【摘要】 目的:探讨稽延性症状对纳曲酮依从性的影响和二者的相关性。方法:采用回顾性流行病学调查的方法,在广东、北京、浙江等地捜集到531例服用纳曲酮的海洛因依赖者,调查有关人口学和社会学信息、药物滥用史、纳曲酮使用和稽延性戒断症状的情况。分析纳曲酮短期组(服用时间≤4周)、中期组(服用时间>4周且<24周)和长期组(服用时间≥24周)脱毒后的稽延性戒断症状评分和服用纳曲酮时间的关系。结果:纳曲酮短期组、中期组和长期组患者脱毒后的稽延性戒断症状评分总分和睡眠障碍、焦虑情绪和躯体症状三类中的7个分项得分经F检验,P<0.05。经进一步的组间两两t检验,在中期组和短期组之间,总分和易醒、早醒、全身无力、手脚不舒服4个分项得分P<0.05。在长期组和短期组之间,总分和易醒、入睡困难、全身无力、烦躁不安4个分项得分P<0.05。在长期组和中期组之间,总分和各分项得分P>0.05。稽延性戒断症状与纳曲酮的依从性呈负相关,在短期-中期-长期组相关性检验中,稽延性戒断症状的总分和4个分项得分(入睡困难、易醒、烦躁不安和全身无力)P<0.05。在短期-中期组相关性检验中,稽延性戒断症状的总分和6个分项得分(入睡困难、易醒、早醒、全身无力、全身难受和四肢不适)P<0.05。结论:稽延性戒断症状是影响纳曲酮早期服药依从性的重要因素,对长期依从性没有影响。如果在服用纳曲酮早期,稽延性戒断症状得到较好控制,纳曲酮的依从性和防复吸的疗效会提高。更多还原

【Abstract】 Objective: To discuss the impact of protracted withdrawal symptoms (PWS) on the compliance of naltrexone and the relativity of these. Methods: Evaluation on the relativity of PWS and compliance of naltrexone for heroin addicts ,which are taking or have taken naltrexone, by multi-center retrospect epidemiological survey. Depending on the time of naltrexone maintenance, all these heroin addicts are divided into three groups, which are short-term group (≤4 weeks), long-term group (≥24 weeks) and medium group (>4 weeks and < 4 weeks).The scale of PWS and information about naltrexone maintenance are the main data. Results: By F-test , there are significant differences in the sum and totally 7 items of the scale, which are parts of three groups, disorder of sleep, somatic symptoms and anxiety respectively(P<0.05). Based on the further P-test among groups, there are significant differences in the sum and 4 items of PWS scale, including easy to wake up, early morning awakening, systemic fatigue and suffering, between short-term and medium group(P<0.05). And the sum and 4 items between short-term and long-term group , including easy to wake up, insomnia, systemic fatigue and dysphoria(P<0.05). But there is no difference between medium and long-term group. The status of PWS is a negative factor on compliance of naltrexone with low relativity. By short-medium-long-term relativity analysis, there are significant relativity on the sum and 4 items (insomnia, easy to wake up, dysphoria and systemic fatigue)(P<0.05). By short-medium-term relativity analysis, there are significant relativity on the sum and 6 items of PWS scale (insomnia, easy to wake up, early morning awakening, systemic fatigue and suffering and dysphoria)(P<0.05). Conclusion: The status of PWS is a negative factor towards the compliance of naltrexone and plays a key role during the early period of naltrexone maintenance therapy. With PWS be well treated, the compliance of naltrexone will be enhanced/improved, so will the anti-relapse efficacy of naltrexone prevention and intervention.更多还原