Bilici Mustafa, Güven Sertaç, Köşker Selcen, Şafak Ayşe, Semiz Ümit Başar
Department of Psychology, İstanbul Gelişim University, İstanbul, Turkey.
Clinic of Psychiatry, Erenköy Psychiatric Training and Research Hospital, İstanbul, Turkey.
Noro Psikiyatr Ars. 2016 Mar;53(1):28-32. doi: 10.5152/npa.2015.9887. Epub 2016 Mar 1.
The number of non-pharmacological controlled studies is insufficient in the treatment of nicotine dependence (ND). Nevertheless, non-pharmacological treatments, such as electroacupuncture (EA), are becoming increasingly popular in the treatment of ND. The aims of this study were to determine the efficacy and safety of "true EA therapy" (TEAT) compared to those of "sham EA therapy" (SEAT) in ND treatment.
Eligible patients who met the DSM-IV criteria for ND (n=450) were included in the study. This study was a double-blinded, sham-controlled clinical trial with a 4-week treatment period and 4-week follow-up conducted between June and December 2009 at a psychiatry outpatient clinic. One hundred and sixty four adult (≥18 years; 44 men, 120 women) cigarette smokers out of 450 patients who met the inclusion and exclusion criteria were enrolled in the study in a ratio of 1:1 to receive TEAT (n=84) or SEAT (n=80). Routine biochemical and hematological tests, chest X-Ray, and ECG were carried out; end-expired carbon monoxide (CO) levels were measured too. Clinical characteristics were obtained through the Fagerström Nicotine Dependence Test (FNDT), Hamilton Rating Scale for Depression (HRSD), and Hamilton Anxiety Scale (HAS). EA was carried out by a trademark device, Antismoke 3000®. Efficacy analyses were performed on "intent-to-treat analysis." Primary outcome was the differences from baseline to endpoint in mean FNDT, number of cigarettes smoked per day, and CO levels at week 4. Secondary outcomes were the same variables at week 8. These variables were assessed via analysis of covariance (ANCOVA).
Mean baseline FNDT, HRSD, HAS, and CO levels of the groups were statistically similar. TEAT and SEAT groups demonstrated no significant changes in the outcome variables and smoking cessation rates (35.7% and 30%, respectively). Of those remaining outside of the study, 8.3% were from the TEAT group and 8.7% were from the SEAT group; there was no statistical difference between the groups. The rate of treatment discontinuation was similar between the TEAT (44%) and SEAT (43.7%) groups (p>0.05). The rates of adverse events were not similar too.
This study showed that both TEAT and SEAT have similar efficacy and safety profiles in patients with ND.
在尼古丁依赖(ND)的治疗中,非药物对照研究的数量不足。然而,诸如电针(EA)等非药物治疗方法在ND治疗中越来越受欢迎。本研究的目的是确定“真电针疗法”(TEAT)与“假电针疗法”(SEAT)相比在ND治疗中的疗效和安全性。
符合DSM-IV ND标准的合格患者(n = 450)纳入本研究。本研究是一项双盲、假对照临床试验,于2009年6月至12月在一家精神科门诊进行,为期4周的治疗期和4周的随访期。450名符合纳入和排除标准的患者中的164名成年(≥18岁;44名男性,120名女性)吸烟者按1:1的比例纳入研究,接受TEAT(n = 84)或SEAT(n = 80)。进行常规生化和血液学检查、胸部X线检查和心电图检查;还测量了呼出终末一氧化碳(CO)水平。通过法格斯特罗姆尼古丁依赖测试(FNDT)、汉密尔顿抑郁评定量表(HRSD)和汉密尔顿焦虑量表(HAS)获得临床特征。电针由商标设备Antismoke 3000®进行。疗效分析采用“意向性分析”。主要结局是第4周时平均FNDT、每日吸烟量和CO水平从基线到终点的差异。次要结局是第8周时相同的变量。这些变量通过协方差分析(ANCOVA)进行评估。
两组的平均基线FNDT、HRSD、HAS和CO水平在统计学上相似。TEAT组和SEAT组在结局变量和戒烟率方面均无显著变化(分别为35.7%和30%)。在未纳入研究的患者中,8.3%来自TEAT组,8.7%来自SEAT组;两组之间无统计学差异。TEAT组(44%)和SEAT组(43.7%)的治疗中断率相似(p>0.05)。不良事件发生率也不相似。
本研究表明,TEAT和SEAT在ND患者中具有相似的疗效和安全性。