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经皮医用大麻(THC:CBD:CBN配方)治疗下肢疼痛性糖尿病周围神经病变的疗效与安全性

Efficacy and Safety of Transdermal Medical Cannabis (THC:CBD:CBN formula) to Treat Painful Diabetic Peripheral Neuropathy of Lower Extremities.

作者信息

Seevathee Khachornsak, Kessomboon Pattapong, Manimmanakorn Nuttaset, Luangphimai Suyan, Thaneerat Tewan, Wanaratna Kulthanit, Plengphanich Sirichada, Thaenkham Thanamet, Sena Wijitra

机构信息

Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

出版信息

Med Cannabis Cannabinoids. 2024 Nov 14;8(1):1-14. doi: 10.1159/000542511. eCollection 2025 Jan-Dec.

Abstract

INTRODUCTION

Diabetic peripheral neuropathy (DPN) represents a prevalent neurological complication affecting millions of patients globally. This clinical investigation evaluated the therapeutic efficacy and safety profile of a novel transdermal medical cannabis formulation (THC:CBD:CBN) in treating painful DPN of the lower extremities.

METHODS

This phase III, double-blind, placebo-controlled, randomized clinical trial was conducted at Don Chan Hospital, Thailand, enrolling 100 participants over a 12-week intervention period. Using a computer-generated randomization sequence, participants were allocated to receive either the standardized cannabis formulation or a matched placebo. The primary outcome measure comprised pain intensity assessment using the validated Thai version of the Neuropathic Pain Symptom Inventory (NPSI-T). Secondary outcomes encompassed treatment-emergent adverse events and dermatological manifestations. Statistical analyses were performed using SPSS Version 28.0, incorporating generalized estimating equation (GEE) modeling and Analysis of Covariance (ANCOVA). The study protocol received approval from the Institutional Review Board of Khon Kaen University and the Kalasin Provincial Public Health Office Ethics Committee, with trial registration in the Thai Clinical Trials Registry.

RESULTS

The intervention group demonstrated statistically significant reductions in NPSI-T scores across all measured dimensions ( < 0.001). Mean total NPSI-T scores decreased markedly from 25.60 to 5.57 in the treatment cohort, contrasting with minimal reduction from 25.24 to 22.85 in the placebo group. GEE analysis revealed significant pain amelioration at weeks 4, 8, and 12 ( < 0.001). The cannabis formulation exhibited an excellent safety profile, with only 10% of participants reporting mild adverse events, comparable to placebo group outcomes.

CONCLUSION

This novel transdermal medical cannabis formulation (THC:CBD:CBN) demonstrated significant therapeutic efficacy in ameliorating painful DPN symptoms while maintaining a favorable safety profile. These findings provide robust clinical evidence supporting its potential as an innovative therapeutic option for managing painful DPN.

摘要

引言

糖尿病周围神经病变(DPN)是一种普遍存在的神经并发症,全球数百万患者受其影响。本临床研究评估了一种新型经皮医用大麻制剂(THC:CBD:CBN)治疗下肢疼痛性DPN的疗效和安全性。

方法

本III期双盲、安慰剂对照、随机临床试验在泰国Don Chan医院进行,在12周的干预期内招募了100名参与者。使用计算机生成的随机序列,参与者被分配接受标准化大麻制剂或匹配的安慰剂。主要结局指标包括使用经过验证的泰语版神经病理性疼痛症状量表(NPSI-T)进行疼痛强度评估。次要结局包括治疗中出现的不良事件和皮肤表现。使用SPSS 28.0版进行统计分析,采用广义估计方程(GEE)建模和协方差分析(ANCOVA)。该研究方案获得了孔敬大学机构审查委员会和呵叻府公共卫生办公室伦理委员会的批准,并在泰国临床试验注册中心进行了试验注册。

结果

干预组在所有测量维度上的NPSI-T评分均有统计学显著降低(<0.001)。治疗组的平均NPSI-T总分从25.60显著降至5.57,而安慰剂组仅从25.24略有降至22.85。GEE分析显示在第4、8和12周疼痛有显著改善(<0.001)。大麻制剂显示出良好的安全性,只有10%的参与者报告有轻度不良事件,与安慰剂组结果相当。

结论

这种新型经皮医用大麻制剂(THC:CBD:CBN)在改善疼痛性DPN症状方面显示出显著的治疗效果,同时保持了良好的安全性。这些发现提供了有力的临床证据,支持其作为治疗疼痛性DPN的创新治疗选择的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a654/11666268/2ca6159d68e8/mca-2025-0008-0001-542511_F01.jpg

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