Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
St Luke's Rehabilitation Institute, Spokane, Washington, USA.
J Spinal Cord Med. 2022 Sep;45(5):656-667. doi: 10.1080/10790268.2020.1865709. Epub 2021 Jan 19.
This scoping review examines the current research on the effect of cannabis upon pain intensity in spinal cord injury (SCI) pain. Chronic pain is a significant secondary condition following SCI, and traditional treatments (e.g. opioids, NSAIDs) are often criticized for providing inadequate relief. As a result, there is increasing interest in and use of cannabis and cannabinoid-based medications as an alternative means of pain control.
The purpose of this review was to examine the scientific evidence on the effect of cannabis/cannabinoids upon pain intensity in SCI by mapping the current literature.
Two hundred and fifty-two studies were identified by searching electronic databases for articles published through February 2020. In addition, reviewers scanned the reference lists of identified articles and examined clinicaltrials.gov for unpublished data in this area. Title, abstract, and full-text reviews were completed by two independent reviewers. Data extraction was performed by a single reviewer and verified by a second reviewer.
Six articles covering five treatment studies were included. Studies yielded mixed findings likely due to large variability in methodology, including lack of standardized dosing paradigms, modes of use, and duration of trial.
The current quality and level of evidence is insufficient to draw reliable conclusions of the efficacy of cannabis upon SCI-related pain itensity. We identify specific limitations of past studies and present guidelines for future research. ClinicalTrials.gov identifier: Nct01606202..
本范围综述检查了关于大麻对脊髓损伤（SCI）疼痛强度影响的当前研究。慢性疼痛是 SCI 后的一种重要的继发性疾病，传统的治疗方法（如阿片类药物、非甾体抗炎药）常常因提供的缓解效果不足而受到批评。因此，人们对大麻和大麻素类药物作为一种替代疼痛控制手段的兴趣和使用越来越大。
本综述的目的是通过绘制当前文献，检查大麻/大麻素对 SCI 疼痛强度影响的科学证据。
通过搜索电子数据库，检索截至 2020 年 2 月发表的文章，确定了 252 项研究。此外，审查员还扫描了确定文章的参考文献列表，并在该领域检查了 clinicaltrials.gov 上未发表的数据。两名独立审查员完成了标题、摘要和全文审查。由一名审查员进行数据提取，并由第二名审查员进行验证。
纳入了五项治疗研究的六篇文章。研究结果存在差异，可能是由于方法学的极大差异所致，包括缺乏标准化的剂量方案、使用模式和试验持续时间。
目前的质量和证据水平不足以得出关于大麻对 SCI 相关疼痛强度疗效的可靠结论。我们确定了过去研究的具体局限性，并提出了未来研究的指南。ClinicalTrials.gov 标识符：Nct01606202。
