

浏览全部资源
扫码关注微信
1.湖南中医药大学研究生院,湖南省长沙市雨花区砂子塘街道韶山中路113号,410208
2.湖南中医药 大学第一附属医院
Received:22 September 2021,
Revised:2021-11-30,
Published:17 June 2022
移动端阅览
袁杨阳,章薇,匡泓俊等.针灸戒烟随机对照试验中临床结局指标的文献研究[J].中医杂志,2022,63(12):1179-1185.
YUAN Yangyang,ZHANG Wei,KUANG Hongjun,et al.Literature Analysis of Clinical Outcome Indicators in Randomized Controlled Trials of Acupuncture for Smoking Cessation[J].Journal of Traditional Chinese Medicine,2022,63(12):1179-1185.
袁杨阳,章薇,匡泓俊等.针灸戒烟随机对照试验中临床结局指标的文献研究[J].中医杂志,2022,63(12):1179-1185. DOI: 10.13288/j.11-2166/r.2022.12.014.
YUAN Yangyang,ZHANG Wei,KUANG Hongjun,et al.Literature Analysis of Clinical Outcome Indicators in Randomized Controlled Trials of Acupuncture for Smoking Cessation[J].Journal of Traditional Chinese Medicine,2022,63(12):1179-1185. DOI: 10.13288/j.11-2166/r.2022.12.014.
目的
2
分析针灸戒烟随机对照试验(RCT)的临床结局指标,为构建针灸戒烟临床试验的核心结局指标集提供基础。
方法
2
计算机检索中国知网(CNKI)、万方数据(WanFang)、维普数据库(VIP)、PubMed、Cochrane library、Web of Science 6个数据库,检索时限为1990年1月至2021年5月,收集数据库中收录的针灸戒烟的临床RCT,对结局指标相关资料(包括结局指标、疗程与随访情况)进行提取,将结局指标按照功能属性分类后进行频次的描述性分析,并对结局指标的组合使用情况进行分析。
结果
2
纳入46篇文献,其中中文24篇、英文22篇,涉及的结局指标为40种(227次),单个文献的结局指标为1~11个,平均每个研究结局指标4.93个,仅有19篇(中文7篇,英文12篇)研究明确指出试验的主要结局指标和次要结局指标。46个RCT的临床结局指标主要分为7类,分别为临床疗效评价(75次、33.0%)、症状或体征(73次、32.2%)、理化检查(46次、20.3%)、安全性事件(26次、11.5%)、中医证候(4次、1.8%)、经济学评估(2次、0.9%)、生活质量(1次、0.4%)。有6篇研究只使用了1类指标,12篇研究使用了2类指标,8篇研究使用了3类指标,14篇研究使用了4类指标,6篇研究使用了5类指标。纳入文献研究的疗程为3天~10周。纳入46篇文献的随访报告率为71.7%(33篇),随访时间≥3个月的中文文献10篇(62.5%),英文文献14篇(82.4%)。
结论
2
针灸戒烟RCT结局指标的选择较丰富,在症状体征、理化检查、生活质量等方面均有涉及,但仍存在结局指标主次不分、指标选择与组合差异性大、缺乏中医治疗特色指标的问题。
Objective
2
To analyze the outcome indicators in the randomized controlled trials (RCTs) of acupuncture for smoking cessation, so as to provide a basis for the establishment of the core outcome set of acupuncture for smoking cessation.
Methods
2
The RCTs of acupuncture for smoking cessation were collected through searching of the six electronic databases such as CNKI, Wanfang, VIP, PubMed, Cochrane Library and Web of Science from January 1990 to May 2021. The data on outcome indicators, treatment course and follow-up status were extracted. The outcome indicators were classified according to the functional attribute for descriptive analysis on frequency, and the combination of outcome indicators was analyzed.
