What is the placebo effect: an alternative way of treatment or a trivial deception? This question is asked by both scientists and ordinary philistines for many years. The use of placebo in clinical studies is no longer a novelty, but how firmly has this concept entered our life? And how much is the effect of this "medicine"? And is this medicine at all? Answers to these and other questions about placebo are available below.
The term "placebo" comes from the Latin placebo - "like me," but means by this word a drug or some procedure that does not in itself cure, but imitates treatment. When a patient believes that the treatment prescribed by the doctor is effective and therefore heals, this is the "placebo effect". This phenomenon in broad medical circles became known at the end of the XVII century. However, with the effect of placebo, our more distant ancestors were well acquainted. So, in ancient Egypt, a calcareous powder was considered a universal medicine, which was presented by local healers in each specific case as an individually selected preparation. And in the Middle Ages for medical purposes often used frog legs, nettle collected in a cemetery on a full moon, or moss from the skull of a deceased person. Surely in those days there would be a considerable number of patients who could tell how much they were helped by all these drugs.
Opening of the century
It is believed that a serious study of the placebo effect began in the US during the Second World War. Front-line hospitals were sorely lacking painkillers and narcotics. Convinced once again that injection of physiological solution acts on patients almost as well as morphine, the anesthesiologist Henry Beecher, returning home, with a group of colleagues from Harvard University began to study this phenomenon. He found that when taking a placebo, 35% of the patients experienced significant relief when instead of the usual medications for a variety of diseases (cough, postoperative and headache, irritability, etc.), they received a placebo.
The placebo effect is not at all restricted by taking medications, it can also be manifested with other types of medical procedures. So, 50 years ago, English cardiologist Aeonard Cobb conducted a unique experiment. He simulated a very popular operation in those years to treat heart failure - ligation of two arteries to increase the flow of blood to the heart. Dr. Cobb during the operation did not bandage the arteries, but only made small incisions on the patient's chest. His scientific deception was so successful that doctors completely abandoned the previous method of treatment.
Scientific evidence
Many experts believe that the placebo secret lies in self-hypnosis, and some put it on a par with hypnosis. However, three years ago, scientists from the University of Michigan proved that the placebo effect has neurophysiological mechanisms. The experiment was carried out on 14 volunteers, who agreed to a rather painful procedure - the introduction of a saline solution into the jaw. After a while, parts of them were given painkillers, and parts - placebo. All participants in the experiment who expected to receive the medicine and received a pacifier began active production of endorphin, a natural anesthetic that blocks the receptors' sensitivity to pain and prevents the spread of unpleasant sensations. The researchers divided the patients into "little reactive" and "very reactive", in which pain decreased by more than 20%, and suggested that people who reacted to placebo had a highly developed ability of the brain to self-regulate. Although it is impossible to explain these differences by physiology.
How it works
Most modern doctors already take into account the placebo effect in their methods. In their opinion, the effectiveness of placebo depends on many factors.
1. Kind of medicine. The tablet should be bitter and either very large or very small. A potent medication must have side effects, such as nausea, dizziness, headache, fatigue. Well, when the medicine is expensive, in a bright package, and the name of the brand is at everyone's ears.
2. Unusual method. Strange manipulation, the use of certain objects and attributes will speed the cure. This in most cases explains the effectiveness of alternative techniques.
3. Fame of the doctor. Any medicine taken from the hands of a well-known famous physician, professor or academician, for many will be much more effective than the same tool received in the district clinic. A good doctor, before prescribing a "dummy", should listen for a long time to the patient's complaints, show sympathy for the most vague symptoms and try to assure him in every way in the success of treatment.
4. Personal characteristics of the patient. It is noted that placebo-responsive more among extroverts (people whose feelings are directed outwards). Such patients are anxious, dependent, ready to agree with doctors in everything. At the same time, placebo-unreactive bowls are found among introvert (people directed inside of themselves), suspicious and suspicious. The greatest reaction to placebo is given by neurotics, as well as people with low self-esteem, not self-confident, inclined to believe in miracles.
Some statistics
According to the Michigan Research Center, the placebo effect is most pronounced in the treatment of headache - 62%, depression - 59%, colds - 45%, rheumatism - 49%, seasickness - 58%, intestinal disorders - 58 %. Curing cancer or severe viral diseases by mere force of suggestion is unlikely to succeed, but positive emotions after taking placebo sometimes help improve the condition even in the most severe cases. This is confirmed primarily by biochemical analyzes.
OPINION EXPERT:
Alexey KARPEEV, General Director of the Federal Research Center for the Study of Traditional Methods of Treatment
Of course, the placebo effect is not an illusion, but an indisputable fact. Due to the deeper use of placebo in clinical studies, it is becoming more firmly entrenched in our lives. Studies of its biochemical nature are conducted in many scientific research institutes of the world, so that the final recognition of this phenomenon is not far off. It remains an open question about the correctness of the application of this technique, as well as its possibilities. The doctor faces an ethical problem: what is more correct - immediately begin to treat the patient or first deceive him so that the person tries to recover himself? Although more than 50% of physicians admit that they use the placebo effect in their medical practice to some extent. Again, the placebo effect is not able to cure any serious illnesses. Modern medicine knows cases of healing people, for example, in the third stage of cancer, but here we are talking about the individual characteristics of the individual and the ability of the body to self-recovery. With the help of the placebo effect, it is possible to reduce pain, give the patient the hope of prolonging life, provide him with a certain amount of comfort, not only psychological. This phenomenon causes noticeable favorable changes in the state of patients, so its use in clinical practice is acceptable when it does not harm the patient.