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。     

丁丙诺啡维持治疗海洛因依赖119例疗效观察

目的：观察丁丙诺啡维持治疗海洛因依赖的疗效,为进一步推广提供依据。方法：119例海洛因依赖者采用丁丙诺啡舌下片维持治疗（BMT）,维持治疗期间进行不良反应监测和生命质量量表评定。结果：119例海洛因依赖者1个月、6个月、12个月的维持率分别为42例（35．3%）、36例（30．2%）、34例（28．6%）。维持治疗期间不良反应轻,无肝肾功能损害。维持治疗前后,患者生命质量评分比较差异有统计学意义（P〈0．05）。结论：丁丙诺啡维持治疗能够显著改善海洛因依赖者的生命质量,不良反应轻,有助于提高脱毒后的操守率,值得推广应用。     

丁丙诺啡舌下含片用于海洛因依赖者脱毒治疗临床评价

目的 :评价丁丙诺啡舌下含片对海洛因依赖者脱毒的效果及不良反应。方法 :采用多中心随机双盲双模拟对照试验及无对照开放试验设计。对照试验选择 2 39例中度海洛因依赖者 ,按照 1:1:2的比例随机分入丁丙诺啡10d组、丁丙诺啡 14d组和美沙酮 14d组。另外 4 9例重度海洛因依赖者使用丁丙诺啡进行 10 - 14d脱毒治疗 ,进行开放观察。结果 :丁丙诺啡舌下含片控制戒断症状总分和主要戒断症状评分与美沙酮比较差异无显著性 (P >0 .0 5 )。焦虑量表评分丁丙诺啡组与美沙酮组比较差异也无显著性 (P >0 .0 5 )。用药前 3d丁丙诺啡单次用量最大可达 6mg ,日剂量最大为 18mg。不良反应较少 ,主要为便秘。停药后无明显戒断症状。结论 :足量使用丁丙诺啡舌下含片用于海洛因依赖脱毒治疗安全有效     

丁丙诺啡舌下片用于海洛因依赖脱毒治疗的临床研究

目的 研究盐酸丁丙诺啡舌下片对于海洛因依赖脱毒治疗的临床疗效及不良反应.方法 根据戒断症状的严重程度、吸毒剂量、方式等给予不同的盐酸丁丙诺啡舌下片观察其疗效及不良反应.结果 脱毒治疗前后比较戒断症状评分差异有统计学意义(P＜0.01),不良反应轻微.结论 盐酸丁丙诺啡舌下片可用于海洛因依赖的早期脱毒治疗、不良反应轻微.     

益安回生口服液联合丁丙诺啡治疗海洛因依赖疗效观察

目的:观察丁丙诺啡 益安回生口服液在海洛因依赖脱瘾治疗中的疗效,探索疗效好,不造成新药瘾的脱毒脱瘾方案。方法:将90例海洛因依赖患者随机分为A、B两组。A组给予丁丙诺啡舌下片 益安回生口服液。B组给予丁丙诺啡舌下片 安慰剂,对照组观察两组的脱瘾疗效。结果:两组戒断症状记分差异有非常显著性意义(P<0.01)。A组在焦虑、肌肉骨骼疼痛、失眠的分级明显优于B组。结论:益安回生口服液与丁丙诺啡舌下片联用能更有效的缓解戒断症状。     

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。     

Rapid detoxification of heroin dependence by buprenorphine

评价丁丙诺啡７－８ｄ递减法治疗海洛因戒断症状（戒毒）的临床疗效．方法：６０例海洛因成瘾者根据依赖程度分为三组，分别给予低、中、高三种剂量丁丙诺啡舌下含服片剂治疗．治疗期间患者戒断症状采用“美国临床研究所麻醉药品评价量表”评价；对海洛因的心理渴求采用“视觉类比量表”自评；丁丙诺啡副作用采用“副反应量表”评价．结果：三组戒毒患者丁丙诺啡平均日消耗量分别为２０，２９和３６ｍｇ．此剂量的丁丙诺啡不仅可有效地控制海洛因戒断症状，且可缩短戒毒时程．结论：丁丙诺啡是一个有希望替代纯阿片受体激动剂的有效、快速戒毒药物．     

盐酸丁丙诺啡舌下片治疗稽延性戒断症状234例

目的：评价盐酸丁丙诺啡舌下片治疗海洛因依赖者稽延性戒断症状(PWS)的效果。方法：将符合DSM Ⅳ海洛因依赖者随机分成2组，治疗组234例继续用盐酸丁丙诺啡舌下片，每日4次，每次2粒，对照组207例则为空白对照，进行为期5 d的抗PWS的治疗比较。选用PWS评定量表进行分析。结果：PWS量表显示盐酸丁丙诺啡舌下片治疗前后总分减少与对照组治疗前后总分减少比较差异有显著性 (P＜0.05)。结论：盐酸丁丙诺啡舌下片治疗PWS，疗效可靠。     

丁丙诺啡和美沙酮对海洛因依赖者脱毒治疗的临床实验研究比较

丁丙诺啡和美沙酮对海洛因依赖者脱毒治疗的临床实验研究比较比较了丁丙诺啡和美沙酮对海洛因依赖的门诊病人脱毒治疗的效果。４５位病人随机分为两组：一组舌下含服丁丙诺啡，另一组口服美沙酮。采用双盲、双模拟对照实验设计，研究丁丙诺啡在一个９０ｄ的脱毒治疗程序中...     

