|
“万变不离其宗”，可能不适用于我们的医疗保健系统。做为一个超过30年的执业医师，我亲身经历了医学技术的爆发（式发展），其中很多（技术）已经改变了我们诊断病理，手术和治疗（的手段）。我承认它们有效的帮助了医生和病人，但是近来（我们却）看到疾病和发病率在社会中的爆发。 What I feel compelled to take issue with, and the reason I am writing this treatise, is that the actual paradigm of medical care has not changed much in spite of all of our technological advances. Physicians have been extensively trained and have held steadfast in the belief that presenting symptoms are entities unto themselves. These symptom complexes have been treated as if they have a life of their own, separate and apart from the innocent bystander host, the person with the medical problem. We have divided the human body into a jigsaw puzzle of component parts. We've taken the jigsaw puzzle apart and assigned a specialist to address each one of these pieces of the whole, losing sight of the fact that everything is part of the whole, and everything we do as physicians to each little part affects the whole person. This has fostered the current allopathic paradigm of "symptom care" in lieu of the more important issue of "health care." 我感觉现在急迫的问题，也是我写下本文的原因，是尽管我们的技术进步很快，但是实际医疗方式却没有太大变化。在广泛的培训中，同时医生也坚信每种症状都有对应的原因（部位）。对复合病症，如果每种（病症）都有对应的原因，则把它们从病患身上一一分离开来。就好像人体是个拼图，我们给每块拼图对应一个专科，却忘记了他们事实上都是整体的一部分，而我们做的每件事都只是从某一专科来影响整个人体。这也导致了现在“症状护理”模式替代了（实际）更重要的“（整体）保健”模式。 In order to establish a system that is truly focused on health care, we need to expose some "myths" that will allow us to unlock the door to creating a more efficient and successful healthcare delivery system.为了建立一个真正的保健系统，我们需要打破一些“神话”，以便为我们建立一个更有效，更成功的医疗服务系统开启成功之门。 Myth #1- Technology has improved healthcare
Ask any physician if he believes that technology has improved health care and you will get a resounding "Yes!" Advances in medical technology now enable us to look inside the human body with relative ease and with great detail. Our surgical tools allow us to operate on all parts of the body with a minimum of trauma and blood loss. Technology has helped us improve the quality of life for millions of patients every year. It has enabled us to save countless lives as well. Therefore, it is certainly a foregone conclusion that technology has, in fact, improved our health. Or has it?（如果）你对任意一个医生问他相信技术改善健保吗，都会得到肯定的回答。现在医疗技术的进步使我们相对容易的看到人体内部的更多细节。我们的外科手术工具使我们可以对身体任意部分做手术，而带来最少的失血和创伤。每年，技术帮助我们改善了数百万计患者的生活质量，无数人的生命得以拯救。因此，毫无疑问，技术改善了我们的健康。真是这样？ Statistically, since the age of technology, there has been an onslaught of increasing pathology. The amount of illness and morbidity in our society is dramatically rising. There are now more cases of cancer, heart disease, arthritis, auto-immune illnesses, endocrine disorders, developmental disorders, allergies, respiratory problems, infectious diseases, neurological problems, musculo-skeletal pathology, gastro-intestinal disorders, psychological illness, etc., than ever before. 据统计，从技术诞生以来（我们）就受到发病激增的冲击。社会上疾病和发病率都大幅上升，和以前任何时候比起来，现在出现了更多的癌症，心脏病，关节炎，自身免疫系统疾病，内分泌失调，发育障碍，过敏，呼吸困难，传染性疾病，神经方面的问题，肌肉骨骼病症，肠道疾病，心理疾病等。 While it is true that our technology has enabled us to better handle the enormity of disorders now facing mankind, it has done literally nothing for "health care." If it had, we would have seen a decrease in the amount of illness and pathology in society. We would have experienced a drop in the amount of people requiring intervention from the medical community. Pharmaceutical companies would not be as rich and powerful as they are if people would be less dependent on medication to "feel well". If anything, advances in technology have fostered a narrow field of vision, focused more on early detection and intervention than on prevention. If, by definition, health care means "the maintenance of good health," then technology has failed miserably to produce any measurable improvement in the overall state of health of mankind. 