Kodi zotsatira za placebo ndi njira yanji ya chithandizo kapena chinyengo chochepa? Funso limeneli likufunsidwa ndi asayansi ndi alembi wamba kwa zaka zambiri. Kugwiritsiridwa ntchito kwa malobo mu maphunziro azachipatala sikunali katsopano, koma kodi lingaliroli mwatchutchutchu linalowa bwanji m'moyo wathu? Ndipo kodi zotsatirapo za "mankhwala" awa ndi zingati? Ndipo kodi mankhwalawa ndi amodzi? Mayankho a mafunso awa ndi ena okhudza placebo alipo pansipa.
Mawu akuti "placebo" amachokera ku malo otchedwa Latinbo - "monga ine," koma amatanthawuza ndi mawuwa mankhwala kapena njira zina zomwe sizichilomboka, koma zimatsatira chithandizo. Pamene wodwalayo amakhulupirira kuti chithandizo chimene dokotala anamuuza ndi chothandiza ndipo amachiza, izi ndi "placebo effect". Chodabwitsa ichi m'magulu akuluakulu azachipatala chinadziwika kumapeto kwa zaka za XVII. Komabe, ndi zotsatira za placebo, makolo athu akutali ankadziwa bwino. Choncho, ku Igupto wakale, ufa wowerengeka unkatengedwa kuti ndi mankhwala a chilengedwe chonse, omwe adawonetsedwa ndi ochiritsa am'deralo payekhapayekha monga chokonzekera payekha. Ndipo m'zaka zamkati zapitazi zofuna zachipatala zimagwiritsa ntchito miyendo ya frog, nettle anasonkhanitsidwa m'manda pamwezi wokhazikika, kapena moss kuchokera ku chigaza cha munthu wakufa. Ndithudi m'masiku amenewo padzakhalanso odwala ambiri amene angadziwe kuchuluka kwa mankhwala omwe adathandizidwa nawo.
Kutsegulidwa kwa zaka zana
Zimakhulupirira kuti kuphunzira kwakukulu kwa zotsatira za placebo kunayamba ku US panthawi ya nkhondo yachiwiri yapadziko lonse. Zipatala zam'mbuyomo zinalibe kusowa mankhwala komanso mankhwala osokoneza bongo. Anatsimikiziranso kuti jekeseni ya njira yothetsera thupi imakhudza odwala pafupifupi morphine, katswiri wamagetsi aamuna Henry Beecher, wobwerera kwawo, pamodzi ndi gulu la anzake ochokera ku yunivesite ya Harvard anayamba kuphunzira izi. Iye adapeza kuti atatenga malo a placebo, odwala 35 pa 100 aliwonse amapeza mpumulo waukulu m'malo mwa mankhwala omwe amayamba chifukwa cha matenda osiyanasiyana (chifuwa, postoperative ndi kupwetekedwa mtima, kupsa mtima, ndi zina zotero), adalandira placebo.
Mpweya wa placebo sungowonjezeredwa ndi kumwa mankhwala, ukhozanso kuwonetseredwa ndi njira zina zamankhwala. Choncho, zaka 50 zapitazo, katswiri wamaphunziro a ku England, dzina lake Aeonard Cobb, anachita zosavuta. Anapanga opaleshoni yotchuka kwambiri m'zaka zomwezo kuti athetse mtima waumtima - kuyika mitsempha iŵiri kuti kuwonjezereka kwa magazi kumtima. Dr. Cobb panthawi ya opaleshoniyo sankagwiritsira ntchito mitsempha, koma amangopanga zochepa za chifuwa cha wodwalayo. Kunyenga kwake kwa sayansi kunapambana kwambiri moti madokotala atasiya njira yothetsera kale.
Umboni wa sayansi
Akatswiri ambiri amakhulupirira kuti chinsinsi cha placebo chimakhala ndi kudzidalira, ndipo ena amachilemba pamtima ndi hypnosis. Komabe, zaka zitatu zapitazo, asayansi ochokera ku yunivesite ya Michigan anatsimikizira kuti zotsatira za placebo zimakhala ndi njira zogwira mtima. Kuyeseraku kunayesedwa ndi anthu odzipereka okwana 14 omwe anavomera njira yowopsya - kuyambitsa njira ya saline m'nsagwada. Patapita kanthawi, magawo awo anapatsidwa mankhwala opweteka, komanso mbali-malo. Onse omwe adayesayesa kuti adzalandile mankhwalawa ndi kulandira pacifier anayamba ntchito yogwiritsira ntchito endorphin, kupweteka kwachilengedwe komwe kumapangitsa kuti odwala amve kupweteka komanso kuchepetsa kufalikira kwa zowawa. Ofufuzawa anagawaniza odwalawo kukhala "ochepa kwambiri" komanso "ochita bwino kwambiri", omwe ululu umachepa ndi oposa 20%, ndipo anati anthu omwe anachita ndi malobo anali ndi luso lapamwamba la ubongo lodzilamulira okha. Ngakhale sikutheka kufotokoza kusiyana kumeneku ndi thupi.
