小剂量利培酮联合曲唑酮应用于海洛因成瘾脱毒期的疗效分析

目的: 探讨小剂量利培酮联合曲唑酮治疗海洛因成瘾脱毒期焦虑、抑郁情绪及失眠的临床疗效及安全性。方法: 将150例海洛因成瘾者随机分成3组,利培酮联合曲唑酮组50例(R+T组),予小剂量利培酮联合曲唑酮治疗,利培酮日剂量为1～2 mg,bid,早晚服用,曲唑酮日剂量50～200 mg,bid,早晚服用;利培酮组50例（R组）,单纯予利培酮治疗,日剂量1～2 mg,bid,早晚服用;曲唑酮组50例（T组）,单纯予曲唑酮治疗,日剂量50～200 mg,bid,早晚服用。疗程均为6周。于治疗前及治疗2、4、6周末,采用汉密尔顿焦虑评定量表（HAMA）、汉密尔顿抑郁评定量表（HAMD）及匹茨堡睡眠质量指数量表(PSQI)进行疗效评定,用不良反应量表（TESS）和实验室检查评定安全性。结果: 3组治疗6周末共脱落21例,余下129例完成6周治疗。R+T组在2、4、6周末HAMA、HAMD和PSQI量表评分与治疗前比较均明显下降,差异均有统计学意义（P<0.05）;R组4、6周末HAMA、HAMD和PSQI量表评分与治疗前比较均明显下降,差异均有统计学意义（P<0.05）;T组4、6周末HAMA、HAMD评分与治疗前比较均明显下降,差异均有统计学意义（P<0.05）,PSQI量表只在6周末评分有明显下降,差异有统计学意义（P<0.05）。R+T组与R、T组在2、4、6周末HAMA、HAMD和PSQI量表评分比较差异均有统计学意义（P<0.05）。3组TESS评分比较,治疗4、6周末,R+T组与T、R组间TESS评分比较差异均无统计学意义（P>0.05）。 结论: 小剂量利培酮联合曲唑酮能够显著改善海洛因成瘾者脱毒期的焦虑,抑郁情绪和睡眠质量,疗效优于单一用药。

Clinical efficacy of low dose risperidone combined with trazodone in the treatment of heroin addicts during detoxification

AIM: To investigate the clinical efficacy and safety of low dose risperidone combined with trazodone in the treatment of anxiety disorders, depression disorders and insomnia from heroin addicts after detoxification. METHODS: One hundred and fifty patients were divided into 3 groups randomly. Fifty patients of risperidone combined with trazodone group(R+T group) were given low dose risperidone and trazodone.Fifty patients of the trazodone group(T group)were only given trazodone and 50 patients of the risperidone group(R group) were only given low dose risperidone, respectively. Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the efficacy before treatment and at the end of 2, 4, 6 weeks after treatment. The safety was evaluated with Treatment Emergent Side-effect Scale (TESS) and laboratory test. RESULTS:Twenty-one patients were fallen off after 6 weeks, and 129 patients completed the course of treatment. There was significantly decrease compared with HAMA,HAMD and PSQI scores in R+T group at the end of 2,4,6 weeks after treatment, the differences were statistically significant (P<0.05); the HAMA,HAMD and PSQI scores of R group were significantly decreased compared with before treatment at the end of 4,6 week, the differences were statistically significant (P<0.05); the HAMA, HAMD scores of T group were significantly decreased compared with before treatment , the differences were statistically significant (P<0.05).PSQI scores decreased significantly only at the end of 6 week, the differences were statistically significant (P<0.05). There were significant differences in HAMA,HAMD and PSQI scores of R+T group compared with group R and group T at the end of 2,4,6 week (P<0.05). Comparison of the TESS scores in the 3 group at the end of 4,6 weeks after treatment showed no significant differences (P＞0.05). CONCLUSION:Low dose risperidone combined with trazodone can significantly improve heroin addicts during detoxification of anxiety, depression and sleep quality. The effect of combined application is better than single drug use.