基于大麻的慢性疼痛产品:一个更新的系统审查
Roger Chou1, Rongwei Fu2, Azrah Y Ahmed1
1Pacific Northwest Evidence-based Practice Center, Division of Medical Informatics, Clinical Epidemiology & Translational Data Science, Department of Medicine, Oregon Health & Science University, Portland, Oregon (R.C., A.Y.A.).
Annals of internal medicine
|December 22, 2025
概括
具有高THC-CBD比率的大麻素可能在慢性疾病中提供轻微的疼痛缓解,但可能导致头和镇静等副作用. 低THC-CBD产品没有显著的好处.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 疼痛管理 疼痛管理
- 证据综合 证据综合
背景情况:
- 对于治疗慢性疼痛的大麻素的有效性和安全性仍然不确定.
- 现有证据需要更新,以告知临床实践和患者护理.
- 大麻素因其 analgesic 特性而越来越多地被探索.
研究的目的:
- 进行关于大麻素对慢性疼痛的益处和危害的最新证据综合.
- 根据其THC-CBD比率,来源和施用方法来评估大麻素.
- 提供当前研究成果的全面概述.
主要方法:
- 在2025年7月之前发表的随机化安慰剂对照试验 (RCT) 的系统审查.
- 在主要数据库中进行的搜索:Ovid MEDLINE,PsycINFO,Embase,Cochrane图书馆和Scopus.
- 数据提取和偏差风险评估由双重审查者进行;证据的强度评估.
主要成果:
- 25个RCT (n=2303) 评估了短期使用大麻素,主要用于神经病痛.
- 高THC-CBD比率的产品 (口服合成/纯化或口腔菌提取) 显示轻微减少疼痛,但增加头,镇静和恶心.
- 纳比龙 (仅含高THC) 减少了疼痛,而德罗纳醇没有;低THC-CBD干预没有显著的益处.
结论:
- 某些具有相似或高THC-CBD比率的大麻素产品可能为神经病痛提供适度的短期疼痛缓解,伴随着常见的不良事件.
- 与dronabinol不同的是,纳比隆在高THC仅产品中表现出有效性.
- 需要对长期结果和各种大麻产品类型进行进一步的研究,特别是那些THC-CBD比率较低的产品.
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