ྏ॓࿐ࣉᅚ 2011, Vol. 19, No. 8, 1115–1125 Advances in Psychological Science DOI: ·研究方法(Research Method)· *安慰剂效应研究实验设计的历史和发展 122 1,3ᅦ໓ґ ჯ৫ሐ ᄎౝ અ ࣑ 1(ᇏݓ॓࿐ჽྏ࣮෮ྏࡲूᇗׄൌဒ൩, Кࣘ 100101) 23(ފКഽٓն࿐࢝ტ࿐ჽྏ༢, െࡅሌ 050024) (൮ഽٓն࿐࿐༝აಪᆩൌဒ൩, Кࣘ 100048) ᅋ ေ 安慰剂处理从最初作为研究某种真实治疗效应的控制条件, 已演变为研究者直接关注的研究目标, 其实验范式也发生了相应变化。双盲随机设计关注真实的治疗是否优于安慰剂处理; 欺骗设计直接比较安慰剂处理效应和自然历史效应的差异, 关注安慰剂效应本身; 公开隐藏设计通过计算公开治疗效应和隐藏治疗效应之差来估计安慰剂效应的大小; 平衡范式可同时观察安慰剂效应和真实治疗效应; 强化范式通过条件性强化获得加强的安慰剂效应, 是研究其作用机制的优化方案; 本课题组建立的迁移强化范式, 研究安慰剂效应从痛觉到情绪的迁移, 是强化范式的重要补充。 ܱՍ 安慰剂效应; 实验范式; 安慰剂预期 ٳোݼ B845;R395 ν໎࠴ིႋ൞ᆷႮᇍਏ֥འᆘྟၩၬط҂൞ྐཌྷᙣ(Finniss, Kaptchuk, Miller, & Benedetti, หק֥ူ࿐ࠇള࿐หྟႄఏ֥ྏളэ2011)bൈ, ୍࣍ট࣮ᆀૌषႨྏള߄b࣐ܵν໎࠴҂ݣႵޅᇍਏࠥѨ֥หၳྟ࿐aപࣜള࿐ބଷӮཞ֩؟ᇕ࣮൭؍, ᄝฮᇉࠇٚم, ൞ѨದႨૌᆭުѨ౦ࣜӈ߶Ⴕaၝკᆡaஂࣁ೦ᆡބڵྟ౦࿂֩ਵთࠒࠞฐཁᇷ֥ڿbν໎࠴ᆃᇕ఼նི֥৯ᄝ୍࣍টၘ෬ਔν໎࠴ིႋ֥ྏളࠏᇅbᆃུ҂ਵთࣜႄఏਔ࣮ᆀ֥ૡ్ܱᇿbၹູν໎࠴ႚႵ“പ֥ᆣऌᆣૼ, ν໎࠴ིႋ൞ᆇൌթᄝ֥ྏളఅི৯”, ၛᇀႿᄝቋ࣍၂ཛૅݓಆݓטҰᇏؿ࿐གྷའ(Price, Finniss, & Benedetti, 2008; གྷ, ૅݓ၄ളӈӈ۳ߑᆀष၂ུѩીႵหၳྟਏZubieta & Stohler, 2009)b ི֥ူ, ଢ֥ᆺ൞ູਔડቀߑᆀ֥ᇍਏ჻ຬ, ν໎࠴ིႋགྷའ֥ิԛఏჷႿ၄ਏൌbᄝႺؿν໎࠴ّႋ(Tilburt, Emanuel, Kaptchuk, ၄࿐ൌᇏ, ൌീଖᇕᇍਏᆭުߑᆀุဒ֥֞ѨCurlin, & Miller, 2008)bമᇀႵ࣮ᆀࣉ၂҄ษં౦ݺሇॖିႵ؟ᇕჰၹğॖି൞ൌീ֥ᇍਏಒൌਔਢԵഈႨν໎࠴ೂޅ၄࿐—࣐ؿߨਔਅݺ֥ᇍਏིݔ; ္Ⴕॖି൞Ѩ౦ෛൈࡗܵν໎࠴Ⴕሢ఼նི֥৯, ൞ᄝѨದ҂ᆩ౦ӱؿള֥ሱಖڿ, ࠧьᄝીႵᇍਏ֥౦ঃ༯֥౦ঃ༯Ⴈ֥, ᆃᇕྛູაѨߑᆩ౦ಃa၄ߑᆃᇕڿ္߶ؿള; ߎॖି൞ߑᆀؓᇍਏᆀࠇူЧദ֥ቔႨ٤ӈྐঠ, ႮՎӁള֥ྏν໎ቔ ႨߏࢳਔѨ౦, ၹՎᆃᇕڿѩ҂൞ႮᇍਏЧ൬۠ರ௹ദႄఏ֥b෮ၛ, ᆺႵᄝሱಖൎၹބν໎࠴:2011-04-07 * 973国家重点基础研究发展计划(Grant 2010CB833904)aིႋ֤֞॥ᇅ่֥ࡱ༯, Ҍି֤ԛଖᇕᇍਏಒ863ݓࡅۚඌ࣮ؿᅚ࠹߃(Grants 2008AA022604)aൌႵི֥ࢲંbԮ֥ਢԵൌဒѩ҂ܱྏν໎࠴ݓࡅሱಖ॓࿐ࠎࣁ૫ഈཛଢ(Grants 30970890 and ིႋ֥ྏപࣜࠏᇅbഡקν໎࠴่ࡱᆺ൞ູਔ30770708)aᇏݓ॓࿐ჽྏ࣮෮ౝ୍ದҌ॓ࠎဒ၂ᇕྍူ֥Ⴕིྟ, മᇀν໎࠴ིႋФࣁ(Grant Y0CX451S01)ބᇏݓ॓࿐ჽᆩ്Էྍ۽ӱुቓۄಠူቔႨဒ֥၂ᇕઐِbෛሢؓν໎(Grant KSCX2-EW-J-8)֩ཛଢᆦӻb ๙ቔᆀ:અ࣑, E-mail: luoj@ ࠴ིႋ֥ಪ്۷ࡆധೆ, ν໎࠴ིႋࠣఃྏ1115
1116 ྏ ॓ ࿐ ࣉ ᅚ ֻ19ज പࣜࠏᇅၘࣜӮູ࣮ᆀܱᇿ֥॓࿐࣮ଢѓbᆀοఅඨ၇ՑٳӮਆቆiiϢޤॆ࿓ౢᄝᆃ၂ݖӱᇏ, ν໎࠴ིႋ֥ൌဒഡ࠹නམ္ቆބ҂ݣॆ֥࿓ౢቆ, ಖުࡎਏིbቋᄝ҂؎ؿᅚb ު֤ԛࢲં, Ⴈᆞӈઔ֥࿓ౢބႨॆ࿓ౢ෮֤ᇍਏིݔཌྷර(Kaptchuk, 1998)bႋھඪ, 1 安慰剂研究的历史 ᆃ۱ൌဒഡ࠹ၘࣜ٤ӈࢤ࣍Ⴕν໎࠴॥ᇅ֥ൌν໎࠴ဒbᄝ1938୍, Diehl֩ದࢺകਔૌ֥ൌဒ॥ᇅ, (Placebo, ঘנე, I shall please)ᆃ۱Սᄝ14ൗࡀ൮ՑႨ, টሱႿᄤড়ഈܦႛ֥५ೞν໎࠴ᆃ۱ۀФ൮ՑႨႿൌဒԩٚ૫b࣮ᆀ֜໓ᆀБۡඪğ“ν໎࠴ቆ֥Ф൫ࢤ൳აൌဒቆुఏট, ఃݣၬაགྷս֥ν໎࠴ݣၬཌྷҵമჹbᄝ1785୍ֻؽϱNew Medicum Dictionayᇏປಆཌྷ֥ԩ, ࢤ൳֥൞ν໎࠴ط҂൞ၦ૬, , ν໎࠴Ф૭ඍູ၂ᇕหקིႋ֥ٚمࠇူࠧ෮ӹ֥ࢋଵᇏ൞ೄบط҂൞ၦ૬, ਆቆࢤ൳ປ, ᆃ၂קၬෙಖႵਔ၄࿐ഈ֥ݣၬಆཌྷ֥ᆷ֝ე”bᆃ۱ൌဒଢ֥ᄝႿဒ၂ᇕၦ, ಯಖ҂Ⴟགྷսν໎࠴֥ݣၬb1817୍, ྩרު֥Quincy૬൞ڎऎႵყٝۋવ֥ቔႨ, ഡᇂਔࢤ൳ၦ૬ቆ’s Lexicon-Medicumᇏ, ν໎࠴ФקၬູႨႿ౼ᄆބࢤ൳ν໎࠴ᇍਏቆ, ࢲݔؿགྷν໎࠴ቆીႵࢤߑᆀط҂൞ߑᆀ൳ၭ֥ޅူ֥ሹӫ, ᆃ၂൳ၦ૬ᇍਏ, ಏࠆ֤აࢤ൬ၦ૬ᇍਏིݔཌྷ֥֒קၬაགྷᄝ֥ݣၬбࢠ์࣍(de Craen, Kaptchuk, ࢲݔbཁಖ, ᆃ۱ൌဒၘࣜࠎЧऎСਔ॥