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。     

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。     

头针治疗海洛因依赖者戒断症状94例的临床研究

目的:比较头针 美沙酮、体针 美沙酮、单纯美沙酮疗法对改善海洛因依赖者脱毒期戒断症状的临床疗效,为今后头针参与戒毒治疗,降低复吸率进行积极的探索。方法:对94例海洛因依赖者用上述三种疗法治疗,随机分为三组,动态观察10天的戒断症状。使用戒断症状量表观察脱毒的疗效。结果:治疗10天后评分显示:头针组控制戒断症状的效果最为完全,体针组也有一定的效果,但不及头针组,两组比较有统计学意义(P<0.01)。两组针刺组的治疗效果均好于单纯美沙酮组(P<0.01)。在脱毒期失眠、焦虑症状的改善方面,头针组和其它两组比较表现出明显的优势(P<0.01)。在脱毒期躯体症状的改善方面,头针组和体针组无统计学差异(P>0.05)。在脱毒期焦虑症状的改善方面,体针组和美沙酮组比较无统计学意义(P>0.05)。结论:头针减轻了海洛因依赖者脱毒期戒断症状,特别是在改善患者的失眠、焦虑等精神依赖方面具有明显的优势,在目前尚无特效的戒毒疗法的情况下,针灸参与戒毒具有疗效肯定、无副作用、经济安全的特点,头针结合药物产生了一定的协同作用。     

丁丙诺啡递减疗法治疗海洛因依赖患者480例临床疗效比较

分别采用１０ｄ递减法和５ｄ递减法用丁丙诺啡对４８０例患者进行戒毒治疗，结果表明：该药治疗期间病人戒断症状控制平稳，撤药反应轻微，未发现丁丙诺啡依赖形成。两种递减法比较结果显示，对于重度依赖患者，１０ｄ疗铲优于５ｄ疗效，对于中度和轻度依赖患者，两种疗法无显著性差异；１０display status     

海洛因依赖并发30例糖尿病分析

本文分析了海洛因依赖并发３０例糖尿病的情况，发现海洛因成瘾对机体内分泌系统的影响，尤其是对糖代谢影响较大。其原因是阿片类毒品抑制了海洛因依赖者内源性阿片类物质生成和丘脑神经元兴奋，导致神经、内分泌系统调节失调、机体感染及自身免疫功能下降有关。提示我们在从事戒毒工作中注意测试血糖及尿糖的变化，以免造成不必要的失误。     

苯妥英钠治疗海洛因依赖者戒断症状临床研究

目的：了解苯妥英钠是否能减少美沙酮等替代品的使用时间并保持脱毒疗效。方法：采用戒断症状自评量表，不良反应监测表，苯妥英钠血药浓度监测等手段，对我所在院病人进行临床观察和实验研究。结果：前5天美沙酮给药联用苯妥英钠后5天组在苯妥英钠的血药浓度达到有效范围内第九天后对戒断症状的控制与单用美沙酮替代递减10天组无显著差异（P〉0．05）。且在整个用药过程中，苯妥英钠的血药浓度在安全有效的范围内。结论：苯妥英钠对治疗阿片类依赖者过程中，能有效减少美沙酮等替代品的使用时间，且不影响疗效。     

丁丙诺啡合并异丙嗪治疗海洛因依赖45例临床研究

丁丙诺啡戒毒治疗安全可靠,递减顺利,停药容易,但在治疗头3天戒断症状较重[1]。异丙嗪有明显的中枢安定作用,能增强麻醉性镇痛作用,临床中经常合并丁丙诺啡或美沙酮用于海洛因依赖的治疗。1资料与方法1.1对象为1998年1月至2002年10月在济宁市精神病防治院接受治疗的自愿戒毒者,随机抽取丁丙诺啡合并异丙嗪治疗45例作为A组,单用丁丙诺啡治疗36例作为B组。患者均为海洛因成瘾,符合CCMD-2-R阿片类物质所致精神障碍的诊断标准。使用海洛因最长时间6年,最短时间1年,患者平均年龄30.13±5.07岁;海洛因用量0.5～2.0 g/日。A组男32例,女13例;B组…     

海洛因成瘾治疗的现况和前景

海洛因成瘾治疗药物，包括能减轻阿片戒断症状和能维持治疗效果的药物。本文综述了多种不同类型药物，有阿片激动剂、阿片部分激动剂、阿片拮抗剂和α2—肾上腺素能受体激动剂等，提供了它们在治疗戒断和维持阶段的应用资料。目前正尝试缩短阿片戒断症状时间以加速去毒进程的实验开发，美国正加紧评价用于维持治疗的法定丁丙诺啡和纳洛酮复方片剂，此法可扩大治疗面，减少静脉扎毒的可能。     