Results
2
Finally, 46 articles (24 in Chinese and 22 in English) were included, involving 40 outcome indicators with frequency of 227. With a minimum of one and a maximum of 11 outcome indicators per study, the average number was 4.93. Only 19 studies (7 in Chinese and 12 in English) clearly defined the primary and secondary outcomes. The outcome indicators in the 46 RCTs were mainly divided into 7 types, including clinical effect (75 times, 33.0%), symptoms and signs (73 times, 32.2%), physical and chemical examination (46 times, 20.3%), safety events (26 times, 11.5%), traditional Chinese medicine (TCM) syndromes (4 times, 1.8%), economic evaluation (2 times, 0.9%), and quality of life (1 time, 0.4%). Six studies used only one type of the outcome indicators, while 12 studies used two types, and 8 studies used three types; 14 studies used four types, and six studies used five types of outcome indicators. The treatment duration of the included studies ranged from 3 days to 10 weeks. The reporting rate of the follow-up was 71.7% (33/46), and the number of studies with follow-up ≥3 months was 10 in Chinese (62.5%) and 14 in English (82.4%).
Conclusion
2
The outcome indicators in the RCTs of smoking cessation by acupuncture are varied, involving symptoms and signs, physical and chemical examination, quality of life and the others. However, there are still some problems, such as unclear definition of primary and secondary outcome indicators, significant difference in the selection and combination of the outcome indicators, and lack of TCM features.
王辰 , 肖丹 , 池慧 . 《中国吸烟危害健康报告2020》概要 [J]. 中国循环杂志 , 2021 , 36 ( 10 ): 937 - 952 .
张明妍 , 李凯 , 蔡慧姿 . 临床试验核心指标集研究发展概况及其在中医药领域的关键问题 [J]. 中医杂志 , 2021 , 62 ( 2 ): 108 - 113 .
彭江华 , 徐丽霞 , 夏雪 . 针刺戒烟临床疗效观察对比分析 [J]. 中国保健营养 , 2020 , 30 ( 26 ): 310 - 311 .
黎宏颖 , 何玮 . 穴位埋线与盐酸安非他酮缓释片治疗烟草依赖对照研究 [J]. 中国针灸 , 2019 , 39 ( 4 ): 384 - 388 .
何蕙均 . 火针对戒烟疗效的临床研究 [D]. 广州 : 广州中医药大学 , 2019 .
刘谈雅 . 中药戒烟巴布贴干预烟草依赖(痰瘀互结证)临床疗效及安全性评价研究 [D]. 沈阳 : 辽宁中医药大学 , 2019 .
秦一冰 , 曲妮妮 , 郑忻 , 等 . 中药戒烟巴布贴联合针刺治疗烟草依赖(痰瘀互结证)临床观察 [J]. 中华中医药杂志 , 2020 , 35 ( 11 ): 5868 - 5872 .
郑忻 , 曲妮妮 , 马丽佳 , 等 . 中药戒烟贴联合“5A”方案对烟草依赖人群(痰瘀互结证)干预临床研究 [J]. 辽宁中医药大学学报 , 2019 , 21 ( 3 ): 113 - 116 .
王莹莹 , 刘朝 , 吴远 , 等 . 针刺戒烟的随机对照研究 [J]. 北京中医药大学学报 , 2018 , 41 ( 7 ): 605 - 610 .
赵红军 , 任晓岚 , 常旭红 , 等 . 自制中药敷贴穴位贴敷戒烟效果研究 [J]. 甘肃中医药大学学报 , 2018 , 35 ( 1 ): 77 - 80 .
张音 . 针刺(结合揿针)治疗戒烟综合征30例临床观察 [J]. 黑龙江中医药 , 2017 , 46 ( 2 ): 60 .
李博灵 . 针刺神门、偏历、膻中组穴戒烟临床疗效观察 [D]. 北京 : 中国中医科学院 , 2016 .
孙维旭 . 中药戒烟贴对“尼古丁依赖症”复吸率的影响 [J]. 光明中医 , 2016 , 31 ( 3 ): 456 - 457 .
张欣 . 肝经子母配穴针刺法治疗肝郁气滞型烟草依赖的临床观察 [D]. 哈尔滨 : 黑龙江中医药大学 , 2016 .
梁伟林 . 戒烟综合征针刺的临床研究 [D]. 广州 : 广州中医药大学 , 2013 .
王伟华 , 宋宇昕 . 针刺加艾灸戒烟疗效的临床试验 [J]. 上海针灸杂志 , 2013 , 32 ( 4 ): 287 - 288 .
