Elikkottil Jaseena, Gupta Pankaj, Gupta Kalpna
Department of Medicine, Minneapolis VA Medical Center, Minneapolis, Minnesota, USA.
J Opioid Manag. 2009 Nov-Dec;5(6):341-57.
Historically and anecdotally cannabinoids have been used as analgesic agents. In recent years, there has been an escalating interest in developing cannabis-derived medications to treat severe pain. This review provides an overview of the history of cannabis use in medicine, cannabinoid signaling pathways, and current data from preclinical as well as clinical studies on using cannabinoids as potential analgesic agents. Clinical and experimental studies show that cannabis-derived compounds act as antiemetic, appetite modulating, and analgesic agents. However, the efficacy of individual products is variable and dependent upon the route of administration. As opioids are the only therapy for severe pain, analgesic ability of cannabinoids may provide a much-needed alternative to opioids. Moreover, cannabinoids act synergistically with opioids and act as opioid sparing agents, allowing lower doses and fewer side effects from chronic opioid therapy. Thus, rational use of cannabis-based medications deserves serious consideration to alleviate the suffering of patients due to severe pain.
从历史和轶事来看，大麻素一直被用作镇痛剂。近年来，人们对开发源自大麻的药物来治疗重度疼痛的兴趣不断升级。本综述概述了大麻在医学上的使用历史、大麻素信号通路，以及目前关于将大麻素用作潜在镇痛剂的临床前和临床研究数据。临床和实验研究表明，源自大麻的化合物具有止吐、调节食欲和镇痛作用。然而，个别产品的疗效各不相同，且取决于给药途径。由于阿片类药物是治疗重度疼痛的唯一疗法，大麻素的镇痛能力可能为阿片类药物提供急需的替代方案。此外，大麻素与阿片类药物协同作用，起到阿片类药物节省剂的作用，使慢性阿片类药物治疗的剂量更低、副作用更少。因此，合理使用基于大麻的药物值得认真考虑，以减轻重度疼痛患者的痛苦。