参附脱毒胶囊控制海洛因戒断症状的多中心临床研究

目的··:为客观评价参附脱毒胶囊对海洛因依赖的脱毒效应、不良反应及安全度。方法·· :按照卫生部原药政管理局制定的《抗阿片类戒断症状药物临床试验指导原则》 ,采用多中心随机双盲对照临床研究。纳入病例临床观察指标为《戒断症状评定量表》、《Hamilton焦虑评定量表》、《不良反应评定量表》 ;实验室检查指标为血尿常规、肝肾功能、心电图、尿液吗啡定性测定。结果··:纳入病例293人 ,随机进入参附脱毒胶囊组203例 ,可乐定组90例。从治疗后戒断症状总分、《Hamilton焦虑评定量表》的评分来看 ,两组无显著性差异。参附脱毒胶囊控制戒断症状的有效率83.3 % ,可乐定的有效率为81.1%。参附脱毒胶囊组的不良反应总分、对血压的影响明显较可乐定为低 (P<0.05)。未发现对肝、肾功能、血尿常规的明显影响。结论··:参附脱毒胶囊控制戒断症状的疗效肯定 ,与可乐定类似。不良反应主要为口干、思睡、头晕 ,多为轻度反应 ,无需处理自行消失。在治疗的初期应给予充分剂量 ,每次1.2 -1.6g ,每日3次。d4起逐日减量至d10疗程结束。     

700例海洛因依赖者心电图的变化

本文观察了７００例海洛因依赖者的心电图，结果表明观察组心电图改变明显高于正常对照组，有非常显著性差异（Ｐ〈０．０１）；观察组ＳＴ－Ｔ改变、心律失常、束支传导阻滞明显高于正常对照组，有非常显著性差异（Ｐ〈０．０１）。     

Patterns of sustained heroin abstinence amongst long-term, dependent heroin users: 36 months findings from the Australian Treatment Outcome Study (ATOS)

AIMS: To determine patterns of past month, 12 month and sustained 36 month heroin abstinence. METHODS: As part of a longitudinal cohort study, 429 heroin users re-interviewed at 36 month follow-up for the Australian Treatment Outcome Study (ATOS). RESULTS: The proportion who had sustained heroin abstinence since baseline declined from 14% at 12 months to 8% at 36 months. The proportion who reported abstinence over the preceding 12 months, however, increased significantly from 14% at 12 months to 40% at 36 months. There were no significant gender differences in the proportions reporting sustained 36 month abstinence. Females, however, were significantly more likely to have maintained abstinence over the 12 months preceding 36 month follow-up. Independent predictors of sustained abstinence over 36 months were fewer treatment episodes since baseline, not committing crime at baseline and higher levels of global psychological distress. CONCLUSIONS: Despite a decline in the proportion who had maintained complete heroin abstinence over 36 months, there were substantial increases in 12 month abstinence patterns. The results illustrate the importance of stable treatment retention.     

Naltrexone treatment of heroin addiction: one-year follow-up

Pre-treatment characteristics and post-treatment outcome measures were compared for 40 patients who began naltrexone maintenance and 77 who did not after a 6-month period of temporary maintenance on L-alpha-acetylmethadol (methadyl acetate LAAM). Patients who chose to begin naltrexone were younger, had fewer incarcerations and fewer months incarcerated prior to LAAM treatment, had fewer opiate-free months following previous treatments, and were more likely to be of Caucasian ethnicity. One year later, significantly more patients who had received any naltrexone than those who had not were no longer in any treatment program and were opiate-free. We found no significant correlations between total duration of naltrexone-treatment and post-treatment outcome variables such as heroin use, arrests, incarcerations or enrollment in a treatment program.     

The role of abstinence and activity in the quality of life of drug users engaged in treatment

There is increasing interest in understanding factors that enhance the quality of life of substance users in treatment, however limited research has been conducted to date. Measures of physical and psychological health, overall quality of life, drug use, and meaningful activity (education, training or employment) were collected at treatment entry and review in two areas of England as part of routine monitoring. Analysis was performed on an initial sample of 10,470 cases in one site and a more targeted assessment of 783 cases (with repeated measures for 528 of these) in the second site. Women reported lower satisfaction with their physical and psychological health at treatment entry compared with men, but these differences were not present at treatment review. Individuals who reported engagement in meaningful activities had significantly higher quality of life than those that did not. Clients in treatment who reported abstinence and engagement in meaningful activity demonstrated the highest quality of life. A holistic approach to supporting problematic substance users that acknowledges the importance of participation in meaningful activity is likely to be beneficial.     