ᇅν໎T࠴ིႋ่֥ࡱ, ѩࠆ֤ਔऎႵགྷսၩၬ֥ν໎࠴ijssen, & Kleijnen, 1999)b 20ൗࡀၛభིႋ(de Craen et al., 1999)b , ᄝਢԵ၄࿐ഈ؎ଖᇕᇍਏ൞ڎႵི, ն၇ऌಃຯ၄ളิ܂֥Ѩ, ط2 安慰剂效应的定义 ҂൞ࡹ৫ᄝႵν໎࠴॥ᇅ֥ൌဒ࣮ࠎԤᆭഈbᄝᆃ၂ൈ௹, ಯಖႵ၂ུದᄝဒଖᇕူࠇෛሢؓν໎࠴ིႋ֥ಪ്ᄀটᄀധೆ, ದૌᇍਏི֥ݔൈࣉྛਔν໎࠴֥॥ᇅ, ᆃུषԷྟؓఃᇯࡶ۳ԛਔбࢠ॓࿐֥קၬbቋԚଽ॓၄ള֥۽ቔູགྷսν໎࠴֥࣮קਔࠎԤb1801୍, ۳ߑᆀ֥บນФקၬູν໎࠴, ᆃ൞ቋ༮ᅎ֥၂John Haygarth൮ՑБۡਔν໎࠴॥ᇅ(Placebo- ᇕקၬ, ުটࡼν໎࠴֥ݣၬຉॺູ“ࡌልࣉྛcontrolled)֥ൌဒࢲݔb֒ൈӈႨ֥၂ᇕᇍਏࠥѨࠃྟူᇍਏ(Active treatment)֥ޅᇉ, ֥ٚم൞ࡼࣁඋݐ(Metallic rods, ӫູPerkins ൌ࠽ഈؓေۄყ่֥ࡱીႵޅူ࿐֥႕ཙ” tractor)٢ᄝദุഈ, ಪູದุॖၛ๙ݖࢤ൳ࣁඋ(Kirsch, 1985), ൞ᆃ၂קၬߎႵсေঔᅚ, ࠧՈ֥႕ཙطߏࢳᆡሑbHaygarthᄝֻ၂฿۳5Ԣਔᇉᆭຓ, ߎႋھЇওٚم(Shapiro & ۱ѨದႨଡٟᄯ֥ࣁඋݐᇍਏ, ؿགྷඹ۱ದMorris, 1978; Wickramasekera, 1985), бೂν໎࠴Ѩ౦ߏࢳb༯၂฿Ⴈᆇᆞ֥ࣁඋݐࣉྛᇍਏ֤ຓ॓൭ඌaν໎࠴ᆌࣳࠇᆀषܱໃյष֥ᇍਏ၎֞ཌྷ֥ࢲݔ, ္൞ඹ۱ದБۡਔѨ౦֥ߏࢳbఖ֩(Hróbjartsson & Gøtzsche, 2001; Moerman & ඪğ“၄࿐ഈေ࿐༝֥ᇗေ၂ज़൞ေਔࢳྏਲ֥Jonas, 2000)bBrody (1980)ิԛν໎࠴൞ህഡ࠹ಣ౦(Passions of the mind)ؓദุሑބࠥѨ߶ӁႨႿଆ၄࿐ᇍਏ֥၂ᇕۄყ่ࡱ, ಒྐႨ֥ളപఅط఼ն֥႕ཙ, ᆃ၂ׄᄝᇍਏᇏӈӈФޭൈީ҂߶ؓ෮ॉҳ่֥ࡱӁളหၳྟᇍਏbಪb”ࣉ၂҄ཿ֞, “ൌဒࢲݔౢ༉іૼ, མའႄູ, ν໎࠴ིႋ൞ᆷႮᇍਏ֥འᆘྟၩၬط҂൞ఏ֥༐ຬބྐႵ؟હն֥പఅིႋ” (de Craen หק֥ူ࿐ࠇള࿐หྟႄఏ֥ྏളэet al., 1999)b࣐ܵીႵૼಒิԛν໎࠴ིႋ֥߄bBrody఼טν໎࠴֥འᆘၩၬ, ఼טؓᇍਏߌۀ, ཁಖၘࣜႵਔაགྷսν໎࠴ིႋཌྷර֥ଆb࣍௹Stewart-WilliamsބPodd (2004)֥ܴׄb ؓν໎࠴ིႋ֥ۀቓਔࣉ၂֥҄Ҁԉ, ૌิ20ൗࡀԚ, ֣ݓ၄ളAdolf Bingleቓਔնܿԛ, ν໎࠴ིႋ൞ᄝದࠇദഈӁള֥ᆇᆞ֥ଆ֥ਢԵ൫ဒটࡎϢޤॆ࿓ౢ(Diphtherria ྏളིႋ, ᆃᇕིႋႋھ݂ၹႿࢤ൳ଖᇕantitoxin serum)ᄝᇍਏϢޤᇏ֥หקིႋbBingleܱྏ֥൞, ָ֞൞࿓ౢᇏ֥ॆᄝఏቔႨᇉࠇٚم֥ᇍਏ, ط҂൞ᆃᇕᇉࠇٚم֥ଽᄝ, ߎ൞҂Їݣॆ֥࿓ౢᄝఏቔႨbࡼ937ߑི৯b
ֻ8௹ ᅦ໓ґ֩: ν໎࠴ིႋ࣮ൌဒഡ࠹֥ൎބؿᅚ 1117 3 影响安慰剂效应研究的因素 ሑ֥ܴҳ္߶ԛགྷհ༂, Ѩದ֥Ѩ౦ીႵߏࢳၛູݺሇਔ, ՖطԛགྷྴБ༂ҵb҂ܵ൞၄ളູਔฐҩ֞ᆇൌ֥ν໎࠴ིႋ, ൌဒഡ࠹ᇏؓߑᆀ֥ᆡሑቔԛ֥ᆐ؎ߎ൞ߑᆀБۡሱ֥࠭ᆡႋھஆԢ֥ࠁཪၹЇওሱಖൎၹaनඔሑ, ᆃᇕ༂ҵᄝ၄࿐थҦᇏ௴ђթᄝbྴБ༂ҵ֥݂߭ބྴБ༂ҵ֩b ॖၛ࣐ॖି๙ݖग़ܴҩਈটཨԢ, бೂग़ܴ֥ࠗ 自然历史(Natural history) ބଷࠗࠃ֩ग़ܴᆷѓ֥ҩਈট؎ྴБ༂ҵ൞ྸ؟Ѩ่ࡱෛൈࡗ֥ࣉ߶ؿളᆡሑ֥ሱڎթᄝb ಖэ߄ބѯ, ᆃࣼ൞ᆡሑ֥ሱಖൎэ߄ၹՎ, ᄝಌك॥ᇅ֥ν໎࠴ིႋൌဒᇏ, ෮(Fields & Levine, 1984), ္ࣼ൞ඪ, ࠧьીႵീБ֥ۡ“ڿੱ”ॖି߶݂ၹႿഈ૫ิ֥֞۲ᇕࠁࡆޅᇍਏބۄყ, Ѩ౦္ॖି߶ԛགྷߏࢳbೂཪၹ, ط٤ν໎࠴ԩbᆃဢ, ᄝࣉྛν໎࠴ིݔФ൫ఞݺᄝѨ౦ԛགྷߏࢳᆭభᆃ၂ൈࡗׄڛႨႋ࣮ݖӱᇏ, ۴ऌऎุ֥ൌဒଢ֥Ґ౼֥۬ਔν໎࠴, ࣼ߶ཌྷྐν໎࠴൞၂ᇕႵི֥ᇍൌဒഡ࠹, ൞ஆԢॖିۄಠၹ֥сေ่ࡱb ਏbཁಖᆃѩ҂ିႨν໎࠴ིႋটࢳ, ၹູՎ4 实验设计的发展 ൈ֥Ѩ౦߫گંೂޅ္߶ؿള, აڛ҂ڛႨν໎࠴ીႵܱ༢b෮ၛູਔඪૼν໎࠴ིႋ, ࣼс 双盲随机设计(Randomized and double-blind ྶᄝൌဒഡ࠹ᇏॉ੮ഡᇂሱಖൎ่ࡱ, Ֆطࡼdesign) ሱಖൎၹބν໎࠴ۄყၹљषটb ؓႿਢԵူൌဒط, ഡᇂν໎࠴่ࡱ֥ 平均数的回归(Regression to the