医生应该对病人讲真话吗：疼痛中反安慰剂效应的机制
To Lie or Tell the Truth: Mechanism of Nocebo Effect in Pain
摘要: 反安慰剂效应广泛存在于临床医学中，并且对人的身体和心理健康都会有危害。尽管安慰剂效应已经有了很多进展，但是由于伦理道德限制，反安慰剂效应的研究并不是很多，我们对它知之甚少。本文从三个方面揭示反安慰剂的内在机制：心理、生物化学、脑机制。1) 反安慰剂有两个心理机制，期待和条件化；2) 反安慰剂与胆囊收缩素密切相关；3) 除了疼痛经验本身相关的脑区外，奖赏回路和情绪相关脑区也涉及，如眶额皮层、伏隔核、脑岛、杏仁核。
Abstract: Nocebo effect broadly exists in clinical trials and it will jeopardize the effect of treatment in pain. Although thorough investigations have been carried on its sibling, placebo effect, nocebo effect has not received enough attention due to ethical constraints. This review systematically reveals nocebo effect in pain from three dimensions: psychology, biochemistry, functional neuroimaging. 1) Nocebo effect is involved with two psychological mechanisms, negative expectation and conditioning; 2) CCK ergic system plays a key role in nocebo hyperalgesia; 3) Except brain network of pain experience, reward and emotion regions are involved in nocebo hyperalgesia.
文章引用：许蛟婧 (2019). 医生应该对病人讲真话吗：疼痛中反安慰剂效应的机制. 心理学进展, 9(3), 429-435. https://doi.org/10.12677/AP.2019.93052

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