Frisaldi Elisa, Shaibani Aziz, Trucco Marco, Milano Edoardo, Benedetti Fabrizio
Neuroscience Department, University of Turin Medical School, Turin, Italy.
Nerve & Muscle Center of Texas, Houston, Texas, USA.
Expert Rev Neurother. 2022 Jan;22(1):15-25. doi: 10.1080/14737175.2022.2012156. Epub 2021 Dec 13.
The widespread use of the word 'placebo' in the medical literature emphasizes the importance of this phenomenon in modern biomedical sciences. Neuroscientific research over the past thirty years shows that placebo effects are genuine psychobiological events attributable to the overall therapeutic context, and can be robust in both laboratory and clinical settings.
Here the authors describe the biological mechanisms and the clinical implications of placebo effects with particular emphasis on neurology and psychiatry, for example in pain, movement disorders, depression. In these conditions, a number of endogenous systems have been identified, such as endogenous opioids, endocannabinoids, and dopamine, which contribute to the placebo-induced benefit.
Every effort should be made to maximize the placebo effect and reduce its evil twin, the nocebo effect, in medical practice. This does not require the administration of a placebo, but rather the enhancement of the effects of pharmacological and nonpharmacological treatments through a good doctor-patient interaction.
“安慰剂”一词在医学文献中的广泛使用凸显了这一现象在现代生物医学科学中的重要性。过去三十年的神经科学研究表明，安慰剂效应是真实的心理生物学事件，可归因于整体治疗环境，并且在实验室和临床环境中都可能很显著。
本文作者描述了安慰剂效应的生物学机制及其临床意义，特别强调了神经病学和精神病学领域，例如在疼痛、运动障碍、抑郁症方面。在这些病症中，已经确定了一些内源性系统，如内源性阿片类物质、内源性大麻素和多巴胺，它们促成了安慰剂诱导的益处。
在医学实践中，应尽一切努力最大化安慰剂效应，并减少其“邪恶双胞胎”——反安慰剂效应。这并不需要给予安慰剂，而是需要通过良好的医患互动来增强药物和非药物治疗的效果。
