十复生和洛非西定治疗海洛因依赖稽延性戒断症状对照研究

目的：探讨十复生胶囊对海洛因依赖患者临床脱毒后稽延性戒断症状的临床疗效及安全性。方法：将128例海洛因依赖患者使用美沙酮临床脱毒1周后随机分成两组（十复生和洛非西定各64例），分别给予十复生胶囊与盐酸洛非西定片治疗2周，采用海洛因稽延性戒断症状评定量表评定疗效，药物不良反应量表评定不良反应。结果：两组之间疗效存在明显差异。结论：十复生胶囊在治疗海洛因依赖患者临床脱毒后的稽延性戒断症状明显优于盐酸洛非西定片。     

泰康宁胶囊对海洛因依赖患者脱毒疗效与安全性的临床观察

目的:观察泰康宁胶囊对海洛因依赖患者的脱毒效果及用药安全性。方法:采用开放试验设计,对50例海洛因依赖患者进行了观察。泰康宁胶囊常规口服剂量为1.5～3.0g,3次/d,根据戒断症状控制及不良反应情况增减剂量,最多可至4.0g,3次/d,连续用药10d。脱毒药效评价指标采用戒断症状逐日总体评分、主要戒断症状逐日分别评分、Hamilton焦虑量表(HAMA)评定。用药期间监测不良反应。结果:每日戒断症状总分、主要戒断症状逐日评分以及HAMA评分与用药前比较,差异均具有统计学意义(P<0.001)。不良反应主要有恶心呕吐、腹泻、口干、复视。对呼吸、心率、血压无影响。结论:泰康宁胶囊用于海洛因依赖患者脱毒治疗安全有效。     

十复生胶囊治疗海洛因依赖50例疗效观察

目的观察非阿片类纯中药制剂十复生胶囊对海洛因依赖戒断症状的疗效及不良反应。方法对50例符合诊断标准的中、重度海洛因依赖者,进行为期10d用药与观察。结果治疗后戒断症状总分值快速下降,在治疗d3控制戒断症状有效率达82%。50例患者均顺利完成治疗,疗程结束时吗啡尿检呈阴性反应,停药后戒断症状无反复,有效率为100%。主要不良反应有嗜睡47例（94%）,头晕34例（68%）,乏力31例（62%）,但程度轻微,在治疗后期用药量逐渐调整后,不良反应均能缓解或消失。结论十复生胶囊控制海洛因依赖者的戒断症状,显效迅速、疗效肯定,安全可靠,值得推广应用。     

中药灵益胶囊控制阿片类戒断症状的临床疗效评价

中药灵益胶囊是用于控制阿片类药物依赖戒断症状的复方中药制剂。已被卫生部批准进行临床试验。本研究采用随机双盲和开放多中心临床试验,共完成330例海洛因依赖者的脱毒效应评定。结果发现灵益胶囊于治疗的第3日控制海洛因戒断症状的显著好转率为71.43%,可乐定为58.47%,两组结果类似,安慰剂组仅为10.53%。灵益胶囊与可乐定的疗效显著优于安慰剂(X2=22.8298,P=0.0000)。疗程结束时戒断症状无反复。提示灵益胶囊具有明显的控制阿片类戒断症状的效应,其总体疗效与可乐定相当。灵益胶囊治疗中,其不良反应明显低于可乐定组(P<0.05),与安慰剂类似(P>0.05)。开放性试验显示,灵益胶囊的疗效与不良反应出现情况与双盲试验类似。     

米氮平对海洛因依赖者脱毒后期稽延性戒断症状的疗效观察

目的观察米氮平片对海洛因依赖者脱毒后期稽延性戒断症状的疗效和不良反应。方法 60例自愿戒毒者脱毒后,由患者自愿选择米氮平片口服治疗,观察其稽延性戒断症状及不良反应,同时设对照组30例,仅作对症治疗。结果在控制稽延性戒断症状方面,米氮平组与对照组相比差异有统计学意义（P〈0.01）;不良反应两组差异无统计学意义（P〉0.05）。结论在应用美沙酮替代递减疗法完成脱毒后,加用米氮平片进行后续的巩固康复治疗,能够有效地控制海洛因依赖者的稽延性戒断症状,且副反应少、安全,值得推广使用。     

