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人类研究综述评估大麻二酚(CBD)的治疗作用和潜力。

A Review of Human Studies Assessing Cannabidiol's (CBD) Therapeutic Actions and Potential.

机构信息

Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA.

HOPES Collaborative Group, University of Connecticut and Hartford Hospital, Hartford, CT, USA.

出版信息

J Clin Pharmacol. 2019 Jul;59(7):923-934. doi: 10.1002/jcph.1387. Epub 2019 Feb 7.

Abstract

Cannabidiol (CBD) is a highly touted product for many different disorders among the lay press. Numerous CBD products are available, ranging from a US Food and Drug Administration (FDA)-approved product called Epidiolex to products created for medical marijuana dispensaries and products sold in smoke shops, convenience stores, and over the Internet. The legal status of the non-FDA-approved products differs depending on the source of the CBD and the state, while the consistency and quality of the non-FDA-approved products vary markedly. Without independent laboratory verification, it is impossible to know whether the labeled CBD dosage in non-FDA-approved CBD products is correct, that the delta-9-tetrahydrocannabinol content is <0.3%, and that it is free of adulteration and contamination. On the Internet, CBD has been touted for many ailments for which it has not been studied, and in those diseases with evaluable human data, it generally has weak or very weak evidence. The control of refractory seizures is a clear exception, with strong evidence of CBD's benefit. Acute CBD dosing before anxiety-provoking events like public speaking and the chronic use of CBD in schizophrenia are promising but not proven. CBD is not risk free, with adverse events (primarily somnolence and gastrointestinal in nature) and drug interactions. CBD has been shown to increase liver function tests and needs further study to assess its impact on suicidal ideation.

摘要

大麻二酚(CBD)在大众媒体中被吹捧为治疗许多不同疾病的产品。有许多 CBD 产品可供选择,从美国食品和药物管理局(FDA)批准的药物 Epidiolex 到为医用大麻药房和在烟店、便利店和互联网上销售的产品。非 FDA 批准产品的法律地位因 CBD 的来源和所在州而异,而这些非 FDA 批准产品的一致性和质量差异很大。如果没有独立的实验室验证,就无法知道非 FDA 批准的 CBD 产品中标签上的 CBD 剂量是否正确,其 δ-9-四氢大麻酚含量是否<0.3%,以及是否没有掺假和污染。在互联网上,CBD 被吹捧用于许多尚未进行研究的疾病,而在那些有可评估人类数据的疾病中,它的证据通常较弱或非常弱。难治性癫痫发作的控制是一个明显的例外,有强有力的证据表明 CBD 有益。在演讲等引起焦虑的事件之前进行急性 CBD 剂量治疗以及在精神分裂症中慢性使用 CBD 是有希望的,但尚未得到证实。CBD 并非没有风险,会产生不良事件(主要是嗜睡和胃肠道)和药物相互作用。已经证明 CBD 会增加肝功能检查,需要进一步研究来评估其对自杀意念的影响。

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