Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems A Clinical Review
Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems A Clinical Review
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DOI：
10.1001/jama.2015.6199
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发表时间：
2015-06-23
影响因子：
120.7
通讯作者：
Hill, Kevin P.
中科院分区：
文献类型：
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作者：
Hill, Kevin P.
重要性截至2015年3月，23个州和哥伦比亚特区有医用大麻法。医生应该了解医用大麻法律的科学原理和实际意义。目的综述医用大麻的药理学、适应症、证据审查通过MEDLINE对1948年至2015年3月期间关于医用大麻的医学文献进行了审查，重点是28项大麻素作为药物治疗适应症以外的适应症的随机临床试验。是2美国食品和药物管理局批准的大麻素（屈大麻酚和nabilone），其中包括恶心和呕吐与化疗和食欲刺激在wastingdiseases.Findings使用大麻慢性疼痛，神经性疼痛，痉挛由于多发性硬化症是由高质量的证据支持。6项试验包括325名患者，研究慢性疼痛，6项试验包括396名患者，研究神经性疼痛，12项试验包括1600名患者，重点是多发性硬化症。这些试验中有几个有积极的结果，表明大麻或大麻素可能是有效的这些indications.CONCLUSIONS和相关性医用大麻是用来治疗的适应症，其中一些有证据支持大麻治疗和许多没有。医生应该教育患者有关医用大麻，以确保它被正确使用，患者将受益于它的使用。
IMPORTANCE As of March 2015, 23 states and the District of Columbia had medical marijuana laws in place. Physicians should know both the scientific rationale and the practical implications for medical marijuana laws.OBJECTIVE To review the pharmacology, indications, and laws related to medical marijuana use.EVIDENCE REVIEW The medical literature on medical marijuana was reviewed from 1948 to March 2015 via MEDLINE with an emphasis on 28 randomized clinical trials of cannabinoids as pharmacotherapy for indications other than those for which there are 2 US Food and Drug Administration-approved cannabinoids (dronabinol and nabilone), which include nausea and vomiting associated with chemotherapy and appetite stimulation in wasting illnesses.FINDINGS Use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence. Six trials that included 325 patients examined chronic pain, 6 trials that included 396 patients investigated neuropathic pain, and 12 trials that included 1600 patients focused on multiple sclerosis. Several of these trials had positive results, suggesting that marijuana or cannabinoids may be efficacious for these indications.CONCLUSIONS AND RELEVANCE Medical marijuana is used to treat a host of indications, a few of which have evidence to support treatment with marijuana and many that do not. Physicians should educate patients about medical marijuana to ensure that it is used appropriately and that patients will benefit from its use.