錯誤的健康訊息(5)

錯誤的健康訊息(5)

吃退熱止痛消炎藥(如Paracetamol【Panadol】等)的好處多，還是壞處多？

吃收鼻水藥(Antihistamines)的好處多，還是壞處多？

吃降血壓藥(如ACEI等)的好處多，還是壞處多？

吃降膽固醇藥(如Statins等)的好處多，還是壞處多？

讓我們透過世界上最權威、全面的西方藥典---馬丁代爾大藥典(Martindale: The Complete Drug Reference)中客觀記載的資料，從治病和對人體各個系統方面的影響看看。

退熱止痛消炎藥

	疾病 / 系統 / 器官組織	正面效果	負面效果	備註
1	感冒的病因(病毒)	無	有
2	發燒(症狀)	有	有
3.	疼痛(症狀)	有	有
4.	發炎(症狀)	有	有
5	神經系統		有
6	免疫系統		有
7	心血管系統		有
8	消化系統		有
9	呼吸系統		有
10	肌肉系統
11	骨骼系統		有
12	泌尿系統		有
13	生殖系統		有
14	內分泌系統		有
15	肝臟		有
16	腎臟		有
17	皮膚 / 毛髮		有
18	五官感覺		有
19	睡眠		有
20	胎兒		有

以上的歸納是根據馬丁代爾大藥典(Martindale: The Complete Drug Reference)中客觀記載的資料所總結。

基本上，寫得出來的都是有實據明顯發生的副作用，你會相信這些副作用只會發生在某些人身上，而不會發生在你身上嗎？

副作用的沒有出現，只是因為程度的不同，而未達到明顯可見的程度而已。因為副作用的出現跟所謂的治療效果是同一原理。你既然相信服藥後必定有止痛、消炎、退燒的效果出現，為何那藥所含有的副作用不會同時出現？

你不是在服用同一粒藥，含有完全相同的化學成份嗎？

就是因為那給人沒有選擇性的作用，你才會覺得西藥合乎科學。既然如此，當說到那可怕的副作用時，你又為何要求那藥有其選擇性，不用如此合乎科學，希望副作用不要發生在自己的身上。有如此荒謬不合乎邏輯的事嗎？

老實的告訴你，縱然你所期望的治療效果不出現在你身上，那一大堆的副作用都必定會出現在你身上，分別是否明顯出現與否而已。因為這是人體所不需要的毒藥。

Nonsteroidal Anti-inflammatory Drugs

“Adverse Effects (副作用)The commonest adverse effects of NSAIDs are generally gastrointestinal disturbances, such as gastrointestinal discomfort (腸胃不適), nausea, and diarrhoea; these are usually mild and reversible but in some patient’s peptic ulceration and severe gastrointestinal bleeding may occur. It is generally agreed that inhibition of cyclo-oxygenase-1 (COX-1) plays an important role in the gastrointestinal effects of NSAIDs; the selective inhibition of COX-2 improves gastrointestinal tolerance.

CNS-related adverse effects (中樞神經副作用) include headache, vertigo, dizziness, nervousness, tinnitus, depression, drowsiness, and insomnia.

Hypersensitivity reactions (過敏性反應) may occur occasionally and include fever, angioedema, bronchospasm, and rashes. Hepatotoxicity (肝毒性) and aseptic meningitis(非感染性腦膜炎), which occur rarely, may also be hypersensitivity reactions. Some patients may experience visual disturbances.

Haematological adverse effects (血液副作用) of NSAIDs include anaemias(貧血), thrombocytopenia(血小板過少), neutropenia(中性白血球過少), eosinophilia, and agranulocytosis. Unlike aspirin, inhibition of platelet aggregation is reversible with other NSAIDs.

Some NSAIDs have been associated with nephrotoxicity (腎毒性) such as interstitial nephritis and nephrotic syndrome; renal failure(腎衰竭) may be provoked by NSAIDs especially in patients with pre-existing renal impairment. Haematuria (血尿) has also occurred. Long-term use or abuse of analgesics, including NSAIDs, has been associated with nephropathy(腎病變). Fluid retention (積液) may occur, rarely precipitating heart failure in susceptible patients. Other cardiovascular adverse effects(心血管副作用) of NSAIDs, including those selective for COX-2 inhibition, are discussed in detail below.

