行为奖励对合并滥用苯丙胺类药的美沙酮维持治疗者的疗效  

Efficiency of contingency-management on patients with methadone maintenance treatment combined with amphetamines abuse

作　　者：刘悦[1] 陈为升[1] 沈雯雯[1] 李龙辉[1] 赖苗军[1] 谢小虎[1] 徐泽民[1] 刘惠芬[1] 周文华[1] LIU Yue;CHEN Wei-sheng;SHEN Wen-wen;LI Long-hui;LAI Miao-jun;XIE Xiao-hu;XU Ze-min;LIU Hui-fen;ZHOU Wen-hua(Ningbo Kangning Hospital,Ningbo 315201,China)

机构地区：[1]宁波市康宁医院,宁波市微循环与莨菪类药研究所,浙江省戒毒研究重点实验室,315201

出　　处：《临床精神医学杂志》2022年第3期180-184,共5页Journal of Clinical Psychiatry

基　　金：宁波市自然科学基金资助项目(2019A610296)。

摘　　要：目的:探讨行为奖励干预(CM)技术对合并滥用苯丙胺类药的美沙酮维持治疗(MMT)者的作用。方法:以抽签法将合并使用苯丙胺类药的55例MMT者随机分为干预组(30例)和对照组(25例)。对照组仅给予常规的MMT,干预组则给予6个月的CM与MMT。分别在干预3个月末、6个月末检测两组的脱失率、尿检阳性率及服药率,使用Barratt冲动量表(BIS-11)评估其冲动性。结果:干预3及6个月末,干预组脱失率、尿检阳性率明显低于对照组,服药率明显高于对照组(P均<0.05)。两组受试者在3个月、6个月时的BIS-11总分及各分量表的得分与基线比较及两组间比较,差异无统计学意义(P>0.05)。结论:CM技术可增加合并滥用苯丙胺类药的MMT者的疗效及治疗依从性,但对冲动性无改善作用。Objective:To explore the positive effects of contingency management(CM)on patients with methadone maintenance treatment(MMT)combined with amphetamines abuse.Method:Fifty-five MMT patients were randomized into intervention group(n=30)and control group(n=25)by means of the draw.The control group received routine MMT,and the intervention group received 6 months of CM and MMT.At the end of 3 months and 6 months,the rates of deletion,urine test positive and medicine taking were evaluated and the impulsivity was also evaluated with Barratt Impulsiveness Scale(BIS-11)in the two groups.Results:Compared with the control group,the intervention group had less drop out rate,less positive rate of urine test and increasing rate of medicine taking at the end of 3 and 6 months(all P<0.05).There were no significant differences in each subscales score and total score of BIS-11 compared to base line in the two groups and between the groups(P>0.05).Conclusion:For MMT patients abusing amphetamines,CM can enhance the curative effect of MMT and increase the treatment adherence,howerver,CM don't improve impulsivity.

关 键 词：美沙酮维持治疗 苯丙胺类药 行为奖励干预 

分 类 号：R749[医药卫生—神经病学与精神病学]