郭宝 , 宫莉莉 . 耳穴贴压联合“5A”法对心绞痛吸烟患者进行戒烟干预的疗效 [J]. 中国医药指南 , 2020 , 18 ( 22 ): 153 - 154 .
柴欣 , 杨金生 , 刘朝 , 等 . 不同针灸戒烟方案戒断效果及疗效影响因素:多中心随机对照研究 [J]. 中国针灸 , 2019 , 39 ( 12 ): 1255 - 1261 .
彭子郡 . 针刺加耳穴按压法戒除烟瘾的临床疗效观察和成本效果比分析 [D]. 北京 : 北京中医药大学 , 2015 .
吴远 . 针灸戒烟临床疗效观察研究 [D]. 北京 : 中国中医科学院 , 2015 .
刘丹 , 邵滢如 , 刘芳 . 针刺配合耳穴贴压改善戒烟后烟草依赖症状的临床研究 [J]. 上海针灸杂志 , 2015 , 34 ( 7 ): 629 - 631 .
储纯 . 穴位补泻在临床戒烟治疗中的应用研究 [D]. 南京 : 南京中医药大学 , 2013 .
王晓军 , 徐斌 , 李继文 , 等 . 贴敷茶对戒烟疗效观察 [J]. 陕西中医 , 2013 , 34 ( 4 ): 430 - 433 .
黄晔 . 烟三针结合耳穴贴压治疗尼古丁依赖的临床观察 [D]. 广州 : 广州中医药大学 , 2012 .
周菊华 , 王柔昉 . 电针配合磁珠耳压戒烟疗效观察 [J]. 南京中医药大学学报 , 2010 , 26 ( 1 ): 79 - 80 .
韩颖 . 针刺配合耳穴贴压治疗戒烟戒断综合征42例 [J]. 针灸临床杂志 , 2006 , 22 ( 11 ): 16 .
CHAE Y , PARK H , KANG O , et al . Acupuncture attenuates autonomic responses to smoking-related visual cues [J]. Complement Ther Med , 2010 , 19 ( 1 ): S1 - S7 .
HYUN M , LEE M S , KANG K , et al . Body acupuncture for nicotine withdrawal symptoms: a randomized placebo-controlled trial [J]. Evid Based Complement Alternat Med , 2010 , 7 ( 2 ): 233 - 238 .
CLAVEL-CHAPELON F , PAOLETTI C , BENHAMOU S . Smoking cessation rates 4 years after treatment by ni-cotine gum and acupuncture [J]. Prev Med , 1997 , 26 ( 1 ): 25 - 28 .
WANG Y , WANG Y , YEH M . Combining education with auricular acupressure to facilitate smoking cessation in young adults [J]. Holist Nurs Pract , 2019 , 33 ( 4 ): 230 - 236 .
LEE EJ . Auricular acupressure and positive group psychotherapy with motivational interviewing for smoking cessation [J]. Holist Nurs Pract , 2019 , 33 ( 4 ): 214 - 221 .
LEE EJ . The effect of auricular acupressure and positive group psychotherapy with motivational interviewing for smoking cessation in Korean adults [J]. Holist Nurs Pract , 2020 , 34 ( 2 ): 113 - 120 .
HYUN S , HUH H , KANG NG . Effectiveness of auricular acupuncture combined with nicotine replacement therapy for smoking cessation [J]. Tob Induc Dis , 2018 , 16 : 40 . doi: 10.18332/tid/94328 http://dx.doi.org/10.18332/tid/94328 .
BILICI M , GUVEN S , KOSKER S , et al . Electroacupuncture therapy in nicotine dependence: a double blind,sham-controlled study [J]. Noro Psikiyatr Ars , 2016 , 53 ( 1 ): 28 - 32 .
ZHANG AL , DI YM , WORSNOP C , et al . Ear acupressure for smoking cessation: a randomised controlled trial [J]. Evid Based Complement Alternat Med , 2013 , 2013 : 1 - 8 . doi: 10.1155/2013/637073 http://dx.doi.org/10.1155/2013/637073 .
FRITZ DJ , CARNEY RM , STEINMEYER B , et al . The efficacy of auriculotherapy for smoking cessation: a randomized,placebo-controlled trial [J]. J Am Board Fam Med , 2013 , 26 ( 1 ): 61 - 70 .
