【摘要】：目的探討戒煙對煙草依賴支氣管哮喘(簡稱哮喘)患者肺功能和生活質(zhì)量的影響及伐尼克蘭的輔助戒煙作用。方法收集2014年8月—2016年4月中山大學(xué)附屬第三醫(yī)院收治的符合納入標準的44例吸煙的哮喘患者的臨床資料。根據(jù)患者干預(yù)3個月后的戒煙狀況,將其分為完全戒煙組(n=17)、部分戒煙組(n=14)和繼續(xù)吸煙組(n=13)。比較3組患者哮喘控制情況[包括醫(yī)生角度(干預(yù)后)和患者角度(干預(yù)前后),患者角度以哮喘控制測試表(ACT)評價],干預(yù)前后肺功能情況[第1秒用力呼氣末容積占預(yù)計值百分比(FEV_1%pred)、用力肺活量占預(yù)計值百分比(FVC%pred)、第1秒用力呼氣末容積占用力肺活量百分比(FEV_1/FVC)、晨間呼氣峰流速(PEFam)、夜間呼氣峰流速(PEFpm)]、生活質(zhì)量[采用哮喘生活質(zhì)量問卷簡略版本(mini AQLQ)評價],伐尼克蘭使用情況。結(jié)果 3組患者干預(yù)后哮喘控制情況(醫(yī)生角度)比較,差異有統(tǒng)計學(xué)意義(P0.05)。3組患者干預(yù)前哮喘控制情況(患者角度)比較,差異無統(tǒng)計學(xué)意義(P0.05);完全戒煙組患者干預(yù)后哮喘控制情況(患者角度)優(yōu)于繼續(xù)吸煙組和部分戒煙組(P0.05)。3組患者干預(yù)前FEV_1%pred、FVC%pred、FEV_1/FVC、PEFam、PEFpm比較,差異無統(tǒng)計學(xué)意義(P0.05);3組患者干預(yù)后FEV_1/FVC比較,差異無統(tǒng)計學(xué)意義(P0.05);完全戒煙組患者干預(yù)后FEV_1%pred、PEFpm高于繼續(xù)吸煙組(P0.05);繼續(xù)吸煙組患者干預(yù)后FVC%pred、PEFam低于部分戒煙組、完全戒煙組(P0.05);干預(yù)后部分戒煙組、完全戒煙組患者FEV_1%pred、FVC%pred、PEFam、PEFpm高于干預(yù)前(P0.05)。3組患者干預(yù)前mini AQLQ評分比較,差異無統(tǒng)計學(xué)意義(P0.05);完全戒煙組患者干預(yù)后mini AQLQ評分高于繼續(xù)吸煙組(P0.05)。3組患者伐尼克蘭使用率比較,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論伐尼克蘭輔助戒煙可增加哮喘患者戒煙率,戒煙可改善吸煙哮喘患者病情、肺功能及生活質(zhì)量。
[Abstract]:Objective to investigate the effects of smoking cessation on lung function and quality of life in patients with tobacco dependent bronchial asthma (Asthma). Methods the clinical data of 44 asthmatic patients who were admitted to the third affiliated Hospital of Sun Yat-sen University from August 2014 to April 2016 were collected. The patients were divided into complete smoking cessation group (n / 17), partial smoking cessation group (n / 14) and continuous smoking group (n / 13) according to their smoking cessation status after 3 months intervention. Three groups of patients with asthma control were compared [including doctor's angle (after intervention) and patient's angle (before and after intervention), the patient's angle was evaluated by asthma control test form (ACT), and the pulmonary function before and after intervention [forced expiratory end volume in 1 second]. Percentage of product to predicted value (FEV_1%pred), percentage of forced vital capacity to predicted value (FVC%pred), percentage of forced expiratory end-expiratory volume occupancy capacity (FEV_1/FVC), peak expiratory flow rate (PEFam),) in the morning, peak expiratory flow rate at night (PEFpm), quality of life [quality of life in asthma] Volume questionnaire brief version of (mini AQLQ) evaluation], Vannickland use. Results there were significant differences in asthma control (doctor's angle) between the three groups after intervention (P0.05). The asthma control status (patient angle) before intervention in group 3 was compared with that of the control group (P 0.05). There was no significant difference between the two groups (P0.05), the control of asthma after intervention in the complete smoking cessation group (P05) was better than that in the continued smoking group and partial smoking cessation group (P0.05). Before intervention, the FEV1predFVCpredFVCpredFVCpredFEV1 / FVC+ PEFamFamPEFFpm had no statistical significance (P0.05), and the difference was not statistically significant (P0.05). There was no significant difference between the two groups (P0.05); the FEVCpred1 PEFpm of the patients with complete smoking cessation was higher than that of the continuous smoking group (P0.05); the FVCpredPe Fam of the patients with continued smoking was lower than that of the partial smoking cessation group (P0.05); the partial smoking cessation group after intervention was lower than that of the complete smoking cessation group (P0.05), and that of the control group was lower than that of the control group (P0.05). There was no significant difference in the mini AQLQ score between the two groups before intervention (P0.05), the mini AQLQ score of the patients with complete smoking cessation after intervention was higher than that of the patients with continued smoking (P0.05), and the utilization rate of Vannickland was higher in the patients with complete smoking cessation (P0.05) than that in the patients before intervention (P0.05), the difference between the two groups was not significant (P0.05), but there was no significant difference between the two groups (P0.05). The difference was statistically significant (P0.05). Conclusion Vannickland can increase the rate of smoking cessation in asthmatic patients, and smoking cessation can improve the condition, pulmonary function and quality of life of asthmatic patients.
【作者單位】： 中山大學(xué)附屬第三醫(yī)院呼吸內(nèi)科;
【基金】：廣東省科技計劃項目(2016A020215220) 國家自然科學(xué)基金資助項目(81470220)
【分類號】：R562.25

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