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如此中西醫結合

醫案日記 2023-05-16 18:05:27

美(mei)國(guo)食品藥物(wu)管理局(FDA)在11月2日發出警(jing)告(gao),警(jing)告(gao)消(xiao)費(fei)者不要(yao)購買、食用從中(zhong)國(guo)進口(kou)的(de)保(bao)健品“蟻(yi)力神”膠囊,并禁止該保(bao)健品進入美(mei)國(guo),因為(wei)這種聲稱能治(zhi)療(liao)男性性功能障礙、增(zeng)強男性性能力的(de)保(bao)健品含(han)有沒有標明的(de)處方藥物(wu)成(cheng)份,使用不當有可能導(dao)致生命(ming)危險。

我曾在(zai)中國(guo)電(dian)視和(he)媒(mei)體上(shang)多(duo)(duo)(duo)次(ci)見到“蟻(yi)力神(shen)”膠囊的(de)(de)(de)廣(guang)告,其廠家自稱它是“以(yi)中國(guo)特產的(de)(de)(de)擬黑多(duo)(duo)(duo)刺螞蟻(yi)體內提取的(de)(de)(de)精貴營養素為主要原料,輔以(yi)多(duo)(duo)(duo)種名(ming)貴中藥材,經十多(duo)(duo)(duo)位專家潛心研究,采用(yong)(yong)高科(ke)技工藝精心研制而成(cheng)的(de)(de)(de)專利產品”,其保健功能為“補腎益氣”,食用(yong)(yong)注(zhu)意事項為“孕(yun)婦、嬰幼(you)兒(er)及青少年兒(er)童(tong)不宜食用(yong)(yong)”,配料為“擬黑多(duo)(duo)(duo)刺螞蟻(yi)、絞股蘭、枸(gou)杞(qi)子、肉蓯(cong)蓉等(deng)”。但是《美國(guo)醫學(xue)學(xue)會雜志》在(zai)今年2月份(fen)發表的(de)(de)(de)文(wen)章指出,“蟻(yi)力神(shen)”膠囊并非(fei)什么天然保健品,而是含有處方強度(du)的(de)(de)(de)藥物成(cheng)份(fen)西地那非(fei)。

西地(di)(di)那非(fei)(fei)是(shi)“偉哥”(正式名稱“萬艾可”)的(de)(de)(de)活性(xing)成份,是(shi)只有(you)(you)憑醫(yi)師處方才(cai)能購買、并(bing)必須(xu)在(zai)醫(yi)師指(zhi)導下才(cai)能服用(yong)的(de)(de)(de)處方藥物。用(yong)于(yu)治(zhi)療勃起障(zhang)礙(ai)(ai)的(de)(de)(de)西地(di)(di)那非(fei)(fei)推薦(jian)劑量(liang)(liang)(liang)為(wei)50毫克,而每粒“蟻(yi)力神”膠(jiao)囊中(zhong),西地(di)(di)那非(fei)(fei)的(de)(de)(de)含量(liang)(liang)(liang)高達55毫克,顯然是(shi)根據其推薦(jian)劑量(liang)(liang)(liang)暗自添加的(de)(de)(de)。FDA的(de)(de)(de)測試肯定了《美國(guo)醫(yi)學(xue)學(xue)會雜(za)志》的(de)(de)(de)發(fa)現。西地(di)(di)那非(fei)(fei)如果與(yu)硝(xiao)酸鹽(yan)類(lei)(lei)藥物同時使用(yong),有(you)(you)可能產生(sheng)嚴重低血(xue)壓,出現生(sheng)命(ming)危(wei)險(xian)。患有(you)(you)心血(xue)管疾(ji)病、糖尿病、高膽固醇(chun)等疾(ji)患的(de)(de)(de)患者經常使用(yong)硝(xiao)酸鹽(yan)類(lei)(lei)藥物,在(zai)這(zhe)類(lei)(lei)患者中(zhong),性(xing)功能障(zhang)礙(ai)(ai)也(ye)是(shi)常見的(de)(de)(de)問題(ti),如果他(ta)們誤信(xin)“蟻(yi)力神”的(de)(de)(de)廣告而擅自服用(yong),就(jiu)可能出現藥物反(fan)應,恐有(you)(you)生(sheng)命(ming)安全之虞。因(yin)此,FDA發(fa)出了警告和禁令。

