Medoff Zev M, Colloca Luana
National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA.
Pain Manag. 2015;5(2):89-96. doi: 10.2217/pmt.15.3.
Expectations of pain relief drive placebo analgesia. Understanding how expectations of improvement trigger distinct biological systems to shape therapeutic analgesic outcomes has been the focus of recent pharmacologic and neuroimaging studies in the field of pain. Recent findings indicate that placebo effects can imitate the actions of real painkillers and promote the endogenous release of opioids and nonopioids in humans. Social support and observational learning also contribute to placebo analgesic effects. Distinct psychological traits can modulate expectations of analgesia, which facilitate brain pain control mechanisms involved in pain reduction. Many studies have highlighted the importance and clinical relevance of these responses. Gaining deeper understanding of these pain modulatory mechanisms has important implications for personalizing patient pain management.
对疼痛缓解的期望驱动着安慰剂镇痛作用。了解改善的期望如何触发不同的生物系统以塑造治疗性镇痛效果，一直是疼痛领域近期药理学和神经影像学研究的重点。最近的研究结果表明，安慰剂效应可以模仿真正止痛药的作用，并促进人体中阿片类药物和非阿片类药物的内源性释放。社会支持和观察性学习也有助于安慰剂镇痛作用。不同的心理特征可以调节镇痛期望，这有助于参与减轻疼痛的大脑疼痛控制机制。许多研究都强调了这些反应的重要性和临床相关性。更深入地了解这些疼痛调节机制对个性化患者疼痛管理具有重要意义。
