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L’effet placebo dans le traitement de la douleur

  • Published:
Douleur et Analgésie

Résumé

Les auteurs analysent plusieurs études cliniques concernant les effets analgésiques du placebo dans le traitement de la douleur. Mimant les effets antalgiques de la thérapeutique verum prescrite, le placebo induit une analgésie importante en moyenne chez 35% des patients avec des variations selon la pathologie étudiée et les modalités du traitement utilisé. L’effect placebo est surtout influencé par les attentes et les convictions du patient, du médecin et de l’entourage et par la qualité de la relation médecin-malade. Correspondant à une véritable analgésie psychogène, il pourrait agir en partie par une libération de substances opioïdes endogènes et aussi peut-être par d’autres actions neuroendocriniennes restant à explorer.

Par la qualité de la relation avec son patient, et par des propositions thérapeutiques adaptées aux attentes et convictions de celui-ci, le médecin peut accroître son efficacité thérapeutique en ajoutant un puissant effect placebo aux effects spécifiques de son traitement.

Summary

The authors analyse several clinical studies in connection with the analgesic effects of placebo.

Copying the analgesic effects of the prescribed therapeutic, the placebo induces a significant analgesia on an average 35% of patients, or some variations according to the studied pathology and the modalities of the used treatment. The placebo effect is especially influenced by the expectations and the beliefs of the patient, the doctor, the circle and the quality of the relation patient-doctor.

Like a real psychogen analgesia, the placebo could act partly by a liberation of endogenous opioid substances and partly by others neuro-endocrinian activities not yet explored. By the quality of the communication with the patient and by the therapeutic resolutions suitable for his expectation and his belief, the doctor induces an important placebo effect and like that increases the specific effects of his treatment.

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  1. Unité de traitement de la douleur, Hôpital Tarnier, 89, rue d’Assas, 75006, Paris

    J. Bruxelle, C. Marquez & D. Valade

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  1. J. Bruxelle
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  2. C. Marquez
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  3. D. Valade
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Bruxelle, J., Marquez, C. & Valade, D. L’effet placebo dans le traitement de la douleur. Doul. et Analg. 1, 19–25 (1988). https://doi.org/10.1007/BF03007377

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  • DOI: https://doi.org/10.1007/BF03007377

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