Curtis Adrienne, Clarke Carl E, Rickards Hugh E
Neuropsychiatry, Birmingham and Solihull Mental Health Trust, Birmingham, UK.
Cochrane Database Syst Rev. 2009 Oct 7;2009(4):CD006565. doi: 10.1002/14651858.CD006565.pub2.
Gilles de la Tourette Syndrome (GTS) is a developmental neuropsychiatric disorder characterised by the presence of chronic motor and phonic tics. Drugs currently used in the treatment of GTS either lack efficacy or are associated with intolerable side effects. There is some anecdotal and experimental evidence that cannabinoids may be effective in treating tics and compulsive behaviour in patients with GTS. There are currently no systematic Cochrane reviews of treatments used in GTS. There is one other Cochrane review being undertaken at present, on the use of fluoxetine for tics in GTS.
To evaluate the efficacy and safety of cannabinoids as compared to placebo or other drugs in treating tics, premonitory urges and obsessive compulsive symptoms (OCS), in patients with GTS.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (in The Cochrane Library Issue 4 2008) , MEDLINE (January 1996 to date), EMBASE (January 1974 to date), PsycINFO (January 1887 to date), CINAHL (January 1982 to date), AMED (January 1985 to date), British Nursing Index (January 1994 to date) and DH DATA (January 1994 to date). We also searched the reference lists of located trials and review articles for further information.
We included randomised controlled trials (RCTs) comparing any cannabinoid preparation with placebo or other drugs used in the treatment of tics and OCS in patients with GTS.
Two authors abstracted data independently and settled any differences by discussion.
Only two trials were found that met the inclusion criteria. Both compared a cannabinoid, delta-9-Tetrahydrocannabinol (Delta(9)THC), either as monotherapy or as adjuvant therapy, with placebo. One was a double blind, single dose crossover trial and the other was a double blind, parallel group study. A total of 28 different patients were studied. Although both trials reported a positive effect from Delta(9)THC, the improvements in tic frequency and severity were small and were only detected by some of the outcome measures.
AUTHORS' CONCLUSIONS: Not enough evidence to support the use of cannabinoids in treating tics and obsessive compulsive behaviour in people with Tourette's syndrome.
抽动秽语综合征（GTS）是一种发育性神经精神障碍，其特征为存在慢性运动性和发声性抽动。目前用于治疗GTS的药物要么缺乏疗效，要么伴有难以耐受的副作用。有一些轶事性和实验性证据表明，大麻素可能对治疗GTS患者的抽动和强迫行为有效。目前尚无关于GTS治疗方法的系统Cochrane综述。目前正在进行另一项Cochrane综述，关于氟西汀用于治疗GTS患者抽动的情况。
评估大麻素与安慰剂或其他药物相比，在治疗GTS患者的抽动、先兆冲动和强迫症状（OCS）方面的疗效和安全性。
我们检索了Cochrane对照试验中央注册库（CENTRAL）（Cochrane图书馆2008年第4期）、MEDLINE（1996年1月至今）、EMBASE（1974年1月至今）、PsycINFO（1887年1月至今）、CINAHL（1982年1月至今）、AMED（1985年1月至今）、英国护理索引（1994年1月至今）和卫生与社会保健部数据库（DH DATA）（1994年1月至今）。我们还检索了已找到的试验和综述文章的参考文献列表以获取更多信息。
我们纳入了比较任何大麻素制剂与安慰剂或其他用于治疗GTS患者抽动和OCS的药物的随机对照试验（RCT）。
两位作者独立提取数据，并通过讨论解决任何分歧。
仅发现两项符合纳入标准的试验。两项试验均将大麻素Δ-9-四氢大麻酚（Delta(9)THC）作为单一疗法或辅助疗法与安慰剂进行了比较。一项是双盲、单剂量交叉试验，另一项是双盲、平行组研究。总共研究了28名不同的患者。尽管两项试验均报告Delta(9)THC有积极效果，但抽动频率和严重程度的改善很小，且仅在一些结局指标中检测到。
没有足够的证据支持使用大麻素治疗抽动秽语综合征患者的抽动和强迫行为。
