澳大利亚全科医生学会《全科医学的预防活动指南》解读与讨论：对过度饮酒者的机会式发现策略和简短施助方式

doi:10.12114/j.issn.1007-9572.2025.0450

中国全科医学 ›› 2026, Vol. 29 ›› Issue (08): 974-981.DOI: 10.12114/j.issn.1007-9572.2025.0450

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澳大利亚全科医生学会《全科医学的预防活动指南》解读与讨论：对过度饮酒者的机会式发现策略和简短施助方式

李安春¹, 何智光², 邱珊娇³, 陈章⁴, 黄文静⁵^,^*()

1．518003广东省深圳市，罗湖医院集团笋岗街道社区健康服务中心
2．518003广东省深圳市，罗湖医院集团金鹏社区健康服务中心
3．518003广东省深圳市，罗湖医院集团黄贝岭社区健康服务中心
4．518003广东省深圳市，罗湖医院集团南湖街道社区健康服务中心
5．518003广东省深圳市，罗湖医院集团居民健康管理中心（社管中心）

收稿日期:2025-12-10 修回日期:2026-01-15 出版日期:2026-03-15 发布日期:2026-02-03
通讯作者: 黄文静
作者贡献：
李安春负责研究的总体构思与设计、资料整合、论文撰写及修订，对文章的学术内容与整体质量负责；黄文静负责研究的构思、论文修订；何智光、邱珊娇、陈章参与研究思路讨论，协助文献检索与资料整理，对论文形成提供支持与修订意见。所有作者已阅读并批准提交的最终稿，并对研究内容的真实性和完整性负责。

Opportunistic Screening Strategies and Brief Help Method for General Practice Patients with Excessive Drinking Behaviour: Insights from the RACGP Guidelines for Preventive Activities

LI Anchun¹, HE Zhiguang², QIU Shanjiao³, CHEN Zhang⁴, HUANG Wenjing⁵^,^*()

1. Sungang Subdistrict Community Health Centre of Luohu Hospital Group, Shenzhen 518003, China
2. Jinpeng Community Health Centre of Luohu Hospital Group, Shenzhen 518003, China
3. Huangbeiling Community Health Centre of Luohu Hospital Group, Shenzhen 518003, China
4. Nanhu Subdistrict Community Health Centre of Luohu Hospital Group, Shenzhen 518003, China
5. Resident Health Management Center, Luohu Hospital Group, Shenzhen 518003, China

Received:2025-12-10 Revised:2026-01-15 Published:2026-03-15 Online:2026-02-03
Contact: HUANG Wenjing

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摘要/Abstract

摘要： 过度饮酒是造成我国严重疾病负担的主要因素之一。然而，在我国基层医疗服务中对酒精使用问题的识别和干预普遍不足，缺乏指导和支持全科医生在基层诊疗中进行过度饮酒筛查和预防活动的建议。本文对澳大利亚全科医生学会（RACGP）发布的《全科医学的预防活动指南》（简称"红皮书"）第十版中关于过度饮酒的建议进行了解读与分析，讨论了其核心建议在中国可能面临的实施障碍。笔者认为，全科医学服务中不适宜进行酒精使用的全面筛查，而基于临床线索触发的机会性筛查策略在中国更具现实可行性。为此，借鉴红皮书的建议和考虑我国基层医疗的实际背景，将过度饮酒的机会式筛查和简短干预纳入公共卫生服务体系中（家庭医生签约服务），通过家医团队协作服务和激励措施为患者赋能，将"发现和帮助"过度饮酒者的做法纳入全科医生的日常实践。

关键词: 饮酒, 酒精使用障碍识别测试, 酒精相关危害, 初级卫生保健, 全科医生

Abstract:

Hazardous alcohol use is a major contributor to the burden of disease in China. However, in primary care settings, alcohol-related problems are often under recognized and under treated, and there is a lack of practical guidance to support general practitioners in screening for and preventing excessive drinking in routine care. This paper interprets and analyzes the latest recommendations on hazardous alcohol use from the Royal Australian College of General Practitioners (RACGP) Guidelines for preventive activities in general practice ("Red Book"), and discusses potential barriers to implementing these core recommendations in the Chinese context. We argue that, compared with universal screening, an opportunistic screening strategy triggered by clinical cues is more feasible and realistic in China. Drawing on the Red Book recommendations and considering the realities of primary care in China, we propose integrating opportunistic screening and brief interventions for excessive drinking into the public health service system (family doctor contract services). Through team based family doctor services, incentive mechanisms, and patient empowerment, the identification and management of hazardous drinkers can be embedded into the routine practice of general practitioners.