济泰片对海洛因依赖者脱毒后期稽延性戒断症状的疗效观察

目的:观察济泰片对海洛因依赖者脱毒后期稽延性戒断症状的疗效和不良反应。方法:对30例自愿戒毒者在停用美沙酮后予以济泰片口服治疗,观察其稽延性戒断症状及不良反应;同时设对照组30例,不用戒毒中药,仅作对症治疗。结果:在控制稽延性戒断症状方面,济泰片组与对照组相比有非常显著性差异(P<0.001);不良反应两组差异无显著性(P>0.05)。结论:在应用美沙酮替代递减疗法完成脱毒后,加用济泰片进行后续的巩固康复治疗,能够有效地控制海洛因依赖者的稽延性戒断症状,且副作用少,安全,值得推广使用。     

吉祥戒毒液对海洛因依赖大鼠戒断症状的抑制作用

目的：研究中药吉祥戒毒液(一种复方的传统中药)对海洛因依赖大鼠戒断症状的疗效。方法：建立海洛因依赖大鼠模型，观察腹腔注射纳洛酮催促戒断以及自然戒断后，吉祥戒毒液对大鼠戒断症状的抑制作用。结果：无论是对纳洛酮催促戒断还是自然戒断的大鼠，吉祥戒毒液高、中、低三个剂量组戒断症状综合积分值均低于生理盐水对照组，但只有高、中剂量的吉祥戒毒液能抑制体重的下降。结论：吉祥戒毒液能明显减轻海洛因依赖大鼠的戒断症状，并且对海洛因依赖大鼠的体重下降有一定的缓解作用。因此，该药是治疗海洛因依赖的有效药物。     

120例海洛因依赖者戒断治疗方案初探

本文总结了１２０例海洛因依赖者自愿戒断治疗的基本情况及治疗效益，并从治疗的易接受性及脱毒效果两方面评价本治疗方案的疗效，结果揭示自愿戒毒者吸食海洛因以男民生居多，待业人员，个体经商者居多，本院采用的戒毒灵制剂与丁丙诺啡联合治疗方案，脱毒治疗疗效较好，易于接受，副反应较少，减少单用药物的剂量，依赖性潜力少。     

两种一氧化氮合酶抑制剂的急性毒性及对海洛因依赖性小鼠戒断综合征的作用

目的··:研究一氧化氮合酶抑制剂NAME和NABE的急性毒性对海洛因依赖小鼠的戒断症状的治疗作用并测定体内一氧化氮 (NO )的含量。方法·· :用NAME和NABE1000mg.kg-1 经灌胃及37.5mg.kg-1 静脉注射给药进行急性毒性实验 ;采用海洛因递增法形成小鼠依赖模型 (海洛因剂量从10mg.kg-1增至50mg.kg-1) ,皮下注射给药4.5d ,采用上述小鼠模型 ,观察NAME及NABE对海洛因依赖小鼠戒断综合征的治疗效果。结果··:NAME和NABE在尾静脉注射37.5mg.kg-1 及灌胃1000mg.kg-1 剂量下未见明显急性毒性 ;NAME16mg.kg-1 、8mg.kg-1 剂量组可明显延长戒断小鼠跳跃潜伏期 ,减少小鼠的戒断跳跃反应数 ,且抑制其腹泻症状 ,而NAME4mg.kg-1剂量组及NABE8mg.kg-1剂量组除对小鼠戒断反应的个别指标有影响外 ,其余作用均不明显 ;NAME对胸腺有一定的保护作用。NAME及NABE减轻海洛因依赖小鼠血液NO水平明显降低。结论··:NAME及NABE毒性均较小 ,NAME减轻海洛因依赖小鼠戒断反应的作用较为明显     

褪黑素对海洛因依赖大鼠的作用

目的 :观察褪黑素 (MT)对海洛因 (Her)依赖大鼠的作用。方法 :将 15 0只大鼠随机分为海洛因依赖模型组、海洛因依赖MT保护组和溶媒对照组。分别用海洛因、海洛因加MT或溶媒处理大鼠。 4 2d后将海洛因模型组大鼠随机分为MT治疗组、美沙酮治疗组、海洛因依赖组、自然戒断组、纳洛酮催促戒断组。然后观察自然戒断或ip纳洛酮催促戒断症状 ;进行淋巴细胞增殖反应和亮氨酸脑啡肽 (L -EK)以及β内啡肽 (β -EP)的测定。结果 :MT保护组及MT治疗组均显示 :MT可缓解大鼠的戒断症状 ;促进海洛因依赖大鼠脾淋巴细胞增殖 ;提高海洛因依赖大鼠脑L -EK和 β-EP水平。 结论 :MT可部分控制海洛因依赖大鼠的戒断症状 ;对海洛因造成的细胞免疫功能低下可能有预防和逆转的作用     

