上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2015, Vol. 35 ›› Issue (10): 1497-.doi: 10.3969/j.issn.1674-8115.2015.10.013

• 论著（临床研究） • 上一篇    下一篇

动机强化治疗提高美沙酮维持治疗效果的随机对照研究

王军1，江海峰2，杜江2，董爱珍1，王建国1，法金茂1，张怀惠1，伍毅1，安孝群1，赵敏2，孙海明2   

  1. 1.上海市杨浦区精神卫生中心， 上海200090; 2.上海交通大学 医学院附属精神卫生中心， 上海200030
  • 出版日期:2015-10-20 发布日期:2015-12-22
  • 通讯作者: 张怀惠, 电子信箱: huaihui.zhang@gmail.com; 孙海明, 电子信箱: sunhm_2008@163.com
  • 作者简介:王军(1973—)， 男， 副主任医师， 学士; 电子信箱: wangjun_psycho@126.com
  • 基金资助:

    上海市卫生系统先进适宜技术推广项目（2013SY011, 2014ZYJB0002）；国家自然科学基金（81271468）

Randomized control trial on improving effect of methadone maintenance treatment by enhancing motivation

WANG Jun1, JIANG Hai-feng2, DU Jiang2, DONG Ai-zhen1, WANG Jian-guo1, FA Jin-mao1, ZHANG Huai-hui1, WU Yi1, AN Xiao-qun1, ZHAO Min2, SUN Hai-ming2   

  1. 1.Shanghai Yangpu District Mental Health Center, Shanghai200090, China； 2.Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai200030, China
  • Online:2015-10-20 Published:2015-12-22
  • Supported by:

    Advanced Appropriate Technology Promotion Project of Shanghai Health System, 2013SY011, 2014ZYJB0002; National Natural Science Foundation of China, 81271468

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摘要：

目的观察上海市杨浦区美沙酮维持治疗门诊开展动机强化治疗的应用效果。方法60名新近接受美沙酮维持治疗的海洛因依赖者被随机分为干预组（n=30）和对照组（n=30）。干预组患者接受常规美沙酮维持治疗联合12周的动机强化治疗，对照组接受常规美沙酮维持治疗。比较两组的维持治疗情况、吗啡尿检结果及成瘾严重程度指数。结果经12周动机强化治疗后，干预组与对照组平均服药天数（66 d和54 d）、尿检阴性次数（8.1次和6.2次）的差异均无统计学意义（P>0.05）。但是在24周观察期内，干预组的职业/社会支持状况、毒品使用情况、乙醇滥用情况及家庭/社会关系改善程度显著优于对照组。结论在上海市杨浦区开展的动机强化治疗未明显提高美沙酮维持治疗的依从性，但有助于美沙酮维持治疗门诊的海洛因依赖者改善其躯体健康状况、职业/社会支持状况、毒品使用严重程度。

关键词: 动机强化治疗, 美沙酮维持治疗, 海洛因依赖者

Abstract:

ObjectiveTo explore the effect of enhancing motivation (EM) of methadone maintenance treatment (MMT) clinic in Yangpu district of Shanghai.MethodsA total of 60 heroin dependents who recently underwent MMT were randomly divided into the control group (n=30) and intervention group (n=30). Patients of the intervention group underwent MMT and 12 weeks of EM and patients of the control group only underwent MMT. Results of MMT, morphine test, and addiction Severity Index (ASI) of two groups were compared.ResultsThe differences of average medication days (66 d versus 54 d) and number of negative urine tests (8.1 versus 6.2) between two groups were not statistically significant after 12 weeks of EM (P>0.05). But the professional and social supports, severity of drug use, alcohol addiction, and family/society relation of the intervention group were remarkably better than those of the control group during the 24 weeks of observation.ConclusionThe EM conducted in Yangpu district of Shanghai does not significantly improve the effect of MMT, but is helpful for improving the physical health and professional and social supports of heroin dependents, and decreasing the severity of drug use.

Key words: enhancing motivation, methadone maintenance treatment, heroin dependent