Dept of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands.
Eur Respir J. 2013 Mar;41(3):727-34. doi: 10.1183/09031936.00014012. Epub 2012 Aug 30.
Smoking cessation is the cornerstone of treatment of chronic obstructive pulmonary disease (COPD) patients. This systematic review evaluates the effectiveness of behavioural and pharmacological smoking cessation strategies in COPD patients. MEDLINE was searched from January 2002 to October 2011. Randomised controlled trials evaluating the effect of smoking cessation interventions for COPD patients, published in English, were selected. The methodological quality of included trials was assessed using the Delphi list by two reviewers independently. The relative risks of smoking cessation due to the intervention, compared with controls, were calculated. Eight studies met the inclusion criteria. Heterogeneity was observed for study population, the intervention strategy, the follow-up period and the outcome. According to the Delphi list methodological quality scores, five studies were considered to be of acceptable quality. Pharmacological therapy combined with behavioural counselling was more effective than each strategy separately. In COPD patients, the intensity of counselling did not seem to influence the results, nor did the choice of drug therapy make a difference. This systematic review makes clear that in COPD patients, pharmacological therapy combined with behavioural counselling is more effective than each strategy separately. Neither the intensity of counselling nor the type of anti-smoking drug made a difference.
戒烟是治疗慢性阻塞性肺疾病（COPD）患者的基石。本系统评价评估了行为和药物戒烟策略在 COPD 患者中的有效性。从 2002 年 1 月到 2011 年 10 月，我们对 MEDLINE 进行了检索。选择了评估 COPD 患者戒烟干预效果的随机对照试验，这些试验以英文发表。两位评审员使用 Delphi 清单独立评估纳入试验的方法学质量。计算了干预措施与对照组相比导致戒烟的相对风险。有 8 项研究符合纳入标准。研究人群、干预策略、随访期和结果存在异质性。根据 Delphi 清单的方法学质量评分，有 5 项研究被认为具有可接受的质量。药物治疗联合行为咨询比每种策略单独使用更有效。在 COPD 患者中，咨询的强度似乎不会影响结果，药物治疗的选择也没有区别。本系统评价清楚地表明，在 COPD 患者中，药物治疗联合行为咨询比每种策略单独使用更有效。咨询的强度和戒烟药物的类型都没有区别。