Distinct Mu,Delta, and Kappa Opioid Receptor Mechanisms Underlie Low Sociability and Depressive-Like Behaviors During Heroin Abstinence

Addiction is a chronic disorder involving recurring intoxication, withdrawal, and craving episodes. Escaping this vicious cycle requires maintenance of abstinence for extended periods of time and is a true challenge for addicted individuals. The emergence of depressive symptoms, including social withdrawal, is considered a main cause for relapse, but underlying mechanisms are poorly understood. Here we establish a mouse model of protracted abstinence to heroin, a major abused opiate, where both emotional and working memory deficits unfold. We show that delta and kappa opioid receptor (DOR and KOR, respectively) knockout mice develop either stronger or reduced emotional disruption during heroin abstinence, establishing DOR and KOR activities as protective and vulnerability factors, respectively, that regulate the severity of abstinence. Further, we found that chronic treatment with the antidepressant drug fluoxetine prevents emergence of low sociability, with no impact on the working memory deficit, implicating serotonergic mechanisms predominantly in emotional aspects of abstinence symptoms. Finally, targeting the main serotonergic brain structure, we show that gene knockout of mu opioid receptors (MORs) in the dorsal raphe nucleus (DRN) before heroin exposure abolishes the development of social withdrawal. This is the first result demonstrating that intermittent chronic MOR activation at the level of DRN represents an essential mechanism contributing to low sociability during protracted heroin abstinence. Altogether, our findings reveal crucial and distinct roles for all three opioid receptors in the development of emotional alterations that follow a history of heroin exposure and open the way towards understanding opioid system-mediated serotonin homeostasis in heroin abuse.     

海洛因依赖者稽延性戒断症状的动态变化

目的：了解停吸海洛因后不同时期稽延性戒断症状的变化情况。方法：对戒断10天以上的281例海洛因依赖者进行稽延症状量表的评定。结果：在稽延性戒断症状的五个主成分中，焦虑和植物神经功能紊乱症状在戒断早期可以消退（3月），睡眠和认知功能障碍在戒断半年后明显改善，渴求则持续时间更长。结论：海洛因依赖者在不同的戒断时期症状表现有所不同，提示其治疗和预防复吸的方法应有针对性的措施。     

可乐宁治疗海洛因成瘾临床疗效观察

使用α-受体激动剂可乐宁对60例海洛因成瘾者戒毒治疗,并与亚冬眠疗法对照进行观察。戒毒期间,可乐宁使用有效率为96.6%,与对照组(71.6%)比较,具有非常显著性差异,证明可乐宁的治疗效果可靠。根据海洛因戒断症状的临床表现和体征,本文将可乐宁治疗分为两组,对药物效能进行观察,治疗后72 h两组疗效结果提示,治疗早期配合使用抗焦虑类药物可以明显提高治疗药物的抑制效能,并能缓解与之伴随的主观不适诸症。结果说明可乐宁适用于各种类型的海洛因成瘾者的戒毒治疗。     

比较40例二氢埃托啡成瘾者与40例海洛因成瘾者的戒断综合征

本文报告４０例二氢埃托啡（ＤＨＥ）成瘾者的戒断症状，并与４０例海洛因成瘾者比较。９５％的ＤＨＥ成瘾者自身ｉｖ给药，欣快感６±４ｓ，持续时间４５±１７ｍｉｎ，ｉｖ１０－２０次／ｄ，日用量高达２．４±１．５ｍｇ，戒断症状与海洛因相同，但严重程度ＤＨＥ（总分２１±１０）比海洛因（总分２９±５）轻。ＤＨＥ滥用而致成瘾，应引起有关部门及社会的高度重视。对ＤＨＥ要加强管理。     

中药戒得安对吗啡依赖性大鼠的脱毒疗效及药物身体依赖性的实验研究

本文研究自拟中药戒得安对吗啡依赖大鼠戒断综合征的治疗效果，并对其是否存在药物身体依赖性作出评价。结果表明，戒得安能明显缓解吗啡依赖大鼠的戒断综合征，戒断症状综合积分及体重减轻情况与无治疗戒断组相比有显著性差异（Ｐ＜０．０１）。实验亦证实戒得安本身无身体依赖性。     

Nine-year follow-up of 86 consecutive patients treated with methadone in general practice, Sydney, Australia