技术使我们更好的处理疑难杂症，这是事实，但从字面上，它对“健保”没有发挥作用。如果有，我们就应看到社会上疾病数量的减少和发病率的降低；找医学界寻求帮助的人数下降；如果人们不依赖药品就能“感觉良好”，制药商不会像现在这样有钱。如果有的话，技术进步就会更专注于疾病的早期预防，检测和干预。如果按照定义，健康保健是指“维护健康状况的良好”，那么技术在提升人类整体健康状况上已经失败。4 Myth #2 - Inflammation is bad
Ask any doctor what to do about inflammation and the answer will be a uniform, "Take an anti-inflammatory." While it is true that taking medication to suppress inflammation can certainly lead to increased comfort, should we be doing that in the first place? Is inflammation bad? Is it something that occurs by freak accident, some physiologic aberration, that occurs and causes great distress and suffering amongst mankind? We have been conditioned to think of inflammation as something bad because it causes pain and makes us miserable, therefore it should be medicated and suppressed. Right? Wrong. 问任何一个医生如何对待炎症都会得到一致的回答“用点消炎药”。虽然这是事实，用药抑制炎症肯定会（让我们感觉）好些，我们应该把它摆在首位吗？炎症是不好的？难道它不是因为某些意外，某些生理失常的发生而造成极大的困扰和痛苦吗？我们已经习惯于认为炎症坏事，因为它导致疼痛，让我们苦不堪言，因此应该用药抑制。对不对？不对。 Inflammation is a directed response by the immune system designed to detoxify, repair and protect tissues under any form of functional or metabolic stress. It is important to understand the purpose of inflammation in order to see why we should not work to suppress it, but rather to support it. 炎症是免疫系统用来清热消毒，修复和保护组织功能和代谢应激下的一种反应。认识到炎症的目的，我们应当支持它而不是抑制它是非常主要的。 Whenever there are tissues in our body under any form of functional or metabolic stress, the problem will be immediately identified by the immune system. It first recruits a pathway called primary inflammation. This pathway is employed by the body in order to detoxify the tissues under stress (as tissues under stress increase their metabolic rate and produce more toxic by-products) as well as facilitate the repair of any injured cells. A primary inflammatory response will produce no symptoms in low-level stress situations, as long as it is efficient in managing the problem. You would not even know that this process is going on because there are no identifiable symptoms such as pain, swelling, redness and heat. Cardinal signs of inflammation will occur only when there is rapid, high level stress in an area such as in acute trauma, repetitive stress episodes, allergic/toxic reactions and metabolic disease. 每当有任何形式的身体功能和代谢应激变化，免疫系统都将会立即发现毛病。首先它引入被称为“主炎症”的手段。这条手段被人体用来给压力下的组织消毒（在压力下的组织会增加他们的代谢率，并产生更多的有毒副产品），同时修复受伤细胞。低压力情况下，只要是在有效的解决问题，“主炎症”不会有任何症状。你甚至不知道状况如何，因为没有任何诸如疼痛，肿胀，发红或者发热的症状。只会在急性的高压力情况下，比如急性创伤，重复伤害，过敏性/毒性发作和代谢性疾病，炎症症状才会发生。 In situations where the stress on the tissues is beyond the capability of the primary pathway, or in situations where there is an inefficient inflammatory response (we will discuss this later in the treatise), the immune system will then incorporate the secondary, or chronic, inflammatory pathway. This pathway is a protective pathway. It prevents rapid tissue destruction by allowing for cellular adaptation to the stress as well as the release of pain-causing chemicals to prevent continued "overuse and abuse" of the involved part. Therefore, the patient becomes aware that there is a problem because they are in pain. 在组织压力超出主要手段能力的情况下，或者炎症效率低下（我们将文章稍后讨论），免疫系统将引入次选，或者称为慢性抗炎手段。这是条保护性手段。