快速戒断法与逐步戒断法戒烟疗效比较及影响因素分析  

Smoking abstinence rate and its associated factors between abrupt and gradual smoking cessation

作　　者：郝冉 周剑平[1] 倪磊[1] 李庆云[1] 时国朝[1] Hao Ran;Zhou Jianping;Ni Lei;Li Qingyun;Shi Guochao(Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, Chin)

机构地区：[1]上海交通大学医学院附属瑞金医院呼吸与危重症医学科,上海200025

出　　处：《中华结核和呼吸杂志》2017年第12期898-902,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的 探讨快速戒断法与逐步戒断法在药物辅助戒烟人群中的疗效及相关影响因素.方法 前瞻性纳入2013年6月至2016年5月瑞金医院戒烟门诊就诊中-重度尼古丁依赖性戒烟者,共纳入314名,其中男305名,年龄（52.1±11.6）岁,女9名,年龄（41.0±12.7）岁;按照1：1原则随机分为快速戒断组（在目标戒断日前3周不控制烟量,入选第22天完全戒断）与逐步戒断组（在目标戒断日前3周逐步减少吸烟量,入选第22天停止吸烟）.其中逐步戒断组157名,快速戒断组157名,14名在随访期间脱落.首要评价指标为彻底戒断率,次要评价指标为时点戒烟率,选择1、3和6个月的第7天统计7d时点戒烟率,统计3个月持续戒烟率并观察戒烟者体重变化以及药物相关不良事件.结果 逐步戒断组彻底戒断率为55%,高于快速戒断组（36.9%,χ2=9.841,P=0.002）;在1、3和6个月7 d时点戒烟率比较中,逐步戒断组与快速戒断组相比无明显差异（所有P〉0.05）;在3个月持续戒烟率比较中,逐步戒断组（17.9%）优于快速戒断组（8.7%,χ2=5.441,P=0.020）;快速戒断组的药物不良反应发生率高于逐步戒断组,其中胃肠道不适发生率分别为39.2%和17.7%,多梦发生率分别为40.2%和13.3%（χ2=20.172、12.336,均P〈0.01）.结论 逐步戒断法可作为部分中-重度尼古丁依赖性戒烟者的选择之一,其戒断率高且戒断症状相对较轻.Objective To analyze and compare the abstinence rate of smoking quitting methods and its associated factors between abrupt and gradual smoking cessation in smokers with drug -based therapy. Methods A prospective clinical study was conducted in patients undergoing quitting smoking intervention in Ruijin Hospital smoking cessation clinic between June 2013 and May 2016.All the subjects were randomized in a 1：1 ratio into the abrupt smoking cessation group （ smoking as usual over 3 weeks before a planned quit day, and then stopping smoking abruptly ） and the gradual smoking cessation group （ gradually reducing tobacco use over 3 weeks before a planned quit day , and then stopping smoking totally ） .The primary outcome was the complete abstinence rate , and the secondary outcomes included 1-month, 3-month and 6 month 7-day point prevalence of abstinence rates and 3 month sustained abstinence rates .Changes of body weight and drug adverse events were also compared .Results A total of 314 moderate to severe nicotine-dependent patients were admitted in the study , including 157 patients in the abrupt smoking cessation and 157 patients in the gradual smoking cessation group .Fourteen patients fell off during the follow-up.For the complete abstinence rate ,the gradual smoking cessation group was higher than the abrupt smoking cessation group（55.0%vs.36.9%,χ2 =9.841,P=0.002） .For 7-d smoking abstinence rate in the 1st, 3rd, 6th month, there was no significant difference between the 2 groups （ all P 〉0.05 ） .As for the 3-month sustained abstinence rate , a higher smoking quitting rate was seen in the gradual smoking cessation group compared to the abrupt smoking cessation group in the 6-month follow-up （17.9% vs.8.7%,χ2 =5.441, P=0.020）.The adverse drug reaction incidence was higher in the abrupt smoking cessation group than the gradual smoking cessation group （Gastrointestinal discomfort：39.2%vs.17.7%,χ2 =12.336,P=0.000;Dreaminess：40.2%vs.13.3%,χ2 =20.172,P=0.000）.Conclusions For moderate

关 键 词：快速戒断 逐步戒断 药物戒烟 戒烟疗效 影响因素 

分 类 号：R163[医药卫生—公共卫生与预防医学]