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大麻素对炎症性肠病的治疗作用:随机对照试验的系统评价和荟萃分析

Cannabinoid Therapeutic Effects in Inflammatory Bowel Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Vinci Antonio, Ingravalle Fabio, Bardhi Dorian, Cesaro Nicola, Frassino Sara, Licata Francesca, Valvano Marco

机构信息

Hospital Health Management Area, Local Health Authority "Roma 1", 00133 Roma, Italy.

Hospital Health Management Area, Local Health Authority "Roma 6", 00041 Albano Laziale, Italy.

出版信息

Biomedicines. 2022 Sep 29;10(10):2439. doi: 10.3390/biomedicines10102439.

Abstract

(1) Introduction: Inflammatory Bowel Disease (IBD) patients may benefit from cannabinoid administration supplementary therapy; currently no consensus on its effect has been reached. (2) Methods: a systematic review of RCTs on cannabinoid supplementation therapy in IBD has been conducted; data sources were MEDLINE, Scopus, ClinicalTrials. (3) Results: out of 974 papers found with electronic search, six studies have been included into the systematic review, and five of them, for a grand total of 208 patients, were included into the meta-analysis. (4) Conclusions: cannabinoid supplementation as adjuvant therapy may increase the chances of success for standard therapy of Crohn's Disease during the induction period; no statement on its potential usage during maintenance period can be derived from retrieved evidence. Its usage in Ulcerative Colitis is not to be recommended. If ever, low-dose treatment may be more effective than higher dosage. Mean CDAI reduction was found stronger in patients treated with cannabinoids (mean CDAI reduction = 36.63, CI 95% 12.27-61.19) than placebo. In future studies, it is advisable to include disease activity levels, as well as patient-level information such as genetic and behavioral patterns.

摘要

(1) 引言:炎症性肠病(IBD)患者可能从大麻素辅助治疗中获益;目前对于其疗效尚未达成共识。(2) 方法:对关于IBD中大麻素补充疗法的随机对照试验进行了系统评价;数据来源为MEDLINE、Scopus、临床试验。(3) 结果:通过电子检索找到974篇论文,其中六项研究被纳入系统评价,五项研究(共208例患者)被纳入荟萃分析。(4) 结论:大麻素补充作为辅助治疗可能会增加克罗恩病诱导期标准治疗成功的几率;从检索到的证据中无法得出其在维持期潜在用途的结论。不建议在溃疡性结肠炎中使用。如果使用,低剂量治疗可能比高剂量更有效。发现使用大麻素治疗的患者平均CDAI降低幅度(平均CDAI降低 = 36.63,95%CI 12.27 - 61.19)大于安慰剂。在未来研究中,建议纳入疾病活动水平以及患者层面的信息,如遗传和行为模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/025c/9599014/69ca1acd73b1/biomedicines-10-02439-g001.jpg

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