基于认知干预的戒烟方法在 COPD 患者戒烟中的效果研究

Study on the effects of smoking cessation methods based on the cognitive intervention in patients with chronic obstructive pulmonary disease

目的：研究轻中度吸烟慢性阻塞性肺病（ COPD）患者戒烟意愿，并评价认知干预戒烟方法对其戒烟的效果。方法在门诊部收集轻中度吸烟COPD患者102例，根据戒烟意愿分为4个区组，区组内再随机分为干预组和对照组。应用社会认知干预指导的戒烟方法对干预组进行6个月的干预，并进行随访评价戒烟效果。结果⑴全部调查对象中，年龄（61．3±12．3）岁，男女性别比为99∶3，体质量指数（23．06±3．39）kg／m2，吸烟指数（包／年）39．81±11．53，每日吸烟量（14．22±2．30）支，学历低者占55．9％，尼古丁依赖程度高者占49．0％，39例（38．2％）希望戒烟，20例（19．6％）强烈希望戒烟；⑵吸烟原因中享乐（7．02）、依赖（6．88）和镇静（6．55）分量表分数较高；⑶干预组与对照组半年持续戒烟率（χ2＝4．993， P ＝0．025）、6月点戒烟率（χ2＝6．668， P ＝0．010）差异均具有统计学意义，3个月（ t ＝2．65， P ＜0．01）和6个月（ t ＝2．07， P ＜0．05）后干预组与对照组体质量的差异具有统计学意义。结论轻中度COPD患者戒烟意愿不高，基于认知干预的戒烟方法是其戒烟成功的有效途径。

Objective To investigate quitting motivation of smoking patients with mild and moder-ate chronic obstructive pulmonary disease （ COPD） and evaluate the effects of smoking cessation methods based on cognitive intervention.Methods A total of 102 smoking patients with mild and moderate COPD from the outpatient department was divided into 4 blocks according to their intention of quitting smoking.Pa-tients in each block were randomly divided into intervention and control groups.Results ⑴All the re-spondents were at an average age of （61.3 ±12.3） years old.The sex ratio of men to women was 99∶3. The average smoking index （bag/year） in all the respondents was （39.81 ±11.53）.The average daily smoking was （14.22 ±2.30） packs.The respondents with a lower degrees accounted for 55.9%and the respondents with high nicotine dependence 49.0%.A total of 39 people （38.2%） hoped to give up smok-ing, 20 people （19.6%） strongly hoped to give up smoking.⑵The main reasons for smoking included en-joyment （7.02）, dependence （6.88）, and calm （6.55）.⑶There were statistically significant difference in the half-year continuous abstinence rates （χ2 =4.993, P =0.025） and in June quit rates （χ2 =6.668, P =0.010） between the intervention （58.82%） and control （33.33%） groups.The weight gain had sig-nificant difference between the intervention and control groups at the 3rd month （ t =2.65, P 〈0.01） or 6th month （ t =2.07, P 〈0.05） after quitting smoking.Conclusions The quitting motivation of smoking patients with mild and moderate COPD is not strong, while the smoking cessation methods based on cogni-tive intervention are effective for those patients.