Russo Ethan, Guy Geoffrey W
GW Pharmaceuticals, Porton Down Science Park, Salisbury, Wiltshire SP4 0JQ, UK.
Med Hypotheses. 2006;66(2):234-46. doi: 10.1016/j.mehy.2005.08.026. Epub 2005 Oct 4.
This study examines the current knowledge of physiological and clinical effects of tetrahydrocannabinol (THC) and cannabidiol (CBD) and presents a rationale for their combination in pharmaceutical preparations. Cannabinoid and vanilloid receptor effects as well as non-receptor mechanisms are explored, such as the capability of THC and CBD to act as anti-inflammatory substances independent of cyclo-oxygenase (COX) inhibition. CBD is demonstrated to antagonise some undesirable effects of THC including intoxication, sedation and tachycardia, while contributing analgesic, anti-emetic, and anti-carcinogenic properties in its own right. In modern clinical trials, this has permitted the administration of higher doses of THC, providing evidence for clinical efficacy and safety for cannabis based extracts in treatment of spasticity, central pain and lower urinary tract symptoms in multiple sclerosis, as well as sleep disturbances, peripheral neuropathic pain, brachial plexus avulsion symptoms, rheumatoid arthritis and intractable cancer pain. Prospects for future application of whole cannabis extracts in neuroprotection, drug dependency, and neoplastic disorders are further examined. The hypothesis that the combination of THC and CBD increases clinical efficacy while reducing adverse events is supported.
本研究考察了四氢大麻酚（THC）和大麻二酚（CBD）的生理及临床效应的现有知识，并阐述了将它们组合用于药物制剂的基本原理。探讨了大麻素和香草酸受体效应以及非受体机制，例如THC和CBD作为独立于环氧化酶（COX）抑制作用的抗炎物质的作用能力。已证明CBD可拮抗THC的一些不良效应，包括中毒、镇静和心动过速，同时自身具有镇痛、止吐和抗癌特性。在现代临床试验中，这使得能够给予更高剂量的THC，为基于大麻提取物治疗多发性硬化症的痉挛、中枢性疼痛和下尿路症状以及睡眠障碍、周围神经性疼痛、臂丛神经撕脱症状、类风湿性关节炎和顽固性癌痛的临床疗效和安全性提供了证据。进一步研究了全大麻提取物在神经保护、药物依赖和肿瘤性疾病方面未来应用的前景。THC和CBD组合可提高临床疗效同时减少不良事件这一假设得到了支持。
