Benson Melissa J, Abelev Sarah V, Connor Susan J, Corte Crispin J, Martin Lewis J, Gold Lucy K, Suraev Anastasia S, McGregor Iain S
Lambert Initiative for Cannabinoid Therapeutics, The University of Sydney, Sydney, New South Wales, Australia.
Faculty of Science, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia.
Crohns Colitis 360. 2020 Apr 16;2(2):otaa015. doi: 10.1093/crocol/otaa015. eCollection 2020 Apr.
Medicinal cannabis (MC) is an increasingly utilized treatment option for various refractory diseases. While robust clinical evidence supporting MC efficacy in inflammatory bowel disease (IBD) is lacking, many IBD patients report using MC to obtain symptomatic relief. Understanding this use and associated outcomes may help inform future clinical trials.
A cross-sectional anonymous online survey was conducted involving Australians with IBD. It examined attitudes and experiences with MC in relation to IBD management. The survey included validated sub-questionnaires assessing quality of life, medication adherence, IBD severity, and functional impairment.
A total of 838 responses were obtained. Results showed 25.3% (n = 212) of respondents were current or previous users of MC (18.1% current, 7.2% previous). Half of the current users also consumed cannabis recreationally although less frequently than for medicinal purposes. Cannabis consumption was via smoking (joints 34.2%; water pipe/bongs 14.5%) or as an oral liquid (19.7%) with products obtained from recreational dealers (44.6%), friends/family (26.1%), or self-grown (9.8%). Only 3 respondents reported using legally accessed products. Clinical ratings of IBD severity did not differ according to cannabis use although users reported more hospitalizations, less engagement with specialist services, and lower medication adherence. IBD symptoms reported as positively affected by cannabis included abdominal pain, stress, sleep, cramping, and anxiety. Most users (92.7%) endorsed cannabis as effective in symptom management. Cannabis-using ulcerative colitis patients reported better quality of life than nonusers on some measures.
Many patients in Australia are using illicit MC to manage their IBD. Further clinical trials are required to validate, or refute, patient claims around MC efficacy for symptom control in IBD.
药用大麻（MC）越来越多地被用于治疗各种难治性疾病。虽然缺乏有力的临床证据支持MC对炎症性肠病（IBD）的疗效，但许多IBD患者报告使用MC来缓解症状。了解这种使用情况及相关结果可能有助于为未来的临床试验提供参考。
对患有IBD的澳大利亚人进行了一项横断面匿名在线调查。调查了与IBD管理相关的对MC的态度和使用经历。该调查包括经过验证的子问卷，用于评估生活质量、药物依从性、IBD严重程度和功能损害。
共获得838份回复。结果显示，25.3%（n = 212）的受访者是MC的当前使用者或曾经使用者（当前使用者占18.1%，曾经使用者占7.2%）。一半的当前使用者也会出于娱乐目的使用大麻，不过频率低于药用。大麻的使用方式包括吸烟（卷烟占34.2%；水烟壶占14.5%）或口服液体（占19.7%），所使用的产品来自娱乐经销商（占44.6%）、朋友/家人（占26.1%）或自行种植（占9.8%）。只有3名受访者报告使用合法获取的产品。IBD严重程度的临床评分在大麻使用者和非使用者之间没有差异，不过使用者报告住院次数更多、与专科服务的接触较少以及药物依从性较低。报告称受大麻积极影响的IBD症状包括腹痛、压力、睡眠、痉挛和焦虑。大多数使用者（92.7%）认可大麻在症状管理方面有效。在某些指标上，使用大麻的溃疡性结肠炎患者报告的生活质量比未使用者更好。
澳大利亚许多患者正在使用非法的MC来管理他们的IBD。需要进一步的临床试验来验证或反驳患者关于MC对IBD症状控制疗效的说法。
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