它保护组织遭到破坏，使细胞减少适当的压力，同时释放出引起疼痛的化学物质来防止相关部位持续的“过度使用和滥用”。因此，病人因疼痛而意识到他们有麻烦了。 Now that you understand this simplified explanation of inflammation, you can see that inflammation is actually a good thing. It is the body's way of trying to help itself deal with these kinds of issues. It should be obvious then, that anti-inflammatory medications actually impair the body's ability to detoxify, repair and protect itself. Additionally, these medications add toxic load to the body and are responsible for many varied side effects.现在既然你已对炎症有了简单的了解，就会发现炎症实际上不是坏事。它是身体处理这类问题的一种方式。显而易见，消炎药实际上是在损害身体的解毒，修复和保护自己的能力。此外，这些药物还增加了身体的负担，以及额外的副作用。 What makes more sense, empirically, is to treat these problems mechanistically and supportively. In other words, we want to work to help make the pathway of primary inflammation more efficient, with supportive, rather than suppressive, protocols. There are many natural medicines that can help accomplish the task of supporting our bodies, be they homeopathic, nutritional or herbal. Additionally, we want to be able to identify the reason(s) that this pathway is not functioning efficiently. 更有意义的事情是，从经验上，条理的，支持性的对待这些问题。换句话说，我们应当支持，而不是抑制来让“主炎症”更有效。有很多天然药物，可以支持我们的身体完成任务。他们是些顺势利导，富有营养的植物。此外，我们需要查明这种手段（“主炎症”）不再有效的原因。3 It is imperative that we look more comprehensively into our patient's physiology in order to detect reasons why the immune system is not up to the task it is being called upon to perform. To do this, we need to understand our patient's lifestyle, diet, adrenal health, the presence of food sensitivities, free-radical levels (free-radicals being compounds that essentially are responsible for cellular damage and degeneration over time), metabolic function analysis and perhaps other tests. In other words, we must work to comprehensively understand our patient's total health picture and not just concentrate on the body part involved in the pathology. 当务之急是找到病人的生理原因，以便及时发现免疫系统为什么无法及时完成工作。要做到这一点，我们需要了解病人的生活方式，饮食，肾上腺健康，食品的敏感性，自由基状况（自由基的化合物，随着时间的推移损害细胞），代谢功能分析和其他测试。换句话说，我们必须要全面理解我们病人的整体健康状况，而不仅仅集中在涉及一部分身体的病理。 Myth #3 - Genetically coded diseases are unavoidable
How many times have you heard someone say, "My mother had arthritis, that's why I have it"? We now believe, through scientific technology, that many diseases are inherited. Genes for specific diseases have been recognized via gene mapping. Many of you may know or have heard of women who have had total bilateral mastectomies, completely prophylactically, because their mothers died of breast cancer, firmly believing that they could not avoid the same fate. 你听过多少次“我妈妈有关节炎，所以我也有”? 虽然通过科技我们知道很多疾病都是遗传的。特定疾病的基因通过遗传图谱留传下来。你们中的很多人可能听过又有谁做了完整的乳房切除手术，因为她的母亲死于乳腺癌，所以坚信自己无法避免同样的命运。 Let's take a closer look at this issue. If having a gene for any illness condemns you to having that disease, then why are you not born with the disease you are coded to have? Why isn't every person who carries a gene for disease suffering at all times from that disease? The answer is that all genes do not express themselves at all times and many never do. There must be a reason why the body would call upon a gene to express itself. Otherwise, none of us would be able to survive the onslaught of genetic expression. So what is it that causes a gene to express itself? If you consider for a moment that diseases are just a complex of symptoms being incorporated by the body in an attempt to protect itself from tissue destruction and/or imminent death, you may begin to get a clearer understanding of what I am trying to say. Once we begin to pay attention to the reasons that a gene might express itself, we may be able to prevent that gene from releasing its code for illness.