丁丙诺啡舌下含服治疗海洛因成瘾者的戒断反应

本文作者用丁丙诺啡舌下含服片脱毒，入组成痛者３７例，每日用丁丙诺啡舌下含服片，前三天最大量８ｍｇ／日，以后逐日递减，１０天停药。与国内常用的丁丙诺啡注射方法脱毒进行比较，结果发现二组效果相当，副作用二组不明显，但舌下含服组每日只需含服１～２次，不用注射，较为方便。     

Buprenorphine: an alternative to methadone for heroin dependence treatment.

Eighty-five heroin addicts who were unwilling to receive methadone maintenance or enter therapeutic communities were assessed, single-blind, for the lowest sublingual dose of buprenorphine that blocked heroin craving (8.0 mg max). All doses were administered daily under observation. After maintenance for 4 to 12 weeks, abstinent subjects (confirmed by urine drug screens) entered a double-blind discontinuation trial and were randomly assigned to receive dose reductions (10% twice weekly for 5 weeks to zero dose, then placebo for 2 weeks) or a stable dose for 7 weeks. Subjects were terminated from discontinuation if heroin was used or they had increased craving/symptoms. Subjects completed the trial if they did not use heroin and had no increase in craving/symptoms. A wide dose range (1.5-8.0 mg/day) was effective in reducing heroin craving and use. Of 73 subjects who received buprenorphine for 4 to 52 weeks, 40 had no prior treatment, despite high levels (mean $/day heroin = 70.5 +/- 94.7) and many years (mean years = 10.7 +/- 8.6) of dependence. Subjects who received dose reductions developed abstinence symptoms, low energy most commonly, associated with drug-seeking behavior. Discontinuation trial outcome (n = 51) shows a highly significant difference between 29 subjects who received dose reductions (28 terminated, 1 completed) and 22 subjects who received no dose reductions (3 terminated; 19 completed) (chi-square = 36.08; p less than .00001). The findings suggest that buprenorphine could be an important medication for reducing demand for heroin by many heroin addicts who remain outside the present health-care system.(ABSTRACT TRUNCATED AT 250 WORDS)     

小剂量丁丙诺啡巩固治疗的初步观察

目的··：观察小剂量Ｂｕｐ片在定期随诊、心理诱导、家庭监护情况下，对海洛因依赖者脱毒后巩固治疗的影响。方法··：选择９０例经过脱毒治疗的病例，随机分成观察组和对照组，两组病例数均为４５例，全程１２周，观察组于前４周每天加用Ｂｕｐ片０．２ｍｇ，每周７片，每例平均２０．４片，共４．０８ｍｇ。结果··：第４、８周的复吸率两组差异有显蓍性。第１２周差异无显著性。结论··：小剂量Ｂｕｐ片对巩固治疗有一定意义，如适量加大Ｂｕｐ剂量、延长服用时间，复吸率可能会进一步降低     

丁丙诺啡舌下含片用于治疗阿片类依赖首次给药时机的探讨

本文通过７３例海洛因依赖者在选用丁丙诺啡给药时机和首次剂量条件下进行的临床观察，显示用丁丙诺啡舌下含片进行脱毒治疗是行之有效的。提出了特别引起重视的用药环节即丁丙诺啡的首次剂量及给药时间问题。同时本试验的结果提示，采用盲法治疗可避免心理因素和人为因素的干扰。     

615例海洛因依赖者复吸原因调查与分析

目的··:了解海洛因依赖者脱毒后复吸的原因 ,寻求有效的预防复吸措施。方法··:采用《药物滥用复吸因素调查表》对615例海洛因依赖者脱毒后复吸的情况进行调查。结果··:在615例被调查者中 ,脱毒后出院3d内复吸的占21.79 % ;1个月内复吸的占52.36 % ;6个月内复吸的占93.50 % ;1a内复吸率高达97.89 %。自愿戒毒、强制戒毒与劳教戒毒出所后不同时间内的复吸率比较无显著性差异 (P>0.05)。难以抗拒的对药物的心理渴求是产生复吸的主要心理因素 (占86.99 % ) ;身体不适、失眠等稽延性戒断症状是产生复吸的主要生理因素 (占76.75 % ) ;毒友引诱是产生复吸的主要社会因素 (占75.94 % )。心理、生理、社会诸因素造成海洛因依赖者脱毒后不能保持操守。结论·· :脱毒后给予必要的对症治疗和坚持不懈的行为矫治 ,以及持之以恒的家庭关心、监督 ,社会帮教、扶持 ,政府部门监控、管制和严惩毒贩 ,清除毒源等综合治理 ,是降低复吸率的有效办法     

Opioid Addicts at Admission vs. Slow-Release Oral Morphine,Methadone, and Sublingual Buprenorphine Maintenance Treatment Participants

