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重新评价安慰剂(哈佛大学教授文章的译文)

已有 1993 次阅读 2022-1-24 07:31 |个人分类:Health & Health-Care System|系统分类:科普集锦

译者注:其实,大脑的治病能力远远超过这篇文章提及的。

我的上一篇:有意识头脑与无意识头脑:心身疾病的流行

https://blog.sciencenet.cn/blog-306792-1321862.html】介绍一本书,是关于“西医”无法治疗的病痛,可以通过“认知”过程,来消除。


The power of the placebo effect

安慰剂效应的力量

December 13, 2021

 

https://www.health.harvard.edu/mental-health/the-power-of-the-placebo-effect

Treating yourself with your mind is possible, but there is more to the placebo effect  than positive thinking.


用你的大脑解除自己的病痛是可能的,但安慰剂效应不仅仅是积极(正面)思考。

 

Your mind can be a powerful healing tool when given the chance. The idea that your brain can convince your body a fake treatment is the real thing — the so-called placebo effect — and thus stimulate healing has been around for millennia. Now science has found that under the right circumstances, a placebo can be just as effective as traditional treatments.

如果你“信”,您的大脑可以成为强大的治疗病痛的工具。你的大脑可以说服你的身体接受虚假治疗的想法是真实的——所谓的安慰剂效应——从而刺激愈合已经存在了数千年。现在,科学发现在适当的情况下,安慰剂可以和传统(西医)疗法一样有效。

 

"The placebo effect is more than positive thinking — believing a treatment or procedure will work. It's about creating a stronger connection between the brain and body and how they work together," says Professor Ted Kaptchuk of Harvard-affiliated Beth Israel Deaconess Medical Center, whose research focuses on the placebo effect.

安慰剂效应不仅仅是积极(正面)思考——相信治疗或程序会起作用。它涉及在大脑和身体之间建立更牢固的联系以及它们如何协同工作,哈佛附属贝丝以色列女执事医疗中心的 Ted Kaptchuk 教授说,他的研究重点是安慰剂效应。

 

Placebos won't lower your cholesterol or shrink a tumor. Instead, placebos work on symptoms modulated by the brain, like the perception of pain. "Placebos may make you feel better, but they will not cure you," says Kaptchuk. "They have been shown to be most effective for conditions like pain management, stress-related insomnia, and cancer treatment side effects like fatigue and nausea."

安慰剂不会降低胆固醇或缩小肿瘤。但是,安慰剂对那些由大脑调节产生的症状起作用,比如对疼痛的感知。 “安慰剂可能会让你感觉更好,但它们不会治愈你,”Kaptchuk 说。 “它们已被证明对疼痛管理、与压力相关的失眠和癌症治疗副作用(如疲劳和恶心)最有效。

 

Does the placebo effect mean failure or success?

安慰剂效应意味着(现代医学)失败还是成功?

 

For years, a placebo effect was considered a sign of failure. A placebo is used in clinical trials to test the effectiveness of treatments and is most often used in drug studies. For instance, people in one group get the actual drug, while the others receive an inactive drug, or placebo. The participants in the clinical trial don’t know if they receive the real thing or the placebo. This way, the researchers can measure if the drug works by comparing how both groups react. If they both have the same reaction — improvement or not — the drug is deemed not to work.

多年来,安慰剂效应被认为是失败的标志。安慰剂用于临床试验以测试治疗的有效性,并且最常用于药物研究。例如,一组人服用真正的药物,而其他人服用一种非活性药物或安慰剂。临床试验的参与者不知道他们收到的是真品还是安慰剂。这样,研究人员可以通过比较两组的反应来衡量药物是否有效。如果他们都有相同的反应——改善与否——药物被认为无效。

 

More recently, however, experts have concluded that reacting to a placebo is not proof that a certain treatment doesn't work, but rather that another, non-pharmacological mechanism may be present.