让我们深入这个问题。如果是疾病的基因导致你也有这个疾病，那为什么你生下来时没有这种疾病？为什么不是每个带有这种基因的人都受尽折磨？答案是很多疾病基因并没有表现出来，甚至从来都没有表现出来。疾病基因的触发必然有它的原因，否则在疾病基因的触发之下没有人能够活下来。那么而是什么触发了疾病基因？考虑一下，疾病就是一系列复杂的来保护自己免于损害或死亡的症状，你可能明白我在说什么。一旦我们开始注意基因触发自己的原因，我们也许就能够防止那些疾病基因触发。 To do this, one must look again at the lifestyle of the patient. As stated earlier, degenerative illness is a function of free radical damage to our cells over time. If someone carries the gene for arthritis, for example, one would expect genetic coding to foster storage of free radicals in their joint tissues. The prolonged exposure to these free radicals over time will cause progressive vicariations, which lead to cellular damage and eventual joint destruction. 要做到这一点，我们必须再来看看病人的生活方式。如前所述，退化性疾病由于自由基持续对我们细胞的损害。如果有人携带关节炎的基因，那么基因编码可能将自由基储存在关节组织里。随着时间的推移，这些自由基会造成渐进损害，最终导致细胞伤害，破坏关节。 But what if we intervene on behalf of gene expression by controlling the formation and liberation of free radicals in the body? Would there then be a need for the gene to express itself? I contend that there would be no need for this gene to express because, as I stated earlier, disease is the body's way of protecting itself from rapid destruction of tissues and/or imminent death. If it doesn't have to go to extraordinary lengths to protect itself, the gene remains dormant and no disease ensues.但是如果我们通过控制自由基的信息和释放来干预基因的表达，结果会怎样？基因还会表达出来吗？我断言它不会表达出来，因为如早期所说的，疾病是身体保护自己免于伤害和死亡的方式。如果还没到保护能力的尽头，那么基因仍然会休眠，没有疾病产生。 So, again, we must look at the lifestyle and diet of the patient to discover why their body is failing to control the formation, liberation and damage caused by free radicals. You have all heard the term "antioxidants" and for good reason. Antioxidants are the nutrients we require in order to neutralize free radicals so they can then be eliminated from the body in a harmless form. Many people in our society live on nutrient deficient diets from highly processed and refined foods that do not supply essential nutrient protection.所以，再次强调，我们必须了解病人的饮食和生活习惯，来找到他们身体为什么对自由基导致的损害控制失败的原因。大家都听说了长期使用抗氧化剂的好处。抗氧化剂有我们所需的营养来消除自由基，使它们在身体中以一种无害的方式淘汰掉。很多人从高度加工和精致的事物中无法获得这种必须的营养物资保障。 You should be beginning to see the pattern here. Are we treating cancer by cutting it out? Are we treating arthritis by suppressing the protective inflammation brought about by years of free radical damage? Does coronary artery bypass grafting cure cardiovascular disease? Of course not. Our goal should be in maximizing understanding of cause and effect and employing life affirming, nutrient-rich diets with a healthy, wholesome, natural lifestyle. This is the way to "prevent" genetically coded diseases. 你应该开始了解这里的模式了。我们要通过切除来治疗癌症吗？我们是通过抑制自由基多年伤害带来的炎症来治疗关节炎吗？通过冠状动脉移植来治疗心血管疾病吗？当然不是。我们的目标是尽可能多的明白（疾病） 的影响和原因，以便有营养，健康自然的生活。这才是预防遗传性疾病的方式。 Myth #4 - Medications improve health
We are, in this country, the most heavily medicated society on the planet. People are taking medications to control the symptoms of countless diseases. These medications are either prescribed by their physicians or purchased over the counter by the patient. I have seen, in my practice, thousands of elderly patients taking upward of 10 prescription medications as well as a few over-the-counter ones. If you ask the average senior how they are feeling, most will say that they feel awful in spite of their medications. How could this be? If the medications are supposedly "keeping them healthy," how come they feel so bad? There are a number of reasons for this. 