安慰剂如果标上品牌名可能会更有效
Placebos Might Work Even Better With a Brand Name安慰剂如果标上品牌名可能会更有效
In a provocative 82-patient study, researchers at MIT found that a dummy pill carrying a $2.50 price tag eases pain much more effectively than an identical pill that patients believe costs just 10 cents.
在一项颇具刺激性（吸引眼球）的研究中，MIT的研究人员对82例患者研究发现一片带有$2.50价格标签的安慰剂可能比患者相信只花了10美分的相同的安慰剂药片更能够有效地减轻疼痛。
The results may help explain, among other things, why some patients report worsening symptoms when they switch from a brand-name drug to a cheaper generic version of the same medicine, principal investigator Dan Ariely tells the Health Blog. “The placebo effect is really about the body’s ability to heal itself and prepare for a future that it expects to happen,” says Ariely, a behavioral economist who took time out from a tour for his book “Predictably Irrational” to talk with us. The findings suggest that factors well beyond what people think is in a pill can have an impact on the medicine’s effectiveness. The results of the study, funded by MIT, appear in the current JAMA.
主要研究人员Dan Ariely告诉健康博客：这一结果可能有助于解释很多事情，比如可以解释为什么一些患者在从品牌药换成相同的仿制药后会报告自己的症状恶化。经济学家Ariely从为他的新书“可以预见的非理性”签售活动中挤出一点时间接受了我们的采访说：“安慰剂的效用实际上是身体治愈自己的能力，也为今后可能发生的一切做准备。”这一结果表明一些除了人们认为药片中包含一些药物之外的因素可以对一种药物的疗效产生影响。MIT为研究结果提供资金，该文刊登在JAMA上。
In the study, healthy volunteers were given a brochure describing a new (and fictional) codeine-like painkiller that had just been approved by the FDA. Then they were randomly assigned to two groups, one of which was told the pill cost $2.50, the other, without further explanation, that it was discounted to a dime.
研究人员给健康志愿者一本描述一种新的（和虚构的）由FDA批准的可待因类止痛药的小册子。然后随机将其分为两组，告知其中一组每片药$2.50，告知另一组每片药打折后为10美分（没有进一步的解释）。
Then researchers administered a series of increasingly powerful electrical shocks to the volunteers’ wrists until each reached his or her maximum pain tolerance.
然后研究人员给志愿者的腕部实施一系列强度增大的电刺激直至达到每个人最大耐受程度。
“The protocol followed an established approach for studying pain,” the researchers wrote in the JAMA report. To back up that assertion, they cited a 2006 paper from the journal Science entitled, “Neurobiological substrates of dread.” (Not to worry: the methods were approved by an MIT committee that oversees human research.)
研究人员在JAMA中报道：“按研究疼痛所建立的方法进行。”为了支持这个论断，他们引用了2006年《科学》中的一篇论文，标题是“恐惧的神经生物学基础。”（不用担心：监视人类研究的MIT委员会已经批准了这个方法）
The participants rated each shock on a scale ranging from “no pain at all” to “worst pain imaginable.” Then they took their pills, which weren’t painkillers at all, and rolled up their sleeves to get the jolts and record their impressions a second time.
受试者对每次电刺激进行评分，从“一点都不痛”到“能够想象到的最严重的疼痛”。然后，受试者们服下他们的药片，这些药片其实根本就不是止疼药，然后让其卷起袖子露出关节记录第二次感受。
The results: 85% of the “regular-price” group reported a reduction in pain after taking the pill compared to 61% in the 10-cent group. Not bad on both counts for a drug that isn’t supposed to do anything.
结果：“常规价格”组的85%感觉吃药后疼痛减轻，而10美分组的61%有此感觉。对于不应该起任何作用的一种“药物（安慰剂）”来说，这两组的结果都不算差。
The better showing by the more costly pill shows that “how you set up people’s expectation is crucial” to treatment effect, says Gregory Berns, a neuroscientist at Emory University School of Medicine. While he has no proof, Berns tells the Health Blog that he thinks pharmaceutical companies take such expectation into account when they set prices for their medicines.
Emory大学医学院的神经学家Gregory Berns说，花费高的药物效果好表明了对于疗效来说“如何设置人们的期望值是非常关键的”。Berns告诉健康博客，虽然他还没有证据，但他认为药厂在为药品定价时应当把这种期望因素考虑进去。
The findings could shed light on patient compliance with their prescriptions, says Ariely, who is moving soon to Duke University. Shifting to a cheaper generic pill may save money, he says, but he asks: “Can a pill be too cheap so people don’t expect it to be good and they don’t take it regularly?”
不久要到Duke大学的Ariely说：这些结果也使病人更清楚要依从处方。他说：“改服便宜的药可能会省钱。”但是他又问：“药太便宜了导致人们认为药不好，那么他们还会规律的服用么？”
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文章中的现象在现实生活中的确存在，我想应该引起专业人士思考。
在使用止痛药、安眠药、营养补充剂、甚至降压药物时都会有上述现象出现，但是同时也应该鉴别出其中的非安慰剂效应，否则机械地生搬硬套更加有害。
治疗，更是一种艺术 \"the state of art\"
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