安慰剂镇痛效应的个体差异及其影响因素

Individual Differences in Placebo Analgesia: Contributions of Psychological and Neurobiological Factors

安慰剂在随机临床试验中有着悠久而重要的作用,主要用于控制考察药物的真实疗效。而近几十年来,安慰剂本身作为一种典型的"身心交互"模型,得到了更多的关注。对安慰剂作用机制的研究也有助于揭示心理因素影响临床结果的本质。然而安慰剂效应在不同的个体中有较大的差异。本文试综述在疼痛领域与安慰剂个体差异相关的文献,并总结影响该差异的各种因素。同时提出目前研究中存在的问题及今后的研究方向。

Placebos are traditionally used as controls in clinical trials to measure the specific effect of certain therapeutic treatment. More recently, placebo analgesia has attacted more attention as a research paradigm for mind-body interaction. Previous studies have demonstrated placebo effects depend on conscious expectancy or learning mechanisms such as conditioning. However, individual response to placebo analgesic effect ranges from no effect（non-responders） to complete pain relief（responders）. The mechanisms underlying this inter-individual differences of placebo responses are poorly understood. Convincing evidence support that efficiency of endogenous receptors, brain activity, and genetic factors may contribute to the individual differences of placebo responses.