Hernandez-Avila Carlos A, Song Changhong, Kuo Lynn, Tennen Howard, Armeli Stephen, Kranzler Henry R
Alcohol Research Center, Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
Alcohol Clin Exp Res. 2006 May;30(5):860-5. doi: 10.1111/j.1530-0277.2006.00101.x.
To extend our previous findings that naltrexone reduced the likelihood of heavy drinking on a given day among problem drinkers, while targeted administration reduced the likelihood of any drinking, we examined the effects of naltrexone and targeted administration on the continuous outcome of drinks/day. Because treatment response may differ by gender, we also compared the effects on this factor.
In a double-blind, placebo-controlled study, problem drinkers (n=150, 58% men) were randomly assigned to 8 weeks of treatment with naltrexone (50 mg/day) or placebo, either daily or on a targeted schedule. All subjects also received brief coping skills therapy. To complement the traditional regression analysis conducted previously, a zero-inflated Poisson regression model was used to examine the effects of medication, schedule of administration, and gender on the number of standard drinks consumed daily.
Targeted naltrexone, and to a lesser extent targeted placebo, yielded a greater reduction in daily drinking than did daily placebo, an effect that did not differ by gender and that was greater than that seen for daily naltrexone treatment. Relative to daily placebo, daily naltrexone reduced the number of drinks/day only among men, at the level of a nonsignificant trend.
Although in both genders, targeted treatments appeared to reduce the volume of drinking, treatment with targeted naltrexone was somewhat better. In contrast, heavy drinking women showed no benefit from daily naltrexone treatment. Further evaluation of the efficacy of targeted treatments and of daily naltrexone and the relationship of these treatments with gender is warranted.
为扩展我们之前的研究结果，即纳曲酮降低了问题饮酒者在特定日子大量饮酒的可能性，而靶向给药降低了任何饮酒的可能性，我们研究了纳曲酮和靶向给药对每日饮酒量这一连续性结果的影响。由于治疗反应可能因性别而异，我们还比较了对这一因素的影响。
在一项双盲、安慰剂对照研究中，问题饮酒者（n = 150，58%为男性）被随机分配接受为期8周的纳曲酮（50毫克/天）或安慰剂治疗，治疗方式为每日给药或靶向给药。所有受试者还接受了简短的应对技能治疗。为补充之前进行的传统回归分析，我们使用零膨胀泊松回归模型来研究药物、给药方案和性别对每日饮用标准饮料数量的影响。
与每日安慰剂相比，靶向纳曲酮以及程度稍轻的靶向安慰剂在每日饮酒量减少方面效果更显著，这种效果在性别上无差异，且大于每日纳曲酮治疗的效果。相对于每日安慰剂，每日纳曲酮仅在男性中减少了每日饮酒量，且仅呈非显著趋势。
虽然在男女两性中，靶向治疗似乎都能减少饮酒量，但靶向纳曲酮治疗效果稍好。相比之下，大量饮酒的女性未从每日纳曲酮治疗中获益。有必要进一步评估靶向治疗以及每日纳曲酮的疗效，以及这些治疗与性别的关系。
