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| 内源性大麻素系统在偏头痛发病机制中的作用* |
| The endocannabinoid system regulates the pathogenesis of migraine |
| 投稿时间：2024-11-18 修订日期：2025-12-31 |
| DOI： |
| 中文关键词: 偏头痛，内源性大麻素系统，镇痛，发病机制 |
| 英文关键词: Migraine, Endocannabinoid System, Analgesia, Pathogenesis |
| 基金项目:山东省自然科学基金(编号：ZR2019BH001,ZR2021YQ55),山东泰山学者计划项目(编号：tsqn201909146 ) |
| 作者 | 单位 | 邮编 | | 朱玉璞 | 济宁医学院，精神卫生学院 | 272000 | | 郁昊* | 济宁医学院，精神卫生学院 | 272000 |
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| 中文摘要: |
| 偏头痛是一种临床常见的慢性致残性疾病，其发病机制目前尚未完全阐明，目前主流观点为三叉神经血管学说，其慢性化过程与中枢敏化和外周敏化密切相关。大麻用于头痛的治疗有悠久的历史，但是其治疗机制尚未完全阐明。内源性大麻素系统痛具有镇痛、调节免疫和情绪等作用，其对神经突触、神经胶质细胞的调控都与偏头痛的病理机制密切相关，该系统可以通过PI3K-Akr，cAMP-PKA等通路调节GABA等神经递质的释放，从而调节疼痛传导通路的上行易化与下行抑制，同时还能够产生显著的抗炎作用，最终介导偏头痛发作及其慢性化。偏头痛的防治目前面临可选药物少，有效率低以及强效镇痛药物无法长期服用等困境。本文以偏头痛的发病机制和内源性大麻素的镇痛机制为切入点进行论述，以期望能系统阐述内源性大麻素系统与偏头痛的关系。 |
| 英文摘要: |
| Migraine is a clinically common chronic disabling disease, and its pathogenesis has not yet been fully elucidated. The current mainstream view of migraine is the trigeminovascular theory, and its chronicization process is closely associated with central and peripheral sensitization. Cannabis has a long history of being used in the treatment of headaches, yet its therapeutic mechanism remains incompletely understood. The endocannabinoid system exerts effects such as analgesia, immune regulation, and mood modulation. Its regulation of neural synapses and neuroglial cells is closely linked to the pathological mechanisms of migraine. This system can regulate the release of neurotransmitters included GABA through pathways such as PI3K-Akt and cAMP-PKA, thereby modulating the ascending facilitation and descending inhibition of pain transmission pathways. Additionally, it can produce significant anti-inflammatory effects, ultimately mediating migraine attacks and their chronicization. The prevention and treatment of migraine currently face challenges such as a limited range of available drugs, low efficacy, and the inability to take potent analgesics for long periods. This article discusses the pathogenesis of migraine and the analgesic mechanism of endocannabinoids as entry points, aiming to systematically elaborate on the relationship between the endocannabinoid system and migraine. |
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