Guarnaccia J B, Khan A, Ayettey R, Treu J A, Comerford B, Njike V Y
Multiple Sclerosis Treatment Center, Yale-Griffin Prevention Research Center, Griffin Hospital - Derby, CT, United States.
Multiple Sclerosis Treatment Center, Yale-Griffin Prevention Research Center, Griffin Hospital - Derby, CT, United States.
Mult Scler Relat Disord. 2021 May;50:102830. doi: 10.1016/j.msard.2021.102830. Epub 2021 Feb 10.
To survey the pattern and benefits of medical cannabis use (MCU) in a cross section of persons with multiple sclerosis (PWMS).
One hundred and fifteen subjects completed a 36-question survey online or on paper which queried aspects of their use of cannabis, including frequency of use, effect on symptoms, and changes in their use of prescription medications, as well asa number of key demographic variables such as age, gender, disease duration and clinical course, etc. All subjects were treated at a multiple sclerosis (MS) clinic in Connecticut and enrolled in the Connecticut Medical Marijuana Program (CTMMP).
Self-reported benefit from cannabis use for two or more symptoms of MS was associated with relapsing remitting MS (RRMS) vs progressive (PMS) (OR 3.043, 95% CI 1.026-9.028, p=0.038) and less benefit for two or more symptoms for those who required a wheelchair vs. those who ambulated without assistance (OR .246, 95% CI .195-.797, p=0.016). General benefit from cannabis use was reported for mood disorders (p<0.001), insomnia (p<0.001), sensory symptoms, including pain (p<0.001), and muscle cramps and spasms (p<0.001). Furthermore, benefit was also significantly associated with symptom severity in the case of insomnia (OR 9.735, 95% CI 2.751-34.445, p<0.001), and cramps and spasms (OR 5.234, 95% CI 1.261-21.729, p=0.014). A significant proportion of respondents had stopped or reduced prescription medications (86% vs. 55%, p<0.001) as a function of finding cannabis more effective than prescription medications. These included opioids, benzodiazepines, muscle relaxers and other pain medications.
MCU among PWMS can lead to the reduction or discontinuation of several categories of prescription medications for symptoms of MS. Persons reporting the most benefit from MCU tended to have a milder form of MS with less disability, in contrast to previous studies. This study confirms the benefit of cannabis in several common MS symptoms, extending these findings to show that benefit can be related to baseline severity of some symptoms.
在多发性硬化症患者（PWMS）群体中调查医用大麻使用（MCU）的模式及益处。
115名受试者通过在线或纸质方式完成了一项包含36个问题的调查问卷，该问卷询问了他们使用大麻的各个方面，包括使用频率、对症状的影响、处方药使用的变化，以及一些关键人口统计学变量，如年龄、性别、疾病持续时间和临床病程等。所有受试者均在康涅狄格州的一家多发性硬化症（MS）诊所接受治疗，并参加了康涅狄格医用大麻计划（CTMMP）。
自我报告称使用大麻对两种或更多种MS症状有益，这与复发缓解型MS（RRMS）而非进展型（PMS）相关（比值比3.043，95%置信区间1.026 - 9.028，p = 0.038）；对于需要轮椅辅助的患者与无需辅助可自行行走的患者相比，使用大麻对两种或更多种症状的益处较少（比值比0.246，95%置信区间0.195 - 0.797，p = 0.016）。报告称使用大麻对情绪障碍（p < 0.001）、失眠（p < 0.001）、感觉症状（包括疼痛，p < 0.001）以及肌肉痉挛（p < 0.001）普遍有益。此外，在失眠（比值比9.735，95%置信区间2.751 - 34.445，p < 0.001）和痉挛（比值比5.234，95%置信区间1.261 - 21.729，p = 0.014）的情况下，益处也与症状严重程度显著相关。相当一部分受访者因发现大麻比处方药更有效而停止或减少了处方药的使用（86%对55%，p < 0.001）。这些药物包括阿片类药物、苯二氮䓬类药物、肌肉松弛剂和其他止痛药。
PWMS中的MCU可导致减少或停用用于MS症状的几类处方药。与先前研究不同的是，报告从MCU中获益最多的人往往患有症状较轻、残疾程度较低的MS。本研究证实了大麻对几种常见MS症状有益，扩展了这些发现以表明益处可能与某些症状的基线严重程度有关。
