安慰剂镇痛及内在机制

中国临床药理学与治疗学 ›› 2011, Vol. 16 ›› Issue (10): 1197-1200.

• 综述与讲座 • 上一篇

安慰剂镇痛及内在机制

张瑞睿^1,2, 郭建友¹

¹中国科学院心理研究所心理健康院重点实验室,北京 100101;
²中国科学院研究生院,北京 100049

收稿日期:2011-08-23 修回日期:2011-10-20 出版日期:2011-10-26 发布日期:2011-11-02
通讯作者: 郭建友,男,博士,副研究员,硕士生导师,研究方向:精神药理学。Tel: 010-64850859, E-mail: guojy@psych.ac.cn
作者简介:张瑞睿,女,硕士研究生,研究方向:精神药理学。Tel: 010-64878231, E-mail: zhangrr@psych.ac.cn
基金资助:
国家自然科学基金(30800301, 31170992)资助

Placebo analgesia and its underlying mechanisms

ZHANG Rui-rui^1,2, Guo Jian-you¹

¹Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China;
²Graduate University of Chinese Acadenry of Sciences, Beijing 100049, China

Received:2011-08-23 Revised:2011-10-20 Online:2011-10-26 Published:2011-11-02

摘要/Abstract

摘要： 安慰剂镇痛效应在常规临床实践中有着非常重要的作用和意义。有意识的预期过程及无意识的条件反射均能产生安慰剂镇痛效应,并影响相应的生理功能。安慰剂镇痛效应可以分为阿片和非阿片成分,这两类安慰剂镇痛效应可能涉及不同的通道、脑区及相关大脑回路。本文综述了产生安慰剂镇痛的机制及神经生理学研究进展,并提出今后的研究方向。

关键词: 安慰剂, 镇痛, 条件化, 期待, 机制

Abstract: Placebo effect is a biological phenomenon with psychosocial-induced biochemical changes in a patient's brain and body. The term placebo-related effects aims to extend the concept of placebo effect to related phenomena and makes the underlying mechanisms better understood. The placebo analgesia effect is induced by different mechanisms, including the expectation of pain relief and conditioning. According to pharmacological studies, placebo analgesia is subdivided into opioid and non-opioid components while functional imaging data has also revealed brain regions and brain network involved in placebo analgesia. On the basis of previous research, this paper discussed the definition and underlying mechanisms of placebo analgesia, and gave some suggestions about related study in future.

Key words: Placebo, Analgesia, Conditioning, Expectation, Mechanism

中图分类号:

R964

张瑞睿, 郭建友. 安慰剂镇痛及内在机制[J]. 中国临床药理学与治疗学, 2011, 16(10): 1197-1200.

ZHANG Rui-rui, Guo Jian-you. Placebo analgesia and its underlying mechanisms[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(10): 1197-1200.

参考文献

[1] 杜宝俊. 中药新药临床研究方案设计中相关问题探讨[J]. 中国临床药理学与治疗学, 2005, 10(9): 1073-1075.
[2] 马玉全, 周俊, 周爱平, 等. 非劣效试验中对照的选择和界值确定方法[J]. 中国临床药理学与治疗学, 2009, 14(9): 961-965.
[3] Beecher HK. The powerful placebo[J]. JAMA, 1955, 159(17): 1602-1606.
[4] Levine JD, Gordon NC, Smith R, et al. Analgesic responses to morphine and placebo in individuals with postoperative pain[J]. Pain, 1981, 10(3): 379-389.
[5] Thompson WG. Placebos: a review of the placebo response[J]. Am J Gastroenterology, 2000, 95(7): 1637-1643.
[6] Benedetti F. Mechanisms of placebo and placebo-related effects across diseases and treatments[J]. Annu Rev Pharmacol Toxicol, 2008, 48(1): 33-60.
[7] White L, Tursky B. A conditioned response model of the placebo effect: predictions of the model [M]. New York: Guilford Press, 1985:255-287.
[8] Amanzio M, Benedetti F. Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specific subsystems[J]. J Neurosci, 1999, 19(1): 484-494.
[9] Gracely RH, Dubner R, Deeter WR, et al. Clinicians' expectations influence placebo analgesia.[J]. Lancet, 1985, 1(8419): 43.
[10] Levine J D, Gordon N C, Fields H L. The mechanism of placebo analgesia[J]. Lancet, 1978, 2(6): 654-657.
[11] Guo JY, Wang JY, Luo F. Dissection of placebo analgesia in mice: the conditions for activation of opioid and non-opioid systems[J]. J Psychopharmcol, 2010, 24(10): 1561-1567.
[12] Benedetti F, Amanzio M, Maggi G. Potentiation of placebo analgesia by proglumide[J]. Lancet, 1995, 346(13): 1321.
[13] Benedetti F, Amanzio M, Thoen W. Disruption of opioid-induced placebo responses by activation of cholecystokinin type-2 receptors[J]. Psychopharmcol, 2011, 213(8): 791-797.
[14] Benedetti F, Pollo A, Colloca L. Opioid-mediated placebo responses boost pain endurance and physical performance: is it doping in sport competitions[J]. J Neurosci, 2007, 27(44): 11934-11939.
[15] Scott DJ, Stohler CS, Egnatuk CM, et al. Individual differences in reward responding explain placebo-induced expectations and effects[J]. Neuron, 2007, 55(2): 325-336.
[16] Wager TD, Rilling JK, Smith EE, et al. Placebo-induced changes in FMRI in the anticipation and experience of pain[J]. Science, 2004, 303(5661): 1162-1164.
[17] Bingel U, Lorenz J, Schoell E, et al. Mechanisms of placebo analgesia: rACC recruitment of a subcortical antinociceptive network[J]. Pain, 2006, 120(1-2): 8-15.
[18] Petrovic P, Kalso E, Petersson KM, et al. A prefrontal non-opioid mechanism in placebo analgesia[J]. Pain, 2010, 150(1): 59-65.
[19] Watson A, El-Deredy W, Iannetti GD, et al. Placebo conditioning and placebo analgesia modulate a common brain network during pain anticipation and perception[J]. J Midwifery Wom Heal, 2009, 145(1): 24-30.
[20] Lui F, Colloca L, Duzzi D, et al. Neural bases of conditioned placebo analgesia[J]. Pain, 2010, 151(3): 816-824.
[21] Vase L, Price DD, Verne GN, et al. The contribution of changes in expected pain levels and desire for pain relief to placebo analgesia[M]. Seattle: IASP Press, 2004:207-232.
[22] Zhuo M. Central inhibition and placebo analgesia[J]. Mol Pain, 2005, 1: 21.
[23] Guo JY, Yuan XY, Sui F, et al. Placebo analgesia affects the behavioral despair tests and hormonal secretions in mice[J]. Psychopharmcol, 2011, 217(1): 83-90.

