真的很用功 馬上把這麼新的東西拿出來 不過我完全同意這篇的看法 ※ 引述《daze (一期一會)》之銘言： : Placebo似乎沒有想像中那麼大的效果。 : 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 縮址：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. : 這篇Review對156個Study做meta-analysis。 : 這些Study的共通點是，有"給Placebo的組"與"完全沒給藥的組"，並且是RCT的。 你說得很正確 這篇論文比較了placebo跟完全沒給藥的差別 結果證實完全沒給藥跟只給安慰劑沒有顯著差別（少數幾個分類有顯著 但是比bias小） 所以顯然完全不給藥就跟給安慰劑的效果一樣好 這點我完全認同 而且在他做研究之前我本來就是這樣相信的 給安慰劑跟完全不鳥他本來就應該沒什麼差異才對 這跟我之前說得安慰劑效應大概在六七成 本身並沒有衝突 因為安慰劑效應是指病人健康有進步就算 這篇文章是比較兩種的差別 本來就是不太一樣的事情 容我多補充一點 我認為安慰劑效應有可能是心理或社會的因素影響而來 （安慰劑有效的機制不明） 病人主觀的心理因素會因為跟「什麼也不做」對照而因此得到不支持的看法 但是病人離開致病的環境、接近醫院的心理影響 還有社會環境的因素 都還無法靠這兩者的對照而得到肯證或否證 : （具體的標準： : 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. : ） : 結果： : 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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