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成人使用大麻减轻疼痛的临床试验的范围综述。

A Scoping Review on Clinical Trials of Pain Reduction With Cannabis Administration in Adults.

作者信息

Haleem Reham, Wright Robert

机构信息

Nordic Cannabis Research Institute, Copenhagen, Denmark.

出版信息

J Clin Med Res. 2020 Jun;12(6):344-351. doi: 10.14740/jocmr4210. Epub 2020 Jun 4.

Abstract

Indications of cannabis use are numerous although the indication to relief pain remains a major research interest and clinical application. Studies investigating the effect of herbal cannabis and cannabis-based medicine on neuropathic, non-neuropathic pain, acute pain and experimentally induced pain were reviewed. A search was performed in PubMed and Cochrane library for articles published in English between January 1, 2000 and May 8, 2020. The search terms used were related to cannabis and pain in adults. We identified 34 studies, of which 30 were randomized controlled clinical trials (RCTs). Varying effects were identified from the RCTs, and as expected more promising effects from non-RCTs. Cannabis-based medications were found most effective as an adjuvant therapy in refractory multiple sclerosis, and weak evidence was found to support the treatment of cancer pain especially in advanced stages. Chronic rheumatic pain showed promising results. Adverse events of cannabis-based treatment were found to be more frequent with tetrahydrocannabinol herbal strains compared to other cannabis-derived products.

摘要

大麻的使用指征众多,尽管缓解疼痛这一指征仍是主要的研究热点和临床应用方向。对研究草药大麻和大麻类药物对神经性疼痛、非神经性疼痛、急性疼痛及实验性诱导疼痛影响的研究进行了综述。在PubMed和Cochrane图书馆中检索了2000年1月1日至2020年5月8日期间发表的英文文章。所使用的检索词与成人的大麻和疼痛相关。我们识别出34项研究,其中30项为随机对照临床试验(RCT)。从RCT中发现了不同的效果,不出所料,非RCT的效果更具前景。发现大麻类药物作为难治性多发性硬化症的辅助治疗最为有效,且发现有微弱证据支持治疗癌症疼痛,尤其是晚期癌症疼痛。慢性风湿性疼痛显示出有前景的结果。与其他大麻衍生产品相比,发现基于四氢大麻酚的草药菌株进行大麻类治疗的不良事件更为频繁。

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