盐酸丁丙诺啡对海洛因依赖者脱毒后预防复吸的研究—248例盐酸丁丙诺啡维持治疗临床研究

目的:研究盐酸丁丙诺啡对海洛因依赖者脱毒后预防复吸的效能。方法:248例海洛因依赖者完成脱毒后给予盐酸丁丙诺啡舌下含片维持治疗,药物剂量从第1月4mg·d-1,2mg·d-1到第2月后一直以1.5mg·d-1维持;维持者每次来所取药时做尿液吗啡检测,填写相关量表。结果:丁丙诺啡舌下含片维持治疗第1,3,6,12,18,24月时的保持率分别为61·69%,29·84%,12·10%,2·65%,1·61%和0·81%。尿液吗啡检测阴性率在前2个月占应检人数的75%以上;渴求强度“非常想”和“不想”因子在第1,6,12月时差异有显著性(P<0·01);稽延性戒断症状总平均分第1月和第3,6,12月比较差异有显著性(P<0·01);不良反应以思睡、便秘为主,后者随维持治疗时间延长而加重。结论:盐酸丁丙诺啡舌下含片维持治疗对海洛因依赖者脱毒后预防复吸有肯定的作用。

EFFICACY OF BUPRENORPHINE HYDROCHLORIDE ON RELAPSE-PREVENTION AMONG HERION DEPENDENT PATIENTS AFTER DETOXIFICATION——248 CASES ON BUPRENORPHINE MAINTENANCE TREATMENT

Objective: To evaluate the efficacy of buprenorphineonrelapse preventionof heroin abuse. Methods: Maintenance treatmentwith sublingual buprenorphine tablets was conducted among248 heroin dependent patientsafter detoxification. The maintenance dose was 4 mgDK]·DK]d~ -1 or 2 mgDK]·DK]d~ -1 atthe firstmonth, and from the secondmonth,it reduced to 1.5 mgDK]·DK] d~ -1 and maintainedat this dose. Patients had to go through urine morphine tests and fill in related questionnairesbefore taking the medicine. Results: The retention ratesof buprenorphine maintenance treatment were 61.69%, 29.84%, 12.10%, 2.65%, 1.61%, 0.81% at1~ st , 3~ rd , 6~ th , 12~ th , 18~ th and 24~ th month, respectively. The negative result of urine morphine tests was more than 75% among those who should be tested at the third week of the second month. The degreesof craving were of great diversity at1~ st , 6~ th , 12~ th month(P <0.01).Great differences were observed in the averagescore of protracted withdrawal syndromes at1~ st , 6~ th , 12~ th month(P<0.01). Sleepand constipation were the main adverse reactions, and the latter was gettingworse as the treatment wenton. Conclusion:Buprenorphine maintenance treatment is effective on relapse prevention of heroin abuse.