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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >The placebo response in the treatment of chronic fatigue syndrome: a systematic review and meta-analysis.
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The placebo response in the treatment of chronic fatigue syndrome: a systematic review and meta-analysis.

机译：安慰剂在慢性疲劳综合症治疗中的反应：系统评价和荟萃分析。

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OBJECTIVE: The placebo response is conventionally asserted to be high in chronic fatigue syndrome (CFS) because of the latter's subjective nature and obscure pathogenesis, but no systematic review of placebo responses has been undertaken. We report such a study. Patient expectation is known to be important in the placebo response. It is also known that CFS patients attending specialist clinics often have strong physical attributions regarding causation and hence skepticism about psychological or psychiatric interventions. If so, the placebo response in CFS may be influenced by the type of intervention according to its perceived rationale. We aimed to estimate the summary placebo response in clinical trials of CFS and to determine whether intervention type influences the placebo response in CFS. METHODS: We searched Medline, Embase, Cochrane Library, PsychInfo, and the references of the identified articles, and contacted experts for controlled trials (randomized or nonrandomized) of any intervention on CFS patients reporting the placebo response as a clinical improvement in physical or general outcomes. Data were extracted from the articles and validity assessment conducted by one reviewer and checked by a second. Meta-analysis and metaregression were performed. RESULTS: The pooled placebo response was 19.6% (95% confidence interval, 15.4-23.7), lower than predicted and lower than in some other medical conditions. The meta-regression revealed that intervention type significantly contributed to the heterogeneity of placebo response (p = .03). CONCLUSION: In contrast with the conventional wisdom, the placebo response in CFS is low. Psychological-psychiatric interventions were shown to have a lower placebo response, perhaps linked to patient expectations.
机译：目的：由于慢性疲劳综合征（CFS）的主观性质和不清楚的发病机理，因此通常认为安慰剂应答较高，但尚未对安慰剂应答进行系统评价。我们报告了这样的研究。已知患者期望在安慰剂反应中很重要。众所周知，到专科诊所就诊的CFS患者通常在因果关系上具有很强的身体属性，因此对心理或精神干预也持怀疑态度。如果是这样，则根据其感知的原理，干预措施的类型可能会影响CFS中的安慰剂反应。我们旨在评估CFS临床试验中的汇总安慰剂反应，并确定干预类型是否会影响CFS中的安慰剂反应。方法：我们搜索了Medline，Embase，Cochrane库，PsychInfo和已鉴定文章的参考文献，并联系专家进行了对CFS患者的任何干预试验的对照试验（随机或非随机），这些干预将安慰剂反应报告为物理或一般临床改善结果。从文章中提取数据并由一名审阅者进行有效性评估，然后由第二名进行检查。进行荟萃分析和荟萃回归。结果：安慰剂合并反应为19.6％（95％置信区间为15.4-23.7），低于预期，且低于某些其他医疗条件。荟萃回归显示，干预类型显着促进了安慰剂反应的异质性（p = .03）。结论：与传统观点相反，CFS中的安慰剂反应低。心理-精神干预被证明具有较低的安慰剂反应，可能与患者的期望有关。

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