金雀花碱用于戒烟：一项文献综述与荟萃分析

Cytisine for smoking cessation: a literature review and a meta-analysis.

作者信息

Etter Jean-François

机构信息

Institute of Social and Preventive Medicine, University of Geneva, 1 rue Michel-Servet, CH-1211 Geneva 4, Switzerland.

出版信息

Arch Intern Med. 2006;166(15):1553-9. doi: 10.1001/archinte.166.15.1553.

DOI:10.1001/archinte.166.15.1553

PMID:16908787

Abstract

BACKGROUND

Cytisine is an agonist of nicotinic receptors; in particular, it binds strongly with alpha(4)beta(2) nicotinic receptors. Cytisine has been used to treat tobacco dependence for 40 years in Eastern Europe. The objective of this study was to review the literature on the effect of cytisine on smoking cessation.

METHODS

Review of PubMed, EMBASE, Psychological Abstracts, BIOSIS, Google.com, and Scholar.google.com, using the keywords cytisine, cytisin, zytisin, cytisinum, Tabex, and smoking cessation. Experts and the manufacturer of Tabex were contacted. Placebo-controlled trials were included in a meta-analysis.

RESULTS

Ten studies reported the effects of cytisine on smoking cessation, including 4 controlled studies (3 placebo controlled). Nine studies used the Bulgarian drug Tabex, containing 1.5 mg of cytisine per tablet, and one Russian study used buccal films containing either 1.5 mg of cytisine or 0.75 mg of cytisine plus 0.75 mg of anabasine. All studies were published between 1967 and 2005 in Bulgaria, Germany, Poland, and Russia. There were 4404 smokers treated with cytisine and 3518 in control conditions. The pooled odds ratio after 3 to 8 weeks in the 3 placebo-controlled trials (2 were double blind and 1 was randomized) was 1.93 (95% confidence interval, 1.21-3.06). For the 2 placebo-controlled double-blind trials with a longer follow-up, the pooled odds ratio after 3 to 6 months was 1.83 (95% confidence interval, 1.12-2.99). One placebo-controlled double-blind trial had follow-up after 2 years (odds ratio, 1.77; 95% confidence interval, 1.29-2.43). Some adverse effects were reported. Most trials were, however, of poor quality.

CONCLUSIONS

Cytisine may be effective for smoking cessation. This fact remained largely unnoticed in the English-language literature.

摘要

背景

金雀花碱是一种烟碱样受体激动剂；特别是，它与α(4)β(2)烟碱样受体紧密结合。在东欧，金雀花碱已被用于治疗烟草依赖40年。本研究的目的是回顾关于金雀花碱对戒烟效果的文献。

方法

检索PubMed、EMBASE、心理学文摘数据库、生物学文摘数据库、谷歌网站以及谷歌学术，使用关键词金雀花碱、金雀花素、异金雀花碱、金雀花碱制剂、Tabex和戒烟。联系了专家以及Tabex的制造商。纳入安慰剂对照试验进行荟萃分析。

结果

十项研究报告了金雀花碱对戒烟的影响，其中包括四项对照研究（三项安慰剂对照）。九项研究使用了保加利亚药物Tabex，每片含1.5毫克金雀花碱，一项俄罗斯研究使用了含1.5毫克金雀花碱或0.75毫克金雀花碱加0.75毫克新烟碱的口腔贴膜。所有研究于1967年至2005年间在保加利亚、德国、波兰和俄罗斯发表。有4404名吸烟者接受了金雀花碱治疗，3518名处于对照条件。三项安慰剂对照试验（两项双盲试验和一项随机试验）在3至8周后的合并比值比为1.93（95%置信区间，1.21 - 3.06）。对于两项随访时间更长的安慰剂对照双盲试验，3至6个月后的合并比值比为1.83（95%置信区间，1.12 - 2.99）。一项安慰剂对照双盲试验在2年后进行了随访（比值比，1.77；95%置信区间，1.29 - 2.43）。报告了一些不良反应。然而，大多数试验质量较差。