Iyiphi impembelelo ye-placebo: enye indlela yokonyango okanye inkohliso encane? Lo mbuzo uphendwa ngabasosayensi kunye neephilistines eziqhelekileyo iminyaka emininzi. Ukusetyenziswa kwe-placebo kwizifundo zekliniki akusisona siqhelo, kodwa njani le ngcamango ingene ngokuqinisekileyo ebomini bethu? Kwaye kungakanani umphumo wale "machiza"? Ingaba le nyeza na? Izimpendulo zale mibuzo neminye nge-placebo zifumaneka ngezantsi.
Igama elithi "placebo" livela kwi-placebo yesiLatini - "njengam," kodwa uthetha ngeli gama isilwanyana okanye enye inkqubo engenziyo yonyango, kodwa ixelisa unyango. Xa isigulane sikholelwa ukuba unyango oluchazwe ngugqirha lusebenza kwaye ngoko luphulukisa, le yinto "ye-placebo effect". Le ngqungquthela kwimizila ebanzi yezokwelapha yaziwa ekupheleni kwekhulu le-XVII. Nangona kunjalo, ngefuthe le-placebo, ookhokho bethu abade kakhulu bebazi kakuhle. Ngako oko, eYiputa yamandulo, i powder powder wasicingwa njengeyonyango yonke, eyaboniswa ngabaphili beendawo kwimeko nganye ekhethekileyo. Kwaye kwi-Middle Ages injongo zonyango zihlala zisetyenziswa imilenze yegrog, i-nettle eqokelelwa emangcwabeni kwenyanga epheleleyo, okanye i-moss ephuma kwi-gazi yomntu ofileyo. Ngokuqinisekileyo ngaloo mihla kwakuya kuba nenani elikhulu lezigulane eziza kuxela ukuba zincedwa kangakanani ngabo bonke aba machiza.
Ukuvulwa kwekhulu
Kukholelwa ukuba isifundo esinzulu sempembelelo ye-placebo saqala e-US ngexesha leMfazwe Yehlabathi yesiBini. Izibhedlele zangaphambili zazingabikho ziphulo kunye nezidakamizwa. Ngokuqinisekileyo kwakhona ukuba ukuxhatshazwa kwesisombululo somzimba kuthatha izigulana phantse kunye ne-morphine, i-anesthesiologist uHenry Beecher, ebuyela ekhaya, kunye neqela labalingane abavela kwiYunivesithi yaseHarvard baqalisa ukufunda le nto. Ufumene ukuba xa uthatha indawo ye-placebo, i-35% yezigulane zafumana ukukhululeka okukhulu xa esikhundleni samachiza aqhelekileyo kwizifo ezahlukahlukeneyo (ukukhwehlela, ukuhamba emva kwentsholongwane kunye nentloko, ukuphazamiseka, njl njl.), Bafumana indawo ye-placebo.
Impembelelo ye-placebo ayinakunqandwa ngokupheleleyo ngokuthatha amachiza, inokubonakaliswa nezinye iintlobo zeenkqubo zonyango. Ngoko, iminyaka engama-50 edlulileyo, isazi se-cardiologist saseNgesi u-Aeonard Cobb senze uvavanyo oluyingqayizivele. Wenza umsebenzi owaziwayo kakhulu kuloo minyaka ukuphatha ukungaphumeleli kwintliziyo - ukugqithiswa kwemibhobho emibili ukwenzela ukwandisa ukuhamba kwegazi entliziyweni. UDkt Cobb ngethuba lo msebenzi akazange afake izibilini, kodwa wenza izinto ezincinci kwisifuba somguli. Ukukhohlisa kwakhe kwenzululwazi kwaphumelela kangangokuthi oogqirha bashiya ngokupheleleyo indlela yokwenza unyango.
Ubungqina besayensi
Iingcali ezininzi zikholelwa ukuba i-placebo eyimfihlo ibonakala ekuziphatheni, kwaye abanye bayifaka kwi-hypnosis. Nangona kunjalo, iminyaka emithathu edlulileyo, izazinzulu ezivela kwiYunivesithi yaseMichigan zabonisa ukuba umphumo we-placebo unendlela ye-neurophysiological. Olu vavanyo lwaqhutyelwa kumavolontiya angama-14, avuma inkqubo enzima kakhulu - ukuqaliswa kwesisombululo se-saline kwisihlunu. Emva kwithuba elithile, iinxalenye zazo zanikezwa iipilisi, kunye nendawo ye-placebo. Bonke abathathi-nxaxheba kulolu vavanyo ababekulindele ukufumana iyeza kwaye bafumana i-pacifier baqala ukuveliswa kwemveliso ye-endorphin, i-anesthetic yemvelo ekhusela ukuvavanya kwamoya kunye nokuthintela ukusabalala kwemizwa engathandekiyo. Abaphandi baye bahlula izigulane zibe "zincinci" kwaye "zisebenziseke kakhulu", apho intlungu iyancipha ngaphezu kwama-20%, kwaye iphakamisa ukuba abantu abaye basabela kwi-placebo babenakho ubuchule obuphucukileyo obuphezulu bobuchopho bokuzilawula. Nangona akunakwenzeka ukuchazela le ntlukwano nge-physiology.
