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安慰剂效应和反安慰剂效应
Placebo and Nocebo Effects


Luana Colloca ... 其他 • 2020.02.06

安慰剂效应和反安慰剂效应分别是患者对自身健康状况的积极和消极预期所产生的效应1,2。这些效应可发生在多种临床环境下,包括在临床实践或临床试验中使用活性药或安慰剂进行治疗、知情同意过程、提供医疗相关信息以及公共卫生宣传活动。安慰剂效应导致有利结局,反安慰剂效应导致有害和危险结局。

不同患者的治疗应答和表现症状所存在的差异可部分归因于安慰剂和反安慰剂效应3-6。在临床实践中,安慰剂效应的发生频率和强度难以确定,而在实验条件下,安慰剂效应的频率和强度范围很广7。例如,在许多治疗疼痛或精神疾病的双盲临床试验中,对安慰剂的应答与对活性药的应答相似,并且在接受安慰剂的参与者中,有多达19%的成人和26%的老年人报告有副作用10。此外,在临床试验中,在接受安慰剂的患者中,有多达1/4因副作用而停药11,12,这提示,反安慰剂效应可能导致了活性药停药或依从性差。





作者信息

Luana Colloca, M.D., Ph.D., and Arthur J. Barsky, M.D.
From the University of Maryland School of Nursing and School of Medicine, Baltimore (L.C.); and the Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston (A.J.B.). Address reprint requests to Dr. Colloca at the University of Maryland School of Nursing, 655 W. Lombard St., Suite 729, Baltimore, MD 21201, or at colloca@umaryland.edu.

 

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