YEH M , CHANG C , CHU N , et al . A six-week acupoint stimulation intervention for quitting smoking [J]. Am J Chin Med , 2012 , 37 ( 5 ): 829 - 836 .
WU T , CHEN F , LIU J , et al . A randomized controlled clinical trial of auricular acupuncture in smoking cessation [J]. J Chin Med Assoc , 2007 , 70 ( 8 ): 331 - 338 .
WHITE AR , MOODY RC , CAMPBELL JL . Acupressure for smoking cessation:a pilot study [J]. BMC Complement Altern Med , 2007 , 8 . doi: 10.1186/1472-6882-7-8 http://dx.doi.org/10.1186/1472-6882-7-8 .
BIER ID , WILSON J , STUDT P , et al . Auricular acupuncture,education,and smoking cessation: a randomized,sham-controlled trial [J]. Am J Public Health , 2002 , 92 ( 10 ): 1642 - 1647 .
HE D , MEDBØ JI , HØSTMARK AT . Effect of acupuncture on smoking cessation or reduction: an 8-month and 5-year follow-up study [J]. Prev Med , 2001 , 33 ( 5 ): 364 - 372 .
YIMING C , CHANGXIN Z , UNG WS , et al . Laser acupuncture for adolescent smokers:a randomized double-blind controlled trial [J]. Am J Chin Med , 2000 , 28 ( 3/4 ): 443 - 449 .
WHITE AR , RESCH K , ERNST E . Randomized trial of acupuncture for nicotine withdrawal symptoms [J]. Arch Intern Med , 1998 , 158 ( 20 ): 2251 .
GEORGIOU AJ , SPENCER CP , DAVIES GK , et al . Electrical stimulation therapy in the treatment of cigarette smoking [J]. J Subst Abuse Treat , 1998 , 10 ( 3 ): 265 - 274 .
WAITE NR , CLOUGH JB . A single-blind,placebo-controlled trial of a simple acupuncture treatment in the cessation of smoking [J]. Br J Gen Pract , 1998 , 48 ( 433 ): 1487 - 1490 .
JANG S , LEE JA , JANG B , et al . Clinical effectiveness of traditional and complementary medicine interventions in combination with nicotine replacement therapy on smoking cessation: a randomized controlled pilot trial [J]. J Altern Complement Med , 2019 , 25 ( 5 ): 526 - 534 .
WANG Y , LIU Z , WU Y , et al . Efficacy of acupuncture is noninferior to nicotine replacement therapy for tobacco cessation: results of a prospective,randomized,active-controlled open-label trial [J]. Chest , 2018 , 153 ( 3 ): 680 - 688 .
HE D , BERG JE , HOSTMARK AT . Effects of acupuncture on smoking cessation or reduction for motivated smokers [J]. Prev Med , 1997 , 26 ( 2 ): 208 - 214 .
VELICER WF , PROCHASKA JO , ROSSI JS . Assessing outcome in smoking cessation studies [J]. Psychol Bull , 1992 , 111 ( 1 ): 23 - 41 .
郭新峰 , 赖世隆 , 梁伟雄 . 中医药临床疗效评价中结局指标的选择与应用 [J]. 广州中医药大学学报 , 2002 , 19 ( 4 ): 251 - 255 .
肖丹 , 褚水莲 , 景行 . 戒烟治疗成功标准的探讨 [J]. 中华结核和呼吸杂志 , 2011 , 34 ( 4 ): 316 - 317 .
刘朝 , 吴远 , 杨金生 . 国内外戒烟临床随机对照试验结局指标报告文献分析 [J]. 中国循证医学杂志 , 2015 , 15 ( 6 ): 730 - 734 .
李慧敏 , 熊兴江 , 胡瑞学 . 中医药治疗急性心肌梗死随机对照试验结局指标的现状分析 [J]. 中医杂志 , 2021 , 62 ( 5 ): 405 - 413 .
孙亚男 , 刘雅莉 , 郭俊明 . 体现中医药干预特色的结局指标集的构建 [J]. 中医杂志 , 2021 , 62 ( 13 ): 1134 - 1137 .
0
Views
2
下载量
5
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010102007558号