认知疗法对不同文化程度慢性阻塞性肺病患者戒烟效果的影响

Influnce of Cognitive Therapy on Effect of Smoking Cessation of Cognitive Therapy for Patients with Chronic Obstructive Pulmonary Disease at Different Degree of Education

目的观察认知疗法对慢性阻塞性肺病(COPD)患者戒烟效果的影响。方法 2010—2012年在或曾在本院住院并且诊断为COPD的老年吸烟患者370例,将患者随机分为两组,干预组和对照组各185例,各组再按照文化程度差异分为小学及以下组、中学组、专科及以上三组,干预组予认知疗法+药物治疗,对照组仅予药物治疗,入组1年后对两组患者戒烟成功率及焦虑表现进行比较。结果 1年后干预组4例失访,3例死亡;对照组6例失访,4例死亡。小学及以下戒烟成功率低于中学、专科及以上,差异有统计学意义(P<0.05)。入组时干预组焦虑自评量表(SAS)评分为(60.50±1.25)分,对照组SAS评分(60.64±1.36)分,两组比较差异无统计学意义(P>0.05);1年后干预组SAS评分(50.85±1.16)分,对照组(60.79±1.42)分,两组比较差异有统计学意义(P<0.05)。结论认知疗法可有效增加中学及以上文化水平COPD患者的戒烟成功率。

Objective To observe the effect of cognitive therapy on smoking cessation for chronic obstructive pulmonary disease（ COPD） patients of different level of education. Methods 370 eldly patients with COPD and smoking in our hospital from 2010 to 2012, which were randomly divided into intervention group and control group, 185 cases in each group. Patients in each group were divided into primary school and the following group,middle school group,college or above group. Intervention group was given cognitive therapy＋drug treatment,control group was given drug treatment only,the quit rate and anxiety performance were compared after 1 year. Results After 1 year withdraw 4 cases,death 3 cases in intervention group;withdraw 6 cases,death 4 cases in control group. Quit rate in primary school and the following group was lower than middle school group,college or above group,the difference was statistically significant（ P﹤0. 05）. Self-rating anxiety scale （SAS）scores of intervention group before entering the group was（60. 50 ± 1. 25）,SAS scores of control group was（60. 64 ± 1. 36）,the difference was not statistically significant（P﹥0. 05）;SAS scores of intervention group after 1 year was（50. 85 ±1. 16）,SAS scores of control group was（60. 79 ±1. 42）,the difference was statistically significant（P﹤0. 05）. Conclusion Cognitive therapy can effectively increase the quit rate of COPD patients with middle school or above level.