然而,最近专家们得出结论,对安慰剂有反应并不能证明某种治疗无效,而是可能存在另一种非药理学机制。

 

How placebos work is still not quite understood, but it involves a complex neurobiological reaction that includes everything from increases in feel-good neurotransmitters, like endorphins and dopamine, to greater activity in certain brain regions linked to moods, emotional reactions, and self-awareness. All of it can have therapeutic benefit. "The placebo effect is a way for your brain to tell the body what it needs to feel better," says Kaptchuk.

我们对安慰剂的作用机制仍不清楚,但它涉及复的神经生物学反应,包括从感觉良好的神经递质(如内啡肽和多巴胺)的增加,到与情绪、情绪反应和自我意识相关的某些大脑区域的更大活动。 所有这些都可以产生治疗益处。 “安慰剂效应是你的大脑告诉身体需要什么才能感觉更好的一种方式,”Kaptchuk 说。

 

But placebos are not all about releasing brainpower. You also need the ritual of treatment. "When you look at these studies that compare drugs with placebos, there is the entire environmental and ritual factor at work," says Kaptchuk. "You have to go to a clinic at certain times and be examined by medical professionals in white coats. You receive all kinds of exotic pills and undergo strange procedures. All this can have a profound impact on how the body perceives symptoms because you feel you are getting attention and care."

但安慰剂并不全是为了释放脑力。你还需要治疗的仪式。 “当你看到这些将药物与安慰剂进行比较的研究时,整个环境和仪式因素都在起作用,”Kaptchuk 说。 “你必须在某些时候去诊所,并由穿着白大褂的医疗专业人员进行检查。你接受各种奇特的药丸并接受奇怪的程序。所有这些都会对身体如何感知症状产生深的影响,因为你感觉到你正在得到关注和照顾。

 

Give yourself a placebo

给自己一副安慰剂

 

Placebos often work because people don't know they are getting one. But what happens if you know you are getting a placebo?

安慰剂经常起作用,因为人们不知道他们正在服用安慰剂。但是,如果您知道自己正在服用安慰剂,会发生什么?

 

A study led by Kaptchuk and published in Science Translational Medicine explored this by testing how people reacted to migraine pain medication. One group took a migraine drug labeled with the drug's name, another took a placebo labeled "placebo," and a third group took nothing. The researchers discovered that the placebo was 50% as effective as the real drug to reduce pain after a migraine attack.

 Kaptchuk 领导并发表在《科学转化医学》上的一项研究通过测试人们对偏头痛止痛药的反应来探索这一点。一组服用标有药物名称的偏头痛药物,另一组服用标有安慰剂的安慰剂,第三组不服用任何药物。研究人员发现,安慰剂在偏头痛发作后减轻疼痛的效果与真正的药物一样有效 50%

 

The researchers speculated that a driving force beyond this reaction was the simple act of taking a pill. "People associate the ritual of taking medicine as a positive healing effect," says Kaptchuk. "Even if they know it's not medicine, the action itself can stimulate the brain into thinking the body is being healed."

研究人员推测,超越这种反应的驱动力是服用药丸的简单行为。 “人们将服药仪式与积极的治疗效果联系起来,卡普楚克说。 “即使他们知道这不是药物,这种行为本身也会刺激大脑认为身体正在被治愈。

 

How can you give yourself a placebo besides taking a fake pill? Practicing self-help methods is one way. "Engaging in the ritual of healthy living — eating right, exercising, yoga, quality social time, meditating — probably provides some of the key ingredients of a placebo effect," says Kaptchuk.

除了服用假药之外,你怎么能给自己服用安慰剂?练习自助方法是一种方法。 “参与健康生活的仪式——正确饮食、锻炼、瑜伽、高质量的社交时间、冥想——可能提供了安慰剂效应的一些关键成分,”Kaptchuk 说。

 

While these activities are positive interventions in their own right, the level of attention you give can enhance their benefits. "The attention and emotional support you give yourself is often not something you can easily measure, but it can help you feel more comfortable in the world, and that can go a long way when it comes to healing."

虽然这些活动本身就是积极的干预措施,但您给予的关注程度可以增强它们的好处。你给自己的关注和情感支持通常不是你可以轻易衡量的,但它可以帮助你在这个世界上感觉更舒服,而且在康复方面会有很长的路要走。

 

 

 




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