我们这个国家的我们是滥用药物最严重的。人们服用药物控制无数疾病的症状。这些药物要么是他们医生开的要么是自己从柜台买的。在我的行医生涯中，我见过成千上万个老年人服用来自多个柜台的十数种药物。如果你问他们感觉如何，大部分可能会说这些药物真是可怕。这怎么可能，如果药物是用来“让他们保持健康的”，现在他们怎么感觉不好呢。有很多原因。 First of all, every medication swallowed is perceived by the immune system as a "poison," because there is nothing in nature that would ever present to the G.I. tract in that form of chemicals. This added "toxic load" places additional stress on the body. These chemicals must be detoxified and eliminated by the body. This need to detoxify causes stress in the liver and kidneys and can damage these vital organs. 首先，每种服下的药物对免疫系统来说都是毒药。因为没有一种天然的东西会像这些化学品样永远在你的肠胃存在。这些“有毒负载”额外增加了身体的负担。这些化学品必须戒除，并排出体外。这给解毒的肝脏和肾脏带来额外压力，并损害这些重要器官。2 Additionally, all medications, because they are designed to interfere with natural body physiology, will produce inevitable side effects. Why? In every situation where a drug is used to block symptoms (the roadblock), the body will undergo physiologic compensations in an effort to get around the roadblock. So, the body will recruit different physiologic pathways in an attempt to bypass the roadblock. Hence, the patient will experience new symptoms as these other pathways elicit undesired effects. Some of the side effects can be potentially more disabling than the symptoms they are being used to treat. 此外，所以的药品，因为它们干扰了身体的自然机理，会产生不可避免的副作用。为什么？在每种药物都是用来阻止（路障）疾病症状情况下，身体会通过不同的途径来排除这些路障。因此，病人又出现了其他新的症状，因为这些其他途径引起了不良反应。一些副作用可能比它们要排除的症状更严重。 Many side effects are treated with additional drugs, further increasing the toxic load. The other issue most important to understand is that the symptoms are a directed response by the body to solve whatever issue needs to be dealt with. If you inhibit these symptoms with medications, symptoms will return when the drug is withdrawn if the body has not successfully solved the problem. 额外的药物带来了副作用，增加了有毒负载。另外一个更重要的是了解这些症状是身体对真正需要解决的疾病的反应。如果用药物来抑制这些症状，那么如果身体还没成功解决疾病，药物一停症状又回来了。 So, what am I saying here? Quite simply, if a patient has high blood pressure and is taking medication to control it, and then they cease taking it, they will see their blood pressure rise again. If they are suffering with an inflammatory problem and are taking anti-inflammatories to control their discomfort, and cease taking their meds, they will again be in pain. If they are suffering with sinus congestion and take a decongestant, they will feel congested again if the drug is withdrawn. Empirically then, we see that the medication has not at all improved their health, just their symptoms. 所以这里我要说的很简单。如果病人试图用药物控制高血压，然后停止服用后，他们将再次看到他们的血压上升。如果他们因炎症痛苦不堪，并服用消炎药来控制自己的不适，一旦停用，他们将再次痛苦。如果他们受到了伤害，鼻窦充血，并使用药物，如果药物被撤回他们将再次感到鼻窦阻塞。根据经验，然后我们看到，这些药物并没有改善他们的健康，只是消除他们的症状。 Myth #5 - Childhood immunizations protect us from serious disease
It's a foregone conclusion that upon the birth of your new baby, immunizations will start as soon as possible to protect your child from many serious childhood illnesses that can devastate his/her health. Pediatricians set up important immunization schedules to be adhered to so that the baby is not left unprotected. In years gone by, many children were afflicted with polio, measles, mumps, Rubella, influenza, small pox, diphtheria, whooping cough and others. Of course, the majority of these children recovered without incident (other than polio, which caused permanent nerve damage most of the time), but there were some children who had serious sequelae and even some who died from these diseases. Modern science discovered a way to confer immunity on these children so that they would never become afflicted with these diseases, and for the most part, it has been successful. The question is, at what price? 