Anesthesiology, Pain Clinic, Hannover Medical School, Hannover, Germany.
Pharmacopsychiatry. 2024 May;57(3):152-159. doi: 10.1055/a-2231-6630. Epub 2024 Jan 10.
Chronic pain is primarily conceptualized as a disease in its own right when it is associated with emotional distress and functional impairment. Pathophysiologically, dysfunction of the cortico-mesolimbic connectome is of major importance, with overlapping signals in the nociceptive and stress systems. The endocannabinoid system plays an important role in the central processing of nociceptive signals and regulates the central stress response. Clinically, there is moderate evidence that cannabis-based medicines (CBM) can contribute to a significant reduction in pain, especially the associated pain affect, and improvement in physical function and sleep quality in a proportion of patients with chronic pain. The analgesic effect appears to be largely independent of the cause of pain. In this context, CBM preferentially regulates stress-associated pain processing.
慢性疼痛主要被视为一种与情绪困扰和功能障碍相关的疾病。从病理生理学上讲，皮质-中脑边缘连接组的功能障碍具有重要意义，疼痛和应激系统存在重叠信号。内源性大麻素系统在疼痛信号的中枢处理中起着重要作用，并调节中枢应激反应。临床研究表明，大麻素类药物（CBM）在一定程度上可以显著减轻疼痛，特别是与疼痛相关的情绪，改善慢性疼痛患者的身体功能和睡眠质量。其镇痛作用似乎在很大程度上与疼痛的原因无关。在这种情况下，CBM 优先调节与应激相关的疼痛处理。
