基于“5A's”模型的中医药戒烟干预效果分析及评价

Analysis and evaluation of effectiveness of traditional Chinese medicine smoking cessation intervention based on "5A's" model

  • 摘要:
    目的 评估基于“5A's”模型的中医药戒烟干预模式的效果。
    方法 纳入无锡市中医医院戒烟门诊收治的60例有戒烟意愿的烟草依赖者。干预方案融合中药茶饮(清肺戒烟茶)、针灸、耳穴贴压等中医疗法, 结合“5A's”模型(询问、建议、评估、帮助、随访)实施综合干预,随访3个月。比较干预前(基线)与干预后1周、1个月、3个月的关键指标变化,包括每日吸烟量、呼气CO值、尼古丁依赖检验量表(FTND)评分及持续戒断率(CO≤6 ppm)。
    结果 干预后3个月持续戒断率达75.0%(45/60), 显著高于自然戒断率(< 5%)。干预后各时间点每日吸烟量、呼气CO值、FTND评分均较基线显著下降(均P < 0.001), 呈时间依赖性改善。不同体质戒烟成功率存在差异,痰湿质(78.6%, 22/28)与湿热质(70.8%, 17/24)成功率较高。未报告严重不良事件。
    结论 基于“5A's”模型的中医药戒烟干预模式整合了中医体质辨证干预方法,可显著提升戒烟成功率,效果确切,安全性良好。

     

    Abstract:
    Objective To evaluate the effectiveness of a traditional Chinese medicine (TCM) smoking cessation intervention model based on the "5A's" model.
    Methods Sixty tobacco-dependent individuals with a desire to quit, treated at the smoking cessation clinic of Wuxi Hospital of Traditional Chinese Medicine were included. The intervention program integrated TCM therapies such as herbal tea (Lung-clearing Smoking Cessation Tea), acupuncture, and auricular acupressure, combined with the "5A's" model (ask, advise, assess, assist, arrange follow-up) to implement comprehensive intervention, with a follow-up period of 3 months. Changes in key indicators, including daily cigarette consumption, exhaled carbon monoxide (CO) value, Fagerström Test for Nicotine Dependence (FTND) score, and continuous abstinence rate (CO≤6 ppm), were compared before intervention (baseline) and at 1 week, 1 month, and 3 months after intervention.
    Results The continuous abstinence rate at 3 months after intervention reached 75.0% (45/60), which was significantly higher than the natural abstinence rate (< 5%). At each time point after intervention, daily cigarette consumption, exhaled CO value, and FTND score all decreased significantly compared to baseline (all P < 0.001), showing time-dependent improvement. Smoking cessation success rates varied among different constitutions, with higher success rates observed in individuals with phlegm-dampness constitution (78.6%, 22/28) and damp-heat constitution (70.8%, 17/24). No serious adverse events were reported.
    Conclusion TCM smoking cessation intervention model based on the "5A's" model integrates TCM constitution-based differentiation intervention methods, significantly improving smoking cessation success rates, with proven effectiveness and good safety.

     

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