刺激 海洛因依赖 戒断症状 丁丙诺啡 

分 类 号：R749.6[医药卫生—神经病学与精神病学]