The status of 86 consecutive heroin addicted patients who presented for methadone treatment to an inner-city Sydney general practice in 1987 and 1988 was sought in 1996, using patients' files and official records; follow-up information was obtained for 79 patients (92%) after a mean period of 8.6 +/- 0.5 years. The mean age at intake was 29 years, patients having used heroin for a mean of 8.5 +/5.1 years (range 1-25). By 1996, 35 (41%) of the 86 patients had remained in continuous treatment. Successful withdrawal from opioids including methadone for a period of 3 months or more was reported by 31 patients (36%) for a mean of 36 months (range 3-84) with 10 of these returning to methadone treatment after prolonged periods of abstinence. Eight patients (9%) died, four from drug overdose. Five patients (6%) who had left treatment were reportedly using street heroin. Seven patients (8%) could not be traced. The most conservative interpretation of these patients' reports is that 56% of the original 86 were well and functional at follow-up. The most optimistic interpretation was that 81% of patients were doing well 9 years later. This study confirms the benefits of methadone maintenance while also demonstrating the serious nature of heroin addiction. \[Byrne AJ. Nine-year follow-up of 86 consecutive patients treated with methadone in general practice, Sydney, Australia. Drug Alcohol Rev 2000;19:153-158]     

丁丙诺啡舌下含片与美沙酮用于海洛因依赖门诊稽延期治疗的对照研究

目的观察丁丙诺啡舌下含片与美沙酮用于海洛因依赖者稽延期治疗的价值。方法对完成脱毒治疗患者，依先后次序交叉纳入观察组与对照组，分别给予丁丙诺啡舌下含片和美沙酮治疗6个月，观察操守时间，并于人组前后做焦虑量表评分。结果丁丙诺啡舌下含片组比美沙酮组的操守时间长（P〈0．01），焦虑评分低（P〈0．05）。结论丁丙诺啡舌下含片于海洛因依赖门诊稽延期治疗能更好地缓解焦虑情绪并延长操守时间。     

Factors associated with 12 months continuous heroin abstinence: findings from the Australian Treatment Outcome Study (ATOS)

AIMS: To determine the role of treatment and client characteristics associated with the achievement of continuous heroin abstinence. DESIGN: Longitudinal cohort study. SETTING: Sydney and Adelaide, Australia. PARTICIPANTS: 570 heroin users re-interviewed at 12 month follow-up for the Australian Treatment Outcome Study (ATOS). FINDINGS: Continuous heroin abstinence was reported by 14% of participants. Continuous abstinence was associated with no previous treatment history, having entered treatment at baseline, and cumulative treatment exposure over the follow-up period. Longer retention times in index maintenance and residential rehabilitation treatments, but not detoxifications, were most associated with abstinence. At baseline, abstinent participants were more likely to have been classified as treatment ready, or to have used heroin less frequently; and less likely to have been daily injectors, using cocaine or criminally involved. CONCLUSIONS: Approximately 14% of ATOS participants achieved continuous heroin abstinence over 12 months. Such an achievement was strongly associated with a longer "dose" of treatment, and with more treatment stability over the follow-up period.     

Long-term methadone maintenance reduces protracted symptoms of heroin abstinence and cue-induced craving in Chinese heroin abusers

BACKGROUND: Cession of heroin use may be followed by a protracted-abstinence (PA) syndrome consisting of craving, negative mood, and physiological changes. PA symptoms have rarely been compared between drug-free and methadone-maintained former heroin users after similar lengths of heroin abstinence. METHODS: Seventy former heroin users were included in one of four groups: in day 15-45 of methadone maintenance therapy (short-term MMT), in month 5-6 of MMT (long-term MMT), opiate-free for 15-45 days after methadone-assisted heroin detoxification (short-term post-methadone), and opiate-free for 5-6 months after methadone-assisted heroin detoxification (long-term post-methadone). PA symptoms (negative mood, dyssomnia, somatization, and craving), and blood pressure and pulse were assessed pre- and post-neutral videotape and pre- and post-heroin videotape. RESULTS: Dyssomnia and the total PA score were worst in short-term post-methadone participants, mood was best in long-term MMT participants, and cue-induced craving was least severe in long-term MMT participants. Blood pressure and pulse did not differ across groups. CONCLUSIONS: Even after acute withdrawal, the first months of heroin abstinence after methadone-assisted detoxification may be more difficult in terms of cue-induced craving and other PA symptoms than the first months of heroin abstinence during MMT. Our findings add to the literature supporting MMT for prevention of cue-induced heroin craving.