关键词: 曲唑酮, 认知行为治疗, 海洛因成瘾者, 社区戒毒

Abstract: AIM: To investigate the clinical application value of trazodone combined with cognitive behavioral therapy on heroin addicts during the period of community detoxification.  METHODS: A total of 140 heroin addictive patients treated by community detoxification management were randomly divided into four groups, 35 patients were given trazodone combined with cognitive behavioral therapy (T+P group), 35 patients were given a single trazodone therapy (T group), 35 patients were given a single cognitive behavioral therapy (P group), and 35 patients were only given community detoxification management (S group), the course of the treatment lasted for 12 weeks. At the time-point of baseline and the weekends 4, 8 and 12 after treatment, four groups were scored by Hamilton anxiety rating scale (HAMA), Hamilton depression rating scale (HAMD), Pittsburgh sleep quality index scale (PSQI), psychological craving rating scale (PCS), Chinese perceived stress scale (CPSS), and urine morphine positive rate. The safety was evaluated with Treatment Emergent Side-effect Scale (TESS) and laboratory test. RESULTS: A total of 125 patients completed the 12 weeks of treatment. HAMA, HAMD and PSQI scores of T+P group and T group on weekends 4, 8 and 12 were significantly reduced when compared with baseline, respectively (P<0.05). HAMA and HAMD scores of P group on weekends 4, 8 and 12 were significantly decreased when compared with baseline, respectively (P<0.05). PSQI scores of P group on weekends 8 and 12 were significantly decreased when compared with baseline, respectively (P<0.05). HAMA, HAMD and PSQI scores of S group on weekend 12 were significantly reduced when compared with baseline, respectively (P<0.05). There were significant differences on the PCS and CPSS scores between T+P group, T group, P group and S group on weekends 4, 8 and 12, respectively (P<0.05). There also showed statistically significant differences on the urine morphine positive rates between T+P group and S group on weekends 4, 8 and 12, respectively (P<0.05). There was no significant difference on the TESS score between T+P group and T group (P>0.05). CONCLUSION: Trazolone combined with cognitive behavior therapy can significantly improve the negative emotions, sleep quality and other related mental symptom of heroin addiction patients in the community detoxification period, and play a positive role in improving the quality of community detoxification management.

Key words: trazodone, cognitive behavioral therapy, heroin addicts, community detoxification