Momwe ikugwirira ntchito
Madokotala ambiri amakono amalingalira kale zotsatira za placebo mu njira zawo. Malingaliro awo, mphamvu ya placebo imadalira pazinthu zambiri.
1. Mtundu wa mankhwala. Pulogalamuyi iyenera kukhala yowawa komanso yaikulu kapena yochepa kwambiri. Mankhwala amphamvu ayenera kukhala ndi zotsatira, monga kunyozetsa, chizungulire, kupweteka mutu, kutopa. Chabwino, mankhwalawa ndi okwera mtengo, phukusi lowala kwambiri, ndipo dzina la chizindikiro liri pa makutu a aliyense.
Njira yachilendo. Kugwiritsidwa mwamphamvu, kugwiritsa ntchito zinthu zina ndi zikhalidwe zidzalimbikitsa chithandizo. Nthawi zambiri izi zimafotokozera kuti njira zowonjezera zimagwirira ntchito.
3. Kutchuka kwa dokotala. Mankhwala amodzi omwe amachotsedwa m'manja mwa dokotala wodziwika wotchuka, pulofesa kapena wophunzira, kwa ambiri adzakhala ogwira ntchito kwambiri kuposa chida chomwecho chopezeka kuchipatala cha chigawo. Dokotala wabwino, asananene kuti "dummy", ayenera kumvetsera nthawi yayitali kwa zodandaula za wodwalayo, kusonyeza chifundo kwa zizindikiro zosadziwika bwino ndikuyesera kumutsimikizira m'njira iliyonse kuti apambane.
4. Makhalidwe a munthu wodwalayo. Zimatchedwa kuti placebo-respondent kwambiri pakati pa extroverts (anthu omwe maganizo awo amachokera kunja). Odwala amenewa ali ndi nkhawa, amadalira, okonzeka kuvomereza ndi madokotala mu chirichonse. Pa nthawi yomweyo, mbale za placebo-zosagwira ntchito zimapezeka pakati pa introvert (anthu amatsogoleredwa mwa iwo okha), akukayikira komanso akukayikira. Chofunika koposa pa malobochi chimaperekedwa ndi ziphuphu, komanso anthu odzidalira, osadzidalira, omwe amakhulupirira zozizwitsa.
Ziwerengero zina
Malingana ndi Michigan Research Center, zotsatira za placebo zimatchulidwa kwambiri pochiza mutu - 62%, kuvutika maganizo - 59%, kuzizira - 45%, rhumatism - 49%, nyanja yachisanu - 58%, matenda a m'mimba - 58 %. Kuchiza khansara kapena matenda akuluakulu a tizilombo ndi mphamvu zowonjezera sizingatheke, koma kukhala ndi maganizo abwino pambuyo pa kutenga placebo nthawi zina kumathandiza kusintha vuto ngakhale m'milandu yoopsa kwambiri. Izi zimatsimikiziridwa makamaka ndi kafukufuku wamaganizo.
CHITSANZO CHA OPENDA:
Alexey KARPEEV, Mtsogoleri Wamkulu wa Federal Research Center kwa Phunziro la Njira Zachikhalidwe Zothandizira
Zoonadi, zotsatira za placebo sizonyenga, koma ndizosatsutsika. Chifukwa cha kugwiritsidwa ntchito kwakukulu kwa placebo mu maphunziro azachipatala, zikukhala zolimba kwambiri m'miyoyo yathu. Zofufuza za chilengedwe chake zimayendetsedwa m'mabungwe ambiri ofufuza za sayansi, kotero kuti kuzindikira kotsiriza kwa chodabwitsa ichi sikuli kutali. Icho chikhalabe funso lotseguka ponena za kulondola kwa kugwiritsa ntchito njira iyi, komanso mwayi wake. Dokotala akukumana ndi vuto lachikhalidwe: ndi chiyani cholondola - nthawi yomweyo amayamba kuchiza wodwala kapena kumunyenga iye kuti munthuyo ayesere kudzipulumutsa yekha? Ngakhale kuti madokotala oposa 50% amavomereza kuti amagwiritsira ntchito mankhwala a placebo muzochita zawo zachipatala. Apanso, zotsatira za placebo sizingathe kuchiza matenda alionse aakulu. Mankhwala amakono amadziwa zochitika za machiritso, mwachitsanzo, mu siteji yachitatu ya khansa, koma apa tikukamba za umunthu wa munthu payekha komanso mphamvu ya thupi kuti adzipulumutse. Mothandizidwa ndi zotsatira za placebo, n'zotheka kuchepetsa ululu, perekani wodwala chiyembekezo chokhalitsa moyo, kumupatsa chitonthozo chokwanira, osati maganizo ake okha. Chodabwitsa ichi chimapangitsa kusintha kwabwino kwa odwala, kotero ntchito yake mu chipatala imavomerezedwa ngati sichivulaza wodwalayo.