戒烟门诊强化心理行为干预的临床戒烟效果

目的 探讨戒烟门诊应用伐尼克兰联合强化心理行为干预的临床戒烟效果以及分析戒烟成功预测指标.方法 将2009年3月至2010年9月复旦大学附属中山医院“吸烟及其相关疾病门诊”进行戒烟咨询和干预者作为研究对象,筛选合适对象,分为加强随访组和普通随访组,主要观察第9～12周持续戒断率,应用logistic回归模型进行戒烟成功预测指标分析.结果 戒烟门诊烟草依赖患者应用伐尼克兰联合强化干预治疗第9～12周持续总体戒断率为52.3％,加强随访组60.9％ (28/46),普通随访组46.2％ (30/65),主要不良反应为恶心(39.6％,44/111),睡眠差和梦境异常(17.1％,19/111),均可耐受,戒断症状少.戒烟准备程度和服药时间可作为戒烟成功预测指标.结论 伐尼克兰联合心理行为干预临床戒断率高,强化心理行为干预更明显增加成功率,是戒烟门诊很好的治疗方案,充分戒烟准备和规律足疗程服药能进一步提高戒烟成功率.

The evaluation of strengthened psychological and behavioral intervention in smoking cessation clinics

Objective To evaluate the effect of psychological and behavioral intervention combined with varenicline smoking cessation clinics and to analyze predictors of successful quitting.Methods Subjects were collected from quitters who went to receive consultation and intervention in “smoking and related diseases” clinic at Zhongshan Hospital,Fudan University from March 2009 to September 2010.Eligible subjects were screened and divided into strengthen follow-up group and control group.The 4 weeks continuous abstinence rate from week 9 through week 12 were observed logistic regression model and used to analyze the predictors of successful quitting.Results Subjects who are addicted to nicotine received strengthening psychological and behavioral intervention combined with varenicline in smoking cessation clinics.The total continuous cessation rate during the 9th-12th week was 52.3％,with 60.9％ (28/46) and 46.2％ (30/65) of strengthen follow-up group and control group respectively.The most frequent adverse effects were nausea 39.6％ (44/111),insomnia and abnormal dreams 17.1％ ( 19/111 ).Adverse effects were tolerable and withdraw symptoms were few.Preparation and medication time can be used as predictors of successful quitting.Conclusion The quit rate of varenicline therapy combining with strengthen intervention is high and strengthening psychological and behavioral intervention could increase the success rate more obviously,which is a good choice for cessation therapy in smoking cessation clinics.Better preparation and regular adequate treatment can improve quit rate.