mean) ଢ֥ᄝႿဒଖᇕူ֥ਏིbఃઆࠠ൞མᆣෛሢҩਈՑඔ֥ᄹࡆ, ᄀ֞ު૫֥ҩਈ, ҩૼଖᇕူႵಒק֥ਏི, ఃᇍਏቔႨсྶཁᇷਈэਈᄀࢤ࣍эਈٳ֥҃ᇏྏ, ࠧनඔbᆃ၂ݺႿν໎࠴bਢԵൌဒсྶԉٳॉ੮ߑᆀ֥ᆩ౦གྷའӫູनඔ֥݂߭bनඔ֥݂߭൞෮Ⴕҩၩಃ, ࠧۡු෮Ⴕߑᆀૌॖିࢤ൳ᆇᆞ֥ူਈ֥эਈ൳ෛࠏ༂ҵ႕ཙ߶іགྷԛ֥ඔ࿐ห, ္ॖିࢤ൳ીႵਏི֥ν໎࠴, ؽᆀ۲ᅝྟbࠧьીႵളބྏၹቔູᇏࢺ֥ν໎࠴50%֥ࠫੱ, ࡼФ൫οචෛࠏჰᄵٳູਆቆ, ིႋթᄝ, ު૫֥ҩਈᆴၹनඔ֥݂߭ౠཟ္ࠃྟူᇍਏቆ(active therapy group)ࠇν໎࠴ᇍ߶э֮(Davis, 2002 )bೂݔФ൫ᄝฮ఼؇ቋۚਏቆbࠃྟူᇍਏቆᇏ۳Ф൫ീࡆ֥൞ᆇᆞ֥֥ൈީࢤ൳ֻ၂ՑਢԵҩਈ, ପહֻؽՑ֥तူ, ν໎࠴ቆ۳֥൞ुఏট۵ᆇᆞူཌྷ֥ҩਈॖି߶ொ֮bᆃဢ, ਆՑҩਈіགྷԛট֥ҵν໎࠴b۴ऌචഡ࠹, ၄ളބߑᆀ҂ᆩ֡ሱၳѩ҂ି݂ၹႿૌࢤ൳֥ޅۄყbၹູਢԵ࠭ࢤ൳֥൞ူߎ൞ν໎࠴bࠃྟူᇍਏ֥ਏൌဒᇏनඔ֥݂߭ӈӈაν໎࠴ིႋൈԛགྷ, ིсྶཁᇷնႿν໎࠴ᇍਏ, ҌିᆣૼᆃᇕူᆺႵࡼࢤ൳ν໎࠴ᇍਏ֥Ф൫ა҂ࢤ൳ν໎࠴ᇍऎႵಒק֥ਏིbᆃᇕٚمၹ҂թᄝؓߑᆀ֥௺ਏ֥Ф൫ࣉྛбࢠ, Ҍିؿགྷॖ݂ၹႿν໎࠴ԩௌ, Ֆطक़ڛਔਢԵൌဒ֥֥໙ี, Фಪູི֥ႋָ֞Ⴕ؟նb ൞ਢԵ൫ဒ֥ߛࣁჰᄵbླေ఼ט֥൞, ච 症状改善的虚报误差(False positive errors) ൌဒᇏЇওࠃྟူᇍਏቆބν໎࠴ᇍਏቆ, ᆺྴБ༂ҵ൞ߑᆀބ၄ളॖି߶ؿള֥հ༂, ିбࢠࠃྟူބν໎࠴ᇍਏ֥ਏིնཬ, ಏ๙ݖྐݼҩંॖၛࢳᆃ၂ׄbྐݼҩં൞مඪૼν໎࠴ིႋЧദָ֞Ⴕ؟նbᆺႵᄝഈ૫၂ᇕྏم, ൞ܱႿದૌᄝ҂ಒק֥౦ঃ༯ਆቆ֥ࠎԤഈᄜᄹࡆሱಖൎቆ, ҌॖၛஆԢሱೂޅቔԛथק֥ંbᄝฐҩଆྐݼൈ, ॖିಖൎaनඔ֥݂߭ބྴБ༂ҵ֩ۄಠၹ, ߶ϜીႵԛགྷ֥ྐݼ؎ູႵྐݼ, ᆃᇕհ༂ӫҌିܔᆞಒܙν໎࠴ིႋ֥նཬbBeecher ູྴБ(Allan & Siegel, 2002)bᆡሑ఼؇֥ଆྟ(1955)ᄝ֥໓ᅣᇏ߭ܤਔ15ཌྷܱ֥࣮, ဢ߶ߑᆀԛགྷྴБ༂ҵ, ২ೂ၄ളۡුႵ֤ԛࢲંඪ26%~58%(न35%)֥ߑᆀᄝൌീν၂ᇕူᇍਏ֥ѨหљႵི, ߑᆀᄝڛႨਔᆃ໎࠴ᆭުᆡሑཁᇷߏࢳbၹູఃᇏ13҂Їᇕူᆭުॖିۋतᆡሑࡨਔ, ൌ࠽ഈ, ᆡሑওሱಖൎቆ, ν໎࠴ቆᇏᆡሑߏࢳ֥Ф൫ൌ࠽ીႵߏࢳ༂ၛູᆡሑߏࢳਔb၄ളႵൈؓᆡഈ္ॖၛ݂ၹႿࠥѨ֥ሱಖൎэ߄, Ֆط֤
1118 ྏ ॓ ࿐ ࣉ ᅚ ֻ19ज ᆃ၂ࢲંಌك॓࿐၇ऌطܼ൳b ٓൔܱᇿᇍਏ൞Ⴎ၄ളఓߎ൞Ⴎ၎ఖఓb܄ 欺骗设计(Deceptive design) षٓൔ൞ׅ֥ࣜӈܿᇍਏ౦, ߑᆀॖၛၩ്֞ൌ࠽ഈ, ᄝਢԵචෛࠏ൫ဒᇏᆺؿགྷࢠཬᇍਏᆞᄝࣉྛ, ᇍਏིႋ൞ᇍਏЧദ֥หၳྟི֥ν໎࠴ིႋ, ჰၹॖି൞܄षۡුߑᆀࢤ൳ᆇႋބν໎࠴ིႋᆭބbᄝႅҟٓൔᇏ, ๙ݖ൙༵ൌူ֥ࠫੱᆺႵ50%b൞, ࣮֒ଢ֥ࣼ൞щݺ֥ӱ, ᄝყ༵קݺ֥ൈࡗࣉྛ࠹ෘࠏ॥ᇅฐษν໎࠴֥ቔႨႵ؟ն֥ൈީ, ν໎࠴ൌീ֥֥࣡ઝᇿഝ, ٜࡗીႵ၄ളࠇൖ, ߑᆀѩ҂ྐ༏ᆰࢤ൞“ࡼေࢤ൳٤ӈႵི֥ူ”, ط٤ᆩ֡ᇿഝ֥षބࢲඏ, ᆃᇕ่ࡱ༯Ф൫ุဒ֞50%ࠫੱࢤ൳ᇍਏ, Վൈ۷ն֥ν໎࠴ིႋࣼі֥ᇍਏིႋ݂Ⴟူ֥หၳّႋط҂൞ν໎࠴ིགྷԛটb ႋbၹՎ, ܄षူᇿഝބႅзူᇿഝᆭҵࣼKirschބWeixel (1988)бࢠਔऴ٥ν໎࠴ᄝॖၛҩਈ֞ν໎࠴ིႋ(Colloca & Benedetti, චൌീቆa௺ௌൌീቆބሱಖൎቆؓྏބ2005)b ളࠃ֥႕ཙ, ѩഡᇂਔऴ٥ν໎࠴֥҂ᆃ၂ٓൔᄝଖུหק֥ൌဒ౦ऎႵޓᇗေ࠴ਈඣbචൌീቆ, ଆژކ֥࣮ߌ֥ၩၬb২ೂ, Benedetti, AmanzioބMaggi (1995)(ഈ૫֥චෛࠏਢԵ࣮ഡ࠹), ۡුФ൫ؓ93۱ྣক్षඌߑᆀҐႨචෛࠏٚمࣉྛ߶Ⴕ50%֥ࠫੱႂႨᆇᆞ֥ऴ٥ࠇಀऴ٥ၹ֥ऴൌဒ, ࠧႨ܄षᇿഝူ, ؿགྷ෪։ଵ֥ᓁ٥; ௺ௌൌീቆ, ଆਢԵൌ֥ਢԵᇍਏߌॆ࠴Ѥܡς(Proglumide)֥ᆸቔႨնႿν໎࠴(ၹູ၄ളᄝᆇൌ֥ᇍਏߌᇏ߶ۡුߑᆀေࢤቔႨ, ν໎࠴֥ቔႨնႿޅԩbಖط, ࣉ၂൳֥ᇍਏ൞Ⴕི֥, ҂߶ಞߑᆀӁളᇉၐ), ۡු҄Ⴈ܄ष-ႅҟٓൔಏᆣૼᆃ၂ࢲં൞հ༂֥bФ൫ေႂႨᆩஇ֥ऴ٥; ሱಖൎቆ, ҂ႂൌဒіૼğ֒ႅзᇿഝѤܡς, ಀԢਔν໎࠴ིႨޅႂਘbࢲݔؿགྷ, ௺ௌൌീቆіགྷԛژކႋ, ࣼ۴Ч҂߶Ӂളᆸིႋ; ط܄षᇿഝѤܡყ௹֥ν໎࠴ིႋ, नઝѲੱބྐඣ(ؓႂς෮Ӂള֥ᆸིႋᄵჹჹնႿν໎࠴֥ቔႨ, Ⴈ֥ႂਘ൞ᆇᆞऴ٥֥ྐඣࡎ)ཁᇷۚႿඪૼѤܡς֥ቔႨරެᆺᄝν໎࠴ؿߨቔႨ֥๙චൌീቆbбࢠ௺ௌൌീቆაሱಖൎቆ֥ҵਫ਼ᇏӁള٢նིႋ, ఃЧദѩીႵᆰࢤ֥ᆸᆴބචൌീቆაሱಖൎቆ֥ҵᆴ, ၛܴҳઝቔႨbᆃ၂ဒူི৯֥ྍٚمؓਢԵൌဒഡѲੱa൬෪ބྏ֩ᆷѓ֥ҵᆴෛ࠴ਈඣؿ࠹Ⴕᇗေ֥ቔႨb২ೂ, ᆺႵူႅྟീࡆҌॖള֥э߄, ࢲݔؿགྷਆቆ֥ҵᆴᄝᆃུᆷѓഈಒקူ৯ིݔ, ᆃൈીႵޅ֥ྏಙ, ၂ᇁіགྷԛཌྷّ൝֥э߄, ᆃུඔऌіૼචᆃູࣼν໎࠴॥