評淨凡皙《談中醫與數典忘祖》
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所有跟貼·加跟貼·新語絲讀書論壇
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送交者: qubo 於 2007-07-09, 08:41:43:
淨凡皙批評中醫“數典忘祖”，舉了兩個例子。實際上都站不住腳，不能服人。
一、青蒿和青蒿素
淨凡皙認為，中藥青蒿燉服完全失去了藥用價值。而且青蒿素在水中溶解度低，口服劑在胃腸里易被分解，根本沒有療效。無論是湯法，或是浸法都沒有療效。這段還引用文獻，看似有根有據。2005年中國藥典中介紹青蒿素“在水中幾乎不溶，在冰醋酸中易溶”、“熔點為 150～153℃”、檢測方法為“取本品，在80℃乾燥至恆重，減失重量不得過 0.5％”。可見，所謂“到60度，分子結構破壞，基本失去藥效”的說法是不對的。
青蒿素的確難溶於水，但在胃腸道酸性環境下可溶。事實上青蒿素製劑有多種，即有注射的針劑，也有口服的片劑和直腸給藥的栓劑。認為口服沒有療效是錯誤的。
對中藥青蒿湯的療效，估計有很多國內文獻證明有效，但一時查不到。非洲的研究發現48位瘧疾患者服藥後4天內有44位瘧原蟲血症消失，症狀明顯改善。德國圖賓根大學的Heide也發現，服用青蒿湯後青蒿素的血藥濃度能達到治療效果，隨機雙盲試驗表明7天用藥後治癒率達74%（奎寧為91%）。但易復發，因此推薦合併用藥。
Trans R Soc Trop Med Hyg. 2004 May;98(5):318-21. Randomized controlled trial of a traditional reparation of Artemisia annua L. (Annual Wormwood) in the treatment of malaria. Mueller MS, Runyambo N, Wagner I, Borrmann S, Dietz K, Heide L.
German Institute for Medical Mission, P.O. Box 1307, 72003 Tübingen, Germany. heide@uni-tuebingen.de
The Chinese medicinal plant Artemisia annua L. (Annual Wormwood) contains the antimalarial compound Artemisinin. The locally grown herb may offer an additional tool for the control of malaria, especially in poor countries where modern antimalarial drugs are often unavailable. In an open, randomized, controlled pilot trial, we investigated the efficacy and safety of
traditional tea preparations of Artemisia annua in the treatment of uncomplicated malaria. Treatment resulted in a quick resolution of parasitaemia and of clinical symptoms. After 7 d of medication, cure rates were on average 74% for the Artemisia preparations compared with 91% for quinine. However, recrudescence rates were high in the Artemisia groups. Therefore, monotherapy with Artemisia annua L. cannot be recommended as alternative to modern antimalarials, but may deserve
further investigation.
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Am J Trop Med Hyg. 2004 Feb;70(2):128-32.
Pharmacokinetic study of artemisinin after oral intake of a traditional preparation of Artemisia annua L. (annual wormwood).
Räth K, Taxis K, Walz G, Gleiter CH, Li SM, Heide L.
Pharmazeutische Biologie, Pharmazeutisches Institut, Universität Tübingen, Tübingen, Germany.
Artemisia annua L. (annual wormwood) contains the antimalarial artemisinin. Aqueous preparations of the dried herb are included in the pharmacopoeia of the People's Republic of China for treatment of fever and malaria. Fourteen healthy male volunteers received one liter of tea prepared from nine grams of Artemisia annua leaves. Blood samples were taken and artemisinin was detected by reversed phase high-perxxxxance liquid chromatography. The mean +/- SD maximum plasma concentration of artemisinin was 240 +/- 75 ng/mL and the mean +/- SD area under the plasma concentration-time curve was 336 +/- 71 ng/mL x hr. Artemisinin was absorbed faster from herbal tea preparations than from oral solid dosage xxxxs, but bioavailability was similar. One liter of an aqueous preparation of nine grams of Artemisia annua contained 94.5 milligrams of artemisinin (approximately 19% of the usually recommended daily dose). Artemisinin plasma concentrations after intake of this herbal tea are sufficient for clinical effects, but insufficient to recommend such preparations as equivalent substitutes for modern artemisinin drugs in malaria therapy.
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13: J Ethnopharmacol. 2000 Dec;73(3):487-93.
The potential of Artemisia annua L. as a locally produced remedy for malaria in the tropics: agricultural, chemical and clinical aspects. Mueller MS, Karhagomba IB, Hirt HM, Wemakor E.
Hopital Nebobongo, Nebobongo, Congo.
The plant Artemisia annua L. (Asteraceae) is listed in the Chinese pharmacopoeia as a remedy for various fevers including malaria, and contains the well-established antimalarial compound artemisinin. In this study, a hybrid xxxx of A. annua was successfully cultivated in Central Africa. The aerial parts of the plant contained 0.63-0.70% artemisinin per dry weight, and approximately 40% of this artemisinin could be extracted by simple tea preparation methods. Five malaria patients who were treated with A. annua tea showed a rapid disappearance of parasitaemia within 2-4 days. An additional trial with 48 malaria patients showed a disappearance of parasitaemia in 44 patients (92%) within 4 days. Both trials showed a marked improvement of symptoms. In our opinion, these results justify further examinations of the antimalarial effect of A. annua preparations.
二、辨症和辯證
淨凡皙說，“上世紀50年代中醫們為了迎合統治者的治國哲學擅自將“辨症”改成“辯證”，就這樣“辯證”成了中醫的終極理論。中醫們擅自修改中醫立足的基本理論，這樣毫無嚴謹治學的原則，毫無學術道德的行為實在讓人不齒”。
首先要說的是，此處“辯證”中的“辯”是個錯別字，應為“辨”。何祚庥老先生曾說中醫很不光彩、冒充科學，就是把“辨證施治”偷偷改成“辯證施治”，實際上是他老人家的誤解。中醫正規教材里都寫為“辨”。所謂“辯證”，不是偷改，而是少數人的誤用。
這一段也說明淨凡皙根本就不了解中醫。中醫“辨證”的說法古已有之，不是到50年代才有。張仲景的《傷寒雜病論》中有大量章節題為“辨某某證”，如“辨太陽病脈證”、“辨太陰病脈證”。“辨”為動詞，“證”為名詞，與“唯物辯證法”中的“辨證”（都是動詞）根本就不是一個意思。著名反中醫人士余雲岫在《我國醫學革命之破壞與建設》中也通篇都是用“證”而非“症”，如“雖藥不對證，或僅授以湯水之類，亦能愈病”、“不知診斷疾病、認識證候之道途”、“小兒瘰癧，即屬此證”，等等。
事實上，中醫既有“辨症”，也有“辨證”，還有“辨病”。按中醫界的說法，所謂“病”，是對某疾病全過程的特點與規律所作的病理性概括；“證”，系機體在疾病發展過程中的某現階段的病理性概括，是對疾病當前本質所作的判斷；“症”，即“症狀”的簡稱，包括自覺的症狀與他覺的體徵，是機體有了病變所具體表現的現象，是診病、辨證的主要依據。淨凡皙對中醫的評論，是把自己對中醫的無知強加於中醫的意淫，這種“毫無嚴謹治學的原則，毫無學術道德的行為實在讓人不齒”。
可笑的是，淨凡皙匿名發文，不知是從哪冒出來的一個網名，偏偏脫褲子放屁，煞有介事地在署名後加上“文責自負”。出了文責，找誰負？怎麼負？
