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大麻素与癫痫:临床疗效及药理学考量

Cannabinoids in epilepsy: clinical efficacy and pharmacological considerations.

作者信息

Espinosa-Jovel C

机构信息

Programa de Epilepsia, Servicio de Neurología, Hospital Occidente de Kennedy, Bogotá, Colombia; Posgrado de Neurología, Universidad de La Sabana, Chía, Colombia.

出版信息

Neurologia (Engl Ed). 2023 Jan-Feb;38(1):47-53. doi: 10.1016/j.nrleng.2020.02.012. Epub 2021 Nov 22.

Abstract

INTRODUCTION

Advances in the development of drugs with novel mechanisms of action have not been sufficient to significantly reduce the percentage of patients presenting drug-resistant epilepsy. This lack of satisfactory clinical results has led to the search for more effective treatment alternatives with new mechanisms of action.

DEVELOPMENT

The aim of this study is to examine epidemiological aspects of the use of cannabis-based products for the treatment of epilepsy, with particular emphasis on the main mechanisms of action, indications for use, clinical efficacy, and safety. We conducted a narrative review of articles gathered from the PubMed, EMBASE, and Google Scholar databases and from the reference sections of relevant publications.

CONCLUSIONS

In recent years there has been growing interest in the use of cannabis-based products for the treatment of a wide range of diseases, including epilepsy. The cannabis plant is currently known to contain more than 100 terpenophenolic compounds, known as cannabinoids. The 2 most abundant are delta-9-tetrahydrocannabinol and cannabidiol. Studies of preclinical models of epilepsy have shown that these cannabinoids have anticonvulsant properties, and 100% purified cannabidiol and cannabidiol-enriched cannabis extracts are now being used to treat epilepsy in humans. Several open-label studies and randomised controlled clinical trials have demonstrated the efficacy and safety of these products.

摘要

引言

作用机制新颖的药物研发进展尚不足以显著降低耐药性癫痫患者的比例。由于缺乏令人满意的临床疗效,人们开始寻找具有新作用机制的更有效治疗方案。

进展

本研究旨在探讨基于大麻的产品用于治疗癫痫的流行病学情况,特别关注其主要作用机制、使用指征、临床疗效和安全性。我们对从PubMed、EMBASE和谷歌学术数据库以及相关出版物的参考文献部分收集的文章进行了叙述性综述。

结论

近年来,人们对基于大麻的产品用于治疗包括癫痫在内的多种疾病的兴趣日益浓厚。目前已知大麻植物含有100多种萜酚类化合物,即大麻素。其中含量最丰富的两种是Δ9-四氢大麻酚和大麻二酚。癫痫临床前模型研究表明,这些大麻素具有抗惊厥特性,100%纯化的大麻二酚和富含大麻二酚的大麻提取物目前正用于治疗人类癫痫。多项开放标签研究和随机对照临床试验已证明了这些产品的疗效和安全性。

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