中国的戒烟干预研究:系统性综述
2012/02/29
摘要
前言:中国拥有世界最多的吸烟者,然而,尚未有系统性综述对中国临床戒烟干预措施的有效性进行评价。本文对中国已有的戒烟研究结果进行总结,比较药物治疗、咨询和中医治疗在戒烟中的疗效。
方法:收集万方和Pubmed电子数据库中文和英文有关戒烟干预的临床试验。共收集到Pubmed数据库234篇文献和万方数据了78篇文献。
结果:本文入选29项研究。其中11项(37.9%)为随机对照试验(RCTs),评价下列干预措施的疗效:咨询(5项研究)、中医(3项研究)和药物治疗(1项研究)、联合药物及咨询(1项研究)、医生建议(1项研究)。与咨询相比,单独药物治疗或药物治疗联合咨询能增加戒断率。中医技术,如针灸、贴压耳穴的戒烟效果要明显好于药物治疗和咨询。但是,我们不能基于这些结果得出结论,因为大部分中医治疗研究为非对照研究,且不能提供戒断的定义。对于有关医生建议的戒烟疗效也尚未有定论。
结论:对中文戒烟研究的回顾性分析显示,药物治疗是戒烟的有效干预措施。有必要进行针对中医和医生建议进行戒烟的随机对照研究,其中需要有长期的随访评价和采用生化方法证实的自我主诉戒断,这样才能为这些戒烟干预措施在中国的临床应用提供循证证据。
(陈欣 审校)
Nicotine Tob Res. 2012 Jan 16. [Epub ahead of print]
A Systematic Review of Smoking Cessation Intervention Studies in China.
Kim SS, Chen W, Kolodziej M, Wang X, Wang VJ, Ziedonis D.
Source
365 Plantation Street, Suite 100, Worcester, MA 01605-2397, USA. sun.kim@umassmed.edu.
Abstract
INTRODUCTION: China has the highest number of tobacco smokers among the world’s nations; however, no systematic review has been conducted of clinical trials on the efficacy of smoking cessation interventions in China. This paper summarizes findings of studies in order to compare the effect of pharmacotherapy, counseling, and Traditional Chinese Medicine (TCM) approaches on the abstinence rate.
METHODS: Clinical trials of smoking cessation interventions published in English or Chinese were extracted from an electronic search of PubMed and WanFang databases. The search yielded 234 studies from the PubMed and 78 studies from the WanFang.
RESULTS: Twenty-nine studies were included in this review. Of these, 11 (37.9%) were randomized controlled trials (RCTs) that assessed the following approaches: counseling (5 studies), TCM (3 studies), pharmacotherapy (1 study), a combination of pharmacotherapy and counseling (1 study), and physician advice (1 study). Pharmacotherapy alone or in combination with counseling generally resulted in a higher abstinence rate than counseling alone. TCM techniques such as acupuncture and ear point seed pressure yielded a much higher abstinence rate than pharmacotherapy and counseling. Findings are inconclusive, however, because most of the TCM studies were noncontrolled trials and did not provide a definition of "abstinence." Findings on the effectiveness of physician advice to quit smoking were also inconclusive.
CONCLUSIONS: A review of smoking cessation studies revealed that pharmacotherapy was effective in China. More RCTs of TCM approaches and physician advice are needed with long-term follow-up assessments and biochemical verification of self-reported abstinence before these approaches are adopted as evidence-based smoking cessation interventions in China.
Nicotine Tob Res. 2012 Jan 16. [Epub ahead of print]
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