曲唑酮联合认知行为治疗在社区戒毒模式管理中应用价值的初步研究  

Preliminary study on the application value of trazodone combined with cognitive behavioral therapy in community detoxification management

作　　者：桂冬辉[1,3] 蔡丹丹 张建兵[1,3] 朱华强 周文华[2,3] GUI Donghui;CAI Dandan;ZHANG Jianbin;ZHU Huaqiang;ZHOU Wenhua(Ningbo Addiction Research and Treatment Center,Ningbo 315010,Zhejiang,China;Ningbo Institute of Microcirculation and Henbane,Ningbo 315010,Zhejiang,China;Key Laboratory of Addiction Research of Zhejiang Province,Ningbo 315010,Zhejiang,China)

机构地区：[1]宁波戒毒研究中心,浙江宁波315010 [2]宁波市微循环与莨菪类药研究所,浙江宁波315010 [3]浙江省戒毒研究重点实验室,浙江宁波315010

出　　处：《中国临床药理学与治疗学》2020年第11期1276-1282,共7页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：国家自然科学基金项目(81671321);浙江省医药卫生科技计划项目(2019KY633);宁波市公益类科技计划资助项目(2019C50076)

摘　　要：目的:初步探讨曲唑酮联合认知行为治疗在海洛因成瘾者社区戒毒期的应用价值。方法:140例海洛因成瘾社区戒毒者随机分成4组,予曲唑酮联合认知行为治疗35例(T+P组),予单一曲唑酮治疗35例(T组),予单一认知行为治疗35例(P组),予单一社区戒毒管理35例(S组),疗程均为12周。于基线及治疗4、8、12周末,采用汉密顿焦虑评定量表(HAMA)、汉密顿抑郁评定量表(HAMD)、匹茨堡睡眠质量指数量表(PSQI)、心理渴求评定量表(PCS)、压力知觉量表(CPSS)及尿吗啡阳性率进行临床疗效评估,采用不良反应量表(TESS)和实验室检查评定安全性。结果:4组治疗12周末共脱失15例,余下125例完成12周治疗。T+P组及T组在4、8、12周末HAMA、HAMD和PSQI评分与基线比较均明显减低,差异均有统计学意义(P<0.05);P组在4、8、12周末HAMA、HAMD量表评分与基线比较均明显下降,差异均有统计学意义(P<0.05);PSQI量表评分在治疗8、12周末与基线比较均有明显下降,差异均有统计学意义(P<0.05);S组在12周末HAMA、HAMD和PSQI量表评分与基线比较均有明显下降,差异均有统计学意义(P<0.05)。T+P组与T组、P组和S组组间在4、8、12周末PCS和CPSS评分比较,差异均有统计学意义(P<0.05)。T+P组与S组组间在4、8、12周末尿吗啡阳性率比较,差异均有统计学意义(P<0.05)。T+P组与T组组间TESS评分比较,差异无统计学意义(P>0.05)。结论:曲唑酮联合认知行为治疗能够显著改善海洛因成瘾者在社区戒毒期的负性情绪、睡眠质量等精神心理症状,对提高社区戒毒模式管理质量具有积极作用。AIM:To investigate the clinical application value of trazodone combined with cognitive behavioral therapy on heroin addicts during the period of community detoxification.METHODS:A total of 140 heroin addictive patients treated by community detoxification management were randomly divided into four groups,35 patients were given trazodone combined with cognitive behavioral therapy(T+P group),35 patients were given a single trazodone therapy(T group),35 patients were given a single cognitive behavioral therapy(P group),and 35 patients were only given community detoxification management(S group),the course of the treatment lasted for 12 weeks.At the time-point of baseline and the weekends 4,8 and 12 after treatment,four groups were scored by Hamilton anxiety rating scale(HAMA),Hamilton depression rating scale(HAMD),Pittsburgh sleep quality index scale(PSQI),psychological craving rating scale(PCS),Chinese perceived stress scale(CPSS),and urine morphine positive rate.The safety was evaluated with Treatment Emergent Side-effect Scale(TESS)and laboratory test.RESULTS:A total of 125 patients completed the 12 weeks of treatment.HAMA,HAMD and PSQI scores of T+P group and T group on weekends 4,8 and 12 were significantly reduced when compared with baseline,respectively(P<0.05).HAMA and HAMD scores of P group on weekends 4,8 and 12 were significantly decreased when compared with baseline,respectively(P<0.05).PSQI scores of P group on weekends 8 and 12 were significantly decreased when compared with baseline,respectively(P<0.05).HAMA,HAMD and PSQI scores of S group on weekend 12 were significantly reduced when compared with baseline,respectively(P<0.05).There were significant differences on the PCS and CPSS scores between T+P group,T group,P group and S group on weekends 4,8 and 12,respectively(P<0.05).There also showed statistically significant differences on the urine morphine positive rates between T+P group and S group on weekends 4,8 and 12,respectively(P<0.05).There was no significant difference on the TESS score between

关 键 词：曲唑酮 认知行为治疗 海洛因成瘾者 社区戒毒 

分 类 号：R964[医药卫生—药理学]