美沙酮维持治疗患者生命质量及其影响因素研究  

Study on Quality of Life and its Influencing Factors in Patients with Methadone Maintenance Treatment

作　　者：唐蕴 曹鹏辉 张帅[2] 杨梅 范妮[2] TANG Yun;CAO Penghui;ZHANG Shuai;YANG Mei;FAN Ni(Outpatient and Emergency Department,Shenzhen Kangning Hospital,Shenzhen 518020,Guangdong,China;Institute of Psycho-neuroscience,the Affiliated Brain Hospital of Guangzhou Medical University,Guangzhou 510370,Guangdong,China)

机构地区：[1]深圳市康宁医院门急诊,广东深圳518020 [2]广州医科大学附属脑科医院精神神经科学研究所,广东广州510370

出　　处：《中国药物滥用防治杂志》2023年第11期1873-1880,共8页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：广东省医学科研基金项目(编号:B2022351);广州市医学重点学科(编号:510101-0101200)。

摘　　要：目的:调查美沙酮维持治疗(MMT)患者的生命质量,探讨其影响因素,为提升MMT服务质量提供依据。方法:从2019年5月—12月广州医科大学附属脑科医院MMT门诊治疗的197例患者,通过自制调查问卷、阿片类稽延性戒断症状评定量表(OP)、海洛因渴求问卷(HCQ)、贝克焦虑量表(BAI)、贝克抑郁量表(BDI)、匹兹堡睡眠质量指数(PSQI)和药物成瘾者生命质量量表(QOL-DA)进行调查。先后使用单因素和多因素线性回归分析其生命质量及其4个领域的影响因素。结果:单因素分析显示,MMT中断次数和OP、HCQ、BAI、BDI、PSQI总分是影响患者生命质量及其4个领域的重要因素。MMT是否中断是躯体功能的影响因素,美沙酮治疗剂量可能影响生命质量及其躯体功能、心理功能和社会功能。进一步多因素线性回归分析提示,MMT中断次数(在戒毒症状及毒副作用2个领域)、OP(在4个领域)、HCQ(在心理、社会功能、戒毒症状及毒副作用3个领域)、BAI(在躯体、心理功能、戒毒症状及毒副作用3个领域)、PSQI总分(在躯体和社会功能2个领域)是MMT患者生命质量的重要影响因素;抑郁情绪(BDI总分)是MMT患者生命质量中社会功能和戒毒症状及毒副作用领域的影响因素(P<0.05)。结论:MMT中断次数、阿片类稽延性戒断症状、渴求、焦虑症状、睡眠质量是MMT患者生命质量的重要影响因素,抑郁情绪对MMT患者生命质量中的社会功能和戒毒症状及毒副作用领域有重要影响。Objective:To investigate the quality of life of patients with methadone maintenance treatment(MMT),and to explore its influencing factors,so as to provide evidence for improving the quality of MMT service.Methods:From May to December 2019,197 patients treated in the MMT clinic of the Affiliated Brain Hospital of Guangzhou Medical University were investigated by self-made questionnaire,opioid protracted withdrawal symptom rating scale(OP),heroin craving questionnaire(HCQ),Beck anxiety inventory(BAI),Beck depression inventory(BDI),Pittsburgh sleep quality index(PSQI)and quality of life scale for drug addicts(QOL-DA).Single factor and multi-factor linear regression were used to analyze the quality of life and its influencing factors in four fields.Results:Univariate analysis showed that the number of MMT interruptions and the total scores of OP,HCQ,BAI,BDI and PSQI were important factors affecting the quality of life of patients and their four fields.Whether MMT was interrupted was the influencing factor of physical function.The dose of methadone treatment might affect the quality of life and its physical function,psychological function and social function.Further multivariate linear regression analysis showed that the number of MMT interruptions(in the field of detoxification symptoms and toxic side effects),OP(in 4 fields),HCQ(in 3 fields of psychological,social function,detoxification symptoms and toxic side effects),BAI(in 3 fields of physical,psychological function,detoxification symptoms and toxic side effects),PSQI total score(in 2 fields of physical and social function)were important factors affecting the quality of life of MMT patients.Depression(BDI total score)was the influencing factor of both social function and detoxification symptoms and toxic side effects in the quality of life of MMT patients(P<0.05).Conclusion:The number of MMT interruptions,opioid protracted withdrawal symptoms,craving,anxiety symptoms,and sleep quality are important factors affecting the quality of life of MMT patients.Depression

关 键 词：美沙酮维持治疗 生命质量 稽延 渴求 心理 影响因素 

分 类 号：R749.6[医药卫生—神经病学与精神病学]