伐尼克兰联合心理干预戒烟对慢性阻塞性肺疾病的疗效观察

目的评估伐尼克兰联合心理干预措施对轻中度慢性阻塞性肺疾病（COPD）吸烟患者烟草依赖的疗效和安全性。方法选取轻中度COPD烟草依赖的患者108例,随机分为干戒组、伐尼克兰组、伐尼克兰＋心理干预（干预组）三组,对伐尼克兰组及干预组给予口服12周伐尼克兰,干预组并给予戒烟咨询及心理干预,随访至24周,观察戒烟者的戒烟率、肺功能变化、不良反应、戒断症状及复吸率。结果干预组12周和24周持续戒烟率分别为77.8%和75%,伐尼克兰组分别为55.6%和41.7%,干戒组分别为25%和8.3%,三组之间差异有统计学意义（P〈0.05）;不良反应主要为恶心、失眠、头痛等,程度轻微,多为一过性。伐尼克兰组12周戒断症状评分为（1.8±2.3）分,干预组为（1.7±2.1）分,均显著低于干戒组（4.1±1.6）分（P〈0.05）。结论伐尼克兰联合心理干预可大大提高戒烟患者短期和长期的戒烟率,伐尼克兰戒烟安全、有效、耐受性好,对我国COPD烟草依赖的患者具有适用性。

Efficacy of Varenicline Combined with Smoking Cessation-counseling for Patients with Chronic Obstructive Pulmonary Disease

Objective To evaluate the efficacy and safety of varenicline in combination with psychological support on smoking cessation therapy in patients with chronic obstructive pulmonary disease(COPD).Methods One hundred and eight tobacco dependent patients with COPD were divided into cold turkey group,varenicline group and varenicline with psychological support group(VPS group).The patients in varenicline group were received the treatment with 12-week varenicline.The patients in VPS group were included for both 12-week varenicline and 10~20 minutes of smoking cessation counseling.Thereafter,patients continued into a non-treatment follow-up phase for an additional 12 weeks.Adverse reactions and clinical efficacy of carbon monoxide-confirmed continuous abstinence rates(CAR) from 12 to 24 weeks were recorded.Results The CAR of treatment phase from week 9~12 was 55.6% in varenicline group,77.8% in VPS group,and 25% in cold turkey group,and the difference was statistically significant among the three groups(P<0.05).The CAR of treatment phase from week 20~24 was 41.7% in varenicline group,75% in VPS group,and 8.3% in cold turkey group,and the difference was statistically significant among the three groups(P<0.05).The common adverse drug reactions were nausea,insomnia and headache,which were generally in mild to moderate intensity and often diminished over time.Mean withdrawal scale score was(1.8±2.3) in varenicline group,(1.7±2.1) in VPS group,and(4.1±1.6) in cold turkey group,there were statistically significant differences in the mean withdrawal scale score among the three groups(P<0.05).Conclusions Varenicline in combination with psychological support is efficacious,safe,and well-tolerated agent for smoking cessation in tobacco dependent patients with COPD.