臺灣中醫戒治海洛因成癮進展

Advances in Traditional Chinese Medicine Treatment of Heroin Addiction in Taiwan

蔡宜洵(Yi-Hsun Tsai) ； 蔡政勳(Cheng-hsun Tsai) ； 蔡孟璋(Meng-Chang Tsai) ； 林皇吉(Huang-Chi Lin) ； 郭純恩(Chun-En Kuo) ； 吳思穎(Szu-Ying Wu) ； 洪裕強(Yu-Chiang Hung) ； 呂佐成(Tsuo-Cheng Lu) ； 林宏隆(Hung-Lung Lin) ； 黃琮融(Tsung-Rung Huang) ； 許世韻(Shi-Yun Hsu) ； 王慧薰(Huei-Syun Wang) ； 胡文龍(Wen-Long Hu)

《中醫藥雜誌》 35卷1期 (2024/06) Pp. 1-15

https://doi.org/10.6940/JCM.202406_35(1).01

摘要

目的：海洛因成癮仍為全球重大公共衛生問題之一，本研究探討近年來臺灣中醫戒治海洛因成癮進展。方法：搜尋2023年以前Pubmed、CEPS中文電子期刊資料庫及GRB政府研究資訊系統裡臺灣中醫戒治海洛因成癮的期刊論文和公開研究計畫，再將搜尋所得文獻進行統整。結果：統整後共納入八篇期刊論文和五篇研究計畫，包括藥物和非藥物治療，其中非藥物治療被廣泛應用於海洛因成癮戒治。經皮穴位電刺激及雷射經絡按摩顯著提升戒癮者的生理健康度，電針和耳穴合併電針則顯著提升戒癮者心理健康。耳穴刺激合併電針及中藥酸棗仁湯可顯著改善整體睡眠品質。經皮穴位電刺激可顯著降低對海洛因的渴求度，耳針合併電針、雷射經絡按摩、耳穴貼壓合併電針、雷射針灸、舌下光針皆有降低海洛因渴求度的趨勢。研究設計差異和收案人數過少可能是現有文獻療效不一的成因，有待後續研究探討。結論：臺灣中醫戒治海洛因成癮主要為非藥物性介入，透過此篇回顧可以了解中醫在戒除毒癮和改善相關症狀都顯示出一定的潛力，且具有操作方便和價格便宜的優勢。未來研究應先取得治療一致性，建立實證較強之前導研究，以爭取經費補助並整合進現有戒治系統中。

關鍵字

藥癮 ； 戒毒 ； 海洛因 ； 中醫 ； 針灸

並列摘要

Objectives: Heroin addiction is still a major public health issue worldwide. This study aimed to explore the recent progress of traditional Chinese medicine (TCM) in the treatment of heroin addiction in Taiwan. Methods: Journal articles and public research projects related to TCM treatment of heroin addiction in Taiwan before 2023 were extracted from PubMed, Chinese Electronic Journal Database (CEPS), and Government Research Bulletin (GRB). The retrieved literatures were then analyzed and summarized. Results: A total of 8 journal articles and 5 research projects were reviewed. The treatments included both medical treatment and non-pharmacotherapy, with non-pharmacotherapy being widely applied in the treatment of heroin addiction. Transcutaneous electrical acupoint stimulation and laser meridian massage significantly improved the physiological health of patients undergoing detoxification treatment. Electroacupuncture with or without combination of auricular acupuncture both significantly enhanced the psychological well-being. The combined treatment of auricular acupuncture and electroacupuncture, as well as the Chinese herbal formula "Suan Zao Ren Tang," significantly improved overall sleep quality. Transcutaneous electrical acupoint stimulation significantly reduced heroin cravings, while trends of reduced cravings were observed in auricular acupuncture combining electroacupuncture, laser meridian massage, auricular acupressure combining electroacupuncture, laser acupuncture, and sublingual light needling. Different study design and limited sample size may lead to inconsistent outcome of research, and further studies are warranted. Conclusion: TCM interventions for heroin addiction in Taiwan primarily involve non-pharmacological approaches. This review demonstrated that TCM interventions showed potential in overcoming drug dependence and improving related symptoms, with the advantages of easy implementation and cost-effectiveness. Future research should focus on achieving treatment consistency and establishing stronger evidence through pilot studies, in order to obtain financial support by government and integrate TCM therapy into heroin addiction treatment system.

並列關鍵字

Drug addiction ； Detoxification ； Heroin ； Traditional Chinese Medicine ； Acupuncture

參考文獻

施宏昇、虞凱強、張尚智、黃奎祐、許中華，中藥改善藥癮替代療法（美沙冬）之療效。中 醫內科醫學雜誌。2018；16(1)：1-14。

黃志男、許文郁、陳運泰、羅綸謙、陳瑜亮、柯詔瀚、李聰界，建立中醫參與戒毒治療模式 研究。中醫藥研究論叢。2020；23(1)：33-43。

顏銘漢、薛文傑、林可寰，海洛因成癮與戒治。家庭醫學與基層醫療。2009；24(4)：131-137。

虞凱強、許中華，探討中醫在海洛因戒毒中扮演的角色。中醫內科醫學雜誌。2017；15(1)： 28-39。

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association, pp. 541, 2013.