戒烟对老年患者疼痛的影响
2011/07/06
摘要
前言:吸烟者出现慢性疼痛和疼痛强度较高的风险增加。然而,尼古丁具有镇痛作用,吸烟者可能会将吸烟作为对付疼痛的一种方法。戒烟有利于吸烟者的长期健康。然而,目前尚不清楚戒烟对疼痛的影响。本试验旨在一项基于老年成人患者的大型纵向研究中,通过二级分析来明确戒烟与疼痛症状变化间的关系。
方法:对两年1次的纵向调查研究数据进行二次分析(1992~2006年),该研究为在50岁以上成人中进行的有代表性的美国健康与退休研究。多变量logistic回归用于分析吸烟状态与疼痛症状之间的关系,该分析对人口统计学、抑郁、自我评定的健康状况、关节炎病史和体重指数进行控制。
结果:多变量分析中,4695名吸烟者在入选时主诉无疼痛或轻度疼痛,吸烟状态并不与疼痛恶化独立相关(优势比[OR]:0.95,95% CI:0.84,1.08)。1118名吸烟者在入选时主诉中度至严重疼痛,吸烟状态与疼痛的改善无独立相关性(OR: 0.87, 95% CI: 0.70, 1.08)。
结论:戒烟与年长成人的疼痛症状变化无独立相关性。这些结果显示,有关戒烟对疼痛症状的影响并不是导致慢性疼痛吸烟者戒烟的障碍。
(林江涛 审校)
Nicotine Tob Res. 2011 May 12. [Epub ahead of print]
Effects of Smoking Cessation on Pain in Older Adults.
Shi Y, Hooten WM, Warner DO.
Source
Department of Anesthesiology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. warner.david@mayo.edu.
Abstract
INTRODUCTION: Smokers are at increased risk of developing chronic pain and suffering higher pain intensity. However, nicotine has analgesic properties, and smokers may view smoking as a means to cope with pain. Smoking cessation is clearly beneficial to the long-term health of smokers. However, it is not known how abstinence from smoking affects pain. The aim of this study was to determine the association between smoking cessation and changes in pain symptoms by secondary analysis of a large longitudinal dataset of older adults.
METHODS: Secondary analyses were performed of longitudinal biennial survey data (1992 through 2006) from the nationally representative Health and Retirement Study of United States adults older than 50 years. Multivariate logistic regressions were utilized to determine the relationship between the changes in smoking status and changes in pain symptoms, controlling for demographics, depression, self-rated health, history of arthritis, and body mass index.
RESULTS: In multivariate analyses, among the 4,695 smokers who reported no pain or mild pain at enrollment, smoking status was not independently associated with exacerbation of pain (odds ratio [OR]: 0.95, 95% CI: 0.84, 1.08). Among the 1,118 smokers who reported moderate to severe pain at enrollment, smoking status was not independently associated with improvement of pain (OR: 0.87, 95% CI: 0.70, 1.08).
CONCLUSIONS: Smoking cessation was not independently associated with changes in pain symptoms in older adults. These results suggest that concerns regarding the effects of abstinence from smoking on pain should not pose a barrier to offering tobacco use interventions to smokers with chronic pain.
Nicotine Tob Res. 2011 May 12. [Epub ahead of print]
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