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[医用大麻对一名患有小儿麻痹后遗症且伴有躯体形式障碍的药物抵抗性恶心的治疗效果]

[Beneficial Effect of Medical Cannabis in the Treatment of a Pharmacoresistant Nausea Associated with a Somatoform Disorder in a Patient with Post-Polio Syndrome].

作者信息

Bleckwenn Markus, Weckbecker Klaus, Voss Sebastian

机构信息

Institut für Hausarztmedizin der Medizinischen Fakultät der Universität Bonn.

出版信息

Dtsch Med Wochenschr. 2018 Mar;143(5):344-348. doi: 10.1055/s-0043-123897. Epub 2018 Mar 5.

Abstract

HISTORY AND CLINICAL FINDINGS

We report a 79-year-old patient with post-polio syndrome (PPS). In the course of this disease, recurrent upper abdominal pain and a therapy-resistant nausea developed without vomiting. In addition, the patient was limited by the combination of muscular weakness, obesity, dietary-treated diabetes and a degenerative spinal cord injury significantly in its mobility and physical capacity.

INVESTIGATIONS AND DIAGNOSIS

Despite extensive diagnostics, no somatic cause could be found neither for the nausea nor for the upper abdominal pain. Due to the psychological stress within the scope of the PPS, the development of a somatoform autonomic function disorder of the upper gastrointestinal tract may have occurred.

TREATMENT AND COURSE

Even under combination therapy of antiemetic and pain-modulating drugs, no adequate symptom control could be achieved. In the absence of therapy alternatives and increasing psychological strain the patient was prescribed medical cannabis. Under the therapy there was a relief of the nausea symptoms and decreased pain.

CONCLUSION

Cannabis is a treatment option for treatment-resistant symptoms as part of a PPS.

摘要

病史及临床发现

我们报告一例79岁的患有小儿麻痹后遗症(PPS)的患者。在该疾病病程中,出现反复上腹部疼痛及难治性恶心,但无呕吐。此外,患者因肌无力、肥胖、饮食控制的糖尿病以及退行性脊髓损伤的综合影响,其活动能力和身体机能受到显著限制。

检查与诊断

尽管进行了广泛的诊断,未发现导致恶心及上腹部疼痛的躯体原因。鉴于PPS范围内的心理压力,可能发生了上消化道的躯体形式自主神经功能障碍。

治疗及病程

即使在使用止吐药和疼痛调节药物的联合治疗下,也未能充分控制症状。由于没有其他治疗选择且心理压力不断增加,给患者开具了医用大麻。在该治疗下,恶心症状得到缓解,疼痛减轻。

结论

大麻作为PPS一部分的难治性症状的治疗选择。

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