The clinical role of the placebo effect is a topic of increasing interest for the scientific community. Focus is shifting from the inert role of placebos in randomized controlled trials (RCTs) to potential effects in clinical applications, since the phenomenon is thought to be inherent in routine clinical practice, affecting therapy success rates. Mediation of the mind-brain-body relationship involves both psychosocial and neurobiological factors, the interaction of which comprises the placebo mechanisms. Psychosocial factors include environmentally induced expectations, reward expectations, and even conditioned responses to certain stimuli. Expectations also depend on previous experience of the patient with a similar procedure and can affect future responses. Moreover, the supportive bedside behavior of the clinician and the positive framing of information provided to the patient have proven to be of great importance, setting the foundations for reconsideration of standardized practices. Neurobiological mechanisms mediate these effects through neurotransmitter and neuromodulator pathways. The best understood mechanisms are those regulating non-opioid- and opioid-mediated analgesic responses that implicate specific brain regions of pain control and activation of endogenous opioids. Other responses concern, among others, hormonal control, motor performance, and antidepressant responses. Although mechanisms underlying placebo responses are not as yet completely elucidated, there is substantial evidence suggesting that placebo effects are indicative of healthy functioning of intact brain structures and occur through actual functional changes, and are not simply subjective symptom reports. These effects can be utilized in treatment optimization while maintaining an ethical and respectful manner toward the patient and the standardized disclosure procedures.

安慰剂效应的临床作用是科学界越来越感兴趣的话题。重点正在从安慰剂在随机对照试验 (RCT) 中的惰性作用转移到临床应用中的潜在影响，因为这种现象被认为是常规临床实践中固有的，会影响治疗成功率。心-脑-身关系的中介涉及心理社会和神经生物学因素，它们的相互作用包括安慰剂机制。社会心理因素包括环境诱发的期望、奖励期望，甚至对某些刺激的条件反应。预期还取决于患者以前进行类似手术的经验，并可能影响未来的反应。而且，临床医生的支持性床边行为和提供给患者的积极信息框架已被证明非常重要，为重新考虑标准化实践奠定了基础。神经生物学机制通过神经递质和神经调节剂途径介导这些效应。最了解的机制是那些调节非阿片类药物和阿片类药物介导的镇痛反应的机制，这些反应涉及疼痛控制和内源性阿片类药物激活的特定大脑区域。其他反应包括激素控制、运动表现和抗抑郁反应等。尽管尚未完全阐明安慰剂反应的潜在机制，有大量证据表明安慰剂效应表明完整大脑结构的健康功能并通过实际功能变化发生，而不仅仅是主观症状报告。这些效果可用于治疗优化，同时保持对患者和标准化披露程序的道德和尊重方式。