已成定局。你的宝宝刚出生就开始接种疫苗，来保护他的健康。儿科设置了重要的免疫程序来防止儿童免于保护。在过去的岁月中，许多儿童患有小儿麻痹症，麻疹，腮腺炎，风疹，流感，天花，白喉，百日咳和其他疾病。当然，这些孩子中大部分恢复了（小儿麻痹症，大部分时候造成永久性神经损伤的以外），但也有一些儿童有严重的后遗症，甚至有些人死于这些疾病。现代科学发现了一种方法，赋予这些孩子免疫力，使他们永远不会被这些疾病折磨，并在大多数情况下，它是成功的。现在的问题是，代价是什么？ If we think for a moment that we are taking infants with immature thymus glands (the main gland responsible for proper immune system function does not mature until around five years of age) and exposing them to numerous live and attenuated viruses, much more frequently than the child could possibly be exposed to any of these diseases, we may begin to understand some of the very discomfiting statistics that have evolved since the age of immunization. Rather than decreasing childhood morbidity and improving the health of all subsequent generations being immunized against these diseases that have affected mankind for thousands of years, we have instead seen a dramatic rise in childhood illness in the form of ADD, ADHD, autism, allergies, learning disabilities, infectious diseases, auto-immune illnesses and, most importantly, cancer. Cancer has been on a frighteningly dramatic rise in small children over the past decades and shows no signs of letting up. Mortality rates for childhood cancers are unacceptably high although technology has slowed the course of death. 让我们想象一下胸腺不成熟的婴儿（主要负责免疫系统功能，直到5岁才发育成熟），使他们频繁地接触少量活的病毒。（和那些可能已经接触到这些病毒的孩子比起来），我们可以得到一些尴尬的关于免疫系统演变的统计。不只没有降低儿童的发病率，提高千百年来人类后代的免疫能力，反而发现注意缺陷障碍，多动症，自闭症，过敏，先天残疾，传染病，自体免疫疾病等儿童疾病的急剧上升，而最重要的是，癌症。在过去的几十年里（发病率）急剧上升。儿童癌症的死亡率高得令人无法接受，虽然技术已经减缓了死亡的过程。 Is there anyone out there, like myself, who is not convinced these childhood morbidity statistics have nothing to do with immunizations? Have we traded off less serious illness for more devastating disease? How did mankind survive and thrive through thousands and thousands of years without being immunized? Are we interfering in a way that has created a weakening, rather than a strengthening, of the human immune system? Is it possible that we are interfering with the natural course of genetic mutation that would have rendered authentic immunity to these diseases? There are too many unanswered questions here for my comfort level. 有没有人像我一样，不相信这些儿童发病率的统计与免疫接种无关？我们用更具破坏性的疾病来交换不太严重的疾病？没有免疫接种，人类怎么是如何在数千千百年来生存和成长的？我们在弱化，而不是加强人体免疫系统，干扰？是否我们可能干扰了对这些疾病的自然免疫？有太多悬而未决的问题。 It is my opinion that it is incumbent upon epidemiologists to delve deeply into this possibility and definitively rule out a link between immunization and childhood morbidity from the aforementioned conditions. 我的建议是，流行病学家必须深入研究这种可能性，并明确排除免疫接种与儿童疾病之间的关联。 Myth # 6 - The double blind - placebo controlled study guarantees safety and efficacy in drug therapy
At this point in the history of mankind, we have been conditioned to abhor symptoms of any kind. Headaches, sneezing, coughing, colds, allergies, pain, infections, hypertension, etc., are no longer tolerated as a part of the process of living. Rather than look into the mechanisms that may be causing these symptoms, we are reaching for the medicine that will suppress them. In so doing, we may feel better, but we now have no motive to look at causes and correct for the issues that may be impairing our health, thus increasing our "need" for more medications over time. 