ᇅൌဒิ܂ਔ၂۱ޓݺ֥࿊ᄴbෛࠏ֥࣮ߌა๙ݖ௺ௌଆ֥ਢԵᆇൌဢ, Benedetti (1996)֥࣮ؿགྷ, Ѥܡςᆺି՜౦္ྸѩ҂ཌྷbೂݔචቆ֥ൌဒ౦Ӂളࣉν໎࠴ّႋᆀ֥ν໎࠴ᆸ, ҂ି՜ࣉν໎࠴֥ྏളིႋა௺ௌൌീቆ֥ਢԵߌӁള҂ّႋᆀ֥ν໎࠴ᆸ(ν໎࠴ّႋᆀᆷ֥൞ི֥ؓႋཌྷّ, ္ྸݖಀ௴ђႨචൌဒ౦ν໎࠴ᇍਏႵૼཁّႋ֥۱ุ, бೂૌᄝν໎টܙူਏི֥ٚمѩ҂ކൡbᆃဢ, ࣮ᆀ࠴ᆸ่ࡱ༯ุဒ֞ฮ఼؇ཁᇷ༯ࢆ, طν໎ؓචෛࠏഡ࠹֥ٚم൞ڎିսіਢԵᇍਏ౦࠴҂ّႋᆀᄵՎّႋ)bν໎࠴ّႋᆀཌྷؓႿ҂ิԛਔᇉၐb ّႋᆀӁളਔ۷؟֥ଽჷྟέோᇉ, ॖିіૼ 公开隐藏设计范式(Open-hidden paradigm) ଽჷྟέோᇉ֥Ӂള൞ѤܡςؿߨቔႨ֥భޅ၄࿐ᇍਏႵਆ۱Ӯٳğᇍਏ֥หၳིิbCollocaބBenedetti (2005)Ϝᆃ۱ൌဒགྷའࢡႋ(ೂหקူႄఏ֥หקّႋ)ބᇍਏ֥МིࣟቓਢԵൌဒᇏ֥ҩ҂ሙჰᄵ(Principle of ႋ(ࠇӫν໎࠴ིႋ)bႵದิԛ၂۱࣮ν໎࠴ིuncertainty), ᆃ൞ࢹႨ֥Heisenbergᄝ࿐ᇏႋ֥Ⴕ౿ଆ, ӫູ܄ष-ႅҟٓൔ (Amanzio & ิԛ֥ҩ҂ሙჰᄵᆃ၂ඌეb࿐ᇏ, ၹҩਈBenedetti, 1999; Amanzio, Pollo, Maggi, & ྛູЧദႺؿ֥৯໘෮ҩਈэਈ֥धؓᆴBenedetti, 2001; Benedetti et al., 2003; Colloca, э֤҂ಒקbᄝူ࣮ᇏ, ਢԵൌဒᇏФ൫ၩLopiano, Lanotte, & Benedetti, 2004; Levine & ്֞ሱ࠭ڛႨਔଖᇕူ, ᆃᇕྏࠃЧദၘGordon, 1984), Ӈ൫ٳᆃਆᇕིႋb܄षႅҟࣜളࠃؿളэ߄, ྏၹႄఏ֥э߄ა
ֻ8௹ ᅦ໓ґ֩: ν໎࠴ིႋ࣮ൌဒഡ࠹֥ൎބؿᅚ 1119 ေҩਈ֥ူ႕ཙࠁᄝ၂ఏ, ֆՂူቔႨ֥ؓᆇൌ֥ူԩ൞ڎऎႵטࢫቔႨb࣐ܵޙҩקэ֤۷ࡆbႨԮ֥ൌဒഡ࠹҂ॖିഡ࠹ഡקਔ۷ູಆ૫่֥࣮ࡱ, ္Їݣਔؓх૧ਢԵൌဒᇏҩ҂ሙ֥หྟbط܄षႅзٓൔФ൫֥௺ௌ, ൌဒ֥ࡎᆴ൳֞၂קാb ஆԢਔᇍਏ֥Мིࣟႋ, ၹՎ္ಀԢਔᇍਏ֥νՎຓ, ᄝKeltner֩(2006)֥࣮ᇏႨਔো໎࠴ყ௹ིႋ, ޓնӱ؇ഈक़ڛਔਢԵൌဒᇏ֥ර֥ޙഡ࠹ট࣮ฮყ௹֥ଷࠏᇅ, ൌဒᇏᆃᇕಌཊb ഡקਆᇕಣՏࠗඣ(ۚބ֮)ބਆᇕฮყ௹ 平衡设计(Balanced design) ඣ(ۚބ֮)bࢲݔؿགྷ, ఼֒ۚ؇֥ಣՏࠗϴԢਔ௺ௌഡ࠹ބ܄षႅҟഡ࠹ᆭຓၛຓ, ෛ఼ۚ؇֥ყ௹ൈ, तೂ౭ଷaଷ֛ބֻؽ࣮ᆀิԛਔਸ਼၂ᇕڿࣉ֥ൌဒഡ࠹-ޙഡ࠹b౸ุۋतҪ֩თіགྷԛཁᇷ֥fMRIࠗࠃ, ޙ֥ν໎࠴࣮ഡ࠹ЇওФ൫֥ყ௹(ࠇྐ)ބ఼֒ۚ؇֥ಣՏࠗϴෛ఼֮؇֥ყ௹ൈ, ᆃུൌ࠽ࢤ൳֥ԩᆃਆ۱ሱэਈbThomas (1987)თ֥ࠗࠃཁᇷ༯ࢆ, ิൕეყ௹ؓฮऎႵႨޙഡ࠹࣮ਔν໎࠴ყ௹ބ၄ള֥ᆐ؎؇טࢫቔႨbKeltner֥࣮ิൕ, ္ॖၛҐႨোරᄝࠥѨ߫گᇏ֥ቔႨbૌ࿊ᄴ200۱ฮaॕ֥ޙഡ࠹ট࣮ν໎࠴ིႋ֥ଷࠏᇅb aаೖބூসളഈၳဢ֥Ф൫, ൌ࠽ഈ5 安慰剂效应本身作为研究目标的实ؓૌ֥Ѩ౦ѩ҂ିቓԛૼಒ֥ᆐ؎bࡼФ൫ٳ验设计 ູඹቆğࠒࠞᆐ؎ѩࢤ൳ν໎࠴ᇍਏቆ, ۳ߑᆀૼಒ֥ᆐ؎ѩۡුݖࠫ฿Ѩ౦ࣼ߶ݺུ, ڛူਢԵူဒᇏ, ؓν໎࠴ིႋࣉྛ॥ᇅӮᆭު߶ݺ֥۷ॹ, ѩ۳ૌڛႨν໎࠴; ࠒࠞᆐູဒଖᇕူਏི֥҂ॖࠇಌ֥҄ᇧbᄝཌྷ֒؎҂ࢤ൳ν໎࠴ᇍਏቆ, ۳ߑᆀૼಒ֥ᆐ؎ѩ၂҆ٳਢԵൌဒᇏ, ူᇍਏଖᇕࠥѨི֥ႋ఼ۡුݖࠫ฿ࣼ߶ݺུ, ҂ླေڛူᇍਏ; ཨ؇ѩ҂ିӑݖν໎࠴ིႋ఼֥؇, ᆃࡗࢤඪૼνࠞᆐ؎ѩࢤ൳ν໎࠴ᇍਏቆ, ۡුߑᆀم؎໎࠴ིႋ఼֥նbν໎࠴ིႋ఼֥؇ָ֞Ⴕ؟ն, ߑޅᇕࠥѨ, ڛူᆭު҂ᆩ߶҂߶ߏࢳѨ౦, ቋᇔथקν໎࠴ིႋЧദ൞ڎႵࡎᆴӮູ࣮ᆀѩ۳ૌڛႨν໎࠴; ཨࠞᆐ؎҂ࢤ൳ν໎࠴ܱᇿ֥ଢѓb ᇍਏቆ, ۡුߑᆀم؎ߑޅᇕࠥѨ, ၹՎ 安慰剂效应的强度到底有多大 م۳ิ܂ူᇍਏbࢲݔؿགྷ, ਆᇛၛު, ࠒν໎࠴ིႋ఼֥؇ָ֞Ⴕ؟ն, ቋᇔथקνࠞᆐ؎ቆ֥Ф൫ေбཨࠞᆐ؎ቆ֥Ф൫߫گֹ۷໎࠴ིႋЧദ൞ڎႵࡎᆴӮູ࣮ᆀܱᇿ֥ଢॹ, طᄝႵν໎࠴ᇍਏԩഈཁᇷҵၳbᆃѓbHróbjartssonބGøtzsche (2001)ؓν໎࠴ིႋ၂ޙഡ࠹֥࣮ඪૼ၄ߑܱ༢ᄝࠥѨ֥߫گᇏ఼֥؇ࣉྛਔჭٳ༅bૌ֥࣮֒ᇏЇওਔ114ؿߨᇗေ֥ቔႨb ۱චෛࠏ൩ဒbࢲݔؿགྷ, ᄝ32۱ႨದඔቔFlaten, SimonsenބOlsen (1999)֥࣮ᇏҐູၹэਈ֥ൌဒᇏ, ીႵؿགྷཁᇷ֥ν໎࠴ིႨਔޙഡ࠹, Їওඹ۱ൌဒ่ࡱğФ൫Фۡᆩႋbᄝਸ਼ຓ82۱ൌဒႨनඔቔູၹэਈ֥ൌ෮ࢤ൳֥ူ൞ࠔಽӿ࠴, ѩࢤ൳ࠔಽӿ࠴ဒᇏ, ؿགྷਔν໎࠴ིႋ, ᆃᇕིႋෛሢဢЧ; Ф൫Фۡᆩ෮ࢤ൳֥ူ൞ࠔಽӿ࠴, ࢤ൳֥ᄹࡆطࡨཬ; ඔऌކѩᆭު, ᄝᇶܴБۡഈؿ֥൞ν໎࠴གྷਔཁᇷ֥ν໎࠴ིႋ, ᄝग़ܴҩਈഈીႵؿ; Ф൫Фۡᆩ෮ࢤ൳֥ူ൞ࠔಽྖٹ࠴, ࢤ൳֥൞ࠔಽӿ࠴; Ф൫Фۡᆩ෮ࢤགྷཁᇷ֥ν໎࠴ིႋbؓ27۱तൌဒֆࣉྛ൳֥ူ൞ࠔಽྖٹ࠴, ࢤ൳֥൞ν໎࠴bࢲٳ༅, ؿགྷν໎࠴ིႋॖฮ༯ࢆቋުݔіૼቔᆀ֤ԛࢲંඪ, ࣐ܵᄝᇶܴБۡބฮ࣮ᇏ, ପུۡුࢤ൳ူ൞ࠔಽྖٹ࠴֥Ф൫бପུۡු൞ࠔಽӿ࠴֥Ф൫Бۡԛ۷֥ۚࠔؿགྷਔࢠ֥ν໎࠴ቔႨ, ၹᄝनඔቔູၹэਈ֥ൌဒᇏބग़ܴҩਈഈીႵཁᇷ֥ν໎࠴ིಽࣅᅦӱ؇, іૼФ൫֥ყ௹(Фۡᆩ൞ࠔಽྖٹႋ, ෮ၛ҂ᆦӻν໎࠴Ⴕ఼ն֥ਢԵིႋᆃ၂ܴ࠴)ۄಠਔࠔಽӿ࠴֥ူིbॖၛुԛ, ޙഡׄbૌ֥ඔऌ҂ࣇᇉၐν໎࠴ིႋ఼֥؇ބ௴࠹ॖࣉྛ؟ᇕбࢠၛࠆ֤۷ࡆಆ૫֥ྐ༏, ҂ࣇђྟ, ቔᆀߎࣉ၂҄ඪᄝᇶܴБۡഈܴҳ֥֞ཁॖၛဒူི֥ႋ, ္ॖၛဒეყ௹ི֥ᇷ֥ν໎࠴ིႋॖିᆺ൞ߑᆀ֥Бۡொཟ, ૌႋ, ѩॖࣉ၂҄ဒؽᆀ֥ࢌིႋ—ეყ௹
1120 ྏ ॓ ࿐ ࣉ ᅚ ֻ19ज ؓᆡሑڿ֥Б္ۡྸᆺ൞ّ႘ਔФ൫མ౼ᄆࡱࣉྛбࢠটܴҳི֥ႋbႮՎुট, Beecher࣮ᆀ֥ౠཟ, ૌЧটીႵᆡሑڿಏБۡӐ֥֝ν໎࠴॥ᇅ֥චෛࠏਢԵൌဒഡ࠹ѩ҂ඪႵb ିಒקν໎࠴ིႋ֥Ԅ؇ࠣఃቔႨࠏᇅ, ၹູᆃVase, RileyބPrice (2002)֥ჭٳ༅ّ࣮ᇕٓൔ༯ۡᆩФ൫ࢤ൳֥൞ᆇᆞ֥ᇍਏࠇᆀ൞νѼਔᆃ၂ܴׄbაHróbjartssonބGøtzsche҂໎࠴(۲ᅝ50%ࠫੱ), Ф൫҂ᆩ֡ሱ࠭൞ڎࢤ൳֥൞, ૌቓਔਆᇕჭٳ༅, ၂۱ٳ༅Ⴈਔ23ਔᆇൌ֥ᇍਏ, ߶Ӂള҂ಒקྟ, ᇀഒႵ၂ུದ۱ฮ֥චෛࠏൌဒ(ۡුФ൫Ⴕ50%֥ࠫੱ҂ཌྷྐࠇປಆ҂ཌྷྐ෮ࢤ൳֥ᇍਏႵིb ࢤ൳ᆸᇍਏ), Վൈν໎࠴ቔູ॥ᇅ่ࡱ; ਸ਼၂ࡼν໎࠴ིႋЧദቔູ࣮ଢ֥, ࣼ൞ູਔ۱ٳ༅Ⴈਔ14۱࣮ν໎࠴ᆸࠏᇅ֥ൌဒࡎν໎࠴ིႋ֥թᄝࠇࠏᇅ, Ф൫ྐူ(ࠇ(ۡුФ൫ࢤ൳֥൞఼৯ᆸ࠴), Վൈν໎࠴ቔν໎࠴)֥ቔႨ࣮ؓν໎࠴ིႋЧദটඪ٤ӈ่ູ࣮ࡱbࢲݔᄝν໎࠴ᆸࠏᇅ࣮ᇏؿགྷсေbᄝൌဒ൩่ࡱ༯Ҡሺν໎࠴ყ௹(ࠇྐ)֥ν໎࠴ིႋ఼؇(नིႋԄ؇ູ)൞ච఼֥؇߶ڿэν໎࠴ིႋ఼֥؇bଢభն҆ٳνൌဒᇏ(नིႋԄ؇ູ)֥5П, ؽᆀႵཁᇷ໎࠴ིႋ֥ൌဒഡ࠹࣐ॖିҐႨ၂ུҦটࡆҵၳbٳ༅ࣉ၂҄ؿགྷ, ეπൕބ่ࡱّഝؽ఼Ф൫ؓν໎࠴ԩ֥ྐb২ೂ, ࣍௹ؓν໎ᆀ৳ކႨ෮ࠆ֤ν໎࠴ིႋ, бֆ۳Ф൫ิ࠴ིႋࠏᇅۋྖ౿֥࣮ᆀնႨ఼߄ν໎࠴܂“෮ࢤ൳ᇍਏ٤ӈႵི” ֥ეྐ༏ࠇᆀֆყ௹(ࠇྐ)֥ٓൔ, ิభ๙ݖ҂่֥ࡱّഝႨ่ࡱّഝေնbၹՎVase֩ದิԛ, ҂ٚمট఼߄Ф൫ؓν໎࠴ᇍਏ֥ྐ, ၛࠆ֤۷֥ൌဒٚمॖି൞֝ᇁν໎࠴ིႋԄ؇҂֥ჰཁᇷ֥ν໎࠴ིႋ, ᆃဢҌି۷ࡆॖौֹ࣮νၹbVase, Petersen, RileyބPrice (2009)ؓν໎࠴໎࠴ིႋ֥ྏപࣜࠏᇅb ᆸࠏᇅ֥࣮ࣉ၂҄ቓਔჭٳ༅, ؿགྷनν 操纵安慰剂预期范式 ໎࠴ིႋԄ؇ູ, ཁᇷնႿν໎࠴ቔູ॥ᇅҠሺყ௹֥ٚൔႵਆᇕğ၂ᇕ൞ეყ௹่ٓࡱ֥࣮(नིႋԄ؇ູ~)bࣉ၂҄ൔ(Verbal expectation), ਸ਼၂ᇕ൞఼߄ყ௹ٓൔٳ༅ؿགྷ, ა؋ൈएՏ࣮ࠗ(≦20s)ཌྷб(न(Reinforced expectation)b ིႋԄ؇ູ), ӉൈएՏࠗ(﹥20s)࣮ࠆ֤ეყ௹๙ݖეྐ༏ބඪڛ֩ࣥۡුФ֥ν໎࠴ིႋ(नིႋԄ؇ູ)۷նb ൫෮ࢤ൳֥ᇍਏऎႵཁᇷ֥ᆸቔႨ, Ф൫ࡹॖၛुԛ, ݖಀ࣮ᆀܱᇿ֥ࣇࣇ൞ᆇൌ֥৫ν໎࠴ᆸ֥ྐbPollo (2001)֩ದ۳ࢤ൳ਔူᇍਏ൞ڎཁᇷݺႿν໎࠴॥ᇅ่ࡱb൞, ྣຓ॓൭ඌ֥δߑᆀൌീν໎࠴ᆸ, ࣮ᇏೂݔᆰࢤϜν໎࠴่ࡱቔູ࣮֥ଢѓ, ط҂൞༵۳Ф൫ᇿഝളඣ, ѩ۴ऌؓളඣ֥૭ቔູ൞චෛࠏൌဒᇏ֥॥ᇅ่ࡱ, ॖၛࠆ֤ჹඍٳູቆğሱಖൎቆ, ߑᆀᆺ൞ࢤ൳ඣ֥ჹնႿචෛࠏൌဒ֥ν໎࠴ིႋ఼؇b֒၂҆ᇿഝ, ીФۡᆩᇿഝူႵᆸིݔ֥ྐ༏; ٳ࣮ᆀಪ്֞ν໎࠴ིႋೂՎ఼ն֥ൈީ, චൌീቆ, ۡුߑᆀᇿഝ֥ॖି൞ᆸူ္ૌ҂ᄜϜν໎࠴॥ᇅ่ࡱቔູူིဒ֥ઐِބॖି൞ν໎࠴, ࠫੱ۲ᅝ50%; ௺ௌྟൌീቆ, ϸെ, ૌ֥ྖ౿ሇཟਔ࣮ν໎࠴ིႋЧۡුߑᆀ۳ૌᇿഝ֥൞٤ӈႵི֥ᆸူbദğೂՎ఼ն֥ν໎࠴ིႋ, ָ֞൞ࠎႿહဢಖުܴҳФ൫ᄝᇿഝളඣᆭުؓᆸူ֥֥ྏࠏᇅ, ࣜႮહဢ֥ളപࣜࠏᇅ๙ਫ਼ൌླਈbൌဒࢲݔіૼğሱಖൎቆေ֥ᆸགྷ֥Ĥཁಖ, ೂݔ࣮ᆀᆰࢤؓν໎࠴ིႋؿളူቋ؟, ູ mg֥נѤ୶٥(Buprenor- ֥ྏބപࣜളࠏᇅۋྖ౿, ࣼႋھࡼν໎࠴phine), චቆླေ mg֥נѤ୶٥, бሱಖ่ࡱᆰࢤቔູ࣮֥ଢѓ, ط҂ᆺ൞Фुቓဒൎቆࢆ֮ਔ21%; ௺ௌቆླေ mg֥נѤଖᇕᇍਏ൞ڎႵི֥॥ᇅ่ࡱ, Վൈႋھ۳Ф൫୶٥, бሱಖൎቆࢆ֮ਔ34%b࣮ᆀಪູ, Ԯղ“ᇍਏ٤ӈႵི”֥ྐ༏b২ೂ, Ⴈభ૫ิ֞ؓളඣ֥҂૭ඍႺؿਔ҂֥ყ௹, Ֆط֥௺ௌഡ࠹ࣼ൞ᆰࢤ࣮ν໎࠴ིႋЧദ, ν໎Ӂള҂֥ν໎࠴ᆸིႋ, ቋᇔ֝ᇁ҂่ࡱ࠴่ࡱ༯ᇶ൫Ԯ־۳Ф൫֥ྐ༏٤ӈಒק, “෮༯ؓᆸူ֥҂ླb ࢤ൳֥ᇍਏ٤ӈႵི”, Ϝν໎࠴่ࡱაؓᅶ่ູਔࠆ֤۷ૼཁ֥ν໎࠴ིႋ, ୍࣍টޓ؟
