建立中醫參與戒毒治療模式研究

The Study of Development Model of Traditional Chinese Medicine Include in Drug Addiction Treatment

背景：台灣約有二十萬以上人口使用過毒品，近年施用年齡層逐漸下探，對個人、家庭、社會影響甚鉅。海洛因為使用毒品之大宗，戒癮治療雖有美沙冬替代療法，惟美沙冬有其副作用，戒治後約三分二以上患者於一至二年內復犯，實為社會穩憂。中醫是國內最普遍使用的輔助及替代療法（CAM），在歐美以針灸協助戒癮已廣被採納，且有一定的實證基礎，台灣具完善的中醫醫療系統，可提供便利醫療服務，故著眼於尋求更完善的戒癮治療模式，以增進戒癮成效，將中醫納入考量是個能夠與世界接軌的最佳模式。研究方法：文獻探討中醫戒毒方案以針灸、耳針為主，由於毒癮患者具有潛在愛滋感染的風險，對執行的醫療人員具風險性，故擬定以非侵入性的「經皮穴位電刺激」戒癮治療模式結合傳統美沙冬療法，從研究中觀察穴位電貼治療的療效，與單純對照組僅執行美沙冬療法的差異性。本研究為非隨機的病例對照研究（nonrandom sampling, case control study），透過研究設計、資料分析與統計，比較中醫介入與常規治療模式差異，並提出臨床實務建議。結果：本研究發現「經皮穴位電刺激」戒癮治療模式可提昇個案生活品質、毒品認知，減緩使用美沙冬後之憂鬱症狀，治療後對於毒品的渴求下降，並且這些評估項目均達統計上的顯著差異

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 country. 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).