| Background Alcohol is the oldest and most widely used psychoactive substances in the world. Alcohol dependence can lead to a series problem of medical, economic and social. The health and social problems is now a global problem caused by Alcohol dependence. The general population drinking epidemiological and the health survey in the five regions of the country in 2001 led by the Institute of Mental Health of Central South University display that male,female and total alcohol consumption rate were 87.3%,31.5% and 61.1% in General population (18+); annual per capita alcohol consumption of pure alcohol is 3.62L;and the male, the female and alcohol dependence overall point prevalence were 6.197%,0.044% and 3.183% respectively.The data show that there were nearly 14 million alcohol abusers in United States according to the US National Institute on Alcohol Abuse and Alcoholism (NIAAA),that is there were one alcohol dependence in thirteen person. Studies have shown that at least 60 kinds of diseases and injuries related to the dangerous drinking. Global alcohol-related diseases accounted for 4% of the total burden of disease (in some countries up to 16%),3.2% death caused by drinking the total mortality,and harm to humans after cardiovascular disease and cancer. In China, production and consumption of alcohol increasing, alcohol-related health and social issues become more prominent, patients with alcohol dependence or alcohol addiction admitted to hospital significantly increasing every year with economic development. Now alcohol dependence has become a international common health problem and heavily impacted individual health and family happiness and social stability.The treatment of alcohol dependence inclode multifaceted problem. Currently the treatment of alcohol dependence is mainly withdrawal period in clinical practice,and the high recurrence rate after withdrawal has been the problem of alcohol treatment. The relapse related to craving closely for alcohol dependence. Finding effective treatments in the late withdrawal and mechanism of alcohol craving is the focus of current research.Objectives1. To understand the activity of hypothalamic-pituitary-adrenal axis (HPA) function in patients of alcohol dependence at different times after withdrawal.2. To understand the characteristics of changes of Adrenocorticotropic(ACTH) hormone and plasma cortisol(CORT) when the environmental cues -induce craving at different times after withdrawal.3. To understand the psychological craving, heart rate, systolic blood pressure changes of the alcohol dependence when the environmental cues -induce craving at different times after withdrawal.4.To investigate the function of activity of hypothalamic-pituitary-adrenal axis (HPA) in the withdrawal and recurrence processin of alcohol dependence.Methods1. According to inclusion criteria, patients with alcohol dependence hospitalized from April 2014 to December 2014 were selected at the Second Affiliated Hospital of Xinxiang Medical addiction inpatient, alcohol dependence group met the diagnostic criteria of DSM-IV, male patients age 18-60 years old, exclude serious physical illness and other psychotic disorders, no previous history of endocrine disorders, obtaining informed consent; The control group from the community, male patients age 18-60 years old, exclude serious physical illness and other psychotic disorders, no previous history of endocrine disorders, obtaining informed consent. The age of alcohol dependence group and the control group no significant difference.2. Alcohol dependence group was given environment cue-induced craving test When completely stop drinking 15d. Record the Psychological craving, systolic blood pressure, heart rate, etc. before and after induced test, to draw peripheral blood 2ml before and after induced test, cryopreservation in freezer at-80 ℃ low temperature, determination the ACTH, CORT concentration of plasma by radioimmunoassay.3. Alcohol dependence group was given environment cue-induced craving test When completely stop drinking 60d. Record the Psychological craving, systolic blood pressure, heart rate, etc. before and after induced test, to draw peripheral blood 2ml before and after induced test, cryopreservation in freezer at-80 ℃ low temperature, determination the ACTH, CORT concentration of plasma by radioimmunoassay.4. The control group was given environment cue-induced craving test when entering the group. Record the Psychological craving, systolic blood pressure, heart rate, etc. before and after induced test, to draw peripheral blood 2ml before and after induced test, cryopreservation in freezer at-80 ℃ low temperature, determination the ACTH, CORT concentration of plasma by radioimmunoassay.5. All dates were analyzed with SPSS20.0 statistical software and Measurement data with the mean and standard deviation. Between the two groups were compared using the t test for independent samples. P<0.05 was considered statistically significant.Results1. The psychological craving heart rate, systolic blood pressure changes of the alcohol dependence before the environmental cues -induce craving at different times after withdrawal.Normal control group without psychological craving before the environment cue-induced craving test,15d and 60d when alcohol dependence group after withdrawal are still apparent psychological craving before the environment cue-induced craving test, there were obvious differences between the two groups; the systolic blood pressure obvious differences between the normal control group and alcohol dependence group,and there was significant difference(P<0.05); Compared with the normal control group, there were differences in heart rate of alcohol dependence group who completely stop drinking 15d and 60d before the environment cue-induced craving test,but the difference was not statistically significant(P>0.05).2. The psychological craving heart rate, systolic blood pressure changes of the alcohol dependence before and after the environmental cues -induce craving at different times after withdrawal.alcohol dependence group who completely stop drinking 15d:The psychologi-cal craving were obvious differences before and after the environment cue-induced craving test, and there was significant