ֻ8௹ ᅦ໓ґ֩: ν໎࠴ིႋ࣮ൌဒഡ࠹֥ൎބؿᅚ 1121 ࣮Ⴈਔ఼߄ყ௹ٓൔ—่ׅࠧࣜࡱّഝ֥ٚࠃbᆃᇕҦ္ဢᄝν໎࠴ིႋ࣮ᇏࣜӈمࣉྛ, ఼߄ؓν໎࠴ᇍਏ֥ྐ, ՖطࡆႨb ఼ν໎࠴ყ௹఼֥؇bऎุط, ֻ၂ᇕҦ, ၛ๙ݖ఼߄࿐༝ࡹ৫֥ν໎࠴ყ௹ࠆི֤֥ႋतν໎࠴ིႋູ২bᄝభ௹ᇏ, ֒तՏ൞ڎૼཁۚႿֆეყ௹ࠇֆ่ࡱّഝĤࠗϴෛν໎࠴ᇍਏԛགྷൈ, ᄵૡႨ఼֮؇֥Vase֩ದ(2002)֥ჭٳ༅ؿགྷ, ეπൕބ่ࡱतՏࠗ; ֒तՏࠗ҂ϴෛν໎࠴ᇍਏӯགྷൈ, ّഝؽᆀ৳ކႨ෮ࠆ֤ν໎࠴ིႋ, бֆ۳ᄵႨ఼ۚ؇֥तՏࠗbФ൫ѩ҂ᆩ֡ᆇൌФ൫ิ܂“෮ࢤ൳ᇍਏ٤ӈႵི” ֥ეྐ༏ࠇ֥౦ঃ, ߶ಪູฮ֥ࢆ֮൞ν໎࠴ᇍਏႄఏᆀֆႨ่ࡱّഝေնbAmanzioބ֥, Ֆط๙ݖభ௹่֥ࡱّഝ఼߄ਔν໎࠴Benedetti (1999)֥࣮ᆦӻᆃ၂ࢲંbᄝᆃ۱ყ௹఼֥؇bᆃ၂࿐༝ݖӱປӮᆭު, ႵݝՏ࣮ࠗᇏ, Ⴚؿν໎࠴ᆸ֥ٚൔႵᇕ, ეყ߫گ֞ჰႵ֥ඣࣉྛν໎࠴ᇍਏ, ဒν໎࠴௹a҂ݣყ௹֥ူ่ࡱّഝބؽᆀ֥৳ކ, ࢲིႋ(Colloca & Benedetti, 2006; Kong et al., 2006; ݔؿགྷეყ௹ބ่ࡱّഝ֥৳ކႺؿ֥ν໎Kong et al., 2009; Wager et al., 2004)b২ೂ, Wager, ࠴ིႋቋնbᄝਸ਼ຓਆ۱࣮ᇏ(Montgomery & MatreބCasey (2006)ࣉྛਔν໎࠴ܻؓࠗႺؿKirsch, 1997; Price et al., 1999), ؿགྷეყ௹ބ໊֥႕ཙ࣮bᆞൔൌဒభۡුФ൫ീࡆ่֥ܻࠗࡱّഝ৳ކཁᇷնႿ่ࡱّഝֆႺؿ֥νಣՏࠗ൞“ۚ”఼؇֥, ൌ࠽ഈႨࡌᆸۛ໎࠴ིႋb ่ࡱ༯ૡࢆܻ֮ࠗՏ఼ࠗ؇, ؓᅶ่ࡱ༯ീࡆBenedetti֩ದ(2003)֥࣮ࣉ၂҄ฐษਔν఼ۚ؇ՏࠗbᆃဢФ൫ᆇൌุဒ֞ူ“ᆸ”໎࠴ིႋᇏ่ࡱّഝࠏᇅބყ௹ࠏᇅᆭࡗ֥ܱ༢, ֥ቔႨ, ࡹ৫ਔν໎࠴ᆸႵི֥ྐbᆞൔൌૌؿགྷ, ეႺؿ֥ყ௹ିܔᄝฮބᄎۿဒᇏဒν໎࠴ᆸིႋൈ, ീࡆ֥൞఼ۚ؇ିᇏӁളཁᇷ֥ν໎࠴ིႋ, ંહဢ֥֥ಣՏࠗ, бࢠν໎࠴่ࡱބ॥ᇅ่ࡱ༯ܻࠗეყ௹ؓളӉࠗބᇉ֥ࠗٳޅ႕Ⴚؿ໊֥э߄bᆃᇕҦᄝ֒భ֥ν໎࠴ིႋཙbೂݔყ༵ؓ՜ࣉളӉࠗྙӮ่ࡱّഝ, ࣮ᇏФܼٗႨbֻؽᇕҦ, ᄝభ௹ࢨࣼ߶Ⴚؿ՜ࣉളӉࠗٳ֥ν໎࠴ّႋ, ࠧь؍, ۳Ф൫ീࡆႵི֥ူࣉྛᆸࠇࢆ֮౦࿂۳ཌྷّ֥ეπൕ္҂ିሇᆃ၂ݖӱbቔᆀಪߒྜ֥ᇍਏ, Ф൫ᆇൌֹุဒ֞ਔူ֥ቔႨ, ູ, ࠗٳ֩ၩ്ളۿି֥ν໎࠴ིႋࡹՖطࡆ఼ਔФ൫ؓူਏི֥ყ௹(ࠇྐ), ಖ৫ᄝ่ࡱّഝࠎԤᆭഈ, აყ௹ܱ; طႵၩ്ުൌീν໎࠴ᇍਏ, ປಆଆٟൌീᆇൌူ֥౦֥ളݖӱೂतބᄎۿି֥ν໎࠴ིႋႮყ, ۡුФ൫൞ဢ֥ူ, ൌ࠽ഈ۳ა֥൞௹ᆃ၂ྏݖӱטࢫb ીႵޅਏི֥ν໎࠴(Benedetti et al., 2004; 可迁移的安慰剂效应(Transferable placebo Benedetti et al., 2003; Petrovic, Kalso, Petersson, & effect) Ingvar, 2002)bၛڵྟ౦࿂֥ν໎࠴ིႋູ࣮২, ᄝЧज़ีቆ֥࣮ᇏ, ૌࡹ৫ਔ၂ᇕྍ֥ᄝPetrovic (2005)ࠣః൙֥౦࿂ν໎࠴ིႋٓൔ—థ၍఼߄ٓൔ, টฐษՖत֞ڵྟ౦࿂࣮ᇏ, భ௹ყ௹఼߄ࢨ؍Ⴕਆᇕ่ࡱ, ၂ᇕ౦ঃ֥థ၍ν໎࠴ིႋbၛສν໎࠴ིႋ࣮൞ห༯ᇿഝᆇᆞႵི֥νקোူЦؽၳྟ֥bбೂ, ᄝൌဒ൩่ࡱ༯ؓႿᆓν໎࠴(Benzodiazepine), Ф൫ܴुڵྟ౦࿂ோൈಒൌིႋ֥࣮, ൞ᄝतᇏ๙ݖ่ࡱّഝ఼߄ุ֥ဒ֞ူ֥νקቔႨ, ਸ਼၂ᇕ౦ঃ༯ᇿഝ֥ٚم, Ⴚ֝Ф൫ࡹ৫ਔؓႿหקԩ֥ᆓྐᓁॆ࠴-ڗઔ༆ୄ(Flumazenil), Ф൫ุဒ֞ڵྟᆭު, ᄜ۳Ⴭྴࡌԩ(ࠧν໎࠴ԩ), Ֆطҩ౦࿂ோႺؿਔ఼ਛ֥ڵྟ౦࿂ߒྜb๙ݖူקФ൫֥ν໎࠴ّႋ(Benedetti et al., 1995; Kong ቔႨ֥ؓб, Ф൫ᆇᆞཌྷྐਔЦؽࢆ֮౦࿂ߒet al., 2006; Matre, Casey, & Knardahl, 2006; ྜ֥ቔႨbᆞൔൌဒᇏဒν໎࠴(ളඣ)νקWager et al., 2006); ࠇᆀࡼՖڵྟ౦࿂ߏࢳᇍਏ౦࿂֥ቔႨൈ, ࡼνקোူߐӮളඣ, ᇏࠆ֤֥ᇍਏყ௹ႨႿႺؿν໎࠴֥౦࿂νקቔФ൫ಯಖಪູႨ֥൞ᆇᆞ֥ူ, ՎൈбࢠνႨ(Petrovic et al., 2005)bഈ૫֥ٚمॖၛࠆ֤໎࠴่ࡱބ॥ᇅ่ࡱ༯ڵྟ౦࿂ߒྜႄఏ֥ଷбࢠॖौ֥หၳྟᆓν໎࠴ིႋࠇᆓ࣡ν໎࠴
