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[用奥沙西泮或氯美噻唑治疗酒精戒断综合征——一项自然观察性研究]

[Treatment of Alcohol Withdrawal Syndrome with Oxazepam or Clomethiazole - A Naturalistic Observational Study].

作者信息

Verthein Uwe, Kuhn Silke, Gabriel Katrin, Mautsch Ulrich, Reimer Jens, Behrendt Klaus

机构信息

Zentrum für Interdisziplinäre Suchtforschung der Universität Hamburg (ZIS), Universitätsklinikum Hamburg-Eppendorf.

Klinik für Abhängigkeitserkrankungen, Asklepios Klinik Nord - Ochsenzoll, Hamburg.

出版信息

Psychiatr Prax. 2018 Mar;45(2):95-102. doi: 10.1055/s-0042-122225. Epub 2017 Apr 3.

Abstract

Whilst internationally benzodiazepines are first choice for treatment of alcohol withdrawal syndrome, Germany has a long tradition with clomethiazole. This study explores effectiveness of clomethiazole versus oxazepam in the treatment of alcohol withdrawal syndrome within an observational, stratified, non-inferiority study in routine care. Main outcome criterion was severity of the alcohol withdrawal syndrome (Alcohol Withdrawal Syndrome [AWS]) Scale in the first five days. Additionally, the association between the detoxification protocol (five vs. ten days) and AWS-Score was examined. 453 patients (74.2 % male, average age 47.1 years [± 9.2]) took part; 249 received oxazepam (55.0 %) and 204 clomethiazole (45.0 %). The average duration of inpatient treatment was 14.0 days (± 6.3) in both groups. The average AWS-score was lower in the oxazepam group compared to the clomethiazole group (50.0 [± 26.5] vs. 56.2 [± 31.5]; p < .05; effect size d = - .25). Patients with a shorter detoxification protocol had a lower AWS sum score compared to patients with a longer protocol (p < .001; d = - .46). In treatment of alcohol withdrawal syndrome in routine care oxazepam yields at least comparable results to clomethiazole.

摘要

在国际上,苯二氮䓬类药物是治疗酒精戒断综合征的首选药物,但德国使用氯美噻唑已有很长的传统。本研究在一项观察性、分层、非劣效性的常规护理研究中,探讨了氯美噻唑与奥沙西泮治疗酒精戒断综合征的有效性。主要结局标准是前五天内酒精戒断综合征(AWS)量表的严重程度。此外,还研究了解毒方案(五天与十天)与AWS评分之间的关联。453名患者(74.2%为男性,平均年龄47.1岁[±9.2])参与了研究;249人接受了奥沙西泮治疗(55.0%),204人接受了氯美噻唑治疗(45.0%)。两组的平均住院治疗时间均为14.0天(±6.3)。奥沙西泮组的平均AWS评分低于氯美噻唑组(50.0[±26.5]对56.2[±31.5];p<0.05;效应大小d=-0.25)。与解毒方案较长的患者相比,解毒方案较短的患者的AWS总分较低(p<0.001;d=-0.46)。在常规护理中治疗酒精戒断综合征时,奥沙西泮产生的结果至少与氯美噻唑相当。

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