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目的··:观察海洛因依赖者血浆 β—内啡肽、ACTH及皮质醇在治疗前后的变化 ,戒断反应与应激反应的关系 ,并探讨糖皮质激素对美沙酮抑制海洛因依赖者戒断反应的影响。方法··:对海洛因依赖者脱毒治疗前后戒断症状分值进行评分 ,治疗前后血浆β—内啡肽、ACTH及皮质醇进行放免测定。结果··:治疗前 ,血浆ACTH、皮质醇水平升高且超过正常值 ,ACTH与戒断评分呈正相关。使用脱毒药物治疗后 ,各组ACTH、皮质醇水平均呈下降趋势 ,且血浆皮质醇水平与戒断症状控制程度相关。1/3量美沙酮配伍强的松60mg·d -1,控制戒断症状的效果不仅优于单用1/3量美沙酮组(P<0.05) ,而且与全量美沙酮组疗效接近(P>0.05)。结论··:海洛因依赖者戒断反应伴有应激反应并与之呈正相关 ,糖皮质激素有协同美沙酮控制海洛因依赖者戒断症状的作用 ,可提高美沙酮的疗效 ,减少美沙酮的用量。
Objective: To observe the changes of plasma β-endorphin, ACTH and cortisol in heroin dependent patients before and after treatment, the relationship between withdrawal reaction and stress response, and to explore the effect of glucocorticoids on the withdrawal of methadone from heroin addicts influences. Methods · · ·: Heroin addiction treatment before and after withdrawal score score, before and after treatment of plasma β-endorphin, ACTH and cortisol were measured by radioimmunoassay. Results: Before treatment, plasma ACTH and cortisol levels increased and exceeded the normal value, ACTH and withdrawal score was positively correlated. After treatment with detoxification, the ACTH and cortisol levels in each group showed a decreasing trend, and the plasma cortisol level was related to the degree of control of withdrawal symptoms. One third of the dose of methadone combined with prednisone 60mg · d -1, the effect of controlling withdrawal symptoms was not only superior to the one third dose of methadone group (P <0.05), but also with the total dose of methadone group (P> 0.05) . Conclusions · ·: The withdrawal response of heroin addicts is associated with and has a positive correlation with the stress response. Glucocorticoids, in combination with methadone, control the withdrawal symptoms of heroin addicts, which can improve the efficacy of methadone and reduce the dosage of methadone.