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帕金森病中的大麻:患者观点。

Cannabis in Parkinson's Disease: The Patients' View.

机构信息

Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

J Parkinsons Dis. 2021;11(1):309-321. doi: 10.3233/JPD-202260.

Abstract

BACKGROUND

Little is known about the patients' view on treatment with medical cannabis (MC) for Parkinson's disease (PD).

OBJECTIVE

To assess the PD community's perception of MC and patients' experience with MC.

METHODS

Applying a questionnaire-based survey, we evaluated general knowledge and interest in MC as well as the frequency, modalities, efficacy, and tolerability of application. Questionnaires were distributed nationwide via the membership journal of the German Parkinson Association and locally in our clinic to control for report bias.

RESULTS

Overall, 1.348 questionnaires (1.123 nationwide, 225 local) were analysed. 51% of participants were aware of the legality of MC application, 28% of various routes of administration (ROA) and 9% of the difference between delta9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD). PD-related cannabis use was reported by 8.4% of patients and associated with younger age, living in large cities and better knowledge about the legal and clinical aspects of MC. Reduction of pain and muscle cramps was reported by more than 40% of cannabis users. Stiffness/akinesia, freezing, tremor, depression, anxiety and restless legs syndrome subjectively improved for more than 20% and overall tolerability was good. Improvement of symptoms was reported by 54% of users applying oral CBD and 68% inhaling THC-containing cannabis. Compared to CBD intake, inhalation of THC was more frequently reported to reduce akinesia and stiffness (50.0% vs. 35.4%; p < 0.05). Interest in using MC was reported by 65% of non-users.

CONCLUSION

MC is considered as a therapeutic option by many PD patients. Nevertheless, efficacy and different ROA should further be investigated.

摘要

背景

对于使用医用大麻(MC)治疗帕金森病(PD)患者的看法知之甚少。

目的

评估 PD 患者群体对 MC 的看法以及患者对 MC 的应用体验。

方法

我们采用问卷调查的方式,评估了对 MC 的一般认知和兴趣,以及应用的频率、方式、疗效和耐受性。问卷通过德国帕金森病协会的会员期刊在全国范围内分发,并在我们的诊所进行局部分发,以控制报告偏差。

结果

共分析了 1348 份问卷(全国范围内 1123 份,本地 225 份)。51%的参与者了解 MC 应用的合法性,28%的参与者了解各种给药途径(ROA),9%的参与者了解 delta9-四氢大麻酚(Δ9-THC)和大麻二酚(CBD)之间的区别。8.4%的患者报告了与 PD 相关的大麻使用,与年轻年龄、居住在大城市以及对 MC 的法律和临床方面有更好的了解有关。超过 40%的大麻使用者报告了疼痛和肌肉痉挛的减轻。僵硬/运动迟缓、冻结、震颤、抑郁、焦虑和不安腿综合征的主观改善超过 20%,总体耐受性良好。54%使用口服 CBD 的患者和 68%吸入含 THC 大麻的患者报告症状改善。与 CBD 摄入相比,吸入 THC 更频繁地被报告能减轻运动迟缓(50.0% vs. 35.4%;p<0.05)。65%的非使用者报告有使用 MC 的兴趣。

结论

许多 PD 患者认为 MC 是一种治疗选择。然而,还需要进一步研究其疗效和不同的 ROA。

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