Tateo Sydney
J Am Assoc Nurse Pract. 2017 Feb;29(2):94-103. doi: 10.1002/2327-6924.12422. Epub 2016 Nov 10.
Cannabinoids are widely used to alleviate intractable symptoms such as pain, nausea, and muscle spasticity. The purpose of this review was to ascertain the current state of the science regarding use of cannabinoids for cancer pain.
Four electronic databases were searched for randomized control trials of cannabinoids and cancer pain. Studies included examined the analgesic effects of cannabinoids for cancer pain. Methodological quality was assessed using the Jadad scale.
Eight randomized control trials met the inclusion criteria for review. Most trials found analgesic effects from cannabinoids when compared to placebo, although not all associations reached statistical significance. The analgesic effects of cannabinoids were also limited by dose-dependent side effects. Side effects most commonly reported were changes in cognition, sedation, and dizziness.
There is evidence that cannabinoids are effective adjuvants for cancer pain not completely relieved by opioid therapy, but there is a dearth of high-quality studies to support a stronger conclusion. Cannabinoids appear to be safe in low and medium doses. Methodological limitations of the trials limited the ability to make sound conclusions. Further research is warranted before efficacy, safety, and utility of cannabinoids for cancer pain can be determined.
大麻素被广泛用于缓解疼痛、恶心和肌肉痉挛等顽固性症状。本综述的目的是确定关于使用大麻素治疗癌症疼痛的科学现状。
检索了四个电子数据库，以查找关于大麻素与癌症疼痛的随机对照试验。纳入的研究考察了大麻素对癌症疼痛的镇痛效果。使用Jadad量表评估方法学质量。
八项随机对照试验符合纳入综述的标准。与安慰剂相比，大多数试验发现大麻素有镇痛效果，尽管并非所有关联都具有统计学意义。大麻素的镇痛效果也受到剂量依赖性副作用的限制。最常报告的副作用是认知改变、镇静和头晕。
有证据表明，大麻素是阿片类药物治疗未能完全缓解的癌症疼痛的有效辅助药物，但缺乏高质量研究来支持更强有力的结论。大麻素在低剂量和中等剂量下似乎是安全的。试验的方法学局限性限制了得出可靠结论的能力。在确定大麻素对癌症疼痛的疗效、安全性和实用性之前，有必要进行进一步研究。
