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大麻使用障碍与肠易激综合征(IBS)的关系:对美国 680 万例住院病例的分析。

Relationship of Cannabis Use Disorder and Irritable Bowel Syndrome (IBS): An Analysis of 6.8 Million Hospitalizations in the United States.

机构信息

Department of Psychiatry, Griffin Memorial Hospital and Oklahoma Department of Mental Health and Substance Abuse (Odmhas), Norman, OK, USA.

Department of Gastroenterology & Hepatology, The Wright Center of Graduate Medical Education, Scranton, PA, USA.

出版信息

Subst Use Misuse. 2020;55(2):281-290. doi: 10.1080/10826084.2019.1664591. Epub 2019 Oct 1.

Abstract

Irritable bowel syndrome (IBS) is a chronic multifactorial gastrointestinal condition that substantially affects the quality of life. Research have suggested an increasing trend in cannabis use to alleviate IBS-related psychiatric symptoms. We aim to investigate the association of psychiatric comorbidities and cannabis use disorders (CUD) in hospitalized IBS patients. We analyzed 31,272 IBS hospitalizations in patients (aged 15-54 years) from the Nationwide Inpatient Sample (NIS). We utilized logistic regression to evaluate the adjusted odds ratio (aOR) of CUD and psychiatric comorbidities. Anxiety (26.3%) and depressive (24.8%) disorders were prevalent and increased the odds for IBS-hospitalization by 2.5 and 1.8 times respectively. Tobacco use disorder was most prevalent (24.5%) followed by CUD (3.7%). After controlling for demographics, psychiatric and medical comorbidities, and other substance use disorders, CUD had higher odds for IBS hospitalizations (aOR 1.407, 95% CI 1.32-1.50). IBS hospitalizations with CUD increased by 32.8% from 2010 to 2014. CUD patients were younger (15-24 years, aOR 5.4, 95% CI 4.27-6.77), males (aOR 1.8, 95% CI 1.59-2.09) and African Americans (aOR 2.8, 95% CI 1.45-2.23) and from low-income families (aOR 1.9, 95% CI 1.58-2.39). We found that patients with CUD have 40.7% higher odds for IBS-hospitalizations with a rising trend of CUD and related psychiatric comorbidities which may further worsen IBS and health quality of life. With limited evidence of efficacy and safety of cannabis in IBS, larger, randomized controlled studies are required to examine its therapeutic efficacy.

摘要

肠易激综合征(IBS)是一种慢性多因素胃肠道疾病,极大地影响了生活质量。研究表明,大麻的使用呈上升趋势,以缓解与 IBS 相关的精神症状。我们旨在研究精神共病与住院 IBS 患者的大麻使用障碍(CUD)之间的关系。我们分析了来自全国住院患者样本(NIS)的 31272 例 15-54 岁 IBS 住院患者的数据。我们利用逻辑回归来评估 CUD 和精神共病的调整后比值比(aOR)。焦虑症(26.3%)和抑郁症(24.8%)的患病率较高,分别使 IBS 住院的几率增加了 2.5 倍和 1.8 倍。烟草使用障碍的患病率最高(24.5%),其次是 CUD(3.7%)。在控制了人口统计学、精神和医疗合并症以及其他物质使用障碍后,CUD 使 IBS 住院的几率更高(aOR 1.407,95%CI 1.32-1.50)。从 2010 年到 2014 年,患有 CUD 的 IBS 住院患者增加了 32.8%。CUD 患者更年轻(15-24 岁,aOR 5.4,95%CI 4.27-6.77),男性(aOR 1.8,95%CI 1.59-2.09)和非裔美国人(aOR 2.8,95%CI 1.45-2.23),且来自低收入家庭(aOR 1.9,95%CI 1.58-2.39)。我们发现,患有 CUD 的患者 IBS 住院的几率增加了 40.7%,而且 CUD 和相关精神共病的上升趋势可能会进一步恶化 IBS 和健康生活质量。鉴于大麻在 IBS 中的疗效和安全性证据有限,需要进行更大规模的随机对照研究来检验其治疗效果。

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