不同种类戒烟药物戒烟效果的网状荟萃分析  

Efficacy of different kinds of smoking cessation drugs for smoking cessation: Network Meta-analysis

作　　者：付延鑫 纪思禹 高胜寒 尚金钰 常新伟 王冉 白亚虎 董延春[1] 宁康[1] Fu Yanxin;Ji Siyu;Gao Shenghan;Shang Jinyu;Chang Xinwei;Wang Ran;Bai Yahu;Dong Yanchun;Ning Kang(Department of Respiratory,the First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Shandong Institute of Respiratory Diseases,Jinan 250014,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)呼吸病学,山东省呼吸疾病研究所,济南250014

出　　处：《中华健康管理学杂志》2023年第9期674-679,共6页Chinese Journal of Health Management

基　　金：山东省自然科学基金资助项目(ZR2021MH200)。

摘　　要：目的应用网状荟萃分析的方法系统评价不同种类戒烟药物的戒烟效果。方法计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国生物医学文献数据库、知网、维普网、万方数据库, 检索时限为建库至2022年11月, 收集安非他酮、伐尼克兰、尼古丁替代疗法(NRT)对比安慰剂对吸烟患者戒断疗效的随机对照试验(RCT)。对符合纳入标准的文献进行资料提取, 采用Cochrane风险偏倚工具进行质量评价后, 采用Stata15.1统计软件进行网状荟萃分析。结果共纳入19项RCT研究, 合计6 106例患者, 涉及3种干预措施(安非他酮、伐尼克兰、NRT)和1种对照措施(安慰剂)。网状荟萃分析结果显示, 短期戒断率方面, 伐尼克兰(OR=4.21, 95%CI:2.32~7.63)、安非他酮(OR=2.81, 95%CI:1.05~7.54)均优于安慰剂(P<0.05)。累积排序区域下面积(SUCRA):伐尼克兰(90.2%)>安非他酮(64.8%)>NRT(41.7%)>安慰剂(3.2%)。长期戒断率方面, 伐尼克兰(OR=3.06, 95%CI:1.59~5.90)、NRT(OR=3.39, 95%CI:2.20~5.21)优于安慰剂(P<0.05)。SUCRA:伐尼克兰(83.8%)>NRT(73.9%)>安非他酮(37.2%)>安慰剂(5.2%)。结论网状荟萃分析结果表明, 相较于安非他酮和NRT, 伐尼克兰具有较好的戒烟效果。Objective To systematically evaluate the efficacy of different kinds of smoking cessation drugs by network Meta-analysis.Methods Literature was retrieved from PubMed,Web of Science,Embase,Cochrane Library,CBM,CNKI,VIP,Wan fang database,from the establishment of the database to November 2022,and randomized controlled trials(RCT)about bupropion,varenicline,nicotine replacement therapy(NRT)versus placebo in the treatment of smoking patients were collected.After data extraction from included literature which met inclusion criteria,and quality evaluation with Cochrane 5.1 risk bias evaluation tool,network Meta-analysis was performed by Stata15.1 software.Results A total of 19 RCTs,involving 6106 patients and three interventions measures(bupropion,varenicline,NRT)and one control measure(placebo)were included.The results of network Meta-analysis showed that in terms of short-term abstinence rate,varenicline[OR=4.21,95%CI(2.32,7.63)],bupropion[OR=2.81,95%CI(1.05,7.54)]were better than placebo(P<0.05).The surface under the cumulative ranking area(SUCRA):varenicline(90.2%)>bupropion(64.8%)>NRT(41.7%)>placebo(3.2%).In terms of the long-term abstinence rate,varenicline[OR=3.06,95%CI(1.59,5.90)],NRT[OR=3.39,95%CI(2.20,5.21)]were better than placebo(P<0.05).SUCRA:varenicline(83.8%)>NRT(73.9%)>bupropion(37.2%)>placebo(5.2%).Conclusion The existing evidence shows that compared with bupropion,NRT,varenicline has the best effect on quitting smoking,but more high-quality randomized trial evidence is needed for verification.

关 键 词：戒烟 药物疗法 治疗结果 随机对照试验 网状荟萃分析 

分 类 号：R163[医药卫生—公共卫生与预防医学]