在人类历史上，我们已经习惯于厌恶任何形式的症状。头痛，打喷嚏，咳嗽，感冒，过敏，疼痛，感染，高血压等，都是生活过程中不可容忍的一部分。而不是看到造成这些症状的机制，我们用药物抑制它们。这样做，我们可能会感觉更好，但我们没有动机去寻找原因和解决可能会损害我们的健康的问题，随着时间的推移从而提高了我们对更多药物的“需要”。 Well, what about these drugs? How do they make it to the market for public consumption? The answer is the "gold standard" double blind, placebo controlled study. Without this approach, there can be no FDA approval and hence, no way to market a drug. So let's look at this approval process more closely. 那么，这些药物是什么？他们如何市场化？答案是“金标准”，双盲，安慰剂对照研究。如果没有这种方法，FDA不会批准，药物没法市场化。因此，让我们更加近距离地观察这个审批过程。 It is imperative that a drug be tested for two main issues in clinical trials, the first being safety and the second, efficacy. Of course we want to know that if a drug proves to control the symptoms it is being designed to control, it can it do it safely, (e.g., with a minimum of "tolerable" side effects). 当务之急是，在临床试验中测试药物的两个问题是，一是安全性和二是疗效。当然，我们想知道，是否它如设计那样来控制症状，并安全的做到（例如，用“容忍”的最少副作用）。 We then want to be able to establish that it is the drug that is working and not the "mind over matter" phenomenon. To ensure this, the drug is given to half of the test subjects and a placebo is given to the other half, who believe that they are actually being given the medication. Both groups are also instructed to refrain from taking other medications so that a "synergy" effect does not confuse the results. It would be harder to know if side effects and/or efficacy are being affected by these other meds so they are eliminated from the trials. The expectation is that there should be a great discrepancy between the medicated group and the control group (placebo) in the relief of symptoms being reported. This establishes the drug's efficacy. 然后，我们希望药物能够工作，而不是“精神控制思想”的现象，它是药物。为了确保这一点，一半测试对象服用药物，另一半相信他们实际上是用药的测试对象服用安慰剂。这两个群体被指示不要服用其他药物，使“协同”效应不会混淆结果，因为很难知道他们是否被其他药物所影响，使他们从试验中淘汰。期望是得到给药组和对照组（安慰剂）关于症状缓解之间巨大差异的报告。这说明了药物的疗效。 All through the clinical trials, all side effects are being reported and catalogued. The side effects are rated as to severity and frequency. The FDA will then look at this "safety" profile and decide whether or not the drug is safe enough to be approved for marketing. 通过临床试验，所有的副作用都被报告，并根据严重程度和频率来打分。 FDA将再看看这个“安全”的资料，并决定是否批准上市的药物足够安全。 So let's assume that a drug has passed the stringent testing requirements and is now FDA approved. Soon, the drug will begin to be prescribed by an ever-increasing number of doctors who believe that new is better. Now, this is where the bigger, broader issues become revealed. Firstly, we mentioned that the medicated group in the study takes the test drug in isolation of other drugs. That is not what happens in real life. As soon as the drug hits the market, it is going to be mixed with lots of other prescription and over the counter medicines, as well as herbal and homeopathic medicines. We now begin to see drug interactions that will cause previously unreported side effects, some of them severe and some of them causing deaths. It is actually after the marketing of the drug that the public becomes the "test subjects" for drug interactions. The Department of Health will quickly respond by informing doctors of these "new" side effects, but it is too late for some people. 所以，让我们假设一种药物已通过严格的测试要求，FDA也批准了。不久，该药物被相信它更好的医生广泛使用。现在，更大，更广泛的问题出来了。首先，我们提到，在研究中采用隔离其他药物的试验药物。这不是在现实生活中发生的事情。只要药物进入市场，它就会与其他处方药，以及草药和顺势疗法药物混合。我们现在开始看到药物的相互作用，将导致以前未报告的副作用，其中有些严重，其中一些造成死亡。它实际上是市场化后的药物，公众成了这些药物交互影响的测试者。卫生署将迅速作出反应，通知医生这些“新”的副作用，但它是对某些人来说为时已晚。 