Pain：抗焦虑药治疗神经性疼痛

2012年10月31日--最近，卡尔加里霍奇基斯脑研究所的一项研究显示，抗焦虑药大麻隆（Nabilone）可以治疗糖尿病周围神经病变或神经性疼痛。在为期12周的有安慰剂对照的临床研究中，研究人员招募了60例糖尿病周围神经病变患者。在研究结束时，服用大麻隆的患者疼痛减少，睡眠和焦虑也得到改善，相比较于安慰剂。

神经科医师和Cory Toth博士说：大麻隆是一个很好的选择，以帮助治疗糖尿病神经性疼痛，该药副作用很少。

在研究中使用的药物通用名称为大麻隆，目前在加拿大用于治疗化疗病人的恶心。这项研究给医生有更多的证据来支持用其处方来治疗糖尿病神经病变疼痛。大麻隆是一种人工合成大麻素，它模拟大麻的一些化学成分。目前已被加拿大卫生部和FDA批准。

2型糖尿病流行率正在迅速增长。最近的研究表明，糖尿病神经病变会导致患者麻木，刺痛，烧灼感和疼痛。大约有一半的糖尿病患者患有糖尿病周围神经病变，服用大麻隆后，患者可以减轻痛苦，这项研究结果发表在十月发行的Pain杂志上。

与疼痛相关的拓展阅读：

• Arthr & Rheum：低水平的维生素D或引发白种人和黑种人不同程度的慢性疼痛
• BMC Med：他莫昔芬可抑制男性乳房发育症和男性乳房疼痛
• Pain Medicine：初级护理患者的疼痛、慢性疾病、抑郁症与IL-6
• 镰状细胞贫血治疗不能止步于疼痛缓解
• Stroke：缺血性卒中后慢性疼痛综合征常见 更多信息请点击：有关疼痛更多资讯

An enriched-enrolment, randomized withdrawal, flexible-dose, double-blind, placebo-controlled, parallel assignment efficacy study of nabilone as adjuvant in the treatment of diabetic peripheral neuropathic pain

Cannabinoids are emerging as potential options for neuropathic pain treatment. This study evaluated an oral cannabinoid, nabilone, in the treatment of refractory human diabetic peripheral neuropathic pain (DPN). We performed a single-center, randomized, double-blind, placebo-controlled, flexible-dose study with an enriched enrolment randomized withdrawal design. DPN subjects with a pain score ?4 (0-10 scale) continued regular pain medications and were administered single-blinded adjuvant nabilone for 4 weeks. Subjects achieving ?30% pain relief (26/37) were then randomized and treated with either flexible-dose nabilone 1-4 mg/day (n = 13) or placebo (n = 13) in a further 5-week double-blind treatment period, with 30% (11/37) of subjects deemed run-in-phase nabilone nonresponders. For nabilone run-in-phase responders, there was an improvement in the change in mean end-point neuropathic pain vs placebo (mean treatment reduction of 1.27; 95% confidence interval 2.29-0.25, P = 0.02), with an average nabilone dose at end point of 2.9 ± 1.1 mg/day, and improvements from baseline for the anxiety subscale of the Hospital Anxiety and Depression Scale, the Medical Outcomes Study sleep scale problems index, and the European Quality of Life-5-Domains index score (each P < 0.05). Nabilone run-in-phase responders reported greater global end-point improvement with nabilone than with placebo (100% vs 31%; P < 0.05). Medication-related confusion led to discontinuation in 2/37 subjects during single-blind nabilone treatment. Potential unmasking occurred in 62% of both groups. Flexible-dose nabilone 1-4 mg/day was effective in relieving DPN symptoms, improving disturbed sleep, quality of life, and overall patient status. Nabilone was well tolerated and successful as adjuvant in patients with DPN.