Uyini umphumela we-placebo: enye indlela yokwelapha noma inkohliso encane? Lo mbuzo ubuzwa bobabili ososayensi namafilimu avamile iminyaka eminingi. Ukusetshenziswa kwe-placebo ezifundweni zemitholampilo akuseyona into enhle, kodwa kanjani lo mqondo wangena ngokuqinile empilweni yethu? Futhi ingakanani umphumela walo "muthi"? Futhi ingabe lo muthi nhlobo? Izimpendulo zale mibuzo neminye mayelana ne-placebo ziyatholakala ngezansi.
Igama elithi "placebo" livela kwi-placebo yesiLatini - "njengami," kepha kusho leli gama umuthi noma inqubo engaziphilisi ngokwayo, kodwa ilandisa ukwelashwa. Uma isiguli sikholelwa ukuthi ukwelashwa okushiwo udokotela kusebenza kahle ngakho-ke kuyaphilisa, lokhu kuyindlela "ye-placebo effect". Lesi simo emibuthanweni enkulu yezokwelapha saziwa ekupheleni kwekhulu le-XVII. Kodwa-ke, ngomphumela we-placebo, okhokho bethu abade kakhulu bebazi kahle. Ngakho-ke, eGibhithe lasendulo, i-powder calcareous yayibhekwa njengomuthi wendawo yonke, okwakhulunywa ngabaphili bendawo endaweni ethile eqondene nokulungiselela okukhethiwe. Futhi eNkathini Ephakathi ngezinhloso zezokwelapha ngokuvamile kusetshenziswa imilenze ye-frog, inambuzane eqoqwe emangcwabeni ngenyanga egcwele, noma i-moss evela ekhanda lomuntu oshonile. Ngokuqinisekile ngalezo zinsuku kwakuyoba nenani elikhulu leziguli ezingatshela ukuthi ziningi kangakanani lezi zidakamizwa ezazisizwa.
Ukuvulwa kwekhulu leminyaka
Kukholelwa ukuthi ukuhlolwa okujulile komphumela we-placebo kwaqala e-US phakathi neMpi Yezwe Yesibili. Izibhedlela zangaphambili zazingenakho ukuphuza izidakamizwa kanye nezidakamizwa. Ngokuqinisekisiwe futhi ukuthi umjovo wesisombululo somzimba uthinta iziguli cishe kanye ne-morphine, i-anesthesiologist uHenry Beecher, ebuyela ekhaya, neqembu labasebenza nabo eHarvard University baqala ukutadisha lesi simo. Uthole ukuthi lapho uthatha i-placebo, iziguli ezingama-35% zathola ukukhululeka okukhulu uma esikhundleni semithi evamile yezifo ezihlukahlukene (ukukhwehlela, ukukhishwa kwe-postoperative kanye nokukhanda ikhanda, ukucasula, njll.), Bathola i-placebo.
Umphumela we-placebo awunqunyelwe nakancane ngokuthatha imithi, ingabonakaliswa nezinye izinhlobo zokwelapha. Ngakho-ke, eminyakeni engama-50 edlule, isazi sezinzwa sase-English Aeonard Cobb senze ukuhlolwa okuyingqayizivele. Wenza umsebenzi owuthandwa kakhulu kulezo zinsuku ukuphatha ukuhluleka kwenhliziyo - ukuxilongwa kwemizwa emibili yokwandisa ukugeleza kwegazi enhliziyweni. UDkt. Cobb ngesikhathi sokusebenza akazange abophe imishanguzo, kodwa wenza kuphela ukubhekwa okuncane esifubeni sesiguli. Ukukhohlisa kwakhe kwesayensi kwaphumelela kakhulu kangangokuthi odokotela bashiya ngokuphelele indlela yokwelashwa yangaphambilini.
Ubufakazi besayensi
Ochwepheshe abaningi bakholelwa ukuthi i-placebo imfihlo ikhona ekuziphatheni, kanti abanye bayifaka nge-hypnosis. Nokho, eminyakeni emithathu eyedlule, ososayensi abavela eNyuvesi yaseMichigan bafakazela ukuthi umphumela we-placebo unendlela ye-neurophysiological. Lokhu kuhlolwa kwenzelwa amavolontiya angu-14, avumelana nenqubo ebuhlungu kakhulu - ukwethulwa kwesisombululo saline emhlathini. Ngemva kwesikhashana, izingxenye zazo zanikezwa izinhlungu zomzimba, futhi izingxenye - indawo ye-placebo. Bonke abahlanganyeli ekuhlolweni ababekulindele ukuthola imithi futhi bathola i-pacifier baqala ukukhiqizwa okusebenzayo kwe-endorphin, ukuhlinzekwa kwemvelo okuvimbela ukuzwela kwe-receptors ebuhlungu futhi kuvimbele ukusabalala kwemizwa engathandeki. Abacwaningi bahlukanisa iziguli zibe "ukungasebenzi kahle" futhi "zisebenza kakhulu", lapho ubuhlungu behle ngo-20%, futhi baphakamisa ukuthi abantu abasabela endaweni ye-placebo babenekhono elithuthukile kakhulu lobuchopho ukuzilawula. Yize kungenakwenzeka ukuchazela lezi zohluko nge-physiology.
