Medical University of Vienna, Vienna, Austria.
Wien Klin Wochenschr. 2020 May;132(9-10):228-231. doi: 10.1007/s00508-020-01626-9. Epub 2020 Mar 24.
The history of medicine and the history of placebo are closely intertwined. To understand placebo and its effects this article gives a brief overview about its history, the possible mechanisms of action and its counterpart, nocebo.The Catholic Church used placebo around the sixteenth century for the separation from real and incorrect exorcisms, but it needed Henry Beecher during World War II to quantify the placebo effect as control arm in well-designed studies.Until today the different mechanisms of action of placebo remain poorly researched. Understanding them would allow its effect to be modulated to better serve in research and clinical settings. Expectation, psychosocial context and conditioning play a significant role in the effect size and amplitude.The counterpart, nocebo, is even less investigated, even it is commonly observed as adverse effects during medical treatments.Conclusion: Placebo and nocebo are both underestimated and underresearched in their value. Through further investigation doctors could strengthen the placebo response and prevent adverse effects to help their patients at low cost. These techniques would benefit the patient-doctor relationship, which is the alter of a trust-based successful therapy.
医学史和安慰剂史紧密交织在一起。为了理解安慰剂及其作用，本文简要概述了它的历史、可能的作用机制及其对应物——反安慰剂。天主教会在 16 世纪左右使用安慰剂来区分真实和错误的驱魔，但直到第二次世界大战期间，亨利·比彻（Henry Beecher）才将安慰剂作为对照臂用于精心设计的研究中，对安慰剂效应进行量化。直到今天，安慰剂的不同作用机制仍未得到充分研究。了解它们将使我们能够调节其作用，以便在研究和临床环境中更好地发挥作用。期望、社会心理背景和条件作用在效应大小和幅度中起着重要作用。其对应物——反安慰剂，甚至研究得更少，即使在医疗过程中经常观察到不良反应。结论：安慰剂和反安慰剂在其价值方面都被低估和研究不足。通过进一步的研究，医生可以增强安慰剂反应，防止不良反应，以低成本帮助患者。这些技术将有益于医患关系，这是成功治疗的信任基础。
