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目的:探讨美沙酮、丁丙诺啡和纳洛酮联合治疗美沙酮依赖的可行性及疗效。方法:分析21例美沙酮依赖患者的脱毒治疗结果。治疗先用美沙酮替代递减治疗约5天,然后使用丁丙诺啡、纳洛酮治疗3-5天;且早期联合抗焦虑药和镇静催眠药等治疗。以纳洛酮催瘾试验、稽延性戒断症状量表和患者对治疗满意度评定以及随访操守情况等评价该方法对美沙酮依赖脱毒治疗的有效性和可行性。结果:脱毒成功率95.23%。出院时稽延性戒断症状评分平均(6.40±1.77)分,病人满意度为非常满意者占80.95%。随访时保持操守者12例(57.14%),操守时间平均(9.69±5.90)月。结论:本方法对美沙酮依赖脱毒成功率高,安全性和可行性较好。
Objective: To investigate the feasibility and efficacy of methadone, buprenorphine and naloxone in the treatment of methadone dependence. Methods: To analyze the results of detoxification treatment in 21 methadone-dependent patients. Treatment with methadone instead of descending treatment for about 5 days, and then use buprenorphine, naloxone treatment 3-5 days; and the early combination of anti-anxiety drugs and sedatives and hypnotherapy and other treatment. The efficacy and feasibility of this method on methadone dependent detoxification were evaluated with naloxone addiction test, protracted withdrawal symptoms scale and evaluation of patients’ satisfaction with treatment as well as follow-up condition. Results: The virus-free success rate was 95.23%. At discharge, the symptoms of protracted withdrawal symptoms averaged (6.40 ± 1.77) points, with 80% satisfied patients being highly satisfied. 12 cases (57.14%) were maintained in the follow-up, and the average duration of conduct was (9.69 ± 5.90) months. Conclusion: The method has high success rate of methadone dependence detoxification, safety and feasibility.