An open-label pilot study of cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis
An open-label pilot study of cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis
复制标题
DOI：
10.1191/1352458504ms1063oa
复制
发表时间：
2004-01-01
影响因子：
5.8
通讯作者：
Fowler, CJ
中科院分区：
文献类型：
--
作者：
Brady, CM;DasGupta, R;Fowler, CJ
大多数多发性硬化症（MS）患者会出现麻烦的下尿路症状（LUTS）。轶事报告表明，大麻可以缓解LUTS，膀胱和神经系统中的大麻素受体是潜在的药理学靶点。在一项开放试验中，我们评估了两种大麻全植物提取物在晚期MS和难治性LUTS患者中的安全性、耐受性、剂量范围和疗效。患者服用含有δ-9-四氢大麻酚（THC）和大麻二酚（CBD;每次喷雾2.5 mg）的提取物8周，然后仅服用THC（每次喷雾2.5 mg THC）8周，然后进入长期扩展。评估包括尿频和尿量图表，失禁垫重量，膀胱测压和视觉模拟量表的继发性麻烦的症状。招募了21名患者，并对15名患者的数据进行了评价。治疗后尿急、尿失禁次数和尿失禁量、尿失禁频率和尿失禁均显著降低（P < 0.05，Wilcoxon符号秩检验）。然而，两种浸提液的每日总排尿量、导管插入量和尿失禁垫重量也显著降低。患者对疼痛、痉挛状态和睡眠质量的自我评估显著改善（P < 0.05，Wilcoxon符号秩检验），疼痛改善持续至中位数35周。几乎没有令人烦恼的副作用，这表明大麻提取物是治疗晚期MS患者泌尿系统和其他问题的安全有效的药物。
The majority of patients with multiple sclerosis ( MS) develop troublesome lower urinary tract symptoms (LUTS). Anecdotal reports suggest that cannabis may alleviate LUTS, and cannabinoid receptors in the bladder and nervous system are potential pharmacological targets. In an open trial we evaluated the safety, tolerability, dose range, and efficacy of two whole-plant extracts of Cannabis sativa in patients with advanced MS and refractory LUTS. Patients took extracts containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD; 2.5 mg of each per spray) for eight weeks followed by THC-only ( 2.5 mg THC per spray) for a further eight weeks, and then into a long-term extension. Assessments included urinary frequency and volume charts, incontinence pad weights, cystometry and visual analogue scales for secondary troublesome symptoms. Twenty-one patients were recruited and data from 15 were evaluated. Urinary urgency, the number and volume of incontinence episodes, frequency and nocturia all decreased significantly following treatment (P < 0.05, Wilcoxon's signed rank test). However, daily total voided, catheterized and urinary incontinence pad weights also decreased significantly on both extracts. Patient self-assessment of pain, spasticity and quality of sleep improved significantly (P < 0.05, Wilcoxon's signed rank test) with pain improvement continuing up to median of 35 weeks. There were few troublesome side effects, suggesting that cannabis-based medicinal extracts are a safe and effective treatment for urinary and other problems in patients with advanced MS.