Effects of different smoking cessation regimens with acupuncture and their influence factors: a multi-center randomized controlled trial

CHAI Xin1 YANG Jin-sheng2 LIU Zhao3 CHEN Feng4 YUAN Gui-hong5 WU Yuan6 ZHANG Lu7 WANG Ying-ying8

(1.School of Acupuncture & Moxibustion and Tuina, Shaanxi University of Chinese Medicine, Xianyang, China 712046)
(2.Exchange and Cooperation Center of TCM toward Taiwan, Hong Kong and Macao, National Administration of TCM, Beijing 100027)
(3.China-Japan Friendship Hospital)
(4.Wangjing Hospital of China Academy of Chinese Medical Sciences)
(5.Jintan District TCM Hospital of Changzhou City, Jiangsu Province)
(6.China Association of Acupuncture-Moxibustion)
(7.Beijing Haidian Hospital)
(8.Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700)
【Knowledge Link】abstinence syndrome

【Abstract】 Objective To evaluate the clinical effect of acupuncture on smoking cessation and abstinence symptoms and to explore the influence factors of acupuncture on smoking cessation. Methods A total of 500 subjects with tobacco dependence were randomly divided into the acupuncture group, the auricular point group, the acupuncture plus auricular point group, the transcutaneous electrical nerve stimulation group (TENS group), and the nicotine replacement therapy group (NRT group), 100 cases in each group. In the acupuncture group, needles were inserted at Baihui (GV20), Lieque (LU7), Hegu (LI4), Zusanli (ST36) and other points. The treatment was given five times a week, once a day in the first two weeks; while three times a week, once every 2 d in the 3rd to 4th weeks; twice a week, once every 3 d in the 5th to 8th weeks. In the auricular point group, the auricular pressure therapy was used at Shenmen (TF4), endocrine (CO18), subcortex (AT4), and sympathia (AH6a), three times a week. In the acupuncture + auricular point group, acupuncture and auricular pressing therapy were both adopted with the same points and manipulation as the previous two groups. Acupuncture was given three times a week and the auricular therapy was given twice a week. In the TENS group, SDZ-Ⅱ B type electric acupuncture apparatus was used to stimulate Lieque (LU7) and Zusanli (ST36), once a day. In the NRT group, the nicotine patch was used on the chest, back and the upper arms of the subjects, once a day. Eight weeks was a course of treatment for every group, and one course was applied with 16 weeks of follow-up. The objective withdrawal rate of subjects in the five groups was evaluated by the level of urine cotinine after eight weeks of treatment and during the follow-up. The subjective withdrawal rate was evaluated by the self-report of subjects in the five groups after eight weeks of treatment and during the follow-up. The withdrawal effect, and scores of the Fagerström Test for Nicotine Dependence (FTND) and Heaviness of Smoking Index (HSI) were compared among groups. A total of 20 indicators were selected as the potential influence factors. With the 72 h objective withdrawal rate based on the content of urinary cotinine after eight weeks of treatment and during the follow-up as the dependent variable, the binomial Logistic regression analysis was applied to screen out the influence factors of therapeutic effect of acupuncture on smoking cessation. Results After eight weeks of treatment, the objective withdrawal rate of subjects among groups was NRT group > acupuncture plus auricular point group > auricular point group > acupuncture group > TENS group. During the follow-up, it was in the sequence of acupuncture + auricular point group > NRT group > acupuncture group > TENS group > auricular point group, but the difference was not statistically significant (P > 0.05). After eight weeks of treatment, the subjective withdrawal rate of subjects among groups was auricular point group > TENS group > acupuncture group > acupuncture + auricular point group > NRT group. During the follow-up visit, it was in the sequence of auricular point group > TENS group > acupuncture + auricular point group > acupuncture group > NRT group. The result in the auricular point group was better than all other four groups (P < 0.05). Except the lower FTND score of the acupuncture group when comparing with the auricular point group during the follow-up (P < 0.05), differences of FTND and HSI scores in each group were not statistically significant after eight weeks of treatment and during the follow-up (P > 0.05). The regression analysis showed that the factors, including nationality, educational background, drinking frequency, FTND score before treatment, HSI score before treatment and smoking cessation for physical reason of family members, were correlated significantly with the withdrawal result after 8-week treatment (P < 0.05), while the factors, such as education background, smoking age, pre-treatment FTND score and different therapeutic methods, were correlated significantly with the withdrawal result during the follow-up (P < 0.05). Conclusion Acupuncture combined with auricular therapy can effectively reduce nicotine dependence and smoking intensity and relieve abstinence symptoms. There are many factors that affect the withdrawal effect in smoking cessation. Hence, the influence factors in smoking cessation with acupuncture should be clearly determined so as to develop the individual regimen for smoking cessation, thus improving the clinical therapeutic effect of acupuncture on smoking cessation.

【Keywords】 Smoking cessation; auricular press therapy; acupuncture and moxibustion; influence factor; nicotine dependence; randomized controlled trial (RCT);

【DOI】

【Funds】 National Special Funding Project of Science and Technology in Traditional Chinese Medicine Industry (201307014) Beijing Funding Project of Science and Technology Development in Traditional Chinese Medicine (JJ2018-97)

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(Translated by JIA RM)

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This Article

ISSN:0255-2930

CN: 11-2024/R

Vol 39, No. 12, Pages 1255-1261

December 2019

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Abstract

  • 1 Clinical information
  • 2 Treatment methods
  • 3 Efficacy observation
  • 4 Discussion
  • References