早在(zai)去(qu)年,在(zai)日本各縣(xian)市(shi)衛生單位公(gong)布的(de)(de)假健(jian)康食品名(ming)單中(zhong),“蟻力神”就因為(wei)被檢(jian)測出(chu)暗自添加西地那非而榜上有(you)(you)名(ming)。這也不是(shi)第一(yi)種(zhong)被發現添加西藥(yao)的(de)(de)國產(chan)保健(jian)品或中(zhong)藥(yao)制劑。臺灣衛生署在(zai)去(qu)年7月1日發布的(de)(de)抽(chou)(chou)樣調查報告指出(chu),他們抽(chou)(chou)樣檢(jian)測了46種(zhong)大(da)陸生產(chan)的(de)(de)中(zhong)藥(yao)制劑,發現有(you)(you)10種(zhong)暗中(zhong)添加了西藥(yao)成(cheng)(cheng)份,其中(zhong)7種(zhong)驗出(chu)含有(you)(you)西地那非,2種(zhong)檢(jian)出(chu)解熱鎮痛(tong)藥(yao)對(dui)乙酰氨基酚成(cheng)(cheng)分,1種(zhong)同時含有(you)(you)降血糖的(de)(de)二甲雙(shuang)胍成(cheng)(cheng)分與芬氟拉明禁藥(yao)成(cheng)(cheng)分,此外(wai),還有(you)(you)1種(zhong)檢(jian)出(chu)高(gao)含量的(de)(de)重金屬汞。

“藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)力不夠(gou),西(xi)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)來湊”,這其(qi)(qi)實是(shi)(shi)(shi)當前國內(nei)中藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)制(zhi)劑(ji)的(de)一(yi)個普(pu)遍現象(xiang)。許(xu)多“補腎壯陽”的(de)中藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)不過是(shi)(shi)(shi)對(dui)“偉哥”的(de)偷(tou)偷(tou)重新包裝,治(zhi)療糖尿(niao)(niao)病(bing)的(de)中藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)制(zhi)劑(ji)都添(tian)加(jia)了(le)降血(xue)糖的(de)西(xi)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao),中藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)感冒沖劑(ji)也(ye)多添(tian)加(jia)了(le)解熱鎮痛藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)。這類中藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)制(zhi)劑(ji),真(zhen)正(zheng)起作(zuo)用的(de)其(qi)(qi)實是(shi)(shi)(shi)添(tian)加(jia)的(de)西(xi)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)成份(fen)(fen),但(dan)是(shi)(shi)(shi)在(zai)(zai)說明(ming)書和(he)廣告中,或(huo)者像“蟻力神(shen)”那樣對(dui)西(xi)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)成份(fen)(fen)隱瞞(man)不提,或(huo)者盡量貶低西(xi)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)成份(fen)(fen)。例如號稱是(shi)(shi)(shi)治(zhi)療糖尿(niao)(niao)病(bing)的(de)中藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)名藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)的(de)“消渴(ke)(ke)丸”,其(qi)(qi)標注的(de)成份(fen)(fen)為:“葛根、地黃、黃芪、天花粉、玉(yu)米(mi)須、五味子、山藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)、格列本(ben)脲(niao)。”而其(qi)(qi)實被列在(zai)(zai)最(zui)后的(de)西(xi)藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)成份(fen)(fen)“格列本(ben)脲(niao)”才是(shi)(shi)(shi)真(zhen)正(zheng)有效的(de)降血(xue)糖成份(fen)(fen),但(dan)是(shi)(shi)(shi)經過這么(me)包裝,卻讓人誤以為“消渴(ke)(ke)丸”是(shi)(shi)(shi)純中藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)制(zhi)劑(ji),制(zhi)造出中藥(yao)(yao)(yao)(yao)(yao)(yao)(yao)也(ye)能治(zhi)糖尿(niao)(niao)病(bing)的(de)神(shen)話。

