呼吸科医生的全程积极参与在慢性气道疾病患者戒烟治疗中的作用

The role of full involvement of respiratory physicians on smoking cessation in patients with chroinc airway disease

目的探讨呼吸科医生全程积极参与的戒烟干预对慢性气道疾病患者戒烟效果的影响,提出针对该类人群有效的戒烟方案。方法将300例烟草依赖的慢性气道疾病患者随机分为2组,对照组(n=150)给予伐尼克兰口服,干预组(n=150)联合医生全程参与的戒烟干预,并在第1、4、8、12、24周对2组患者进行随访。结果31.3%的对照组患者和65.3%的干预组患者在24周时戒烟成功,且肺功能均有改善,干预组最大肺活量(FVC)、第一秒用力呼气量(FEV1)、第一秒用力呼气量/最大肺活量(FEV1/FVC)水平均优于对照组(P<0.05);呼吸科医生全程参与的戒烟干预(OR=0.434)及本科及以上学历(OR=0.154)是戒烟成功的保护性因素,吸烟量>20支/d(OR=2.379)及戒烟前准备不充分(OR=8.040)是戒烟成功的危险性因素。结论呼吸科医生全程参与的戒烟干预可提高慢性气道疾病患者的戒烟成功率,并可改善其肺功能。

Objective To evaluate the effects of the whole-course therapy and active participation of respiratory physicians on smoking cessation in chronic airway disease patients so as to propose an effective smoking cessation treatment plan in this population.Methods A total of 300 subjects were randomly divided into 2 groups:a control group(comprising 150 subjects who received just oral varenicline)and an intervention group(comprising 150 subject who received the intervention with active participation of physicians).Patients in both groups were followed up at 1,4,8,12 and 24 weeks following the first day of smoking cessation.Results Smoking abstinence at 24 weeks occurred in 31.3%of participants in the control group and 65.3%of participants in the intervention group.Lung function in both groups was improved,and the FVC,FEV1 and FEV1/FVC levels in the intervention group were better than in the control group(P<0.05).The active participation of physicians(OR=0.434)and having a bachelor’s degree or above(OR=0.154)were protective factors for successful smoking cessation.Smoking more than 20 cigarettes per day(OR=2.379)and inadequate preparation before quitting smoking(OR=8.040)were risk factors for unsuccessful smoking cessation.Conclusion The active participation of physicians can significantly increase lung function and the success rate of smoking cessation therapy in patients with chronic airway disease.