International Collaboration On Repair Discoveries (ICORD), University of British Columbia (UBC), Vancouver, Canada.
Department of Physical Therapy, UBC, Vancouver, Canada.
Curr Neuropharmacol. 2021;19(3):402-432. doi: 10.2174/1570159X18666200420085712.
People with spinal cord injuries (SCI) commonly experience pain and spasticity; limitations of current treatments have generated interest in cannabis as a possible therapy.
We conducted this systematic review to: 1) examine usage patterns and reasons for cannabinoid use, and 2) determine the treatment efficacy and safety of cannabinoid use in people with SCI.
PubMed, Embase, Web of Science and Cumulative Index to Nursing and Allied Health Literature databases were queried for keywords related to SCI and cannabinoids.
7,232 studies were screened, and 34 were included in this systematic review. Though 26 studies addressed cannabinoid usage, only 8 investigated its therapeutic potential on outcomes such as pain and spasticity. The most common method of use was smoking. Relief of pain, spasticity and recreation were the most common reasons for use. A statistically significant reduction of pain and spasticity was observed with cannabinoid use in 83% and 100% of experimental studies, respectively. However, on examination of randomized control trials (RCTs) alone, effect sizes ranged from - 0.82 to 0.83 for pain and -0.95 to 0.09 for spasticity. Cannabinoid use was associated with fatigue and cognitive deficits.
Current evidence suggests that cannabinoids may reduce pain and spasticity in people with SCI, but its effect magnitude and clinical significance are unclear. Existing information is lacking on optimal dosage, method of use, composition and concentration of compounds. Long-term, double-blind, RCTs, assessing a wider range of outcomes should be conducted to further understand the effects of cannabinoid use in people with SCI.
脊髓损伤（SCI）患者常伴有疼痛和痉挛；目前治疗方法的局限性使得大麻类物质作为一种潜在治疗方法受到关注。
我们进行了这项系统评价，以：1）研究大麻类物质使用的模式和原因，2）确定大麻类物质治疗 SCI 患者的疗效和安全性。
在 PubMed、Embase、Web of Science 和 Cumulative Index to Nursing and Allied Health Literature 数据库中，使用与 SCI 和大麻类物质相关的关键词进行检索。
筛选出 7232 篇研究，其中 34 篇被纳入本系统评价。虽然 26 项研究涉及大麻类物质的使用，但只有 8 项研究调查了其在疼痛和痉挛等结局方面的治疗潜力。最常见的使用方法是吸烟。缓解疼痛、痉挛和娱乐是最常见的使用原因。在 83%和 100%的实验研究中，大麻类物质的使用分别观察到疼痛和痉挛有统计学意义的减轻。然而，单独检查随机对照试验（RCTs），疼痛的效应量范围为-0.82 至 0.83，痉挛的效应量范围为-0.95 至 0.09。大麻类物质的使用与疲劳和认知缺陷有关。
目前的证据表明，大麻类物质可能减轻 SCI 患者的疼痛和痉挛，但它的疗效大小和临床意义尚不清楚。关于最佳剂量、使用方法、化合物的组成和浓度等方面的信息还很缺乏。应该进行长期、双盲、RCT，评估更广泛的结局，以进一步了解大麻类物质在 SCI 患者中的使用效果。