1122 ྏ ॓ ࿐ ࣉ ᅚ ֻ19ज ིႋ, ν໎࠴ིႋ൞ڎॖၛՖतყ௹֞౦࿂Ⴃҩဒ)္ؿགྷਔཁᇷ֥ॆၝკቔႨ, ѩࣉ၂҄ؿყ௹Ӂളॴਵთ֥థ၍ഉ҂ౢԣ, ᆃᆞ൞థ၍ྟགྷّ႘౦࿂ࠗࠃඣ֥ᇉ๛ބയഈཆᇉࠗν໎࠴ིႋ్࣮֥ೆׄbऎุ࣮නਫ਼൞ğ༵୩؇ཁᇷ༯ࢆ(Guo et al., 2011), ඪૼథ၍ྟν໎ᄝतᇏൌീྴࡌᇍਏ(ν໎࠴)ؓν໎࠴֥ྐ࠴ིႋ൞ॴᇕթᄝ֥གྷའb ࣉྛ༵௹఼߄, ಞФ൫ุဒ֞ᆃᇕᇍਏ(ν໎࠴)ॖథ၍֥ν໎࠴ིႋٓൔ൞ҐႨ఼߄ٓൔؓत֥“ᇍਏቔႨ”, ֒तՏࠗϴෛν໎࠴ᇍ࣮ν໎࠴ིႋ֥၂۱ᇗေҀԉ, ᆃᇕٓൔᄝޓնਏԛགྷൈ, ᄵૡႨ఼֮؇֥तՏࠗ; ֒ӱ؇ഈଆਔ၂ུഠ߶གྷའbᄝଖ၂หק֥໓߄तՏࠗ҂ϴෛν໎࠴ᇍਏӯགྷൈ, ᄵႨ఼ۚ؇ᇏ, ೂݔದૌؿགྷଖ۱ᇣეࠇപਲᄝ၂ᇕ౦ᇏ֥तՏࠗbФ൫ѩ҂ᆩ֡ᆇൌ֥౦ঃ, ߶ਲဒ, ࣼޓಸၞᄝః၂ུ౦ᇏཌྷྐ֥ቔಪູฮ֥ࢆ֮൞ν໎࠴ᇍਏႄఏ֥, Ֆط๙ݖႨbࠇᆀ, ၂֊ଖ۱இ֥၂ᇕഅᄝཨٮᆀᇏభ௹่֥ࡱّഝ఼߄ਔν໎࠴ყ௹఼֥؇bࡹ৫ਔྐ, ၂இ֥ఃӁࣼޓಸၞФಖުۡුФ൫ᆃဢ֥ᇍਏ္߶ؓڵྟ౦࿂֥ߒྜࢤ൳bॴ๙֡ν໎࠴ིႋ֥ൌဒഡ࠹ᄝޓնӱ؇ؿߨޓݺ֥ᇍਏቔႨ, Ф൫ᄝν໎࠴่ࡱބ॥ᇅഈଆਔᆃུഠ߶གྷའ, ࠧᄝ၂ק่ࡱ༯ࡹ৫่ࡱ༯ܴु֩ᆴ֥ڵྟோ, ଢ֥ᄝႿܴҳν໎ਔ໗ܥ֥ྐ, ᆃᇕྐࣼॖିᄝଖུܱ৳֥࠴Ⴕི֥ྐ൞ڎ߶Ֆतཟڵྟ౦࿂ᇏథ၍b ӆކؿളథ၍bૌູ֥࣮ᆃུགྷའ֥ࢳิऎุط, ૌ൬ࠢਔದোФ൫֥ྛູaଷ܂ਔ၇ऌb ބۿିՈ܋ᆒ֥ඔऌၛࠣФ൫֥ྛູބࠗ 安慰剂效应的脑机制 ඣඔऌ, ᆣૼథ၍ྟν໎࠴ིႋಒൌթᄝbෛሢದૌؓν໎࠴ིႋಪ്֥ࡆധބଷӮཞᄝ࣮၂ᇏ, ૌປӮਔਆ۱ྛູൌဒބ၂۱ଷඌ֥ؿᅚ, ܱႿν໎࠴ིႋଷࠏᇅ֥࣮൳֞ൌဒ, ֻ၂۱ྛູൌဒؿགྷֆՂ֥ეྟν໎ਔ࣮ᆀ֥ܱᇿbᄝᆃུ࣮ᇏ, ൌဒഡ࠹ն؟࠴ყ௹ીႵФ൫֥ڵྟ౦࿂ุဒؿളཁᇷэ߄, ҐႨეყ௹ࠇ఼߄ყ௹ٓൔটฐ෬ν໎࠴ིႋطథ၍ྟ఼߄ყ௹ٓൔ༯, ν໎࠴ყ௹Ф൫֥֥ቔႨࠏᇅbଢభ, ν໎࠴ིႋ֥ࠏᇅ࣮ᇶေڵྟ౦࿂ุဒཁᇷࢆ֮(Zhang & Luo, 2009); ֻࠢᇏᄝν໎࠴ᆸਵთ, ߎႵഒਈ࣮ടࠣஂࣁؽ۱ྛູൌဒ, ૌ࠻ဒหၳ֥ฮν໎࠴ི೦ᆡaၝკᆡބ౦࿂࣮(de la Fuente-Fernandez, ႋ, ္ဒథ၍ྟ֥౦࿂ν໎࠴ིႋ, ࢲݔіૼSchulzer, & Stoessl, 2004; Mayberg et al., 2002; ࠻Ⴚؿਔཁᇷ֥ฮν໎࠴ིႋ, ္ႺؿਔཁᇷPetrovic et al., 2005)b ֥౦࿂ν໎࠴ིႋbൌဒ࠺ਔଷ, ࢲݔؿ၂ٚ૫, ࣮ؿགྷ, ଷଽ֥µ-έோ༢ॖିགྷ, ა॥ᇅ่ࡱཌྷб, థ၍ྟν໎࠴่ࡱ༯ڵྟҕაν໎࠴ᆸ, ႨPET൳ุཁཞඌູՎิ౦࿂ோႺؿ۷֮ږ؇֥P2ބ۷ۚږ؇֥N2, ܂ਔᆰࢤ֥ᆣऌbZubieta֩ದ(2005) ႨਔPET11ᆣૼν໎࠴ིႋᄝۋतྐ༏֥ᄪ௹ࡆ۽ࢨ؍ඌބCٯୄ(carfentanil)—µ-έோဢᇉ൳(300msଽ)ࣼၘؿളbᄝ࣮ؽᇏ(Zhang, Qin, Guo, ุ࿊ᄴྟൕሶ࠴(µ-opioid receptor-selective & Luo, 2011)ೱ࿊ԛν໎࠴ّႋᆀࣉೆނՈൌဒbradiotracer), ဒਔყ௹ᆸ֥ν໎࠴൞ڎॖၛࢲݔؿགྷ, థ၍ྟν໎࠴่ࡱ༯, აڵྟ౦࿂ࡆࠗࠃଽჷྟέோဢᇉ֥പࣜ־ᇉbൌဒᇏႵਆ۽ૡ్ཌྷܱ֥ྞಥނaଷ֛aބМҧభ२ջ֩ଷᇕൌဒ่ࡱğ॥ᇅ่ࡱބν໎࠴่ࡱ, ܴҳଽჷ֥ࠗࠃཁᇷࡨ, ط༒༯२ջіགྷູࠗࠃᄹྟέோ༢֥ࠗࠃބµ-έோဢԨ൳ุ֥э߄b఼bඪૼథ၍ྟν໎࠴ིႋಒൌߏࢳਔڵྟ౦࿂, ࣮ཁൕ, ν໎࠴่ࡱ༯ა٢ഝྟൕሶ࠴ࢲކ֥ᆃᇕν໎࠴ט॥ॖି൞๙ݖڴଽҧభ२ջࣉྛµ-έோဢԨ൳ุ(synaptic µ-opioid receptors)ॖ֥bᆃਆ۱࣮Ԛ҄іૼ, థ၍ྟν໎࠴ིႋಒႨྟ༯ࢆ, ඪૼν໎࠴่ࡱ༯ଽჷྟέோ༢іൌթᄝ, ॖौֹႺؿਔྛູaଷބBoldྐݼ֩གྷԛ۷ཁᇷ֥ࠗࠃ; ദุቐҧ(Տ֥ࠗҧ)֥ᆷѓ֥э߄b࣮ᇏૌቓਔൌဒ, ႨМຓҧభحҪaႷҧ༒భ२ջ߭aႷҧభଷ֛ཬඊФ൫, ဒत֞౦࿂֥థ၍ྟν໎࠴ིႋބቐҧڴ҆໕ሑุ֩თᄝν໎࠴่ࡱ༯іགྷԛ൞ڎթᄝbࢲݔؿགྷ, భ௹ᄝतᇏࡹ৫ν໎࠴۷ૼཁ֥έோဢᇉࠗࠃbWager, ScottބZubieta ᆸ, ᆭުᄝၝკྛູҩဒᇏ(࿇ແҩဒބ఼௧Ⴓ(2007)Ⴈဢ֥ٚمؿགྷ, ν໎࠴่ࡱ༯, ঁ