With use of a randomized study design, quality of life (QOL) and physical symptoms of opioid addicts at admission were compared with slow-release oral morphine, methadone, and sublingual buprenorphine maintenance program participants after 6 months of treatment. The study was conducted from February to July 2004 in the outpatient drug user treatment center at University Department of Psychiatry at Innsbruck, providing maintenance treatment programs and detoxification in Tyrol, Austria. One hundred twenty opioid users seeking treatment were compared with 120 opioid-dependent patients retained for 6 months on a slow-release oral morphine, methadone, or sublingual buprenorphine maintenance program. The German version (“Berlin Quality of Life Profile”) of the Lancashire Quality of Life Profile was used, and illicit opioid use was determined by urinalysis. Physical symptoms were measured by using the Opioid Withdrawal Scale. Urinalyses revealed a significantly lower consumption of cocaine and opioids in all three substitution groups than in patients at admission (p < 0.001 and p ≤ 0.004, respectively). Both the buprenorphine and the methadone maintenance group showed significantly more favorable values than opioid clients at admission for stomach cramps (p ≤ 0.002), muscular tension (p ≤ 0.027), general pain (p ≤ 0.001), feelings of coldness (p ≤ 0.000), heart pounding (p ≤ 0.008), runny eyes (p ≤ 0.047), and aggressions (p ≤ 0.009). Patients who received slow-release oral morphine treatment generally showed the least favorable QOL scores compared with patients at admission or sublingual buprenorphine and methadone clients. Patients in the sublingual buprenorphine or methadone program showed nearly the same QOL scores. The buprenorphine and the methadone maintenance group showed significantly more favorable values than opioid clients at admission regarding leisure time (p ≤ 0.019), finances (p ≤ 0.014), mental health (p ≤ 0.010), and overall satisfaction (p ≤ 0.010). Slow-release oral morphine is a well-established treatment for pain, but more research is required to evaluate it as a treatment for heroin dependence. The present data indicate that slow-release oral morphine could have some disadvantages compared with sublingual buprenorphine and methadone in QOL, physical symptoms, and additional consumption. The results further suggest that buprenorphine treatment is as effective as methadone in effects on quality of life and physical symptoms.     

Relationship between plasma cortisol levels, withdrawal symptoms and craving in abstinent and treated heroin addicts

Twelve-month treatment of heroin addicts with methadone or buprenorphine normalized plasma cortisol levels, and controlled withdrawal symptoms as well as craving. During treatment, the time course of plasma cortisol levels and craving was not strictly correlated: heroin craving was more elevated at 12 than at 3 months. The results suggest a correlation between hypercortisolism, withdrawal symptoms and heroin use and suppose a more complex role for craving and its components in drug-taking behaviour. The main goal of the pharmacological treatment of opioid-dependence should be addressed at the normalization of hypothalamic-pituitary-adrenocortical (HPA) axis more than at the control of craving.     

尼莫地平控释片辅助治疗海洛因戒断综合征

目的··:观察钙拮抗剂尼莫地平控释片对海洛因戒断综合征的辅助治疗作用。方法··:治疗组30例 ,采用美沙酮、丁丙诺啡梯度替代递减法治疗 ,同时口服尼莫地平控释片60mg,每天2次。对照组单纯使用美沙酮、丁丙诺啡梯度替代递减法治疗 ,10d为一疗程。结果··:治疗期间治疗组戒断症状评分较低 ,尤其是d4两组戒断症状评分有显著性差异(P<0.05),两组焦虑症状 ,脱毒率及美沙酮、丁丙诺啡平均用量无显著性差异。结论··:尼莫地平控释片对海洛因戒断症状有一定辅助治疗作用 ,尤其对忽冷忽热、腹痛、周身疼痛不适、心悸胸闷等戒断症状控制较好 ,可在临床实践中进一步总结应用     

Intimate relationship characteristics associated with condom use among drug users and their sex partners: a multilevel analysis

This study compared the safety and efficacy of sublingual buprenorphine tablets with oral methadone in a population of opioid-dependent individuals in a double-blind, randomized, 6-week trial using a flexible dosing procedure. Fifty-eight patients seeking treatment for opioid dependence were recruited in three outpatient facilities and randomly assigned to substitution with buprenorphine or methadone. The retention rate was significantly better in the methadone maintained group (90 vs. 56%; P<0.001). Subjects completing the study in both the treatment groups had similar proportions of opioid positive urine samples (buprenorphine 62%; methadone 59%) and positive urine specimens, as well as mean heroin craving scores decreased significantly over time (P=0.035 and P<0.001). The proportion of cocaine-positive toxicology results did not differ between groups. At week six mean stabilization doses were 10.5 mg per day for the sublingual buprenorphine tablet, and 69.8 mg per day for methadone, respectively. Patient performance during maintenance was similar in both the groups. The high attrition rate in the buprenorphine group during the induction phase might reflect inadequate induction doses. Thus, buprenorphine is a viable alternative for methadone in short-term maintenance treatment for heroin dependence if treatment induction is done with adequate dosages.