子宫内膜息肉50例临床病理分析及其药物治疗效果研究

目的：探讨子宫内膜息肉的临床病理分析及其药物治疗效果。方法：对我院近六个月接收的50例子宫内膜息肉患者进行病理分析,随机分为两组,实验组和对照组,每组各有25例。实验组采用宫腔镜下电切,再采用左炔诺孕酮进行系统治疗。对照组采用宫腔镜下电切后,口服优思明进行治疗,对患者的病理情况进行回顾性分析。结果：实验组患者复发率低于对照组,满意度高于对照组（P＜0.05）。其中实验组中息肉样腺肌瘤19例,由富含平滑肌组织的基质包绕大小和形态不等的子宫内膜腺体,但无不典型性改变;非典型性息肉样腺肌瘤6例,由杂乱无章的不规则腺体构成,具有明显的腺体结构复杂性和细胞非典型性,伴有鳞状上皮化生。结论：子宫内膜息肉具有特异的病理特征,为良性病变,但是非典型性息肉存在低度恶性潜能,需完整切除肿物,防止复发。     

A multiple baseline analysis of treatment for heroin addiction

The effects and side effects of behavioral treatment for heroin abuse was assessed in a multiple baseline across behaviors design. Self-reported urges to take heroin, urine drug screens, assertiveness in rejecting efforts of drug pushers, and financial status were measured throughout the study. After baseline measures were taken on all responses, covert sensitization was begun, which decresed drugs urges and was associated with abstinence from drug use and positive change in assertiveness. However, extended baseline estimates of financial status indicated the client's liabilities were reliably increasing. Behavioral contracting was then implemented successfully influencing work behavior and paying back debts. Daily follow-up measures of drug use were assessed over a three month period, with no change in drug urges or use. A six month follow-up indicated no changes in drug urges or use, and the client was financially independent and employed in a responsible job. The results indicate the independence of reducing drug use and increasing some pro-social behaviors, and support the necessity of programs designed to decrease maladaptive while increasing adaptive behavior.     

海洛因成瘾的防治及神经机理研究——香山科学会议第105次学术讨论会纪要

１９９８年１０月６日－９日,在北京香山举行了香山科学会议第１０５次学术讨论会。会议的主题为“海洛因成瘾的神经机理及其防治”。韩济生院士、秦伯益院士、池志强院士担任本次会议的执行主席。来自北京医科大学神经科学研究所、中国军事医学科学院毒物药物研究所、中...     

28例中、重型颅脑损伤伴海洛因戒断综合征的诊治

目的:探讨中、重型颅脑损伤吸毒患者戒断综合征的临床特点及救治措施.方法:分析28例患者临床资料,探讨临床表现、治疗方法和效果.结果:全部病例以呼吸浅促为特征,予吗啡或度冷丁、甚至亚低温等治疗有效.结论:详细追问病史及辅助检查,结合呼吸浅促突出特征,有助于与颅内损伤占位效应鉴别.应用吗啡或度冷丁、甚至亚低温治疗是抢救成功关键.     

Abstinence and drug abuse treatment: Results from the Drug Outcome Research in Scotland study

Aims: To identify the proportion of drug users contacting drug treatment services in Scotland who were able to become abstinent 33 months after having started a new episode of treatment and to identify which services were most closely associated with such abstinence. Design: Follow-up survey of 695 of the Drug Outcome Research in Scotland respondents 33 months following recruitment into the study. Setting: Scotland. Participants: Injecting drug users who were initially contacted at drug treatment services and then followed up for 33 months post-recruitment. Measurements: Self-reported drug use and service usage. Findings: Although becoming drug free was the expressed goal of the majority of drug users recruited into the Drug Outcome Research in Scotland study, at 33 months following recruitment only 5.9% of females and 9.0% of males had been totally drug free (excluding possible alcohol and tobacco use) for a 90-day period in advance of being interviewed. There was considerable variation within this study in the proportion of drug users becoming drug free dependent upon the services they had been in contact with. The level of achieved abstinence in this Scottish study was substantially lower than that identified in the National Treatment Outcomes Research Study in England. Conclusions: There is a need to establish why so few drug users in contact with the methadone programme in Scotland appear able to become drug free 33 months after having contacted this service. On the basis of the results presented in this paper there is a need to ensure that drug users seeking help in becoming drug free are able to access residential rehabilitation services although at the present time such services are relatively rare within Scotland.     

Abstinence and drug abuse treatment: Results from the Drug Outcome Research in Scotland study

Aims: To identify the proportion of drug users contacting drug treatment services in Scotland who were able to become abstinent 33 months after having started a new episode of treatment and to identify which services were most closely associated with such abstinence. Design: Follow-up survey of 695 of the Drug Outcome Research in Scotland respondents 33 months following recruitment into the study. Setting: Scotland. Participants: Injecting drug users who were initially contacted at drug treatment services and then followed up for 33 months post-recruitment. Measurements: Self-reported drug use and service usage. Findings: Although becoming drug free was the expressed goal of the majority of drug users recruited into the Drug Outcome Research in Scotland study, at 33 months following recruitment only 5.9% of females and 9.0% of males had been totally drug free (excluding possible alcohol and tobacco use) for a 90-day period in advance of being interviewed. There was considerable variation within this study in the proportion of drug users becoming drug free dependent upon the services they had been in contact with. The level of achieved abstinence in this Scottish study was substantially lower than that identified in the National Treatment Outcomes Research Study in England. Conclusions: There is a need to establish why so few drug users in contact with the methadone programme in Scotland appear able to become drug free 33 months after having contacted this service. On the basis of the results presented in this paper there is a need to ensure that drug users seeking help in becoming drug free are able to access residential rehabilitation services although at the present time such services are relatively rare within Scotland.