Department of Neurology, Center for Neurological Restoration - Headache and Chronic Pain Medicine, Cleveland Clinic Neurological Institute, Cleveland, OH, 44195, USA.
Headache. 2018 Jul;58(7):1139-1186. doi: 10.1111/head.13345.
Comprehensive literature reviews of historical perspectives and evidence supporting cannabis/cannabinoids in the treatment of pain, including migraine and headache, with associated neurobiological mechanisms of pain modulation have been well described. Most of the existing literature reports on the cannabinoids Δ -tetrahydrocannabinol (THC) and cannabidiol (CBD), or cannabis in general. There are many cannabis strains that vary widely in the composition of cannabinoids, terpenes, flavonoids, and other compounds. These components work synergistically to produce wide variations in benefits, side effects, and strain characteristics. Knowledge of the individual medicinal properties of the cannabinoids, terpenes, and flavonoids is necessary to cross-breed strains to obtain optimal standardized synergistic compositions. This will enable targeting individual symptoms and/or diseases, including migraine, headache, and pain.
Review the medical literature for the use of cannabis/cannabinoids in the treatment of migraine, headache, facial pain, and other chronic pain syndromes, and for supporting evidence of a potential role in combatting the opioid epidemic. Review the medical literature involving major and minor cannabinoids, primary and secondary terpenes, and flavonoids that underlie the synergistic entourage effects of cannabis. Summarize the individual medicinal benefits of these substances, including analgesic and anti-inflammatory properties.
There is accumulating evidence for various therapeutic benefits of cannabis/cannabinoids, especially in the treatment of pain, which may also apply to the treatment of migraine and headache. There is also supporting evidence that cannabis may assist in opioid detoxification and weaning, thus making it a potential weapon in battling the opioid epidemic. Cannabis science is a rapidly evolving medical sector and industry with increasingly regulated production standards. Further research is anticipated to optimize breeding of strain-specific synergistic ratios of cannabinoids, terpenes, and other phytochemicals for predictable user effects, characteristics, and improved symptom and disease-targeted therapies.
已对支持大麻/大麻素治疗疼痛（包括偏头痛和头痛）的历史观点和证据进行了全面的文献综述，其中包括相关的疼痛调节神经生物学机制。现有的大部分文献都报告了大麻素 Δ-四氢大麻酚（THC）和大麻二酚（CBD）或一般的大麻。有许多大麻品种在大麻素、萜烯、类黄酮和其他化合物的组成上差异很大。这些成分协同作用，产生广泛的益处、副作用和品种特征变化。了解大麻素、萜烯和类黄酮的个体药用特性对于杂交品种以获得最佳标准化协同成分是必要的。这将使针对个别症状和/或疾病（包括偏头痛、头痛和疼痛）成为可能。
综述大麻/大麻素治疗偏头痛、头痛、面部疼痛和其他慢性疼痛综合征的医学文献，以及大麻在对抗阿片类药物流行方面的潜在作用的支持证据。综述涉及主要和次要大麻素、初级和次级萜烯以及类黄酮的医学文献，这些物质构成了大麻的协同增效作用。总结这些物质的个体药用益处，包括镇痛和抗炎特性。
越来越多的证据表明大麻/大麻素具有各种治疗益处，特别是在治疗疼痛方面，这也可能适用于偏头痛和头痛的治疗。也有证据表明，大麻可能有助于阿片类药物戒断和逐渐减少，因此它可能成为对抗阿片类药物流行的潜在武器。大麻科学是一个快速发展的医学领域和产业，其生产标准也在不断得到规范。预计将进一步研究，以优化大麻品种特定协同大麻素、萜烯和其他植物化学物质的比例，以实现可预测的用户效果、特征，并改善针对症状和疾病的治疗。