ֻ8௹ ᅦ໓ґ֩: ν໎࠴ིႋ࣮ൌဒഡ࠹֥ൎބؿᅚ 1123 ҆حွaᕟ҆భ२ջaڴҧ໕ሑุaڴҧФۂaν໎࠴่ࡱ༯, ҕაࢂആّႋ֥ଷ-༒༯భ२ջႷҧྞಥނ໊֩҆іགྷԛ۷఼֥έோဢᇉࠗࠗࠃཁᇷᄹ఼(zhang et al., 2011)b ࠃbൈଷӮཞ္࣮ࣉ၂҄ิ܂ਔཌྷර֥ᆣऌ, Ⴎၛഈᆣऌॖၛुԛ, ଷଽ֥έோ༢ބ؟Petrovic֩ದ(2002)ႨਔPETӮཞඌ, ᄝѓሙϘς༢ॖିҕაਔν໎࠴ིႋ֥טᇅ, ൞, ֥Տࠗӱᇏؓν໎࠴ᆸބέோဢᇉ(ೋ൞ڎᆃਆ۱༢ᄝ෮Ⴕ֥ν໎࠴ིႋ֒ᇏؿߨٯୄ)ᆸࣉྛбࢠb࣮ࢲݔіૼ, έோဢቔႨ, ߎ൞۲ሱᆺؓหၳ֥ൌဒ่ࡱؿߨቔႨಯᇉބν໎࠴ᆸაᕟ҆భ२ջთଷ࿓ੀ֥ᄹ҂ౢԣ, ႵրႿࣉ၂ູ֥࣮҄ᆭิ܂ᆣऌb ࡆႵܱ, ᄝέோဢᇉᆸބν໎࠴ᆸਆᇕ่6 结语 ࡱ༯ᕟ҆భ२ջთބଷۄ֥ࠗࠃႵཁᇷ֥ᆞཌྷܱ, ᄝޅԩ֥ؓᅶ่ࡱ༯ਆ۱თ֥ࠗࠃν໎࠴ིႋ൞၂۱ܼٗթᄝѩؓദྏࡲूऎཁᇷཌྷܱ, ಪູν໎࠴ᆸބέோᇉᆸթႵᇗေၩၬ֥ज़ีb୍࣐ܵ࣍টದૌၘࣜषؓᄝཌྷර֥പࣜࠏᇅbWager֩ದ(2004)ႨfMRIᆃ۱གྷའࣉྛࢠധೆ֥ฐ෬, ط҂ࣇࣇ൞ࡼఃुඌҩਈν໎࠴ᆸႄఏ֥ଷࠃэ߄, ࢲݔؿቔਢԵ၄࿐ਵთᇏ၂۱ླေࡆၛ॥ᇅ֥ۄಠэਈ,གྷ, ᄝಣՏ֥ࠗν໎࠴ყ௹௹ࡗ, ਆҧМຓҧቔູ၂ቆऎႵ؟ᇗگᄖࠏᇅ֥ྏദགྷའ, ν໎భحွބЇݣ֝ඣܵᇛຶᇉ֥ᇏଷთࠗࠃb࠴ིႋ֥ቔႨބჰᇀࣂᆺ୫ౢਔޓഒ၂҆ٳbν໎࠴่ࡱ༯Տࠗ௹ࡗ, ؓҧ౭ଷaభ҆ଷ֛ଢభ, ؓႿν໎࠴ིႋ֥࣮ᇶေࠢᇏᄝაਢԵބᕟ҆భ२ջࠃྟཁᇷ༯ࢆb࣐ܵ҂࣮ᆭူ࿐ཌྷܱ֥ज़ีഈ, ൞ν໎࠴ིႋಏֹܼٗࡗࠆ֤֥ࢲݔթᄝٳఆ, ᆃུ࣮ᆣऌіૼᄝթᄝൌ࠽ളࠃᇏbଢభܼٗҐႨ֥Їওᆌࣳaభحွބభ҆२ջҕაν໎࠴ט॥b ۲ᇕਏၛࠣྏᇍਏᄝଽ֥ᇍਏაۄყࣥॖਸ਼၂ٚ૫, PET൳ุཁཞඌ္ؿགྷ, ଷଽ֥ିაν໎࠴ིႋႵૡ్ܱ༢, طაν໎࠴ིႋૡ؟Ϙς༢္ҕაਔν໎࠴ט॥bᄝScott֩ದ్ܱ৳֥ྐݖӱമᇀॖି൞ದো֥ሷ࢝ބྐဟ11(2007)֥࣮ᇏ, ႨPETඌބCূ੯с০֥ྏࠎԤbૌॖၛؿߨྏ࿐ӉႿൌဒഡ࠹(raclopride)ቔູൕሶ࠴ဒ؟Ϙςᇉ֥ࠗࠃ, ֥Ⴊ൝, ຉᅚν໎࠴ིႋ࣮֥ൌဒٓൔ, ఃᇏࢲݔؿགྷν໎࠴ᆸིႋაڙۯނଽ֥؟ϘςࠗЧज़ีቆႨథ၍ྟν໎࠴ིႋٓൔ, ᄝᆃٚ૫ࠃཁᇷཌྷܱ; ࣉ၂҄ႨfMRIဒਔᆃུФ൫ቓਔ၂ུႵၭ֥Ӈ൫bၹՎ, ૌಪູՖྏ࿐ؓࣁఫࢂആّ֥ႋ, ؿགྷᄝڙۯނ֥ࠗࠃᇏ, ֥࣮ؓഡ࠹නਫ਼ԛؿট࣮ν໎࠴ིႋ֥ྏപν໎࠴ّ֥ႋაؓࣁఫ֥ࢂആّႋႵཁᇷཌྷܱ, ࣜࠏᇅऎႵᇗေၩၬ, ᆃॖି൞ՖਢԵူ࿐֝іૼν໎࠴ིႋؿߨቔႨ֥ࠏᇅॖି൞ࢂആყཟ֥ν໎࠴ིႋ࣮ཟྏ࿐֝ཟ֥ν໎࠴࣮௹bᆃ၂࣮ཬቆ(Scott et al., 2008)Ⴛቓਔࣉ၂҄જࣉ֥ᇗေ၂҄b 1111֥࣮, ૌൈႨCٯୄބCূ੯с০ҕॉ໓ང টܴҳέோ༢ބ؟Ϙς༢֥ࠃbࢲݔؿགྷ, Allan, L. G., & Siegel, S. (2002). A signal detection theory ᄝν໎࠴่ࡱ༯, ঁ҆حွa༒༯భ҆२ջaڙanalysis of the placebo effect. Evaluation & the Health ۯނaଷ֛aྞಥނބ֝ܵᇛຶᇉܴҳ֞έோProfessions, 25(4), 410–420. പࣜ־ᇉࠗࠃᄹ఼; ᄝЇওڙۯނᄝଽ֥ڴҧࠎAmanzio, M., & Benedetti, F. (1999). Neuropharmacological dissection of placebo analgesia: expectation-activated ָނܴҳ֞؟Ϙςപࣜ־ᇉ֥ࠗࠃᄹ఼; ᇶุܴopioid systems versus conditioning-activated specific ဒ֥֞ν໎࠴ིႋაڙۯނ֥έோᇉބ؟Ϙςsubsystems. The Journal of Neuroscience, 19(1), 484–494. ࠃྟіགྷԛཁᇷ֥ᆞཌྷܱ, іૼᆃུଷAmanzio, M., Pollo, A., Maggi, G., & Benedetti, F. (2001). ॖିҕაν໎࠴ིႋ֥טࢫbSchweinhardt, Response variability to analgesics: a role for non-specific activation of endogenous opioids. Pain, 90, 205–215. Seminowicz, Jaeger, DuncanބBushnell (2009)֥Beecher, H. K. (1955). The powerful placebo. Journal of the fMRI࣮ࣉ၂҄іૼ, ν໎࠴ᆸིႋ֥նཬაAmerican Medical Association, 159(17), 1602–1606. ڴ҆໕ሑุaଷ֛ބభحွ֥ߧᇉૡ؇ཁᇷᆞཌྷBenedetti, F. (1996). The opposite effects of the opiate ܱ, іૼν໎࠴ט॥ބࢂആ༢ॖିႵૡ్ܱantagonist naloxone and the cholecystokinin antagonist proglumide on placebo analgesia. Pain, 64(3), 535–543. ༢bᄝథ၍ྟν໎࠴ིႋ֥fMRI࣮ᇏ, ؿགྷᄝ
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