difference(P<0.05); the systolic blood pressure were obvious differences before and after the environment cue-induced craving test, and there was significant difference(P<0.05);the heart rate were obvious differences before and after the environment cue-induced craving test, and there was significant difference(P<0.05); alcohol dependence group who completely stop drinking 60d:The psychological craving were obvious differences before and after the environment cue-induced craving test, and there was significant difference(P<0.05); the systolic blood pressure were differences before and after the environment cue-induced craving test, but the difference was not statistically significant(P>0.05);the heart rate were obvious differences before and after the environment cue-induced craving test, and there was significant difference(P<0.05);3. The psychological craving heart rate, systolic blood pressure changes of the alcohol dependence before the environmental cues -induce craving test at different times after withdrawal.The psychological craving were obvious differences between the alcohol dependence who completely stop drinking 15d and the alcohol dependence who completely stop drinking 60d before the environmental cues -induce craving test, and there was significant difference(P<0.05); the systolic blood pressure were differences between the alcohol dependence who completely stop drinking 15d and the alcohol dependence who completely stop drinking 60d before the environmental cues -induce craving test, but the difference was not statistically significant(P>0.05); the heart rate were differences between the alcohol dependence who completely stop drinking 15d and the alcohol dependence who completely stop drinking 60d before the environmental cues -induce craving test, but the difference was not statistically significant(P>0.05).4. The psychological craving heart rate, systolic blood pressure changes of the alcohol dependence after the environmental cues -induce craving test at different times after withdrawal.The psychological craving were obvious differences between the alcohol dependence who completely stop drinking 15d and the alcohol dependence who completely stop drinking 60d after the environmental cues -induce craving test, and there was significant difference(P<0.05); the systolic blood pressure were differences between the alcohol dependence who completely stop drinking 15d and the alcohol dependence who completely stop drinking 60d after the environmental cues -induce craving test, but the difference was not statistically significant(P>0.05); The heart rate were obvious differences between the alcohol dependence who completely stop drinking 15d and the alcohol dependence who completely stop drinking 60d after the environmental cues -induce craving test, and there was significant difference(P<0.05).5. The characteristics of changes of Adrenocorticotropic(ACTH) and plasma cortisol(CORT) in the alcohol dependence before the environmental cues -induce craving test at different times after withdrawal.The characteristics of changes of Adrenocorticotropic (ACTH):The Adrenocorticotro pic (ACTH) concentration were obvious differences between alcohol dependence group who completely stop drinking 15d before environmental cues -induce craving test and the normal control group, and there was significant difference(P<0.05); the Adrenocorticotr opic(ACTH) concentration were obvious differences between alcohol dependence group who completely stop drinking 60d before environmental cues -induce craving test and the normal control group, and there was significant difference(P<0.05).The characteristics of changes of plasma cortisol(CORT):The cortisol(CORT) concentration were obvious differences between alcohol dependence group who completely stop drinking 15d before environmental cues -induce craving test and the normal control group, and there was significant difference(P<0.05); the cortisol(CORT) concentration were obvious differences between alcohol dependence group who completely stop drinking 60d before environmental cues-induce craving test and the normal control group, and there was significant difference(P<0.05).6. The characteristics of changes of Adrenocorticotropic(ACTH) and plasma cortisol(CORT) in the alcohol dependence before and after the environmental cues -induce craving test at 15d after withdrawal.The Adrenocorticotropic(ACTH) concentration were obvious differences in the alcohol dependence group who completely stop drinking 15d before and after the environmental cues -induce craving test, and there was significant difference(P<0.05); The plasma cortisol(CORT) concentration were obvious differences in the alcohol dependence group who completely stop drinking 15d before and after the environmental cues -induce craving test, and there was significant difference(P<0.05);7. The characteristics of changes of Adrenocorticotropic(ACTH) and plasma cortisol(CORT) in the alcohol dependence before and after the environmental cues -induce craving test at 60d after withdrawal.The Adrenocorticotropic(ACTH) concentration were obvious differences in the alcohol dependence group who completely stop drinking 60d before and after the environmental cues -induce craving test, and there was significant difference(P<0.05); The plasma cortisol(CORT) concentration were differences in the alcohol dependence group who completely stop drinking 60d before and after the environmental cues -induce craving test, but the difference was not statistically significant(P>0.05).Conclusions1. Because of the environmental cues -induce craving.the changes of psychological craving, heart rate, Systolic blood pressure were reflected during different times in the alcohol dependence who completely stop drinking, and with increasing time of withdrawal,the alcohol dependence response to environmental cues tend to fall.2.The hypothalamic-pituitary-adrenal axis (HPA) is increased after withdrawal in alcohol dependence, and with increasing time of withdrawal, the function of hypothalamic-pituitary-adrenal axis (HPA) would tends to balance.3.It is suggested that to decrease the sensitivity of drinking relaed cues and adjust the function of hypothalamic-pituitary-adrenal axis (HPA) may be of help to desrease craving and prevent relapse. |