Other adverse effects include photosensitivity(光過敏). Alveolitis, pulmonary eosinophilia, pancreatitis(胰腺炎), Stevens-Johnson syndrome, and toxic epidermal necrolysis are other rare adverse effects. Induction or exacerbation of colitis(腸炎) has also been reported.” Martindale: The Complete Drug Reference 36th Ed.

對血液造成的副作用。

“Effects on the blood. The UK CSM has provided data on the reports it had received between July 1963 and January 1993 on agranulocytosis and neutropenia.1 Several groups of drugs were commonly implicated, among them NSAIDs for which there were 133 reports of agranulocytosis (45 fatal) and 187 of neutropenia (15 fatal). The most frequently implicated NSAID was phenylbutazone with 74 reports of agranulocytosis (39 fatal) and 40 of neutropenia (4 fatal).” Martindale: The Complete Drug Reference 36th Ed.

對骨胳造成的副作用。西醫只會叫你服食鈣片，服食止痛藥。看看今時今日市民的骨質如此差，是誰之過？

所有消炎止痛藥的作用就是抑制前列腺素(Prostaglandins)的製造。

“Effects on bone. Prostaglandins have been shown to play an important role in the bone-healing process and, consequently, the decrease in prostaglandin levels produced by NSAID use may impair the healing process.¹ Under experimental conditions, many NSAIDs including the cyclo-oxygenase-2 (COX-2) inhibitors have been shown to reduce healing.” Martindale: The Complete Drug Reference 36th Ed.

對心血管造成的副作用。可導致高血壓、心衰竭、血管栓塞。

“Effects on the cardiovascular system.

BLOOD PRESSURE. A meta-analysis1 of 50 randomised studies of the effects of NSAIDs on blood pressure in a total of 771 patients found that NSAIDs had elevated mean supine blood pressure by 5 mmHg.

HEART FAILURE. The recent use of NSAIDs has been associated with an increased risk of developing heart failure in elderly patients.¹

THROMBOTIC EVENTS. After the introduction of the selective cyclo-oxygenase-2 (COX-2) inhibitors, concerns arose that the risk of thrombotic events such as myocardial infarction and stroke might be increased in patients treated with these selective NSAIDs, and their safety was continuously reviewed by some regulatory bodies.” Martindale: The Complete Drug Reference 36th Ed.

對中樞神經造成的副作用。可導致頭痛、耳聾、耳鳴、抑鬱、失眠等等。

“Effects on the CNS. A literature review¹ revealed that headache, hearing loss, and tinnitus are the most frequent CNS adverse effects in patients taking NSAIDs. Aseptic meningitis had occurred rarely in patients using NSAIDs such as naproxen, sulindac, or tolmetin, but the most common reports were in patients with SLE who were receiving ibuprofen (see also p.64).” Martindale: The Complete Drug Reference 36th Ed.

對電解質造成的副作用。

“Effects on electrolytes. See Effects on the Kidneys, below” Martindale: The Complete Drug Reference 36th Ed.

對眼造成的副作用。

“Effects on the eyes. Ocular effects such as blurred vision occur rarely in patients taking NSAIDs. Other more serious effects on the eyes associated with NSAIDs also appear to be rare…. Ocular adverse effects have also been reported with the selective Cyclo-oxygenase-2 (COX-2) inhibitors.² There have been reports of severe corneal toxicity associated with the use of some topical NSAIDs, such as diclofenac and ketorolac, in the eye (see p.45).” Martindale: The Complete Drug Reference 36th Ed.

對女性生育造成的副作用。

這是一件十分諷刺的事實。現代城市有那麼多婦女不育，其中最重要的元兇就是它。西醫不斷的處方止痛藥給痛經的婦女，另一方面又給人做人工受孕；卻從不說給病人知道這止痛、消炎藥會導致人不育。因為他們自己也不知道。

“Effects on fertility. Reversible infertility has been reported in women on long-term NSAIDs.^1-3 Prostaglandins are considered to be involved in the processes of ovulation and it is thought that NSAIDs may compromise ovulation via inhibition of cyclo-oxygenase-2 (COX-2). Women trying to become pregnant may need to avoid treatment with NSAIDs.” Martindale: The Complete Drug Reference 36th Ed.

對腸胃造成的副作用。

“Effects on the gastrointestinal tract. NSAIDs can cause clinically important damage of the gastrointestinal tract, increasing the incidence of bleeding in the upper gastrointestinal tract and of perforation, although serious complications and death are relatively infrequent. They have also been associated with damage to the distal small intestine and colon.¹” Martindale: The Complete Drug Reference 36th Ed.