In addition, as the public use of the drug increases, there is now a much larger population of people using the drug and the statistics begin to change. What may have been reported to occur in 2 percent of the original test group may now be seen to be occurring in 6 percent of a broader population. Additionally, new side effects, not previously reported in clinical trials, become apparent. This is because there are so many variables in human physiology that results are often skewed by small populations of people who live in and around the same geographic location. 此外，由于药物被公众大量使用，统计数据也开始改变。可能已报告发生在原有测试组的2％，现在可以被看作是发生在一个更广泛人口中的6％。此外，新的副作用，而不是以前在临床试验报告，愈来愈明显。这是因为很多生活在同一地理位置的小群体导致结果起了变化。 Lastly, clinical trials do not reveal the effects of long-term use. This, again, is something that turns the public into human guinea pigs. The recent Vioxx debacle bears this out. 最后，临床试验中没有发现长期使用的效果。公众又成了小白鼠。最近Vioxx的崩溃证明了这一点。 So, in fact, this double blind placebo controlled study does not guarantee safety or efficacy because the test leaves far too many questions unanswered. 所以实际上，双盲对照研究并不会保证疗效和安全，因为它留下太多无法回答的问题。 Where Do We Go From Here?
The focus on optimization of health not only depends on a working knowledge of genetics, but a deeper understanding of cause and effect through a working knowledge of epigenetics. Integrative medicine (the practice of conventional and holistic medicine) seeks to relate cause and effect in the treatment and prevention of illness by addressing the causative factors in the patient's diet, lifestyle and environment. When the medical profession embraces the duality of symptom care and the optimization of health by addressing epigenetic influences on gene , we will begin to see a decrease in morbidity and an overall improvement in quality of life. 保持更健康的重点不仅取决于遗传学知识，还应更深入的了解因果。综合医疗（传统和整体医学的实践）旨在对病人的饮食习惯，生活方式和环境致病因素的治疗，以及找到因果关系来预防疾病。当医学界拥抱症状的二重性，解决疾病基因的表达，我们将看到发病率减少以及生活质量的整体改善。 Our goal is to educate the public on how to stay as healthy as possible. Correcting mechanisms of pathology requires a receptive public, one that is willing to alter diet and lifestyle for their own benefit. One can easily extrapolate that in order to have a clean, natural, chemical free diet, issues of environmental toxicity can no longer be tolerated. We would now have a society of proactive people whose goal is to protect their health, the health of their children and grandchildren as well as preserve nature so we can be a part of it rather than a detriment to it. 我们的目标是教育公众如何保持健康。纠正病理机制，需要公众愿意为自己的健康改变饮食和生活方式。人们可以很容易推断，为了有一个干净，自然的，无有害化学物质的饮食，环境毒性的问题不再被容忍。我们才会有一个目标积极，保护自己的健康，以及子女和孙辈健康的社会。同时保护自然，我们是它的一部分，而不是损害它。 The future of our health depends on knowledge and action. The future of our survival depends on knowledge and action. We can no longer afford to be innocent bystanders of our own health. The system is bursting at the seams. It is costing us far too much money to administer medical/surgical care. True, we have technology that can facilitate early detection, but this technology by no means confers prevention of disease on any of us. As such, we have become masters of symptom control and disease management but unfortunately, we are losing the battle to increasing morbidity and suffering. 我们健康的未来取决于知识和行动。未来我们的生存依赖于知识和行动。我们再也不能以无辜的旁观者（心态来对待）我们的健康。千里之堤毁于蚁穴。它耗费我们太多的钱来医疗和做外科护理。诚然，我们的技术可以方便早期发现疾病，但是这决不是说疾病的预防依赖这些技术。而是我们成为控制症状和疾病管理的主人，但不幸的是，我们在与不断增长的发病率和痛苦的搏斗中，正走在失败的路上。 Follow Dr. Robert A. Kornfeld on Twitter: www.twitter.com/holfoot153 在twitter上关注罗伯特医生：www.twitter.com/holfoot153 |
|
|
