Department of Surgical Sciences, Oral Medicine Section, University of Turin, Turin, Italy.
Private Practice, Turin, Italy.
Pain Med. 2021 Feb 4;22(1):142-151. doi: 10.1093/pm/pnaa318.
To evaluate the use of a Cannabis sativa oil in the management of patients diagnosed with primary burning mouth syndrome (BMS).
Prospective, open-label, single-arm pilot study.
University hospital.
Seventeen patients with diagnosed BMS were included.
Subjects were treated for 4 weeks with a full cannabis plant extract, which was prepared from standardized plant material (cannabis flos) in specialized pharmacies by means of Romano-Hazekamp extraction and was diluted in oil (1 g of cannabis in 10 g of olive oil). The primary outcome was the change in pain intensity (assessed by the visual analog scale, Present Pain Intensity scale, McGill Pain Questionnaire, and Oral Health Impact Profiles) at the end of the protocol and during the succeeding 24 weeks; the neuropathic pain was also investigated with a specific interview questionnaire (DN4-interview [Douleur Neuropathique en 4 Questions]). Levels of anxiety and depression were considered as secondary outcomes, together with reported adverse events due to the specified treatment.
Subjects showed a statistically significant improvement over time in terms of a clinical remission of the oral symptoms. Levels of anxiety and depression also changed statistically, displaying a favorable improvement. No serious reactions were detailed. None of the patients had to stop the treatment due to adverse events.
In this pilot evaluation, the C. sativa oil provided was effective and well tolerated in patients with primary BMS. Further bigger and properly defined randomized controlled trials, with different therapeutic approaches or placebo control, are needed, however.
评估大麻籽油在原发性灼口综合征(BMS)患者管理中的应用。
前瞻性、开放标签、单臂试验研究。
大学医院。
纳入 17 名确诊为 BMS 的患者。
患者接受为期 4 周的全大麻植物提取物治疗,该提取物由标准化植物材料(大麻花)在专门的药店中通过 Romano-Hazekamp 提取方法制备,并稀释在油中(1 克大麻在 10 克橄榄油中)。主要结局是在方案结束时和随后的 24 周内疼痛强度的变化(通过视觉模拟评分、当前疼痛强度评分、麦吉尔疼痛问卷和口腔健康影响概况评估);通过特定的访谈问卷(DN4-访谈[4 个问题的神经性疼痛])还调查了神经性疼痛。焦虑和抑郁水平被视为次要结局,同时还考虑了因特定治疗而发生的不良事件。
患者在口腔症状的临床缓解方面表现出随时间的统计学显著改善。焦虑和抑郁水平也发生了统计学变化,显示出有利的改善。未详细描述严重反应。没有患者因不良事件而停止治疗。
在这项试验评估中,使用的大麻籽油对原发性 BMS 患者有效且耐受性良好。然而,需要进一步进行更大规模和定义明确的随机对照试验,采用不同的治疗方法或安慰剂对照。