穴位埋线与盐酸安非他酮缓释片治疗烟草依赖对照研究

Comparative study of acupoint catgut embedding and bupropion hydrochloride sustained-release tablets for tobacco dependence

目的:比较穴位埋线与盐酸安非他酮缓释片治疗烟草依赖的临床疗效。方法:将符合纳入标准的烟草依赖患者100例,随机分为穴位埋线组与药物组,每组50例。穴位埋线组分别在心俞、神门、甜美穴、太冲穴埋线,每2周治疗1次,治疗4次。药物组口服盐酸安非他酮缓释片,第1～3天每日1次,每次150 mg;第4～7天每日2次,每次150mg;第8天后每日1次,每次150mg,共治疗7周。比较两组患者治疗前后的法氏烟草依赖评估量表(FTND)评分、第4周及第8周点戒烟率和连续戒烟率及疗效、治疗依从率和不良反应率。结果:共纳入100例患者,97例完成研究(流失率3%),其中穴位埋线组49例、药物组48例。两组患者治疗后FTND评分较治疗前均降低(均P<0.05),治疗后组间比较差异无统计学意义(P>0.05);第4周、第8周,穴位埋线组点戒烟率分别为40.8%(20/49)、79.6%(39/49),药物组点戒烟率分别为41.7%(20/48)、83.3%(40/48),两组疗效相当(均P>0.05)。穴位埋线组连续戒烟率为40.8%(20/49),与药物组的41.7%(20/48)疗效相当(P>0.05)。穴位埋线组完全依从率为61.2%(30/49),药物组完全依从率为37.5%(18/48),穴位埋线组明显优于药物组(P<0.05)。穴位埋线组不良反应率为12.2%(6/49),药物组不良反应率为29.2%(16/48),穴位埋线组明显低于药物组(P<0.05)。结论:穴位埋线可有效改善戒烟后烟草依赖的症状,其疗效与盐酸安非他酮缓释片接近,且临床依从性好,不良反应少。

Objective To compare the clinical efficacy of acupoint catgut embedding and bupropion hydrochloride sustained-release tablets in the treatment of tobacco dependence. Methods A total of 100 patients with tobacco dependence who met the inclusion criteria were randomly divided into an acupoint catgut embedding group and a drug group, 50 cases in each group. In the acupoint catgut embedding group, acupoint catgut embedding was applied at Xinshu(BL 15), Shenmen(HT 7), Tianmei(Extra), Taichong(LR 3), the treatment was given once every 2 weeks for 4 times;The bupropion hydrochloride sustained-release tablets was orally administered in the drug group for 7 weeks, 150 mg each time, once a day for the first 3 days, twice daily from day 4 to day 7, and once a day after day 8. The Fagerstr?m test for nicotine dependence(FTND) score before and after treatment, the 4 th and 8 th week smoking cessation rate, the continuous smoking cessation rate and efficacy, compliance rate and adverse reaction rate were compared in the two groups. Results A total of 100 patients were enrolled, and 97 patients completed the study(loss rate was 3%), including 49 cases in the acupoint catgut embedding group and 48 cases in the drug group. The FTND scores in the two groups were lower than those before treatment(both P<0.05). There was no significant difference between the two groups after treatment(P>0.05). At the 4 th and the 8 th week,the smoking cessation rate in the acupoint catgut embedding group was 40.8%(20/49) and 79.6%(39/49) respectively, the smoking cessation rate in the drug group was 41.7%(20/48) and 83.3%(40/48) respectively, the two groups were equally effective(both P>0.05). The continuous smoking cessation rate in the acupoint embedding group was 40.8%(20/49),which was equivalent to 41.7%(20/48) in the drug group(P>0.05). The rate of complete compliance in the acupoint embedding group was 61.2%(30/49), which was significantly better than 37.5%(18/48) in the drug group(P<0.05). The adverse reaction rate in the acupoint catgut embedding group was 12.2%(6/49), which was significantly lower than 29.2%(16/48) in the drug group(P<0.05). Conclusion Acupoint catgut embedding can effectively improve the symptoms of tobacco dependence after smoking cessation. Its curative effect is close to that of bupropion hydrochloride sustained-release tablets, and it has good clinical compliance and less adverse reactions.