Key words: Alcohol drinking, Alcohol use disorder identification test, Alcohol-related harm, Primary health care, General practitioner

李安春,何智光,邱珊娇,等. 澳大利亚全科医生学会《全科医学的预防活动指南》解读与讨论：对过度饮酒者的机会式发现策略和简短施助方式[J]. 中国全科医学, 2026, 29(08): 974-981. DOI: 10.12114/j.issn.1007-9572.2025.0450.
LI Anchun,HE Zhiguang,QIU Shanjiao, et al. Opportunistic Screening Strategies and Brief Help Method for General Practice Patients with Excessive Drinking Behaviour: Insights from the RACGP Guidelines for Preventive Activities[J]. Chinese General Practice, 2026, 29(08): 974-981. DOI: 10.12114/j.issn.1007-9572.2025.0450.

图/表 2

参考文献 26

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建议	建议强度	频率
1.对18岁及以上的成年人（包括孕妇）进行不健康饮酒的筛查	有条件的建议	每2年1次（基于临床实践的建议）
2.可使用酒精使用障碍的识别测试-酒精消耗（AUDIT-C）工具进行评估
3.为有饮酒风险或危险的人提供简短的行为咨询干预，以减少不健康饮酒

建议	建议强度	频率
1.对18岁及以上的成年人（包括孕妇）进行不健康饮酒的筛查	有条件的建议	每2年1次（基于临床实践的建议）
2.可使用酒精使用障碍的识别测试-酒精消耗（AUDIT-C）工具进行评估
3.为有饮酒风险或危险的人提供简短的行为咨询干预，以减少不健康饮酒

建议	建议强度	频率
1.建议健康男性和女性每周饮酒量不超过10个标准酒精量^a，任何1 d不超过4个标准酒精量^a，以降低酒精相关疾病和伤害的危害风险	建议（强烈）	机会性
2.建议儿童和年龄<18岁的人不要饮酒，以降低受伤和其他健康危害的风险	建议（强烈）	不适用
3.建议妊娠或计划妊娠的妇女不要饮酒，以防止酒精对胎儿造成伤害	建议（强烈）	机会性
4.建议哺乳期妇女不饮酒对婴儿最安全	建议（强烈）	机会性
5.应向有饮酒风险的人提供关于饮酒风险的简短建议高危饮酒模式在以下人群中更为常见： ·18~25岁的年轻人 ·年龄>60岁的人 ·有精神或身体健康问题的人 ·有酒精依赖家族史的人 ·使用违禁药物或服用与酒精有相互作用的药物的人	基于临床实践的建议	不适用

建议	建议强度	频率
1.建议健康男性和女性每周饮酒量不超过10个标准酒精量^a，任何1 d不超过4个标准酒精量^a，以降低酒精相关疾病和伤害的危害风险	建议（强烈）	机会性
2.建议儿童和年龄<18岁的人不要饮酒，以降低受伤和其他健康危害的风险	建议（强烈）	不适用
3.建议妊娠或计划妊娠的妇女不要饮酒，以防止酒精对胎儿造成伤害	建议（强烈）	机会性
4.建议哺乳期妇女不饮酒对婴儿最安全	建议（强烈）	机会性
5.应向有饮酒风险的人提供关于饮酒风险的简短建议高危饮酒模式在以下人群中更为常见： ·18~25岁的年轻人 ·年龄>60岁的人 ·有精神或身体健康问题的人 ·有酒精依赖家族史的人 ·使用违禁药物或服用与酒精有相互作用的药物的人	基于临床实践的建议	不适用

澳大利亚全科医生学会《全科医学的预防活动指南》解读与讨论：对过度饮酒者的机会式发现策略和简短施助方式

Opportunistic Screening Strategies and Brief Help Method for General Practice Patients with Excessive Drinking Behaviour: Insights from the RACGP Guidelines for Preventive Activities

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