Osher Research Center, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02215, United States.
Conscious Cogn. 2011 Sep;20(3):784-91. doi: 10.1016/j.concog.2010.12.009. Epub 2011 Mar 11.
Evidence that placebo acupuncture is an effective treatment for chronic pain presents a puzzle: how do placebo needles appearing to patients to penetrate the body, but instead sitting on the skin's surface in the manner of a tactile stimulus, evoke a healing response? Previous accounts of ritual touch healing in which patients often described enhanced touch sensations (including warmth, tingling or flowing sensations) suggest an embodied healing mechanism. In this qualitative study, we asked a subset of patients in a singleblind randomized trial in irritable bowel syndrome to describe their treatment experiences while undergoing placebo treament. Analysis focused on patients' unprompted descriptions of any enhanced touch sensations (e.g., warmth, tingling) and any significance patients assigned to the sensations. We found in 5/6 cases, patients associated sensations including "warmth" and "tingling" with treatment efficacy. The conclusion offers a "neurophenomenological" account of the placebo effect by considering dynamic effects of attentional filtering on early sensory cortices, possibly underlying the phenomenology of placebo acupuncture.
证据表明，安慰剂针灸对于慢性疼痛是一种有效的治疗方法，这提出了一个难题：看起来针已经刺进了患者的身体，但实际上只是扎在皮肤表面，以触觉刺激的方式，怎么能引起治疗反应呢？以前关于仪式性触摸治疗的描述中，患者经常描述增强的触摸感（包括温暖、刺痛或流动感），这表明存在一种体现治疗机制。在这项单盲随机试验中，我们要求一部分肠易激综合征患者在接受安慰剂治疗时描述他们的治疗体验。分析集中在患者对任何增强的触摸感（如温暖、刺痛）的自发描述，以及患者对这些感觉赋予的任何意义。我们发现，在 6 例中的 5 例中，患者将“温暖”和“刺痛”等感觉与治疗效果联系起来。这一结论通过考虑注意力过滤对早期感觉皮层的动态影响，为安慰剂效应提供了一种“神经现象学”解释，可能是安慰剂针灸现象学的基础。
