Stienrut Pramote, Pongpirul Krit, Phutrakool Phanupong, Savigamin Chatuthanai, Sermsaksasithorn Pim, Chanhom Ornpapha, Jeamjumrus Panthakan, Pongchaichanon Pimlada, Nootim Preecha, Soisamrong Mala, Chuthaputti Anchalee, Wanaratna Kulthanit, Thaneerat Tewan
Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand.
Center of Excellence in Preventive and Integrative Medicine and Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Med Cannabis Cannabinoids. 2024 Jul 17;7(1):125-137. doi: 10.1159/000540153. eCollection 2024 Jan-Dec.
The legalization of cannabis in Thailand has renewed interest in its traditional medical use. This study aimed to explore the prescribing patterns of traditional practitioners and assess the impact of cannabis oil on patients' quality of life, with a specific focus on comparing outcomes between cancer and non-cancer patients.
We conducted a prospective observational cohort study across 30 sites in 21 Thai provinces to analyze the use of "Ganja Oil," a cannabis extract in 10% coconut oil, prescribed for symptoms like pain, anorexia, and insomnia across a diverse patient group, including cancer and migraines. Quality of life was assessed using the Edmonton Symptom Assessment Scale (ESAS) and EQ-5D-5L at baseline, 1, 2, and 3 months. The study included a predefined subgroup analysis to compare the effects on cancer versus non-cancer patients. Data management was facilitated through Research Electronic Data Capture (REDCap), with statistical analysis performed using Stata/MP.
Among 21,284 participants, the mean age was 54.10 ± 15.32 years, with 52.49% being male. The baseline EQ-5D-5L index was 0.85 ± 0.24. Significant differences in EQ-5D-5L indices were seen between cancer patients (0.79 ± 0.32) and non-cancer patients (0.85 ± 0.23; < 0.001). ESAS scores also differed significantly between these groups for all symptoms, except anxiety. The most frequent prescription of Ganja Oil was oral administration at bedtime (88.26%), with the predominant dosage being three drops daily, approximately 0.204 mg of tetrahydrocannabinol in total. Posttreatment, significant improvements were noted: the EQ-5D-5L index increased by 0.11 points (95% CI: 0.11, 0.11; < 0.001) overall, 0.13 points (95% CI: 0.12, 0.14; < 0.001) for cancer patients, and 0.11 points (95% CI: 0.10, 0.11; < 0.001) for non-cancer patients. ESAS pain scores improved by -2.66 points (95% CI: -2.71, -2.61; < 0.001) overall, -2.01 points (95% CI: -2.16, -1.87; < 0.001) for cancer patients, and -2.75 points (95% CI: -2.80, -2.70; < 0.001) for non-cancer patients, with similar significant improvements in other symptoms.
Our study indicates potential benefits of Ganja Oil for improving quality of life among Thai patients, as a complementary treatment. These findings must be viewed in light of the study's design limitations. Further controlled studies are essential to ascertain its efficacy and inform dosing guidelines.
泰国大麻合法化重新引发了人们对其传统医学用途的兴趣。本研究旨在探索传统从业者的处方模式，并评估大麻油对患者生活质量的影响，特别关注比较癌症患者和非癌症患者的治疗结果。
我们在泰国21个省份的30个地点进行了一项前瞻性观察队列研究，以分析“大麻油”（一种10%椰子油中的大麻提取物）在包括癌症和偏头痛患者在内的不同患者群体中用于缓解疼痛、厌食和失眠等症状的使用情况。在基线、1个月、2个月和3个月时，使用埃德蒙顿症状评估量表（ESAS）和EQ-5D-5L评估生活质量。该研究包括一个预定义的亚组分析，以比较对癌症患者和非癌症患者的影响。通过研究电子数据采集（REDCap）进行数据管理，使用Stata/MP进行统计分析。
在21284名参与者中，平均年龄为54.10±15.32岁，男性占52.49%。基线EQ-5D-5L指数为0.85±0.24。癌症患者（0.79±0.32）和非癌症患者（0.85±0.23；P<0.001）的EQ-5D-5L指数存在显著差异。除焦虑外，所有症状的ESAS评分在这两组之间也存在显著差异。大麻油最常见的处方是睡前口服（88.26%），主要剂量为每日三滴，总共约0.204毫克四氢大麻酚。治疗后，观察到显著改善：总体上EQ-5D-5L指数增加了0.11分（95%置信区间：0.11，0.11；P<0.001），癌症患者增加了0.13分（95%置信区间：0.12，0.14；P<0.001），非癌症患者增加了0.11分（95%置信区间：0.10，0.11；P<0.001）。ESAS疼痛评分总体改善了-2.66分（95%置信区间：-2.71，-2.61；P<0.001），癌症患者改善了-2.01分（95%置信区间：-2.16，-1.87；P<0.001），非癌症患者改善了-2.75分（95%置信区间：-2.80，-2.70；P<0.001），其他症状也有类似的显著改善。
我们的研究表明，大麻油作为一种辅助治疗方法，对改善泰国患者的生活质量具有潜在益处。必须根据该研究的设计局限性来看待这些发现。进一步的对照研究对于确定其疗效和制定给药指南至关重要。