Isebenza kanjani
Odokotela abaningi banamuhla baye bacabangisisa ngomphumela we-placebo ezindleleni zabo. Ngokombono wabo, ukusebenza kwe-placebo kuncike ezintweni eziningi.
1. Uhlobo lwemithi. Ithebhulethi kufanele ibe mbaba futhi ibe enkulu noma encane kakhulu. Imithi enamandla kumele ibe nemiphumela emibi, njengesiyaluyalu, isizungu, isisu, ukukhathala. Yebo, uma umuthi uyabiza, kuphakethe elikhanyayo, negama lomkhiqizo liyizindlebe zomuntu wonke.
2. Indlela engavamile. Ukukhwabanisa okungaqondakali, ukusebenzisa izinto ezithile kanye nezimfanelo kuzosheshisa ukwelashwa. Lokhu kwenzeka ezimweni eziningi kuchaza ukusebenza kwamasu okunye.
3. Udumo lodokotela. Noma imuphi umuthi othathwe ezandleni zodokotela owaziwa odumile, uprofesa noma ofundisayo, abaningi bazosebenza kangcono kunethuluzi elifanayo elitholwa emtholampilo wesifunda. Udokotela omuhle, ngaphambi kokubeka "i-dummy", kufanele alalele isikhathi eside izikhalazo zesiguli, bonisa ukuzwelana ngezibonakaliso ezingacacile kakhulu futhi uzame ukumqinisekisa ngazo zonke izindlela empumelelweni yokwelashwa.
4. Izici zobuntu zesiguli. Kuphawulwe ukuthi i-placebo-responsive more among extroverts (abantu abanemizwa eqondiswa ngaphandle). Iziguli ezinjalo zikhathazeka, zixhomekile, zilungele ukuvumelana nodokotela kuzo zonke izinto. Ngesikhathi esifanayo, izitsha ze-placebo-ezingasebenzi ezingatholakali phakathi kwe-introvert (abantu abaqondiswa ngaphakathi kwabo), okusolisayo nokusola. Ukusabela okukhulu kunazo zonke endaweni ye-placebo kunikezwa yizinzwa ze-neurotics, kanye nabantu abanokuzethemba, abazethembi, abazimisele ukukholelwa ezimangalisweni.
Ezinye izibalo
Ngokusho kweMichigan Research Centre, umphumela we-placebo ukhulunywa kakhulu ekwelapheni kwekhanda - 62%, ukucindezeleka - 59%, ukushisa - 45%, i-rheumatism - 49%, ukuguga kwamanzi - 58%, ukuphazamiseka kwamathumbu - 58 %. Ukuphulukisa umdlavuza noma izifo ezinzima zegciwane ngokucindezela nje nje akunakwenzeka ukuphumelela, kodwa imizwa emihle emva kokuthatha indawo ye-placebo ngezinye izikhathi kusiza ukuthuthukisa isimo ngisho nasezikhungweni ezimbi kakhulu. Lokhu kuqinisekiswa ngokuyinhloko ngokuhlaziywa kwamakhemikhali.
I-EXPERT:
U-Alexey KARPEEV, uMqondisi Jikelele we-Federal Research Center ye-Study of Methods of Treatment
Yiqiniso, umphumela we-placebo akuyona into ekhohlisayo, kodwa iqiniso elingenakuphikwa. Ngenxa yokusetshenziswa okujulile kwe-placebo ezifundweni zemitholampilo, kuqiniswa kakhulu ekuphileni kwethu. Ukuhlolwa kwemvelo yezinto eziphilayo kuqhutshwa ezindaweni eziningi zocwaningo lwezesayensi, ukuze ukuqaphela kokugcina kwalesi simo akude kakhulu. Kuhlala umbuzo ovulekile mayelana nokufaneleka kwesicelo sale nqubo, kanye namathuba ayo. Udokotela ubhekene nenkinga yokuziphatha: yini eyilungile - ngokushesha ukuqala ukuphatha isiguli noma kuqala ukumkhohlisa ukuze umuntu azame ukuzithola ngokwakhe? Nakuba odokotela abangaphezu kuka-50% bayavuma ukuthi basebenzisa umphumela we-placebo emisebenzini yabo yezokwelapha ngezinga elithile. Futhi, umphumela we-placebo awukwazi ukuphulukisa noma iziphi izifo ezimbi. Imithi yesimanje iyazi izimo zokuphulukisa abantu, isibonelo, esigabeni sesithathu somdlavuza, kodwa lapha sikhuluma ngezici zomuntu ngamunye kanye nekhono lomzimba ekuzivuseleleni. Ngosizo lomphumela we-placebo, kungenzeka ukunciphisa ubuhlungu, unike isiguli ithemba lokukhulisa impilo, kumnikeze inani elithile lokududuza, hhayi kuphela kwengqondo. Lesi simo senza ushintsho olubonakalayo olubonakalayo esimweni seziguli, ngakho ukusetshenziswa kwalo emtholampilo kuyamukeleka uma kungalimazi isiguli.