Enck P, Klosterhalfen S
Department of Internal Medicine VI/Psychosomatics, University Hospitals Tuebingen, Tuebingen, Germany.
Neurogastroenterol Motil. 2005 Jun;17(3):325-31. doi: 10.1111/j.1365-2982.2005.00676.x.
The nature and determinants of the placebo response are widely unknown, as are the underlying psychological and biological mechanisms. High placebo response rates in functional bowel disorders (functional dyspepsia, irritable bowel syndrome) are similar to those in non-intestinal diseases (depression, pain, Parkinson's disease) and not too dissimilar to other organic gastrointestinal diseases (duodenal ulcer, inflammatory bowel diseases). Methodological reasons (regression to the mean, shift in signal detection through manipulation of expectations) and psycho-biological mechanisms (Pavlovian conditioning of biological processes) are proposed to explain a large component of the response variance in clinical trials. Psychobiological mechanisms of the placebo response in functional and organic diseases can also be identified in brain function studies (such as imaging).
安慰剂反应的本质和决定因素，以及潜在的心理和生物学机制，目前仍广为人知。功能性肠道疾病（功能性消化不良、肠易激综合征）中的高安慰剂反应率与非肠道疾病（抑郁症、疼痛、帕金森病）相似，与其他器质性胃肠疾病（十二指肠溃疡、炎症性肠病）也没有太大差异。有人提出了方法学原因（均值回归、通过操纵期望来改变信号检测）和心理生物学机制（生物过程的巴甫洛夫条件反射）来解释临床试验中很大一部分反应差异。在脑功能研究（如成像）中，也可以识别出功能性和器质性疾病中安慰剂反应的心理生物学机制。
