CORE, University College London, Research Department of Clinical, Educational and Health Psychology, London WC1E 7HB, UK.
Drug Alcohol Depend. 2010 Apr 1;108(1-2):110-4. doi: 10.1016/j.drugalcdep.2009.12.008. Epub 2010 Jan 13.
The aim of this systematic review was to compare the efficacy of methadone, buprenorphine, clonidine and lofexidine for opioid detoxification. Mixed treatment comparison meta-analyses were used to synthesise the data as it is designed for data-sets where limitations in standard pairwise meta-analyses make comparisons difficult to interpret.
A systematic search was conducted using the following databases: CENTRAL, CINAHL, Embase, HMIC, Medline and PsycINFO.
RCTs that included opioid dependent participants over a mean age of 16 receiving opioid detoxification using buprenorphine, methadone, clonidine or lofexidine were included in the systematic review. Included studies were quality assessed and the completion of treatment data was extracted by the author and a research assistant independently. Mixed treatment comparison methods were used to synthesise the data.
There were 23 RCTs included in the systematic review (and 20 included in the meta-analysis) comprising a total of 2112 participants. Buprenorphine and methadone were ranked as the most effective methods of opioid detoxification followed by lofexidine and clonidine respectively.
Buprenorpine and methadone appear to be the most effective detoxification treatments. While the analysis suggests buprenorphine is the most effective method of detoxification there is some uncertainty on whether it is more effective than methadone and requires further research to confirm this result.
本系统评价旨在比较美沙酮、丁丙诺啡、可乐定和洛非西定在阿片类药物戒毒中的疗效。混合治疗比较荟萃分析用于综合数据，因为它是为数据集中存在标准成对荟萃分析难以解释的局限性而设计的。
使用以下数据库进行了系统搜索：CENTRAL、CINAHL、Embase、HMIC、Medline 和 PsycINFO。
包括年龄在 16 岁以上的阿片类药物依赖参与者在内的 RCT，使用丁丙诺啡、美沙酮、可乐定或洛非西定进行阿片类药物戒毒的研究被纳入系统评价。纳入的研究进行了质量评估，作者和一名研究助理独立提取完成治疗的数据。使用混合治疗比较方法综合数据。
系统评价包括 23 项 RCT（Meta 分析中包括 20 项），共纳入 2112 名参与者。丁丙诺啡和美沙酮被评为阿片类药物戒毒最有效的方法，其次是洛非西定和可乐定。
丁丙诺啡和美沙酮似乎是最有效的戒毒治疗方法。虽然分析表明丁丙诺啡是最有效的戒毒方法，但尚不确定它是否比美沙酮更有效，需要进一步研究来证实这一结果。
