Chest:戒烟:针灸pk尼古丁替代疗法

2018-01-25 吴星 环球医学

吸烟是人类健康和社会发展的重大威胁,每年造成全球约600万例死亡。2017年11月,发表在《Chest》的一项由中国科学家进行的前瞻性、随机、活性对照、开放性试验的结果表明,对于戒烟,针灸的疗效非劣效于尼古丁替代疗法(NRT)。

吸烟是人类健康和社会发展的重大威胁,每年造成全球约600万例死亡。2017年11月,发表在《Chest》的一项由中国科学家进行的前瞻性、随机、活性对照、开放性试验的结果表明,对于戒烟,针灸的疗效非劣效于尼古丁替代疗法(NRT)。

背景:研究者设计和进行了此项多中心、随机、活性对照、开放性试验,旨在评估针灸、耳穴贴压和NRT对中国人群戒烟的疗效。

方法:这项随机对照试验于2013年10月~2016年2月在中国的7家医院进行。招募了符合条件的参与者,并通过中央随机系统按照1:1:1的比例将他们随机分配到针灸、耳穴位点压或NRT的组中。所有治疗都进行8周,16周末次访问。首要结局测量为戒烟日后24周的一氧化碳(CO)证实的24小时点戒烟率(<百万分之10)。

结果:总共纳入了300名参与者,195例完成研究,流失率为35.00%。针灸组和NRT组都有2例不良事件。24周时,针灸组CO证实的24小时点戒烟率为43.00%,NRT组为44.00%,两组相似(P>0.05),都显着高于耳穴贴压组的30.00%(P<0.05)。24周时,针灸组的Fagerstrom尼古丁依赖试验和明尼苏达尼古丁戒断量表评分显着低于耳穴贴压组和NRT组(P<0.05)。Kaplan-Meier分析显示,针灸组复发时间(44.12天)非显着性长于NRT组(41.8天),但显着长于耳穴贴压组(29.53天)。

结论:针灸是一种安全和可能的戒烟治疗选择,但是需要进一步研究来确定其作用。

中国戒烟有多个可及治疗选择,需要头对头比较来报告治疗选择。本多中心、随机、活性对照、开放性试验显示,针灸和NRT之间在戒烟中的非劣效性。二者均优于耳廓穴位点压。更重要的是,当前结果与香港正在进行的7年观察性研究的结果相似,表明不管研究地点,针灸疗效的可靠性。

当戒烟治疗选择的安全性和疗效相似时,成本在决定治疗选择时更重要。对于中国患者,针灸的成本低于NRT的成本。这可能使得在本试验中,针灸是更令人满意的治疗,但可能不适用于其他试验。同样地,研究者建议考虑针灸作为帮助吸烟者戒烟的方法之一。

原始出处:

Wang YY, Liu Z, Wu Y, et al. Efficacy of Acupuncture Is Noninferior to Nicotine Replacement Therapy for Tobacco Cessation: Results of a Prospective, Randomized, Active-Controlled Open-Label Trial. Chest. 2017 Nov 23. pii: S0012-3692(17)33126-4. doi: 10.1016/j.chest.2017.11.015. [Epub ahead of print].

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    2018-10-28 Smile2680
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    2018-02-02 xiangyuzhou971
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    2018-01-25 衣带渐宽

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