美沙酮维持治疗海洛因依赖患者的吸烟行为与疼痛强度

目的探讨接受美沙酮维持治疗(methadone maintenance treatment,MMT)的海洛因依赖患者(heroindependent patients,HDPs)吸烟行为与疼痛强度关系。方法 603例MMT门诊HDPs完成社会人口学和临床特征问卷、吸烟问卷、吸烟严重程度指数评估和Zung氏抑郁自评量表,用五点口述分级评分法评估疼痛强度。结果协方差分析控制社会人口学变量、临床特征变量和抑郁症状的混杂作用后,吸烟HDPs的疼痛强度高于非吸烟HDPs(F=11.836,P=0.002),两两比较,中重度尼古丁依赖患者疼痛强度最高,轻度尼古丁依赖患者次之,无尼古丁依赖患者疼痛强度最低[(3.11±1.04)vs.(2.67±1.13)vs.(2.47±1.15),均P0.01]。结论 MMT门诊HDPs的吸烟行为与疼痛存在显著关联,尼古丁依赖程度越重,疼痛强度越高。

The study on the association between smoking and pain intensity in heroin-dependent patients receiving methadone maintenance treatment

Objective To explore the relationship between smoking and pain intensity in heroin-dependent patients (HDPs) receiving methadone maintenance treatment (MMT).Methods A total of 603 HDPs from MMT outpatients completed a socio-demographic and clinical characteristics questionnaire,a smoking questionnaire,Heaviness of Smoking Index,and Zung's Self-rating Depression Scale.Five-point Verbal Rating Scale was used to assess pain intensity.Results After adjustment for the confounding effects of socio-demographics,clinical characteristics,and depressive symptoms in the analysis of covariance,smokers had significantly higher pain intensity score compared with non-smokers (F=1 1.836,P=0.002).Multiple comparisons showed that the pain intensity level of patients with moderate-to-severe nicotine dependence was the highest,patients with mild nicotine dependence took the second place,and patients with no nicotine dependence was the lowest [(3.11±1.04) vs.(2.67±1.13) vs.(2.47± 1.15),all P＜0.05].Conclusion Smoking is significantly associated with pain in HDPs receiving MMT.The more severe the nicotine dependence that a HDP has,the intense the pain he/she has.