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安慰剂理论及其对研究和临床实践的启示:近期文献综述

Placebo theory and its implications for research and clinical practice: a review of the recent literature.

作者信息

Koshi Edvin B, Short Christine Ann

机构信息

Pain Management Unit, Department of Anesthesia, Dalhousie University, Queen Elisabeth II Health Sciences Center, Halifax, Nova Scotia, Canada.

出版信息

Pain Pract. 2007 Mar;7(1):4-20. doi: 10.1111/j.1533-2500.2007.00104.x.

Abstract

Although placebo effect is a common phenomenon in medicine and research, its mechanisms are not well understood. With the advent of modern medicine, placebo became a symbol for an outdated, morally questionable practice implying deceit and paternalism. However, in recent years, there has been an increasing amount of rigorous research into the mechanisms of placebo response and placebo analgesia with most studies coming from the field of pain medicine. New theories on placebo mechanisms have shown that placebo represents the psychosocial aspect of every treatment and the study of placebo is essentially the study of psychosocial context that surrounds the patient. Therefore, its understanding is essential for researchers and all medical practitioners, particularly those dealing with patients suffering from pain, depression, and motor disorders. In this article, we review the theories on placebo mechanisms and discuss their implications for clinical practice and the design of clinical trials.

摘要

尽管安慰剂效应在医学和研究中是一种常见现象,但其机制尚未得到充分理解。随着现代医学的出现,安慰剂成为了一种过时的、在道德上存在问题的做法的象征,意味着欺骗和家长式作风。然而,近年来,对安慰剂反应和安慰剂镇痛机制进行了越来越多的严谨研究,其中大部分研究来自疼痛医学领域。关于安慰剂机制的新理论表明,安慰剂代表了每种治疗的心理社会层面,对安慰剂的研究本质上是对围绕患者的心理社会背景的研究。因此,对于研究人员和所有医学从业者,尤其是那些治疗疼痛、抑郁和运动障碍患者的人员来说,理解安慰剂效应至关重要。在本文中,我们回顾了关于安慰剂机制的理论,并讨论了它们对临床实践和临床试验设计的影响。

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