曲唑酮联合纳曲酮对海洛因依赖者防复吸的疗效  

Clinical curative effect of trazodone combined with naltrexone on relapse prevention in heroin addicts

作　　者：蔡丹丹[1] 桂冬辉[1] 张建兵[1] 周文华[1] 

机构地区：[1]宁波戒毒研究中心,浙江宁波315010

出　　处：《中国新药与临床杂志》2014年第11期827-830,共4页Chinese Journal of New Drugs and Clinical Remedies

基　　金：科技部"十二五"支撑项目(2012BAI01B07)

摘　　要：目的评估曲唑酮联合纳曲酮治疗海洛因依赖者防复吸的临床疗效及安全性。方法将160例海洛因依赖者随机分成两组，试验组和对照组各80例。两组患者均先经过东莨菪碱复合麻醉（杨氏1＋1）脱毒治疗，待尿吗啡检测转阴性后，研究组给予曲唑酮（100～200mg·d^-1，bid）联合纳曲酮（50mg·d^-1，qd）治疗，对照组单纯给予纳曲酮治疗，住院治疗2周后维持治疗12个月。采用心理渴求量表（PCS）、稽延性戒断症状量表（Pwss）和纳曲酮维持率在出院时与维持治疗1、3、6、9、12个月后进行评分分析，用副反应症状量表（TESS）评价安全性。结果共135例完成全部研究，对照组67例，研究组68例。与出院时相比，两组治疗1、3、6、9、12个月的PCS得分及PWSS得分均下降（P〈0．01）。治疗1、3、6个月时研究组的PCS和PWSS均低于对照组（P〈0．05），9、12个月时两组组间无显著差异（P〉0．05）；研究组的纳曲酮维持率高于对照组，有非常显著差异（P〈0．01）。两组不良反应轻微，研究组的TESS总分小于对照组（P〈0．05或P〈0．01）；6个月后两组比较无显著差异（P〉0．05）。结论曲唑酮能明显提高纳曲酮维持治疗的依从性。曲唑酮联合纳曲酮是一种安全、有效的预防海洛因依赖者复吸的治疗方案。AIM To investigate the curative effect and safety of trazodone combined with naltrexone on relapse prevention in heroin addicts. METHODS Totally 160 heroin addicts were randomly divided into two groups, 80 cases in each group. Both groups were detoxified by scopolamine- chlorpromazine balanced intravenous anesthesia until the urine morphine test was negative. The study group was treated with trazodone （100 - 200 mg·d^-1, bid） combined with naltrexone （50 mg·d^-1, qd）, while the control group was only given naltrexone. The patients were hospitalized for 2 weeks followed by a maintenance treatment for 12 months. Both groups were scored by Psychological Craving Scale （PCS）, Protracted Withdrawal Syndrome Scale （PWSS）,and naltrexone-keeping- rate at the time-point of and 1, 3, 6, 9, 12 months after the discharge from the hospital. Adverse drug reactions were evaluated at the same time by Treatment Emergent Symptom Scale （TESS） . RESULTS Altogether 135 patients completed the treatment, 67 in the control group and 68 in the study group. Compared with prior to discharge, the PCS and PWSS of the two groups declined at the treatment time-point of 1, 3, 6, 9, 12 months after hospital discharge （P 〈 0.01） . The PCS and PWSS of the study group were lower than those of the control group at the treatment time-point of 1, 3, 6 months （P 〈 0.05）, but there was no significant difference at 9, 12 months after hospital discharge （P 〉 0.05）. The naltrexone-keeping- rate of the study group was higher than that of the control group （P 〈 0.01 ） . The adverse reactions were mild. The TESS score of the study group was lower than that of the control group at the treatment time-point of 1, 3 months （P 〈 0.05）, but there was no significant difference at 6, 9, 12 months （P 〉 0.05）. CONCLUSION Trazodone can improve the compliance of nahrexone- keeping. Trazodone combined with naltrexone is a safe, effective treatment protocol for relapse prevention in heroin addicts.

关 键 词：曲唑酮 纳曲酮 海洛因依赖 

分 类 号：R971[医药卫生—药品]