局部辣椒素治疗大麻素呕吐综合征的疗效：一项回顾性队列研究。
Efficacy of topical capsaicin for the treatment of cannabinoid hyperemesis syndrome: A retrospective cohort study.
机构信息
University of California, San Francisco, 1001 Potrero Ave, San Francisco, CA 94110, USA.
Department of Emergency Medicine, University of California, San Francisco, 1001 Potrero Ave, San Francisco, CA 94110, USA.
出版信息
Am J Emerg Med. 2021 May;43:142-148. doi: 10.1016/j.ajem.2021.01.073. Epub 2021 Jan 29.
BACKGROUND
Cannabis Hyperemesis Syndrome (CHS) is a clinical disorder characterized by abdominal pain and intractable vomiting among patients with chronic marijuana use. We sought to assess the efficacy of capsaicin to determine whether it could reduce ED length of stay in patients with CHS.
METHODS
his retrospective observational study was conducted among patients with CHS. Patients were classified based on whether they received capsaicin, which was pseudorandomized and dependent on the pharmacist available. Outcomes included time to discharge, number of medications given, bounceback rate, and admission rate. Statistical analyses included t-tests, survival analyses, and cox regressions.
RESULTS
55 patients (35 capsaicin, 20 no capsaicin) met inclusion criteria. There was no difference in time to discharge between the experimental and control groups (4.46 h vs 3.52 h, p = 0.10), rounds of medications given (2.60 vs 3.54, p = 0.09), bounceback rate within 24 h (0.11 vs 0.10, p = 0.43), or admission rate to the hospital (0.19 vs 0.05, p = 0.07). A survival analysis and cox regression showed no difference in time to discharge. A subgroup analysis between patients who received capsaicin within their first two rounds of treatment had statistically significantly shorter length of stays than patients who received capsaicin afterwards, (4.83 h vs 7.09 h, p = 0.01).
CONCLUSION
Topical capsaicin was not associated with shorter length of stays than no capsaicin. When given earlier during an ED visit, it is associated with a shorter length of stay than when given later.
背景
大麻呕吐综合征（CHS）是一种临床疾病，其特征是慢性大麻使用者出现腹痛和顽固性呕吐。我们试图评估辣椒素的疗效，以确定其是否可以减少 CHS 患者的 ED 住院时间。
方法
这是一项回顾性观察性研究，纳入了 CHS 患者。根据是否接受辣椒素治疗将患者进行分类，该治疗是随机的，取决于药剂师是否有空。主要结局指标为出院时间、使用药物的种类、反弹率和再入院率。统计学分析包括 t 检验、生存分析和 Cox 回归。
结果
55 例患者（35 例接受辣椒素治疗，20 例未接受辣椒素治疗）符合纳入标准。实验组和对照组的出院时间无显著差异（4.46 h 与 3.52 h，p=0.10）、用药轮次（2.60 与 3.54，p=0.09）、24 h 内反弹率（0.11 与 0.10，p=0.43）或再入院率（0.19 与 0.05，p=0.07）。生存分析和 Cox 回归均显示两组出院时间无显著差异。对前两轮治疗中接受辣椒素治疗的患者进行亚组分析，发现其住院时间显著短于随后接受辣椒素治疗的患者（4.83 h 与 7.09 h，p=0.01）。
结论
与未接受辣椒素治疗相比，局部使用辣椒素并不能缩短住院时间。如果在 ED 就诊早期给予，与后期给予相比，住院时间更短。
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