The power of the placebo effect - Emma Bryce

譯者: Ann Chen 審譯者: Max Chern

In 1996, 56 volunteers took part in a study

1996 年時，56 位自願者參與一項研究

to test a new painkiller called Trivaricaine.

以測試一種新的止痛藥， 名叫 Trivaricaine

On each subject, one index finger was covered in the new painkiller

每個實驗對象的一隻食指 都被塗上新的止痛藥

while the other remained untouched.

而另一食指則保留原樣

Then, both were squeezed in painful clamps.

而後，兩隻食指 都用會致痛的鉗子夾緊

The subjects reported that the treated finger hurt less than the untreated one.

實驗對象敘述 塗藥食指較沒塗藥的不痛

This shouldn't be surprising,

這本應不足為奇

except Trivaricaine wasn't actually a painkiller,

但是事實上，Trivaricaine 不是止痛藥

just a fake concotion with no pain-easing properties at all.

只是一種毫無止痛功效的假混合物

What made the students so sure this dummy drug had worked?

是什麼讓學生如此肯定這假藥有效呢？

The answer lies in the placebo effect,

答案在於「安慰劑效應」

an unexplained phenomenon

是種尚未被解釋的現象

wherein drugs, treatments, and therapies that aren't supposed to have an effect,

在原本應無效的藥物、治療及各種療法

and are often fake,

─ 且往往是假的 ─

miraculously make people feel better.

卻神奇地讓病人感覺好些

Doctors have used the term placebo since the 1700s

自 1700 年代起， 醫生已使用「安慰劑」這個詞

when they realized the power of fake drugs to improve people's symptoms.

當時他們已了解 假藥改善病人症狀的效力

These were administered when proper drugs weren't available,

當合適藥物缺乏或有人幻想自己生病時， 醫生會使用安慰劑

or if someone imagined they were ill.

In fact, the word placebo means "I shall please" in Latin,

事實上，安慰劑在拉丁文 是「我會使你滿意」之意

hinting at a history of placating troubled patients.

隱喻它撫慰受折磨的病人 由來已久了

Placebos had to mimic the real treatments in order to be convincing,

安慰劑必須酷似真的治療以取信病人

so they took the form of sugar pills,

所以他們採用糖製錠劑

water-filled injections,

充水注射針劑

and even sham surgeries.

甚至模擬手術

Soon, doctors realized that duping people in this way had another use:

很快地，醫生了解此種欺瞞人們方式 有另一用途：

in clinical trials.

使用在臨床試驗

By the 1950s, researchers were using placebos as a standard tool

1950 年代之前，研究人員已用安慰劑 作為試驗新治療的標準方法

to test new treatments.

To evaluate a new drug, for instance,

例如，為評估新藥

half the patients in a trial might receive the real pill.

實驗中的一半病人可能服用真藥

The other half would get a placebo that looked the same.

另一半則服用外觀一樣的安慰劑

Since patients wouldn't know whether they'd received the real thing or a dud,

既然病人都不知道 服用的是真的或無用的

the results wouldn't be biased,

研究人員認為結果將不帶偏見

researchers believed.

Then, if the new drug showed a significant benefit compared to the placebo,

如果相較於安慰劑， 新藥呈現有顯著的功效

it was proved effective.

則証實它有效

Nowadays, it's less common to use placebos this way because of ethical concerns.

現今已較少這樣使用安慰劑， 由於有道德上的疑慮

If it's possible to compare a new drug against an older version,

如果可能以新藥 比較舊型的藥或另一現有的藥

or another existing drug,

that's preferable to simply giving someone no treatment at all,

那會優於完全不給任何治療

especially if they have a serious ailment.

尤其當他們有嚴重疾病時

In these cases, placebos are often used as a control to fine-tune the trial

這些情況下，安慰劑常被作為 微調實驗的控制項

so that the effects of the new versus the old or alternative drug

讓新型、舊型或替代藥的效用 可被精確地比較

can be precisely compared.

But of course, we know the placebos exert their own influence, too.

但當然， 我們知道安慰劑也發揮本身的作用

Thanks to the placebo effect,

由於安慰劑效應

patients have experienced relief from a range of ailments,

很多疾病的病人感覺症狀舒緩

including heart problems,

包括心臟病

asthma,

氣喘

and severe pain,

及劇烈疼痛

even though all they'd received was a fake drug or sham surgery.

即使他們所接受的 完全是假藥或模擬手術而已

We're still trying to understand how.

我們仍在嘗試理解這作用原理

Some believe that instead of being real,

有些人認為那不是真正舒緩

the placebo effect is merely confused with other factors,

安慰劑效應只不過 和其他因素相混淆而已

like patients trying to please doctors by falsely reporting improvements.

例如病人為取悅醫生 而作症狀改善的不實敘述

On the other hand,

反之

researchers think that if a person believes a fake treatment is real,

研究人員認為 若一個人相信假治療是真的

their expectations of recovery actually do trigger physiological factors

他們期待康復的心理 會真正激起一些生理因子

that improve their symptoms.

從而改善了症狀

Placebos seem to be capable of causing measurable change in blood pressure,

安慰劑似乎對血壓、心跳速率

heart rate,

and the release of pain-reducing chemicals, like endorphins.

及止痛化學物質的釋放── 例如內啡肽（endorphin）有明顯改變

That explains why subjects in pain studies often say placebos ease their discomfort.

這說明疼痛實驗中，為何實驗對象常說 安慰劑舒緩他們的不適

Placebos may even reduce levels of stress hormones,

安慰劑甚至可降低 壓力賀爾蒙的數值

like adrenaline,

如腎上腺素

which can slow the harmful effects of an ailment.

這可減緩疾病的有害影響

So shouldn't we celebrate the placebo's bizarre benefits?

所以我們不該頌揚 安慰劑的奇特效益嗎？

Not necessarily.

未必

If somebody believes a fake treatment has cured them,

如果有人認為假治療已治癒他們

they may miss out on drugs or therapies that are proven to work.

他們可能錯過 使用真正有效藥物或治療的時機

Plus, the positive effects may fade over time,

另外，這正面效用 可能隨時間逐漸消失

and often do.

而且常常是如此

Placebos also cloud clinical results,

安慰劑也會混淆臨床效果

making scientists even more motivated to discover

讓科學家更有動機去發現

how they wield such power over us.

它們是如何有這能力操控我們的

Despite everything we know about the human body,

雖然我們知道有關人體的一切

there are still some strange and enduring mysteries,

但仍有些奇怪的不解之謎

like the placebo effect.

例如安慰劑效應

So what other undiscovered marvels might we contain?

所以我們還有什麼其他未發現的奇蹟嗎？

It's easy to investigate the world around us

我們很容易在研究周圍的世界時

and forget that one of its most fascinating subjects

忘記最有趣的課題之一

lies right behind our eyes.

就在我們的頭腦裡

翻譯：Ann Chen