| Objective:Chronic obstructive pulmonary disease(COPD) is one of the most common diseases of respiratory system, and cause a heavy economic burden to the family and social. It is more popular in smokers than in non-smokers. It was reported that the elderly have a long history of smoking half will develop into COPD, more than 80% of COPD-associated morbidity is attributed to tobacco smoking. Evidence Based Medicine proved that smoking cessation could improve the state of COPD patients effectively. Our study aim to improve the clinical symptoms and prevent the pulmonary function deterioration of COPD patients, and then provide the reference of preventing and treating the COPD patients by helping the smoking COPD patients to give up smoking.Methods:All the 337 subjects were recruited from the pulmonary department of Affiliated Hospital of Cheng De Medical College from September 2008 to March 2013, all the patients had long smoking history, and they were given smoking cessation intervention, and were divided into 2 groups, smoking cessation group and smoking group. When enrolling the test, all the patients were consent to fill the questionnaire. When the patients were in stable stage, some tests were given to them, including pulmonary function, clinical symptoms scores, density of exhaled CO and BODE scores. Every 3 months after the first test, all the COPD patients were recalled follow-up to review the above-mentioned indicators and recorded the smoking cessation rates. At the end of the second year, analyzed the smoking cessation rate and changes of the clinical symptoms and lung function.Results:1.Comparions of smoking cessation rate: the rate of smoking cessation was 54.30%(183), 40.35%(136), 33.23%(112), 30.86%(104), at the time of 3 month, 6month, 1year and 2 year. The rate of adhere giving up smoking was 24.63%(83), and the rate of never try to give up smoking was 38.28%(129). Older age,higher education level,higher MRC score promote smoking cessation,but women and higher smoking index disadvantage smoking cessation.2. Choose the 83 patients who adhere giving up smoking and 129 patients who never try to give up smoking, and then compare their lung function and clinical symptoms at the origin and the end of observation.2.1 Comparisons of clinical symptom scores between the two groups: At the beginning, the symptom scores were not significantly different between the two groups(p>0.05). At 1 year later and 2 year later, compared with smoking group, smoking cessation group had a better clinical symptom, the difference was statistical significance(p <0.05).1 year later the clinical symptom scores in smoking cessation group was lower then the first test, but compare the clinical symptom scores at 1 year later and 2 year later, there was no significantly different(p>0.05). 1 year later the clinical symptom scores in smoking group was higher then the first test, and 2 year later was higher then 1 year later, both the difference were statistical significant(p<0.05).2.2 Comparisons of BODE scores between the two groups: At the beginning, the BODE scores were not significantly different between the two groups(p>0.05). At 1 year later and 2 year later, compared with smoking group, smoking cessation group had a lower BODE scores, the difference was statistical significance(p<0.05).1 year later the BODE scores in smoking cessation group was significantly lower then the first test(p<0.05), but compare the BODE scores at 1 year later and 2 year later, there was no significantly different(p>0.05). 1 year later the BODE scores in smoking group was higher then the first test, and 2 year later the BODE scores was higher then 1 year later, both the difference were statistical significant(p<0.05).2.3 Comparisons of exacerbation frequency between the two groups: At 1 year later and 2 year later, compared with smoking cessation group, smoking group had more exacerbation frequency, the difference was statistical significant(p<0.05).2.4 Comparisons of FEV1 and FVC between the two groups: At the beginning, the FEV1 and FVC were not significantly different between the two groups(p>0.05). At 1 year later and 2 year later, compared with smoking group, smoking cessation group had higher FEV1 and FVC, the difference was statistical significant(p<0.05).1 year later FEV1 in smoking cessation group was significantly higher then the first test(p<0.05), but compare FEV1 at 1 year later and 2 year later, there was no significantly different(p>0.05). 1 year later and 2 year later, FEV1 in smoking cessation group were higher then the first test, but the difference were not statistically significant. 1 year later FEV1 and FVC in smoking group were lower then the first test, and 2 year later FEV1 and FVC were lower then 1 year later, all the difference were significant(p<0.05).Conclusions:1. Quitters began to relapse after 3 months smoking cessation intervention, so we should strengthen the intervention after three months. After successfully quit smoking more than one year, relapse reducing. There were many factors affected the rate of smoking cessation, and cessation programs should be developed according to the different condition of patients.2. Smoking cessation could improve the lung function and clinical symptoms in COPD patients who had smoking history. |
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