Mi Qindong, Zhao Xiaolong, Zhang Zhijun, Bao Fei
Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Tob Induc Dis. 2025 Feb 10;23. doi: 10.18332/tid/200550. eCollection 2025.
This study aims to systematically evaluate the efficacy and safety of auricular acupuncture-related therapies (AARTs) in managing nicotine dependence (ND).
We searched eight databases from their inception through December 2024 and screened randomized controlled trials (RCTs) evaluating AART for ND. The primary outcome was the ND cessation rate. We assessed study quality using the ROB-2 tool and applied the GRADE approach to determine the certainty or quality of of evidence.
Nine RCTs involving 1032 patients were analyzed. Meta-analysis results indicate that AART significantly reduces the Minnesota Nicotine Withdrawal Scale score (MNWS) in ND patients compared to nicotine replacement therapy (NRT) (mean difference, MD=1.47; 95% CI: 0.06-2.88, p<0.05). However, no significant differences were observed in ND point cessation rate, Fagerström test for nicotine dependence score (FTND), Hamilton Anxiety Scale score (HAMA), daily smoking volume, or exhaled CO levels between AART and NRT. Notably, AART was associated with a lower incidence of adverse events compared to NRT (relative risk, RR=0.15; 95% CI: 0.04-0.56, p<0.01). There were also no significant differences in the ND point cessation rate between auricular-plaster therapy (APT), body acupuncture (BA), and the combination of APT and BA.
AART is effective in improving ND, showing greater efficacy in reducing MNWS and enhanced safety compared to NRT. Given the limited number of studies, the optimal AART regimen remains undetermined. Further research is needed to confirm and refine these findings.
本研究旨在系统评价耳针相关疗法（AARTs）治疗尼古丁依赖（ND）的疗效和安全性。
我们检索了8个数据库，检索时间从建库至2024年12月，并筛选了评估AART治疗ND的随机对照试验（RCTs）。主要结局是ND戒断率。我们使用ROB-2工具评估研究质量，并采用GRADE方法确定证据的确定性或质量。
分析了9项涉及1032例患者的RCTs。荟萃分析结果表明，与尼古丁替代疗法（NRT）相比，AART显著降低了ND患者的明尼苏达尼古丁戒断量表评分（MNWS）（平均差，MD = 1.47；95%置信区间：0.06 - 2.88，p < 0.05）。然而，在ND点戒断率、尼古丁依赖Fagerström测试评分（FTND）、汉密尔顿焦虑量表评分（HAMA）、每日吸烟量或呼出CO水平方面，AART与NRT之间未观察到显著差异。值得注意的是，与NRT相比，AART的不良事件发生率较低（相对风险，RR = 0.15；95%置信区间：0.04 - 0.56，p < 0.01）。耳穴贴压疗法（APT）、体针疗法（BA）以及APT与BA联合治疗之间的ND点戒断率也没有显著差异。
AART在改善ND方面有效，与NRT相比，在降低MNWS方面显示出更大的疗效且安全性更高。鉴于研究数量有限，最佳的AART方案尚未确定。需要进一步的研究来证实和完善这些发现。
