Modum Bad Psychiatric Center, Vikersund, Norway; University of Wisconsin-Madison, Madison, WI, United States.
Int Rev Neurobiol. 2018;139:191-210. doi: 10.1016/bs.irn.2018.07.019. Epub 2018 Aug 6.
Response to placebos has been documented experimentally for many medical disorders and had been verified in laboratory studies. However, the mechanisms that produce the response to placebos are not well identified, although it appears that the relationship between the medical practitioner and the patient plays an important role. Humans and other eusocial animals evolved to heal in a social context, so it is not surprising that the healing relationship is an important factor in the delivery of health services. Several well-designed studies have examined aspects of the relationship and response to placebo and the evidence is strong that various aspects of the relationship augment response to placebo. There is also meta-analytic evidence that the relationship improves physical and mental health services. Finally, there are three possible ways the relationship augments the response to placebo: combats loneliness, increases expectancies for relief, and coregulates emotions and decreases arousal.
对于许多医学疾病，已经有实验记录证明了安慰剂的反应，并且在实验室研究中得到了验证。然而，产生安慰剂反应的机制还没有得到很好的确定，尽管看起来医患关系起着重要的作用。人类和其他真社会性动物是在社会环境中进化而来的，因此，治疗关系是提供医疗服务的一个重要因素，这并不奇怪。几项精心设计的研究已经检查了关系和对安慰剂的反应的各个方面，有强有力的证据表明，关系的各个方面都增强了对安慰剂的反应。还有荟萃分析的证据表明，这种关系改善了身心健康服务。最后，有三种可能的方式可以增强安慰剂的反应：对抗孤独感，增加对缓解的期望，以及调节情绪和降低兴奋度。
