Do "placebo responders" exist?
Do "placebo responders" exist?
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DOI：
10.1016/j.cct.2008.02.002
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发表时间：
2008-07-01
影响因子：
2.2
通讯作者：
Wechsler, Michael E.
中科院分区：
文献类型：
--
作者：
Kaptchuk, Ted J.;Kelley, John M.;Wechsler, Michael E.
安慰剂效应一直备受争议。为了推进安慰剂效应的科学研究，重要的是要确定安慰剂对任何特定疾病的反应是否可靠-即，如果对单次安慰剂给药有反应，则在类似条件下重复给药类似安慰剂也会有安慰剂反应。一个肯定的答案将允许更复杂的临床试验设计和更精确的安慰剂效应基础研究实验。本文回顾了多次服用安慰剂的实验，以回答“是否存在可靠的安慰剂应答者？”“本文还研究了存在一致的安慰剂反应者的证据，即在一种情况下对安慰剂作出反应的人将在另一种情况下作出反应或使用不同类型的安慰剂仪式。这两个问题的现有证据大部分是在1967年之前进行的。这一早期证据是矛盾的，方法论上的薄弱，并且足够古老，可以被认为是病史。自1969年以来，至少有8项实验将哮喘患者暴露于多次给予安慰剂的情况下，并欺骗性地暗示“治疗”是一种积极的药物。虽然这项研究的结果并不明确，可能不等同于非欺骗性条件，但这一调查表明，如果存在可靠和一致的安慰剂反应，则可以在该人群中检测到。最后，本文提出了一个模型，严格调查安慰剂反应的稳定性。(c)2008年爱思唯尔公司All rights reserved.
The placebo effect has been the subject of much controversy. For a scientific investigation of placebo effects to advance it is important to establish whether a placebo response in any particular illness is reliable - i.e., if there is a response to a single placebo administration there will also be a placebo response to the repeated administration of a similar placebo in similar conditions. A positive answer would allow more sophisticated clinical trial designs and more precise basic research experiments on the placebo effect. This article reviews experiments that used multiple administrations of placebo to answer the question "do reliable placebo responders exist?" This paper also examines the evidence for the existence of a consistent placebo responder, i.e. a person who responds to placebo in one situation will respond in another condition or using a different type of placebo ritual. Much of the existing evidence for these two questions was performed before 1967. This early evidence is contradictory, methodologically weak and is sufficiently old to be considered medical history. Since 1969, at least eight experiments exposed asthma patients to multiple administrations of placebo given with deceptive suggestions that the "treatment" was an active medication. While the results of this research are not unequivocal, and may not be equivalent to non-deceptive conditions, this line of inquiry suggests that if a reliable and consistent placebo response exists it could be detected within this population. Finally, this paper proposes one model to rigorously investigate the stability of placebo responses. (c) 2008 Elsevier Inc. All rights reserved.