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大麻素对化疗引起的恶心和呕吐的管理有效吗?

Are cannabinoids effective for the management of chemotherapy induced nausea and vomiting?

作者信息

Morales Mariaignacia, Corsi Oscar, Peña José

机构信息

Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.

Proyecto Epistemonikos, Santiago, Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile.

出版信息

Medwave. 2017 Dec 28;17(9):e7119. doi: 10.5867/medwave.2017.09.7119.

Abstract

INTRODUCTION

Nausea and vomiting are common side effects in cancer patients treated with chemotherapy. Proper control of these symptoms might improve quality of life in these patients. Addition of cannabinoids to standard antiemetic treatment has been proposed in order to improve control of these symptoms.

METHODS

To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.

RESULTS AND CONCLUSIONS

We identified 16 systematic reviews that include 61 primary studies. Out of these, four were randomized trials that answered our question. At present, given that the certainty of the evidence is very low, it is unclear whether the addition of cannabinoids to standard antiemetic regimes benefits patients with chemotherapy induced nausea and vomiting. Cannabinoids probably increase adverse effects substantively.

摘要

引言

恶心和呕吐是接受化疗的癌症患者常见的副作用。妥善控制这些症状可能会改善这些患者的生活质量。有人提出在标准止吐治疗中添加大麻素以更好地控制这些症状。

方法

为回答这个问题,我们使用了Epistemonikos,这是最大的健康系统评价数据库,通过筛选多个信息来源来维护,包括MEDLINE、EMBASE、Cochrane等。我们从系统评价中提取数据,重新分析原始研究的数据,进行荟萃分析,并使用GRADE方法生成结果总结表。

结果与结论

我们确定了16项系统评价,其中包括61项原始研究。其中四项是回答我们问题的随机试验。目前,鉴于证据的确定性非常低,尚不清楚在标准止吐方案中添加大麻素是否对化疗引起的恶心和呕吐患者有益。大麻素可能会大幅增加不良反应。

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