安慰剂镇痛及内在机制

Placebo analgesia and its underlying mechanisms

PDF (PC)

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	毛君, 荣玉, 李炎根, 熊登喜, 赵鹏, 查正江. 氟比洛芬酯在颅脑损伤患者镇痛治疗中的临床应用效果观察及安全性分析[J]. 中国临床药理学与治疗学, 2023, 28(9): 1056-1060.
[2]	何李华, 朱秀之, 江一舟. 三阴性乳腺癌免疫治疗研究进展[J]. 中国临床药理学与治疗学, 2023, 28(8): 842-853.
[3]	王朝义, 宋强, 熊鑫, 王梦远. 肉芽肿性小叶性乳腺炎诊疗进展[J]. 中国临床药理学与治疗学, 2023, 28(8): 910-917.
[4]	李爽, 韩淑贞, 戴瑜婷, 修明慧, 杜籼芹, 和建政, 蔺兴遥. 基于多种化疗肠损伤发生机制的中医药防治进展[J]. 中国临床药理学与治疗学, 2023, 28(5): 583-593.
[5]	张明康, 马彦荣, 靳永文, 周燕, 崔睿睿, 武新安. 药源性急性间质性肾炎的临床研究进展[J]. 中国临床药理学与治疗学, 2023, 28(4): 419-428.
[6]	曹放, 覃开蓉, 郑国爽, 赵德伟. 基于网络药理学探讨银杏叶干预激素性股骨头坏死的作用机制[J]. 中国临床药理学与治疗学, 2023, 28(3): 266-275.
[7]	张莉, 蔺兴遥, 尚芸, 王强. 冻伤的病理机制及治疗研究进展[J]. 中国临床药理学与治疗学, 2023, 28(3): 347-354.
[8]	李欣宇, 黄鑫. 美洛昔康的临床应用研究现状[J]. 中国临床药理学与治疗学, 2023, 28(2): 189-197.
[9]	陈玉林, 蒋虎刚, 王新强, 刘凯, 李应东, 安涛, 赵信科. 基于网络药理学和分子对接探讨芪参益心颗粒治疗射血分数保留型心力衰竭的作用机制[J]. 中国临床药理学与治疗学, 2023, 28(10): 1081-1092.
[10]	刘丹, 刘明, 金良友, 潘娟, 辛昊儒, 刘梦圆, 李鑫, 郑坤, 冯晓灵. 木香烃内酯抗肿瘤活性研究进展[J]. 中国临床药理学与治疗学, 2023, 28(10): 1168-1176.
[11]	苏洋, 周峰, 丁金磊. 艾司氯胺酮复合舒芬太尼对胸腔镜肺癌根治术后情绪及镇痛的影响[J]. 中国临床药理学与治疗学, 2023, 28(1): 59-65.
[12]	黄会珍, 韩磊, 林晓冬, 陈磊. 胰腺炎发病机制相关信号通路研究进展[J]. 中国临床药理学与治疗学, 2023, 28(1): 109-113.
[13]	王欣, 孙合亮, 张庆伟, 刘存明, 王忠云, 杨春. 小剂量艾司氯胺酮在胸腔镜下肺叶切除术患者术后镇痛中的作用[J]. 中国临床药理学与治疗学, 2022, 27(9): 998-1003.
[14]	邵明坤, 刘蓉, 孙品, 关水, 廖炳灿, 李莎, 丛滔, 梁凯, 马辉, 孙长凯. 褪黑素人体网络机制及其临床应用[J]. 中国临床药理学与治疗学, 2022, 27(9): 1031-1040.
[15]	张伟, 王迎斌, 曹璐, 刘艳, 张丽, 刘婕婷. 自噬在肠缺血再灌注损伤中的研究进展[J]. 中国临床药理学与治疗学, 2022, 27(9): 1061-1066.