Nso Nso, Nyabera Akwe, Nassar Mahmoud, Alshamam Mohsen S, Sumbly Vikram, Vest Mallorie, Patel Nehal, Ojong Gilbert, Rizzo Vincent
Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.
Internal Medicine, New York City Health and Hospitals/Queens, New York, USA.
Cureus. 2021 Oct 17;13(10):e18841. doi: 10.7759/cureus.18841. eCollection 2021 Oct.
Globally, around 15%-40% of patients suffering from inflammatory bowel disease (IBD) use Cannabis for pain reduction, increased appetite, and reduced need for other medications. Although many patients report having benefited by using Cannabis in IBD, there is still a lack of consensus regarding the use of Cannabis in IBD. The aim is to identify, explore and map literature on the potential protective role of Cannabis against IBD through this scoping review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during the search to answer the focal question: (1) Does Cannabis play a protective role against IBD as assessed by clinical remission; (2) If yes, what is the mechanism of action for this protective role. There were only three randomized controlled trials (RCTs) and three observational studies that satisfied the selection criteria of this scoping review. Although promising results including the improvement in general well-being/ Harvey-Bradshaw Index, health perception enhancement [4.1±1.43 to 7±1.42 (p = 0.0002)], weight gain, Crohn's Disease Activity Index (CDAI) score<150, Mayo scores (4-10), and reduction in clinical complications have been found in some studies, its medical use in IBD is still questionable due to the lack of high-quality evidence. Future RCTs studies should determine the cannabis treatment parameters and validate its safety and effectiveness in the IBD setting. The highlights include: the current literature provides inconclusive evidence concerning the protective role of cannabis for IBD patients; limited research evidence regarding the therapeutic use of cannabinoids for IBD warrants future investigation via RCTs; cannabis provides some benefits to IBD patients by improving their general well-being perceptions, Harvey-Bradshaw Index, Mayo scores, and minimizing their clinical complications.
在全球范围内，约15%-40%的炎症性肠病（IBD）患者使用大麻来减轻疼痛、增加食欲并减少对其他药物的需求。尽管许多患者报告称使用大麻对IBD有帮助，但对于在IBD中使用大麻仍缺乏共识。本综述旨在通过范围界定审查来识别、探索和梳理关于大麻对IBD潜在保护作用的文献。在检索过程中遵循了系统评价和Meta分析的首选报告项目（PRISMA）指南，以回答核心问题：（1）大麻在临床缓解方面是否对IBD起保护作用；（2）如果是，这种保护作用的作用机制是什么。仅有三项随机对照试验（RCT）和三项观察性研究符合本范围界定审查的纳入标准。尽管在一些研究中发现了包括总体幸福感/哈维-布拉德肖指数改善、健康感知增强[4.1±1.43至7±1.42（p = 0.0002）]、体重增加、克罗恩病活动指数（CDAI）评分<150、梅奥评分（4-10）以及临床并发症减少等有前景的结果，但由于缺乏高质量证据，其在IBD中的医学应用仍存在疑问。未来的RCT研究应确定大麻治疗参数，并验证其在IBD环境中的安全性和有效性。要点包括：当前文献关于大麻对IBD患者保护作用的证据尚无定论；关于大麻素在IBD治疗用途的研究证据有限，值得通过RCT进行未来研究；大麻通过改善IBD患者的总体幸福感感知、哈维-布拉德肖指数、梅奥评分以及减少临床并发症，为IBD患者带来了一些益处。
