怀孕的吸烟者使用药物戒烟的疗效和安全性:荟
2012/12/13
摘要
背景:怀孕的吸烟者使用药物戒烟的疗效和安全性尚不清楚。
目的:在怀孕的吸烟者中研究药物戒烟的疗效和安全性。
检索策略:2011年6月检索PubMed、Embase和CENTRAL。
选择标准:随机对照临床试验(RCT)、准RCT和回顾性或前瞻性对照研究。
数据收集和分析:基于最长的随访数据和最近一次数据,研究怀孕的吸烟者使用药物戒烟的疗效。
主要结果:共收集到74篇文献,7项研究(5项RCT、1项准RCT和1项前瞻性研究),共涉及1386名怀孕的吸烟者。732名位于干预组,654名位于对照组。基于最长随访数据对7项研究进行固定效应荟萃分析。结果显示,药物治疗对戒烟具有显著影响(RR 1.80; 95% CI 1.32-2.44)。基于研究设计类型的亚组荟萃分析,对于RCT(RR 1.48; 95% CI 1.04-2.09)和其他类型研究(RR 3.25; 95% CI 1.65-6.39)具有类似的结果。妊娠后期的戒断率,干预组为7%-22.6%(平均戒断率:13.0%; 95% CI 10.9-15.2%)。有几项研究报道了轻症和严重的副作用。
结论:本研究显示,有临床证据支持怀孕的吸烟者采用药物戒烟。有必要进行更多的RCT证实该结论。
(陈欣 审校)
BJOG. 2012 Aug;119(9):1029-1039. doi: 10.1111/j.1471-0528.2012.03408.x.
Efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers: a meta-analysis.
Myung SK, Ju W, Jung HS, Park CH, Oh SW, Seo H, Kim H; for the Korean Meta-Analysis (KORMA) Study Group.
Source
Smoking Cessation Clinic, Family Medicine Clinic, and Centre for Cancer Prevention and Detection, National Cancer Centre, Gyeonggi-do Carcinogenesis Branch, Research Institute, National Cancer Centre, Gyeonggi-do Department of Family Medicine, School of Medicine, Graduate School, Seoul National University, Seoul Department of Obstetrics and Gynaecology, School of Medicine, Medical Research Institute, Ewha Womans University, Seoul Total Health Care Centre, Gangbuk Samsung Hospital, Seoul Department of Family Medicine, Eulji University Hospital, Daejon Department of Family Medicine, Healthcare System Gangnam Centre, Seoul National University Hospital, Seoul Department of Nursing, Shinheung College University, Gyeonggi-do, South Korea.
Abstract
BACKGROUND:The efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers has not yet been established.
OBJECTIVE:To investigate the efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers.
SEARCH STRATEGY:A search was made of PubMed, Embase and CENTRAL in June 2011.
SELECTION CRITERIA:Randomised controlled trials (RCTs), quasi-RCTs and retrospective or prospective controlled studies were included.
DATA COLLECTION AND ANALYSIS:The main analyses were designed to examine the efficacy of pharmacotherapy for smoking cessation among pregnant smokers based on the longest follow-up data available and from data obtained at the latest available time-point in pregnancy in each study.
MAIN RESULTS:Of 74 articles identified from the databases, seven studies (five RCTs, one quasi-RCT and one prospective study) involving a total of 1386 pregnant smokers, 732 in the intervention groups and 654 in the control groups, were included in the final analyses. In a fixed-effects meta-analysis of all seven studies based on the longest follow-up data available, pharmacotherapy had a significant effect on smoking cessation (relative risk [RR] 1.80; 95% confidence interval [CI] 1.32-2.44). Subgroup meta-analysis by type of study design also showed similar findings for RCTs (RR 1.48; 95% CI 1.04-2.09) and other types of studies (RR 3.25; 95% CI 1.65-6.39). The abstinence rate at late pregnancy in the intervention ranged from 7 to 22.6% (mean abstinence rate 13.0%; 95% CI 10.9-15.2%). A few minor adverse effects and serious adverse effects were reported in several studies.
AUTHOR’S CONCLUSIONS:This study indicates that there may be clinical evidence to support the use of pharmacotherapy for smoking cessation among pregnant smokers. Further RCTs are needed.
BJOG. 2012 Aug;119(9):1029-1039. doi: 10.1111/j.1471-0528.2012.03408.x.