這種(zhong)用(yong)(yong)中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)包裝西(xi)(xi)藥(yao)(yao)(yao)(yao)的(de)虛假(jia)宣(xuan)傳(chuan),利用(yong)(yong)的(de)是(shi)(shi)中(zhong)(zhong)(zhong)(zhong)(zhong)國人(ren)(ren)的(de)民(min)族自尊心(xin)和現(xian)代醫(yi)學(xue)知識的(de)缺乏。我見到過一(yi)個(ge)感冒藥(yao)(yao)(yao)(yao)的(de)廣告,號(hao)稱(cheng)其(qi)(qi)中(zhong)(zhong)(zhong)(zhong)(zhong)的(de)“西(xi)(xi)藥(yao)(yao)(yao)(yao)治(zhi)(zhi)(zhi)癥(zheng)(zheng)狀,中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)抗(kang)(kang)病(bing)毒(du)”,便(bian)是(shi)(shi)迎合了許多中(zhong)(zhong)(zhong)(zhong)(zhong)國人(ren)(ren)心(xin)目(mu)中(zhong)(zhong)(zhong)(zhong)(zhong)“西(xi)(xi)藥(yao)(yao)(yao)(yao)治(zhi)(zhi)(zhi)標、中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)治(zhi)(zhi)(zhi)本”的(de)迷(mi)信心(xin)理。其(qi)(qi)實現(xian)代醫(yi)學(xue)還(huan)沒能(neng)(neng)找到抗(kang)(kang)感冒病(bing)毒(du)的(de)特效藥(yao)(yao)(yao)(yao),對感冒的(de)治(zhi)(zhi)(zhi)療(liao)(liao)只能(neng)(neng)是(shi)(shi)減輕癥(zheng)(zheng)狀讓患者感到舒(shu)服一(yi)些,“西(xi)(xi)藥(yao)(yao)(yao)(yao)治(zhi)(zhi)(zhi)癥(zheng)(zheng)狀”是(shi)(shi)真的(de),“中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)抗(kang)(kang)病(bing)毒(du)”則是(shi)(shi)吹牛而(er)已,如果真能(neng)(neng)抗(kang)(kang)病(bing)毒(du),哪里還(huan)用(yong)(yong)得(de)著(zhu)用(yong)(yong)西(xi)(xi)藥(yao)(yao)(yao)(yao)“治(zhi)(zhi)(zhi)癥(zheng)(zheng)狀”?不久前(qian)國內大肆宣(xuan)傳(chuan)用(yong)(yong)中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)治(zhi)(zhi)(zhi)療(liao)(liao)艾(ai)滋(zi)病(bing)人(ren)(ren),這些宣(xuan)傳(chuan)有(you)意無(wu)意地(di)忽略了一(yi)個(ge)重(zhong)要細節:其(qi)(qi)實治(zhi)(zhi)(zhi)艾(ai)滋(zi)病(bing)病(bing)人(ren)(ren)用(yong)(yong)的(de)還(huan)是(shi)(shi)西(xi)(xi)藥(yao)(yao)(yao)(yao)的(de)雞尾(wei)(wei)酒(jiu)療(liao)(liao)法,中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)是(shi)(shi)做為輔助(zhu)藥(yao)(yao)(yao)(yao)物,試(shi)(shi)驗是(shi)(shi)否能(neng)(neng)用(yong)(yong)中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)來減輕雞尾(wei)(wei)酒(jiu)療(liao)(liao)法的(de)副作用(yong)(yong)。所以這不是(shi)(shi)用(yong)(yong)中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)治(zhi)(zhi)(zhi)療(liao)(liao)艾(ai)滋(zi)病(bing),而(er)是(shi)(shi)臨床試(shi)(shi)驗中(zhong)(zhong)(zhong)(zhong)(zhong)藥(yao)(yao)(yao)(yao)是(shi)(shi)否能(neng)(neng)輔助(zhu)西(xi)(xi)藥(yao)(yao)(yao)(yao)治(zhi)(zhi)(zhi)療(liao)(liao)艾(ai)滋(zi)病(bing)。

我并(bing)不(bu)是(shi)(shi)要(yao)全(quan)盤否定中(zhong)(zhong)(zhong)藥(yao)(yao)的(de)(de)價值。像其(qi)他民(min)族的(de)(de)傳統醫術一(yi)樣,做為(wei)已有(you)幾千年歷史的(de)(de)經(jing)驗(yan)積(ji)累,沒(mei)有(you)人(ren)會否認(ren)會有(you)某(mou)些中(zhong)(zhong)(zhong)藥(yao)(yao)藥(yao)(yao)物是(shi)(shi)有(you)用(yong)的(de)(de),但是(shi)(shi)其(qi)有(you)效性(xing)和實(shi)用(yong)性(xing)必須經(jing)過(guo)現代醫學方法驗(yan)證才能確(que)認(ren)。用(yong)中(zhong)(zhong)(zhong)藥(yao)(yao)包裝西(xi)藥(yao)(yao),盜用(yong)西(xi)藥(yao)(yao)推(tui)銷中(zhong)(zhong)(zhong)藥(yao)(yao),如(ru)此(ci)“中(zhong)(zhong)(zhong)西(xi)醫結(jie)合”,反(fan)映的(de)(de)恰恰是(shi)(shi)這些人(ren)已對(dui)中(zhong)(zhong)(zhong)藥(yao)(yao)完全(quan)失去(qu)了(le)信心(xin),而(er)只能一(yi)方面依賴(lai)西(xi)藥(yao)(yao),一(yi)方面利(li)(li)用(yong)中(zhong)(zhong)(zhong)國(guo)人(ren)普遍相(xiang)信中(zhong)(zhong)(zhong)藥(yao)(yao)的(de)(de)心(xin)理發(fa)財而(er)已。這種(zhong)做法在國(guo)內(nei)不(bu)僅很少被揭露、被懲罰,甚(shen)至還(huan)受到鼓勵(li),在瞞和騙中(zhong)(zhong)(zhong)讓(rang)國(guo)粹發(fa)揚光大,有(you)人(ren)得(de)名(ming)得(de)利(li)(li),有(you)人(ren)得(de)了(le)安慰(wei),各得(de)其(qi)所。不(bu)過(guo),關起門來自得(de)其(qi)樂也(ye)就(jiu)算了(le),如(ru)果想(xiang)靠這種(zhong)欺騙手段(duan)讓(rang)中(zhong)(zhong)(zhong)藥(yao)(yao)走向世界,開什么國(guo)際(ji)玩笑?

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