NORML: 類風溼性關節炎
- Ingrid Wei
- Apr 13
- 3 min read
類風濕性關節炎(RA)是一種關節炎症性疾病,特徵包括疼痛、僵硬、腫脹以及最終的肢體功能喪失。類風濕性關節炎約影響1%的人口,主要是女性。
大麻素,包括CBD,已被確認具有抗炎、抗關節炎和抗風濕特性,[1-4] 並且內源性大麻素系統已被提出作為類風濕性關節炎的調節因子。[5-6]
然而,目前很少有研究評估大麻或大麻素在類風濕性關節炎(RA)患者中的使用。在其中一項試驗中,研究人員報告指出,在五週期間使用大麻提取物的患者在運動時的疼痛、休息時的疼痛、睡眠質量、炎症和疼痛強度等方面相對安慰劑組有顯著改善。[7] 其他評估合成大麻素在風濕性疾病患者中的應用的臨床試驗結果則較為混合。[8] 2021年《臨床風濕病學雜誌》發表的文獻綜述對26篇系統性評審文獻進行了分析。作者總結道:“大麻、大麻衍生產品和合成大麻素可能會輕微減少類風濕性關節炎患者的疾病活動度。”然而,他們也警告說:“其使用可能對疼痛減輕幾乎沒有影響,並可能輕微增加神經系統的不良反應。關於大麻、大麻衍生產品和合成大麻素對嚴重不良事件風險的影響,證據仍不確定。”[9] 目前還有關於使用CBD治療骨關節炎患者的其他人類臨床試驗在進行中。[10]
儘管研究結果有限,類風濕性關節炎(RA)患者經常報告將大麻作為治療手段。例如,在2005年一項澳大利亞醫療大麻患者的匿名問卷調查中,25%的受訪者表示使用大麻素治療RA。[11] 一項對英國醫療大麻患者的調查發現,超過20%的受訪者報告使用大麻來緩解關節炎症狀。[12] 一項對州登記的醫療大麻疼痛患者的綜述報告指出,27%的患者使用大麻治療關節炎。[13] 最近,2020年在《風濕病學》期刊上發表的調查數據報告稱:“近20%的風濕性疾病患者積極使用大麻,並改善了疼痛。… 我們的綜合分析強調了大麻對疼痛的有益效果,並強化了大麻可用於鎮痛的觀點。”[14]
參考文獻
[1] Zaka et al. 2017. Comparative in silico analyses of Cannabis sativa, Prunella vulgaris and Withania somnifera compounds elucidating the medicinal properties against rheumatoid arthritis. Journal of Molecular Graphs & Modeling 74: 296-304.
[2] Malfait et al. 2000. The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine. Journal of the Proceedings of the National Academy of Sciences 97: 9561-9566.
[3] Lowin et al., 2020. Cannabidiol: A killer for inflammatory rheumatoid arthritis synovial fibroblasts. Cell Death & Disease 11 [E-pub ahead of print].
[4] Croxford and Yamamura. 2005. Cannabinoids and the immune system: potential for the treatment of inflammatory diseases. Journal of Neuroimmunology 166: 3-18.
[5] Gui et al. 2015. The endocannabinoid system and its therapeutic implications in rheumatoid arthritis. International Immunopharmacology 26: 86-91.
[6] Kaur et al. 2020. The endocannabinoid signaling pathway as an emerging target in pharmacotherapy, earmarking mitigation of destructive events in rheumatoid arthritis. Life Sciences 257 [E-pub ahead of print].
[7] Blake et al. 2006. Preliminary assessment of the efficacy, tolerability and safety of a cannabis medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. Rheumatology 45: 50-52.
[8] Fitzcharles et al. 2016. Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases: A systematic review of randomized controlled trials. Schmerz 30: 47-61.
[9] Schulze-Schiappacasse et al. 2021. Are cannabis, cannabis-derived products, and synthetic cannabinoids a therapeutic tool for rheumatoid arthritis? A friendly summary of the evidence. Journal of Clinical Rheumatology. [E-pub ahead of print].
[11] Swift et al. 2005. Survey of Australians using cannabis for medical purposes. Harm Reduction Journal 4: 2-18.
[12] Ware et al. 2005. The medicinal use of cannabis in the UK: results of a nationwide survey. International Journal of Clinical Practice 59: 291-295.
[13] Aggarwal et al. 2009. Characteristics of patients with chronic pain accessing treatment with medical cannabis in Washington state. Journal of Opioid Management 5: 257-286.
[14] Guillouard et al. 2020. Cannabis use assessment and its impact on pain in rheumatologic diseases: A systematic review and meta-analysis. Rheumatology 60: 549-556.
原文標題:《Rheumatoid Arthritis》
原文作者:NORML
原始網站:https://norml.org
翻譯者:大麻101
翻譯日期:2025年4月
翻譯聲明:本文章由原文翻譯而來,原文發表於NORML。如需閱讀原文,請訪問 https://norml.org/marijuana/library/recent-medical-marijuana-research/rheumatoid-arthritis/
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