背景:怀孕的吸烟者使用药物戒烟的疗效和安全性尚不清楚。
目的:在怀孕的吸烟者中研究药物戒烟的疗效和安全性。
检索策略:2011年6月检索PubMed、Embase和CENTRAL。
选择标准:随机对照临床试验(RCT)、准RCT和回顾性或前瞻性对照研究。
数据收集和分析:基于最长的随访数据和最近一次数据,研究怀孕的吸烟者使用药物戒烟的疗效。
主要结果:共收集到74篇文献,7项研究(5项RCT、1项准RCT和1项前瞻性研究),共涉及1386名怀孕的吸烟者。732名位于干预组,654名位于对照组。基于最长随访数据对7项研究进行固定效应荟萃分析。结果显示,药物治疗对戒烟具有显著影响(RR 1.80; 95% CI 1.32-2.44)。基于研究设计类型的亚组荟萃分析,对于RCT(RR 1.48; 95% CI 1.04-2.09)和其他类型研究(RR 3.25; 95% CI 1.65-6.39)具有类似的结果。妊娠后期的戒断率,干预组为7%-22.6%(平均戒断率:13.0%; 95% CI 10.9-15.2%)。有几项研究报道了轻症和严重的副作用。
结论:本研究显示,有临床证据支持怀孕的吸烟者采用药物戒烟。有必要进行更多的RCT证实该结论。
(陈欣 审校)
BJOG. 2012 Aug;119(9):1029-1039. doi: 10.1111/j.1471-0528.2012.03408.x.
Efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers: a meta-analysis.
Myung SK, Ju W, Jung HS, Park CH, Oh SW, Seo H, Kim H; for the Korean Meta-Analysis (KORMA) Study Group.
Source
Smoking Cessation Clinic, Family Medicine Clinic, and Centre for Cancer Prevention and Detection, National Cancer Centre, Gyeonggi-do Carcinogenesis Branch, Research Institute, National Cancer Centre, Gyeonggi-do Department of Family Medicine, School of Medicine, Graduate School, Seoul National University, Seoul Department of Obstetrics and Gynaecology, School of Medicine, Medical Research Institute, Ewha Womans University, Seoul Total Health Care Centre, Gangbuk Samsung Hospital, Seoul Department of Family Medicine, Eulji University Hospital, Daejon Department of Family Medicine, Healthcare System Gangnam Centre, Seoul National University Hospital, Seoul Department of Nursing, Shinheung College University, Gyeonggi-do, South Korea.
Abstract
BACKGROUND:The efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers has not yet been established.
OBJECTIVE:To investigate the efficacy and safety of pharmacotherapy for smoking cessation among pregnant smokers.
SEARCH STRATEGY:A search was made of PubMed, Embase and CENTRAL in June 2011.
SELECTION CRITERIA:Randomised controlled trials (RCTs), quasi-RCTs and retrospective or prospective controlled studies were included.
DATA COLLECTION AND ANALYSIS:The main analyses were designed to examine the efficacy of pharmacotherapy for smoking cessation among pregnant smokers based on the longest follow-up data available and from data obtained at the latest available time-point in pregnancy in each study.
MAIN RESULTS:Of 74 articles identified from the databases, seven studies (five RCTs, one quasi-RCT and one prospective study) involving a total of 1386 pregnant smokers, 732 in the intervention groups and 654 in the control groups, were included in the final analyses. In a fixed-effects meta-analysis of all seven studies based on the longest follow-up data available, pharmacotherapy had a significant effect on smoking cessation (relative risk [RR] 1.80; 95% confidence interval [CI] 1.32-2.44). Subgroup meta-analysis by type of study design also showed similar findings for RCTs (RR 1.48; 95% CI 1.04-2.09) and other types of studies (RR 3.25; 95% CI 1.65-6.39). The abstinence rate at late pregnancy in the intervention ranged from 7 to 22.6% (mean abstinence rate 13.0%; 95% CI 10.9-15.2%). A few minor adverse effects and serious adverse effects were reported in several studies.
AUTHOR’S CONCLUSIONS:This study indicates that there may be clinical evidence to support the use of pharmacotherapy for smoking cessation among pregnant smokers. Further RCTs are needed.
BJOG. 2012 Aug;119(9):1029-1039. doi: 10.1111/j.1471-0528.2012.03408.x.
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加强戒烟热线的有效性:寻找更好的辅助药物治
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