安慰剂和安慰剂效应以及与药理干预相关的机制:一个总体审查
Elisa Frisaldi1, Aziz Shaibani2,3, Fabrizio Benedetti4
1Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy elisa.frisaldi@unito.it.
BMJ open
|October 17, 2023
概括
本综合性综述总结了药理干预中的安慰剂和nocebo效应. 在各种疾病中确定了机制,为临床实践和未来研究提供了见解.
科学领域:
- 心理神经免疫学 心理神经免疫学
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 安慰剂和安慰剂效应显著影响药理疗法的患者结果.
- 了解这些影响背后的机制对于优化治疗策略至关重要.
研究的目的:
- 综合现有关于与药理干预相关的安慰剂和nocebo效应的知识.
- 识别和描述这些现象的潜在机制和影响大小.
主要方法:
- 采用了一种综合性审查方法,使用多次系统性审查评估2 (AMSTAR 2) 工具对系统性审查进行批判性评估.
- 在没有时间限制的情况下,在主要数据库 (MEDLINE/PubMed,Scopus,Web of Science,PsycINFO,Cochrane) 进行了全面的文献搜索.
- 数据通过叙事综合和表格总结进行了综合,包括95%的置信区间 (CI).
主要成果:
- 该审查分析了372项研究,包括41项高质量的系统性审查,涉及超过158,000名参与者.
- 对安慰剂/安慰剂效应的机制在各种疾病中具有特征,如疼痛,帕金森病,偏头痛,抑郁症,焦虑症和各种生理系统.
- 效应大小在安慰剂效应中从0.08到2.01不等,在nocebo效应中从0.32到0.90不等.
结论:
- 这份全面的综述为临床医生和研究人员提供了宝贵的资源.
- 它强调了为临床应用准备的发现,并确定了未来对安慰剂和无效果效应的研究的关键差距.
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