Should cocaine-abusing, buprenorphine-maintained patients receive auricular acupuncture? Findings from an acute effects study.
Should cocaine-abusing, buprenorphine-maintained patients receive auricular acupuncture? Findings from an acute effects study.
复制标题
滥用可卡因、丁丙诺啡维持治疗的患者是否应该接受耳针治疗？
DOI：
10.1089/acm.1999.5.567
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Avants,SK
中科院分区：
文献类型：
--
作者：
Margolin,A;Avants,SK
目的：丁丙诺啡是一种具有μ-激动剂性质的合成阿片类药物，目前正在等待食品和药物管理局（FDA）批准作为治疗海洛因成瘾个体的维持剂。与广泛使用的阿片类药物美沙酮不同，丁丙诺啡是一种k受体拮抗剂。研究将针灸的作用与κ受体的内源性配体强啡肽的释放联系起来，提出了丁丙诺啡可能阻断针灸作用的可能性。在这项研究中，我们试图收集关于这个问题的初步数据，以指导可卡因滥用，丁丙诺啡维持患者的临床护理。设计：组间分析比较丁丙诺啡和美沙酮维持患者在单次耳针治疗后的急性效应评级。受试者：34名可卡因滥用，阿片类药物依赖患者，18名丁丙诺啡维持患者，16名美沙酮维持患者。干预：单次40分钟的耳针治疗;每个耳廓插入4根针。结果测量：急性效应评分在四个领域：疼痛，deqisensations，放松效果，主观experiences.Results：有两组之间的急性效应等级没有显着差异。两组患者均报告positive effects.Conclusions：这些初步研究结果与丁丙诺啡不阻断耳针的解释一致，支持临时建议，即可卡因滥用患者维持丁丙诺啡不应被排除接受耳针或参与这种治疗方式的临床研究。此外，需要对这个问题进行对照研究，并提供临床结果。
Objective:Buprenophrine is a synthetic opioid with μ-agonist properties currently pending Food and Drug Administration (FDA) approval as a maintenance agent for treating heroin-addicted individuals. Unlike methadone, a widely used opioid maintenance agent, buprenorphine is a k-receptor antagonist. Research linking the effects of acupuncture to the release of dynorphin, the endogenous ligand for the κ-receptor, raised the possibility that buprenorphine may block acupuncture's effects. In this study, we sought to gather preliminary data on this issue in order to guide the clinical care of cocaine-abusing, buprenorphine-maintained patients.Design:Between-group analysis comparing buprenorphine- and methadone-maintained patients on ratings of acute effects after a single session of auricular acupuncture.Subjects:Thirty-four (34) cocaine-abusing, opioid-dependent patients, eighteen (18) maintained on buprenorphine, and sixteen (16) maintained on methadone.Intervention:A single, 40-minute session of auricular acupuncture; four needles were inserted in each auricle.Outcome measures:Acute effect ratings in four domains: pain,de qisensations, relaxation effects, subjective experiences.Results:There were no significant differences in acute-effects ratings between the two groups. Patients in both groups reported positive effects.Conclusions:These preliminary findings are consistent with the interpretation that buprenorphine does not block auricular acupuncture, supporting the provisional recommendation that cocaine-abusing patients maintained on buprenorphine should not be excluded from receiving auricular acupuncture or from participating in clinical studies of this treatment modality. Further, controlled research on this issue, with clinical outcomes, is needed.