应用大麻治疗帕金森病运动障碍的随机双盲交叉研究  

Cannabis for dyskinesia in Parkinson disease: A randomized double blind crossov er study

作　　者：Carroll C.B. Bain P.O. Teare L. 姚庆和 

机构地区：[1]ITTC Building, Tamar Science Park, Plymouth, PL6 8BX, United Kingdom Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第3期53-54,共2页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Background: The long term treatment of Parkinson disease (PD) may be complica ted by the development of levodopainduced dyskinesia. Clinical and animal model data support the view that modulation of cannabinoid function may exert an antid yskinetic effect. The authors conducted a randomized, double blind, placebo co ntrolled crossover trial to examine the hypothesis that cannabis may have a bene ficial effect on dyskinesia in PD. Methods: A 4 week dose escalation study was performed to assess the safety and tolerability of cannabis in six PD patients w ith levodopa induced dyskinesia. Then a randomized placebo controlled crossove r study (RCT) was performed, in which 19 PD patients were randomized to receive oral cannabis extract followed by placebo or vice versa. Each treatment phase la sted for 4 weeks with an intervening 2 week washout phase. The primary outcome measure was a change in Unified Parkinsons Disease Rating Scale (UPDRS) (items 32 to 34) dyskinesia score. Secondary outcome measures included the Rush scale, Bain scale, tablet arm drawing task, and total UPDRS score following a levodopa challenge, as well as patient completed measures of a dyskinesia activities of daily living (ADL) scale, the PDQ 39, on off diaries, and a range of category rating scales. Results: Seventeen patients completed the RCT. Cannabis was well tolerated, and had no pro or antiparkin sonian action. The re was no evidence for a treatment effect on levodopa induced dyskinesia as ass essed by the UPDRS, or any of the secondary outcome measures. Conclusions: Orall y administered cannabis extract resulted in no objective or subjective improveme nt in dyskinesias or parkinsonism.Background: The long term treatment of Parkinson disease (PD) may be complica ted by the development of levodopainduced dyskinesia. Clinical and animal model data support the view that modulation of cannabinoid function may exert an antid yskinetic effect. The authors conducted a randomized, double blind, placebo co ntrolled crossover trial to examine the hypothesis that cannabis may have a bene ficial effect on dyskinesia in PD. Methods: A 4 week dose escalation study was performed to assess the safety and tolerability of cannabis in six PD patients w ith levodopa induced dyskinesia. Then a randomized placebo controlled crossove r study (RCT) was performed, in which 19 PD patients were randomized to receive oral cannabis extract followed by placebo or vice versa. Each treatment phase la sted for 4 weeks with an intervening 2 week washout phase. The primary outcome measure was a change in Unified Parkinsons Disease Rating Scale (UPDRS) (items 32 to 34) dyskinesia score. Secondary outcome measures included the Rush scale, Bain scale, tablet arm drawing task, and total UPDRS score following a levodopa challenge, as well as patient completed measures of a dyskinesia activities of daily living (ADL) scale, the PDQ 39, on off diaries, and a range of category rating scales. Results: Seventeen patients completed the RCT. Cannabis was well tolerated, and had no pro or antiparkin sonian action. The re was no evidence for a treatment effect on levodopa induced dyskinesia as ass essed by the UPDRS, or any of the secondary outcome measures. Conclusions: Orall y administered cannabis extract resulted in no objective or subjective improveme nt in dyskinesias or parkinsonism.

关 键 词：交叉研究 随机双盲 左旋多巴 帕金森病 运动障碍 安慰剂对照 写字板 交叉试验 动物模型 萃取物 

分 类 号：R742.5[医药卫生—神经病学与精神病学]