Cannabis in painful HIV-associated sensory neuropathy - A randomized placebo-controlled trial
Cannabis in painful HIV-associated sensory neuropathy - A randomized placebo-controlled trial
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DOI：
10.1212/01.wnl.0000253187.66183.9c
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发表时间：
2007-02-13
期刊：
影响因子：
9.9
通讯作者：
Petersen, K. L.
中科院分区：
文献类型：
--
作者：
Abrams, D. I.;Jay, C. A.;Petersen, K. L.
目的：探讨烟熏大麻对人类免疫缺陷病毒(HIV)相关性感觉神经病的神经病理性疼痛的影响及实验性疼痛模型。方法：2003年5月至2005年5月在住院综合临床研究中心进行的前瞻性、随机、安慰剂对照试验，研究对象为患有疼痛的HIV相关感觉神经病的成年人。患者被随机分配到吸食大麻(3.56%四氢大麻酚)或相同的安慰剂香烟，每天抽三次大麻类化合物，为期5天。主要结果测量包括慢性疼痛的分级和疼痛强度降低30%的百分比。采用皮肤热刺激法和热/辣椒素敏化模型评价了烟熏大麻的急性镇痛和抗痛敏作用。结果：50名患者完成了整个试验。与安慰剂(p=0.03)相比，吸食大麻减少了34%(中位数减少；IQR=-71，-16)的日常疼痛(IQR=-29，8)。据报道，大麻组的疼痛减轻幅度超过30%，大麻组为52%，安慰剂组为24%(p=0.04)。第一支大麻香烟可减轻慢性疼痛的中位数为72%，而服用安慰剂的为15%(p<；0.001)。大麻可减少实验引起的对毛发和von Frey毛发刺激的痛敏(p
Objective: To determine the effect of smoked cannabis on the neuropathic pain of HIV-associated sensory neuropathy and an experimental pain model. Methods: Prospective randomized placebo-controlled trial conducted in the inpatient General Clinical Research Center between May 2003 and May 2005 involving adults with painful HIV-associated sensory neuropathy. Patients were randomly assigned to smoke either cannabis (3.56% tetrahydrocannabinol) or identical placebo cigarettes with the cannabinoids extracted three times daily for 5 days. Primary outcome measures included ratings of chronic pain and the percentage achieving > 30% reduction in pain intensity. Acute analgesic and anti-hyperalgesic effects of smoked cannabis were assessed using a cutaneous heat stimulation procedure and the heat/capsaicin sensitization model. Results: Fifty patients completed the entire trial. Smoked cannabis reduced daily pain by 34% (median reduction; IQR = -71, -16) vs 17% (IQR = -29, 8) with placebo (p = 0.03). Greater than 30% reduction in pain was reported by 52% in the cannabis group and by 24% in the placebo group (p = 0.04). The first cannabis cigarette reduced chronic pain by a median of 72% vs 15% with placebo (p < 0.001). Cannabis reduced experimentally induced hyperalgesia to both brush and von Frey hair stimuli (p