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背景：台湾约有二十万以上人口使用过毒品，近年施用年龄层逐渐下探，对个人、家庭、社会影响甚巨。海洛因为使用毒品之大宗，戒瘾治疗虽有美沙冬替代疗法，惟美沙冬有其副作用，戒治後约三分二以上患者於一至二年内复犯，实为社会稳忧。中医是国内最普遍使用的辅助及替代疗法（CAM），在欧美以针灸协助戒瘾已广被采纳，且有一定的实证基础，台湾具完善的中医医疗系统，可提供便利医疗服务，故着眼於寻求更完善的戒瘾治疗模式，以增进戒瘾成效，将中医纳入考量是个能够与世界接轨的最佳模式。
研究方法：文献探讨中医戒毒方案以针灸、耳针为主，由於毒瘾患者具有潜在爱滋感染的风险，对执行的医疗人员具风险性，故拟定以非侵入性的「经皮穴位电刺激」戒瘾治疗模式结合传统美沙冬疗法，从研究中观察穴位电贴治疗的疗效，与单纯对照组仅执行美沙冬疗法的差异性。本研究为非随机的病例对照研究（nonrandom sampling, case control study），透过研究设计、资料分析与统计，比较中医介入与常规治疗模式差异，并提出临床实务建议。
结果：本研究发现「经皮穴位电刺激」戒瘾治疗模式可提升个案生活品质、毒品认知，减缓使用美沙冬後之忧郁症状，治疗後对於毒品的渴求下降，并且这些评估项目均达统计上的显着差异（P<0.05）。
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Chih-Nan Huang1 Wen-Yu Hsu2 Yun-Tai Chen1 Lun-Chien Lo3
Yu-Liang Chen1 Chao-Han Ke1 Tsung-Chieh Lee1*
1Department of Traditional Chinese Medicine, Changhua Christian Hospital, Changhua, Taiwan
2Psychiatric department, Changhua Christian Hospital, Changhua, Taiwan
3School of Chinese Medicine, China Medical University, Taichung, Taiwan
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Background: Drug addiction is a chronic medical illness and an important public health problem worldwide. The population of drug abuse had reached about 200,000 in Taiwan, and the age distribution is mainly in young adults. The most widely used substance is heroin in our ry. Methadone substitution therapy has been the treatment of first choice for opiate dependence, but patient on Methadone substitution therapy report a wide side effects, and relapse rate is up to two third of methadone treatment patients between one to two years. Therefore, adjuvant therapeutic interventions for drug addiction patients are needed. Traditional Chinese medicine (TCM) is the most common used therapy of complementary and alternative medicine. Acupuncture in treating drug addiction is widely accepted in western society and has evidence base. Taiwan has complete TCM system but lack of TCM in treating drug addiction. We need to establish a model for TCM as an alternative therapy included in addiction treatment and provide a better care system for drug addiction.
Methods: The literature discusses that Chinese medicine drug rehabilitation programs mainly focus on acupuncture, auricular acupuncture or auricular acupoints, but they are risky for medical personnel performing. We plan to establish Transcutaneous electrical acupoint stimulation (TEAS) drug addiction model, compare the differences between TEAS and conventional treatment models through research design, data analysis and statistics, and propose clinical practical recommendations.
Result: This study found that TEAS model can improve the quality of life of patients and drug awareness, slow down the symptoms of depression after the use of Methadone, and change the perception and mentality of drugs after treatment. These items were statistically significant (P<0.05).
Keywords：drug addiction treatment, methadone, traditional medicine,transcutaneous electrical acupoint stimulation
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231.3建立中医叁与戒毒治疗模式研究
