药物戒烟的循证性临床指南综述

目的:了解和介绍循证性临床指南中药物戒烟的条款。方法:通过Medline、TRIPdatabase和NGC等9个数据库或指南类网站搜集有关指南。采用比较、归纳和罗列的方式介绍有关内容。结果:收集到HEA等6个循证性临床指南。(1)戒烟的一线药物有尼古丁制剂和安非拉酮,二线药物有可乐定和去甲替林;(2 )尼古丁替代疗法是有效的、安全的和主要的药物戒烟方法;(3)安非拉酮是有效的、安全的戒烟药物;(4)可乐定和去甲替林是有效的戒烟药物,应在一线药物无效或禁忌时在医生的监督下应用;(5 )没有足够的证据显示安定、普萘洛尔和美加明等药物的戒烟效果;(6 )尼古丁制剂对妊娠、心血管疾病患者基本上是安全的;(7)戒烟一般伴有体重的增加。结论:应该鼓励吸烟者戒烟;应该鼓励应用药物进行戒烟。

SYSTEMATIC REVIEWS ON PHARMACEUTICAL THERAPY OF SMOKING CESSATION IN EVIDENCE- BASED CLINICAL PRACTICE GUIDELINES

Objective: To introduce relevant recommendations on pharmaceutical therapy for smoking dedependence in the evidence-based guidelines. Methods: Nine databases including Medline, TRIPdatabase,etc. were searched. Recommendations were extracted from the evidence-based guidelines and the findings compared. Results: Six guidelines were selected and assessed. The baseline drug for smoking cessation included nicotine replacement therapy(NRT) and bupropion;the second consisted of clonidine and nortriptyline. NRT was an effective,safe and basic treatment in tobacco cessation;Bupropion an effective and safe treatment;Clonidine and nortriptyline an effective treatment,but should be guided by a physician or used when the baseline drug was not responded. No evidence suggested that diazepam,propranolol,mecamylamine,etc were effective. NRT is safe in pregnant women or patients with cardiovascular disease. The body weight increased when smoking cessation done. Conclusion: Smoking cessation should be encouraged and drug for smoking cessation should be promoted.