真的很用功 马上把这麽新的东西拿出来 不过我完全同意这篇的看法 ※ 引述《daze (一期一会)》之铭言： : Placebo似乎没有想像中那麽大的效果。 : 我翻到 Cochrane Library 的一篇Review： : 《Placebo interventions for all clinical conditions》 : （http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/ : CD003974/frame.html 缩址：http://0rz.tw/LUu02 ） : Plain language summary : Placebo treatments for all clinical conditions : It has been widely believed that placebo (dummy) treatments (for example : sugar tablets) are associated with substantial effects on a wide range of : health problems. However, this belief is not based on evidence from ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ : randomised trials that use a placebo treatment for one group of people, while ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ : another group receives no treatment. The effect of placebo treatments was ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ : studied by reviewing more than 150 such trials covering many types of : healthcare problems. Placebo treatments caused no major health benefits, : although they possibly had a small effect on outcomes reported by patients, : for example pain. : 这篇Review对156个Study做meta-analysis。 : 这些Study的共通点是，有"给Placebo的组"与"完全没给药的组"，并且是RCT的。 你说得很正确 这篇论文比较了placebo跟完全没给药的差别 结果证实完全没给药跟只给安慰剂没有显着差别（少数几个分类有显着 但是比bias小） 所以显然完全不给药就跟给安慰剂的效果一样好 这点我完全认同 而且在他做研究之前我本来就是这样相信的 给安慰剂跟完全不鸟他本来就应该没什麽差异才对 这跟我之前说得安慰剂效应大概在六七成 本身并没有冲突 因为安慰剂效应是指病人健康有进步就算 这篇文章是比较两种的差别 本来就是不太一样的事情 容我多补充一点 我认为安慰剂效应有可能是心理或社会的因素影响而来 （安慰剂有效的机制不明） 病人主观的心理因素会因为跟「什麽也不做」对照而因此得到不支持的看法 但是病人离开致病的环境、接近医院的心理影响 还有社会环境的因素 都还无法靠这两者的对照而得到肯证或否证 : （具体的标准： : We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The : Cochrane Library Issue 4, 2002), MEDLINE (1966 to 2002), EMBASE (1980 to 2002), : Biological Abstracts (1986 to 2002), and PsycLIT (1887 to 2002). We contacted : experts on placebo research, and read references in the included trials. : We included randomised placebo trials with a no-treatment control group : investigating any health problem. : ） : 结果： : We found no statistically significant pooled effect of placebo in 38 studies : with binary outcomes (4284 patients), relative risk 0.95 (95% confidence : interval (CI) 0.89 to 1.01). The pooled relative risk for patient-reported : outcomes was 0.95 (95% CI 0.88 to 1.03) and for observer-reported outcomes : 0.91 (95% CI 0.81 to 1.03). There was heterogeneity (P=0.01) but the funnel : plot was symmetrical. There was no statistically significant effect of : placebo interventions in the four clinical conditions investigated in three : trials or more: pain, nausea, smoking, and depression, but confidence : intervals were wide. : We found an overall effect of placebo treatments in 118 trials with : continuous outcomes (7453 patients), standardised mean difference (SMD) -0.24 : (95% CI -0.31 to -0.17). The SMD for patient-reported outcomes was -0.30 (95% : CI -0.38 to -0.21), whereas no statistically significant effect was found for : observer-reported outcomes, SMD -0.10 (95% CI -0.20 to -0.01). There was : heterogeneity (P<0.001) and large variability in funnel plot results even for : big trials. There was an apparent effect of placebo interventions on pain : (SMD -0.25 (95% CI -0.35 to-0.16)), and phobia (SMD -0.63 (95% CI -1.17 to : -0.08)); but also a substantial risk of bias. There was no statistically : significant effect of placebo interventions in eight other clinical : conditions investigated in three trials or more: nausea, smoking, depression, : overweight, asthma, hypertension, insomnia and anxiety, but confidence : intervals were wide. : Authors' conclusions： : There was no evidence that placebo interventions in general have clinically : important effects. A possible small effect on continuous patient-reported : outcomes, especially pain, could not be clearly distinguished from bias. --

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