评论
打印
When we think placebos, we think of sugar pills.
通常当我们想到安慰剂时，我们会想到糖丸。
But what if a surgery can be a placebo as well?
但如果手术也可以成为安慰剂，效果如何？
When surgeries were first used their sole purpose was to save lives.
当第一台手术在人类身上进行时，唯一的目的就是挽救生命。
So, it was pretty obvious when operations worked as intended and when they didn't.
所以，手术是否达到预期效果，这一点非常明显。
But today we've developed procedures that aren't designed to to save patients, but to improve quality of life.
但是今天我们制定的一些手术方案，并不是为了挽救患者的生命，而是为了提高他们的生活质量。
Opening the door to whole new kind of surgeries that might take advantage of the placebo effect.
由此开启了可能利用安慰剂效应来进行手术的全新之门。
The Placebo Effect we've talked about a lot, it's the idea that you feel better because you got some medical attention, even if that isn't necessarily medical treatment.
我们之前已经讨论过许多关于安慰剂效果的内容了，由于你得到了一些医疗护理，即便未必是药物治疗，你也会感觉好多了。
The classic example is the administration of a sugar pill instead of a drug.
典型的例子就是糖丸替代药物。
Even though there was no drug involved, patients will sometimes report that they feel better, and can walk away "cured."
即使没有药物摄入，患者有时会说他们感觉好转，已经“治愈”。
It may be hard to think of a surgery as just a placebo, because after all, when you go under the knife, you're going UNDER a KNIFE.
手术可能很难被看作安慰剂，因为毕竟，你在刀下时，你就在刀下。
A surgeon is actually doing something; they're slicing and dicing, but it turns out, because surgery is so serious and there's all this prep many have the mindset that 'if it's surgery it's meaningful.'
外科医生实际上在做一些事情；他们在切片和切块，但事实证明，因为手术非常严谨，所以人们都有这样一种心态，但凡手术，必有意义。
And that is exactly what makes surgery a great placebo.
这正是手术成为安慰剂的真正原因。
In fact, studies on the placebo effect found that invasive surgery has a stronger effect than non-invasive, injections are better than sugar pills.
事实上，安慰剂效果的研究发现，侵入性手术比非侵入性手术具有更强的作用，注射针剂比糖丸效果更好。
Which may help explain why procedures like acupuncture will sometimes test as no more effective than a placebo.
这可能有助于解释为什么针灸等疗法有时与安慰药剂效果相似。
One researcher wrote that injections "seem to associate with higher placebo effects and more 'magic'"
一位研究人员写道，注射“似乎比安慰药剂效果更好”，“魔力更强”。
They test this by performing both real and sham surgeries on test subjects.
他们通过对测试对象进行真实和虚假手术，来对这一点进行测试。
A sham surgery is procedure designed to make the patient think they're having the real operation, but no real treatment is done.
假手术是为了让病人认为他们接受了实际手术而设计的程序，但实际上病人并没有接受真实治疗。
There ARE real surgeries that are actually done every year, that test as no better than a placebo.
真实的手术每年还是会做，而测试结果并不比安慰剂效果更好。
One of these is arthroscopic surgery for osteoarthritis of the knee; 692,000 were performed in 2010.
其中之一是关节镜手术治疗，这种手术用于治疗膝关节骨性关节炎；2010年共实施了692,000次。
Patients who undergo these treatments usually report feeling better afterwards, even if they were only given the "sham" surgery.
经过这些治疗的患者通常会说感觉好转，而实际上他们只是接受了“假手术”。
And that's not the only one, a vertebroplasty where cracked vertebrae are filled in with bone cement to alleviate back pain,
此外，还有范例，一种椎体成形术，即用骨水泥填充带有裂纹的椎骨，以缓解背痛，
and percutaneous myocardial laser revascularization were both tested against placebos and found no more effective than shams!
还有经皮心肌激光血管重建术，都对安慰剂进行了测试，结果发现真假手术效果相似！
The placebo illusion is even more convincing when patients can watch a live feed of their operation and have a little souvenir scar when it's all over.
当患者可以观看他们的手术监控，并在一切结束时，留下一个小小的纪念疤痕，安慰剂错觉就更加令人信服了。
Before the pretend surgeries were shown to be placebos hundreds of thousands of people in the United States had them done each year at a cost of billions of dollars.
在证明假手术可以充当安慰剂以前，美国每年进行手术的人数多达十万，每年耗资数十亿美元。
So, now that we have evidence that they might not work, is it ethical to keep doing them?
那么，如今我们有证据表明他们可能无效，继续这样做是否合乎道德？
Is it ethical to TRICK people into thinking they got effective surgery?!
欺骗人们，让他们认为自己得到了有效的手术治疗是否合乎道德？
It's a tough cookie either way you slice it.
这件事情很难说。
The kicker: there are even ethical problems with TESTING surgeries against a placebo in the first place.
首先与安慰剂相比，测试性手术从一开始就存在道德问题。
It's hard to do a double-blind study on surgery where both the patient and surgeon have no idea if they're administering the treatment or a placebo, because a surgeon knows if they cut you up or not, right?
双盲的手术研究很难施展，患者和外科医生都不知道他们是在进行真实治疗还是安慰治疗，因为外科医生知道他们是否在你身上开刀了，对不对？
There are examples -- but the ethics are closely watched.
有一些例子 - 但伦理受到密切关注。
Drugs have to prove they're more effective than a placebo in order to be approved by the FDA, but a 2014 systematic review of almost 3,000 surgical trials found only 53 were tested against sham operations.
为了获得FDA的批准，药物必须证明它们比安慰剂更加有效，但在2014年，我们对近3000台实验型手术进行了系统性回顾，其中只有53例手术的测试结果对假手术进行了驳斥。
Again, because of ethics.
再次，因为道德。
Sham surgeries CAN help determine if a procedure is actually doing something.
假手术可以帮助确定手术是否真的有效。
BUT, anytime you slice into someone you're introducing a lot more risk than there is in a sugar pill, especially if anesthesia is involved.
但是，无论何时，当您对某人进行手术切入时，总会比进行糖丸测试风险更大，尤其是在使用麻醉的情况下。
On the other hand, if a surgery was widespread but later proved ineffective, then didn't performing all those operations expose more people to risk than if a small trial had the placebo option?
另一方面，如果某项手术被普遍应用，但后来被证明无效，那么与进行一项小型安慰剂试验相比，执行手术是否会使更多的人面临风险？
Placebo surgery is a tough question that the medical community is still grappling with today, and regardless, it looks like you can chalk up one more big win for the placebo effect.
安慰剂手术是一个棘手的问题，医学界今天仍在努力，不管怎样，安慰剂又记一功。
Fun fact: Before arthroscopic knee surgery was shown to be as effective as a placebo it was the most common orthopedic procedure in the US.
趣味知识：在人们知晓关节镜手术与安慰剂等效之前，它是美国最常见的整形手术。
For more on crazy surgeries how about a full body transplant, what some people call a head transplant, check it out Crystal's video on it here.
有关疯狂手术的更多内容，关于全身移植的情况，有人称之为头部移植，请在这里查看克里斯特尔的视频。
Thanks for watching Seeker, please subscribe for more videos.
感谢观看，敬请订阅。
