Objective: To compare the efficacy of different acupuncture frequencies in tobacco-dependent patients and explore the impact of nicotine metabolite rate (NMR) on smoking cessation in the intervention with acupuncture.
Methods: A total of 120 cases of tobacco-dependent patients were randomly divided into a high-frequency group (60 cases, 12 cases dropped off) and a low-frequency group (60 cases, 6 cases dropped off). In the two groups, smoking cessation counseling was provided prior to acupuncture. Acupuncture was applied to Baihui (GV 20), Lieque (LU 7), Zusanli (ST 36), etc. Additionally, electric stimulation was added at Lieque (LU 7) and Zusanli (ST 36), with continuous wave, 15 Hz in frequency. The duration of treatment was 8 weeks in either group. In the high-frequency group, the treatment was given 5 times weekly from week 1 to week 4, and was 3 times weekly from week 5 to week 8. In the low-frequency group, the treatment was given 3 times weekly from week 1 to week 4, and was twice a week from week 5 to week 8. The immediate withdrawal rate, persistent withdrawal rate, the score of Fagerstrőm test for nicotine dependence (FTND) before and after treatment, as well as the score of Minnesota nicotine withdrawal scale (MNWS) in 1 and 8 weeks of treatment were compared among the patients with high and low NMR between the two groups separately. The Logistic regression analysis was used to screen the influencing factors of smoking cessation in the intervention with acupuncture.
Results: After treatment, there was no statistical significance of the differences in the immediate withdrawal rate (35.4% [17/48] vs 29.6% [16/54]) and the persistent withdrawal rate (33.3% [16/48] vs 25.9% [14/54]) between the high-frequency group and the low-frequency group (P>0.05). The difference in withdrawal rate had no statistical significance between high and low NMR patients (P>0.05). FTND scores after treatment were lower than those before treatment (P<0.01) and MNWS scores were lower than those in 1 week of treatment (P<0.01) in the two groups. However, the differences had no statistical significance between the two groups and between the patients with high NMR and low NMR (P>0.05). Age, education level and NMR were the influencing factors of smoking cessation in the intervention with acupuncture (P<0.05).
Conclusion: Acupuncture with different frequencies has no obvious impact on the efficacy in tobacco-dependent patients. The lower nicotine metabolite rate in individuals, the better efficacy of acupuncture. The smokers with high nicotine metabolite rate may obtain a better effect of cessation in the high-frequency intervention with acupuncture.
目的：比较不同频次针刺治疗烟草依赖患者的疗效，并探讨尼古丁代谢率（NMR）对针刺戒烟效果的影响。方法：将120例烟草依赖患者随机分为针刺高频组（60例，脱落12例）与针刺低频组（60例，脱落6例）。两组在针刺治疗前均进行戒烟辅导，针刺穴取百会、列缺、足三里等，并于列缺和足三里行电针治疗（连续波，频率15 Hz），均治疗8周，其中针刺高频组第1~4周每周治疗5次，第5~8周每周治疗3次；针刺低频组第1~4周每周治疗3次，第5~8周每周治疗2次。比较两组高、低NMR患者点戒断率、持续戒断率及治疗前后烟草依赖评估量表（FTND）评分与治疗1、8周后明尼苏达尼古丁戒断症状量表（MNWS）评分；采用Logistic回归分析筛选针刺戒烟的影响因素。结果：治疗后，针刺高频组、针刺低频组点戒断率[35.4%（17/48）vs 29.6%（16/54）]及持续戒断率[33.3%（16/48）vs 25.9%（14/54）]比较，差异均无统计学意义（P>0.05）；高、低NMR患者戒断率比较差异无统计学意义（P>0.05）。两组治疗后FTND评分均较治疗前降低（P<0.01），MNWS评分均较治疗1周后降低（P<0.01），但组间及高、低NMR患者间比较差异无统计学意义（P>0.05）；年龄、教育程度、NMR为针刺戒烟疗效的影响因素（P<0.05）。结论：不同频次针刺治疗烟草依赖者疗效未见明显差异，个体NMR越低，针刺疗效更佳，高NMR吸烟者接受高频次的针刺治疗戒烟效果可能更优。.
Keywords: acupuncture; nicotine metabolite rate; smoking cessation; tobacco-dependence; withdrawal rate.