I sebenza njani
Oogqirha abaninzi banamhlanje sele baqwalasela impembelelo ye-placebo kwiindlela zabo. Ngoluvo lwabo, ukusebenza kwe-placebo kuxhomekeke kwiimeko ezininzi.
1. Uhlobo lweyeza. Ithebhulethi kufuneka ibe buhlungu kwaye inkulu okanye incinci kakhulu. Amachiza enamandla kufuneka abe nemiphumo emibi, njengentlungu, isisu, intloko, ukukhathala. Ewe, xa iyeza libiza, kwiphakeji eqaqambileyo, kunye negama lekhontrakthi eendlebe zomntu wonke.
2. Indlela engavamile. Ukunyanzeliswa okungaqhelekanga, ukusetyenziswa kwezinto ezithile kunye neempawu ziza kukhawuleza unyango. Oku kwimeko ezininzi kuchaza ukusebenza kwamanye amacebo.
3. Udumo logqirha. Naliphi na isicatshulwa esithathwe ezandleni zonyango owaziwayo owaziwayo, unjingalwazi okanye umfundi wezemfundo, ezininzi ziya kusebenza ngokugqithiseleyo kunokuba ithuluzi elifanayo lifunyenwe kwikliniki yesithili. Ugqirha olungileyo, ngaphambi kokumisela "i-dummy", kufuneka aphulaphule ixesha elide kwizikhalazo zesigulane, bonisa uvelwano kwiimpawu ezicacileyo kwaye uzama ukumqinisekisa ngandlela-thile kwimpatho yonyango.
4. Iimpawu zomntu zesigulane. Kuphawulwe ukuba i-placebo-impendulo engakumbi phakathi kwe-extroverts (abantu abaneemvakalelo zabo ezijoliswe ngaphandle). Ezi zigulane zixhalabile, zithembele, zikulungele ukuvumelana noogqirha kuyo yonke into. Ngexesha elifanayo, izitya ze-placebo-ezingasebenziyo zifunyenwe phakathi kwe-introvert (abantu abalawulwa ngaphakathi kwabo), bakrokre kwaye bakrokre. Impendulo enkulu kunazo zonke kwi-placebo inikezwa ngama-neurotics, kunye nabantu abanokuzithemba, abazithembeli, bathambekele ekukholweni kwimimangaliso.
Ezinye iinkcukacha
Ngokutsho kweMichigan Research Centre yaseMichigan, i-effectbo ye-placebo ibonakala kakhulu kunyango lwe-headache - 62%, ukuxinezeleka - 59%, ukubandisa - 45%, i-rheumatism - 49%, ukugukula kolwandle - i-58%, izifo zamathumbu - 58 %. Ukuphilisa umdlavuza okanye izifo ezinentsholongwane ezibangelwa yintsholongwane kungenakukwazi ukuphumelela, kodwa iimvakalelo ezintle emva kokuthatha indawo ye-placebo ngezinye izihlandlo zikunceda ukuphucula imeko nakwiimeko ezinzima kakhulu. Oku kuqinisekiswa ngokuyinhloko ngokuhlalutya kwezinto eziphilayo.
INKCAZELO YOMFAKATHI:
I-Alexey KARPEEV, uMlawuli oyiNtloko weSizwe soPhando lwe-Federal for the Study of Methods of Treatment
Ewe, impembelelo ye-placebo ayikho inkohliso, kodwa inyaniso engenakuphikiswa. Ngenxa yokusetyenziswa ngokujulileyo kwe-placebo kwizifundo zekliniki, kuya kuqina ngakumbi kwimpilo yethu. Izifundo zezinto eziphilayo zendalo ziqhutywa kwiinkalo ezininzi zophando zezenzululwazi zehlabathi, ukwenzela ukuba ukuqaphela kokugqibela le nto ayikude. Kuhlala umbuzo ovulekileyo malunga nokuchaneka kokusetyenziswa kweli cwangciso, kunye namathuba ayo. Ugqirha ubhekene neengxaki zokuziphatha: yintoni echanekileyo-ngokukhawuleza ukuqala ukunyanga isigulane okanye kuqala ukumkhohlisa ukuze loo mntu azame ukuzifumana ngokwakhe? Nangona abangaphezu kwama-50% oogqirha bavuma ukuba basebenzise impembelelo ye-placebo kwizonyango zabo kwizinga elithile. Kwakhona, isiphumo se-placebo asikwazi ukuphilisa nasiphi na isifo esibi. Amachiza anamhlanje uyazi izipho zokuphulukisa abantu, umzekelo, kwisigaba sesithathu somhlaza, kodwa apha sithetha ngeziganeko zomntu ngamnye kunye nokukwazi komzimba ukuzilungisa. Ngomncedisi wempembelelo ye-placebo, kunokwenzeka ukunciphisa intlungu, kunika isigulane ithemba lokwandisa ubomi, kumnika ubuninzi benduduzo, kungekhona nje kwengqondo. Le nto ibangela ukuba utshintsho olubonakalayo olubonakalayo kwiimeko zezigulane, ngoko ke ukusetyenziswa kwalo kwinkqubo yeklinikhi kuyamkeleka xa kungalimazi isigulane.