丁丙诺啡维持治疗预防海洛因成瘾复发及预后转归  

Return analysis on prevention of relapse and prognosis in heroin addicts with buprenorphine maintenance therapy

作　　者：桂冬辉[1] 蔡丹丹[1] 黄燕燕[1] 黄安娜 张建兵[1] 周文华[1] GUI Donghui;CAI Dandan;HUANG Yanyan;HUANG Anna;ZHANG Jianbing;ZHOU Wenhua(Ningbo AddictionReseach and Treatment Center, Ningbo 315010 , China)

机构地区：[1]宁波戒毒研究中心

出　　处：《中国临床药学杂志》2019年第4期241-245,共5页Chinese Journal of Clinical Pharmacy

基　　金：宁波市医学科技计划项目(编号2017A48)

摘　　要：目的评估丁丙诺啡维持治疗预防海洛因成瘾复发的疗效及预后转归情况。方法将120例海洛因成瘾患者随机分成2组,每组60例。研究组经美沙酮递减脱毒后转接丁丙诺啡维持治疗,对照组直接予美沙酮维持治疗。2组分别于基线和维持治疗1、3、6、12个月时采用心理渴求量表(PCS),成瘾行为严重程度指数量表(ASI),脱失率和复吸率评估临床疗效及预后转归,采用不良反应症状量表(TESS),实验室检查指标及心电图检查评估治疗的安全性。结果共74例完成全部研究,其中研究组41例,对照组33例。研究组在维持治疗1个月时的脱失率和复吸率与对照组比较,差异均无统计学意义(P>0.05);在维持治疗3、6、12个月时脱失率和复吸率与对照组比较,差异均有统计学意义(P<0.05或P<0.01)。2组在ASI的各因子评分及PCS评分在维持治疗1个月时不管是组内比较(与基线比较)还是组间比较,差异均无统计学意义(P>0.05);在维持治疗3、6、12个月时,不管是组内比较(与基线比较)还是组间比较,差异均有统计学意义(P<0.05或P<0.01)。2组在维持治疗2、3、6、12个月时的不良反应总分比较,差异均有统计学意义(P<0.05或P<0.01)。结论丁丙诺啡维持治疗能显著降低海洛因成瘾复发率和改善预后,不良反应轻微,依从性高。AIM To evaluate the efficacy of buprenorphine in preventing relapse and prognosis of heroin addicts. METHODS A total of 120 heroin addicts were randomly divided into 2 groups, with 60 cases in each group. The study group was detoxified by methadone and treated with buprenorphine, while the control group was only given methadone. Both groups were scored by psychological craving scale(PCS), addiction severity index scale(ASI), losing rate and relapse rate at the time-point of base line and after 1, 3, 6 and 12 months of mainten-ance treatment. Adverse drug reactions were observed at the same time by treatment emergent symptom scale(TESS), laboratory examination indexes and electrocardiographic examination. RESULTS A total of 74 patients completed the study, including 41 patients in the study group and 33 patients in the control group. The difference of the losing rate and relapse rate of the study group was not statistically significant comparing to the control group after 1 month of maintenance treatment(P>0.05), but there were statistically significant differences after 3, 6 and 12 months of maintenance treatment(P<0.05 or P<0.01). Comparing to the base line, the factors scores of ASI and PCS of 2 groups weren’t statistically significant after 1 month of maintenance treatment(P>0.05), but there were statistically significant differences after 3, 6 and 12 months of maintenance treatment(P<0.05 or P<0.01). Comparing to the control study, the factors scores of ASI and PCS of the study group weren’t statistically significant after 1 month of maintenance treatment(P>0.05), but there were statistically significant differences after 3,6 and 12 months of maintenance treatment(P<0.05 or P<0.01). The adverse drug reactions were statistically significant between 2 groups after 2,3,6 and 12 months of maintenance treatment(P<0.05 or P<0.01). CONCLUSION Buprenorphine maintenance therapy can significantly reduce the relapse rate and improve the prognosis of heroin addictions. The adverse drug reactions are slight and the co

关 键 词：丁丙诺啡 美沙酮 海洛因成瘾 复发 预后 

分 类 号：R749.64[医药卫生—神经病学与精神病学]