Effect of 2/100 Hz Transcutaneous Electrical Nerve Stimulation on Sexual Dysfunction and Serum Sex Hormone of Heroin Addicts
WU Liuzhen, CUI Cailian, HAN Jisheng
（Neuroscience Research Institute, Beijing Medical University, Beijing (100083)）
Objective: To evaluate the effect of 2/100 Hz electrical stimulation produced by Han′s acupoint nerve stimulator (HANS) in treating heroin induced sex dysfunction.Methods: Thirty-three heroin addicts were randomly divided into 2 groups to receive either buprenorphine (BPN group, n＝16) or HANS plus small dose of BPN (HANS group, n＝17) for 14 days. The doses of BPN were tailored according to individual requirement that could totally abolish withdrawal syndrome. The frequency of HANS was 2Hz and 100 Hz shifting automatically, each lasting for 3 seconds. The stimulation was applied to 8 acupoints, the Hegu and Laogong of one upper limb, Neiguan and Waiguan of another limb, Sanyinjiao and Xingjian of both lower limbs, for 30 min. The therapy was carried out 3－4 times per day in the initial two weeks of treatment, and reduced to 1－2 times per day in the following 2 weeks.Results: (1) The urine analysis for morphine in both groups turned to negative 14 days after treatment. (2) After 2 weeks of treatment, the composite score (Visual Analog Scale, VAS) of sexual function in HANS group showed a 102% increase (P＜0.01) compared with before treatment and was 107% of that in the BPN group (P＜0.01). (3) After 4 weeks treatment the serum concentration of luteinizing hormone (LH) and testosterone (T) in the HANS group showed a 137% and 118% increase respectively compared with those before treatment (P＜0.05), and the level of LH was 79.6% of that in the BPN group (P＜0.05).Conclusion: The 2/100 Hz transcutaneous electrical stimulation produced by Han′s acupoint nerve stimulator could improve the recovery of sexual function and raise the serum concentration of LH and T in heroin addicts.
Key words transcutaneous electrical nerve stimulation, heroin addict, sexual dysfunction, luteinizing hormone, testosterone
我们于1992年11月～1993年8月观察了韩氏穴位神经刺激仪(HANS)对海洛因成瘾者的治疗作用，结果显示能有效地抑制戒断症状，缓解心动过速，并能改善睡眠(1)。在进一步的研究中我们发现HANS能明显改善因吸食或注射海洛因导致的性机能障碍。为此我们在广州某自愿戒毒所对33例志愿受试者进行了为期3个月的临床观察。
资料和方法
1 临床资料 33例志愿受试者均为已婚成年男性，均符合《中国精神疾病分类方案与诊断标准》(CCMD-2-R)和美国精神病学会《诊断和统计手册第三版修订本》(DMS-3-R)的诊断标准。临床观察过程中有6例脱出，33例顺利完成全程，年龄20～41岁；吸毒史1.5～5年；使用量1～3g/d；吸毒方式烫吸6例，静脉注射27例；性机能障碍史0.5～4年。
2 临床选穴和电刺激参数及电刺激仪简介 分别选一侧上肢合谷和劳宫，对侧上肢内关和外关，两侧下肢的行间和三阴交。刺激频率为2/100Hz，即2Hz与100Hz交替出现，各持续3s；电流强度：阈值(电极下开始有感觉)为5～7mA，第1日5～10mA；第2日8～15mA；第3日以后15～30mA。1～7日内，每日治疗3～4次，8～14日内，每日治疗3次，15～28日内，每日治疗1～2次。以往应用的便携式HANS(1)有A、B两个输出通道，可同时刺激4个穴位，用于1名患者。此次研究应用的为中型HANS(4个输出通道，可同时刺激8个穴位)，每台用于1名患者。
3 受试者入组标准 所有受试者除必须符合DMS-3-R的诊断标准外，还需满足下列标准：(1)无下腹部(包括回肠、结肠、直肠)及阴茎和睾丸损伤。(2)无先天性生殖器官缺陷。(3)无任何能够影响到睾丸或性器官机能的急慢性炎症、传染病(如肺结核等)。(4)无性病史或性病治疗史(至少在试验前12个月内)。(5)无超常用药史(指对性机能有影响的药物，但阿斯匹林、麻醉镇痛药、咖啡因、酒精、大麻等除外)(2)。
4 分组及给药方法 依据入组的顺序，随机分为丁丙诺啡组(BPN组，16例)和HANS组(17例)，两组BPN的应用剂量均以能完全消除患者戒断症状、无痛苦为标准。BPN组的实际用量为：首日平均日剂量为(±S，1.56±0.20)mg，第2日平均日剂量为(1.78±0.22)mg，第3日平均日剂量为(1.84±0.20)mg，以后逐日递减，第14日减至0，14日平均总剂量为(12.90±1.34)mg。HANS组的实际用量为：首日平均日剂量为(0.28±0.03)mg，第2日平均日剂量为(0.35±0.03)mg，以后逐日递减，第5日减至0，14日平均总剂量为(1.01±0.07)mg。与PBN组的总用量相比，HANS组的用量仅为前者的7.8%(3)。盐酸丁丙诺啡注射液(天津药物研究院药业有限责任公司出品)由广州市公安局戒毒委员会办公室赠；ACON牌一次性吗啡尿样检验药盒由公安部物证鉴定中心提供；血清促黄体生成激素(LH)和睾酮(T)放射免疫测定试剂盒均购自中美合资天津九鼎公司，LH的试剂盒敏感度为0.2～5.0m