對腎臟造成的副作用。

“Effects on the kidneys. NSAIDs can produce renal disorders on systemic or topical use,¹ some of which are due to their inhibition of prostaglandin synthesis….

ACE inhibitors and angiotensin receptor antagonists can also produce renal impairment and combined use with NSAIDs should be undertaken with great care.^10,11 The Australian Adverse Drug Reactions Advisory Committee¹⁰ stated in August 2003 that over 50% of cases of renal failure reported to the committee were associated with use of NSAIDs, ACE inhibitors, or diuretics (alone or together); where all these were taken together the fatality rate for reported cases of renal failure was 10%. Prostaglandin inhibition may also lead to salt and water retention particularly when there is pre-existing hypertension or sodium depletion.⁴ NSAIDs, therefore, tend to counteract the action of diuretics and antihypertensives.^2,4 There have been isolated reports of severe hyponatraemia and other symptoms resembling the syndrome of inappropriate antidiuretic hormone secretion in patients taking NSAIDs.^12,13 Potassium homoeostasis is less dependent on prostaglandins and hyperkalaemia occurs infrequently with NSAIDs.³ It is more likely to occur in patients with specific risk factors such as those receiving potassium supplements or potassium-sparing diuretics. ³ Indometacin appears to be the main NSAID implicated.

NSAIDs may cause acute interstitial nephritis, perhaps involving an allergic response,^2,3,14 and it may progress to interstitial fibrosis or papillary necrosis.^3,15 Analgesic abuse or prolonged excessive use can produce nephropathy, a condition characterised by renal papillary necrosis and chronic interstitial nephritis, and, eventually, renal failure.¹⁶” Martindale: The Complete Drug Reference 36th Ed.

對肝臟造成的副作用。

“Effects on the liver. A retrospective study involving over 220 000 adults who were either using, or had used, NSAIDs identified a small excess risk of serious, acute non-infectious liver injury; in current users there was a twofold increase in risk and there was a predominance of the cholestatic type of liver injury among such patients.” Martindale: The Complete Drug Reference 36th Ed.

對肺臟造成的副作用。

“Effects on the lungs. Adverse pulmonary effects such as pneumonitis, alveolitis, pulmonary infiltrates, and pulmonary fibrosis, often suggestive of an allergic or immune reaction, have been reported with a number of NSAIDs.” Martindale: The Complete Drug Reference 36th Ed.

對胰臟造成的副作用。

“Effects on the pancreas. A review¹ of drug-induced pancreatitis considered that sulindac was amongst the drugs for which a definite association with pancreatitis had been established. There had been isolated reports of pancreatitis with ketoprofen, mefenamic acid, and piroxicam but any association was considered to be questionable. A more recent population-based, casecontrolled study found a substantial variation in the risk of pancreatitis between individual NSAIDs.² The increase in risk was highest for diclofenac and ketoprofen (adjusted odds ratios of 5.0 and 4.8, respectively), with indometacin and ibuprofen showing smaller but nonetheless significant increases (odds ratios of 3.6 and 1.5, respectively).” Martindale: The Complete Drug Reference 36th Ed.

對皮膚造成的副作用。

“Effects on the skin. The diverse cutaneous reactions to NSAIDs including those selective for cyclo-oxygenase-2 (COX-2) inhibition have been reviewed.¹” Martindale: The Complete Drug Reference 36th Ed.

“Hypersensitivity. NSAIDs have produced a wide range of hypersensitivity reactions in susceptible individuals; the most common include skin rashes, urticaria, rhinitis, angioedema, bronchoconstriction, and anaphylactic shock.” Martindale: The Complete Drug Reference 36th Ed.

“Overdosage. In general, symptoms of NSAID poisoning are mild, and usually include nausea and vomiting, headache, drowsiness, blurred vision, and dizziness. There have been isolated case reports of more serious toxicity, including seizures, hypotension, apnoea, coma, and renal failure, although usually after ingestion of substantial quantities. Seizures are a particular problem with mefenamic acid overdosage.” Martindale: The Complete Drug Reference 36th Ed.

西醫給予你甚麼的訊息？

不就是說中藥會傷肝、腎嗎？當歸會導致子宮肌瘤嗎？

其實，這些都是不合乎事實的數據，因為都是單味藥動物的數據；與現實中醫辨證論治用方劑應用在人身上是完全不相乎合。

然而，西藥有那麼多嚇人臨床的副作用，卻是隻字不提。為何？