评净凡皙《谈中医与数典忘祖》
--------------------------------------------------------------------------------
所有跟贴·加跟贴·新语丝读书论坛
--------------------------------------------------------------------------------
送交者: qubo 于 2007-07-09, 08:41:43:
净凡皙批评中医“数典忘祖”，举了两个例子。实际上都站不住脚，不能服人。
一、青蒿和青蒿素
净凡皙认为，中药青蒿炖服完全失去了药用价值。而且青蒿素在水中溶解度低，口服剂在胃肠里易被分解，根本没有疗效。无论是汤法，或是浸法都没有疗效。这段还引用文献，看似有根有据。2005年中国药典中介绍青蒿素“在水中几乎不溶，在冰醋酸中易溶”、“熔点为 150～153℃”、检测方法为“取本品，在80℃干燥至恒重，减失重量不得过 0.5％”。可见，所谓“到60度，分子结构破坏，基本失去药效”的说法是不对的。
青蒿素的确难溶于水，但在胃肠道酸性环境下可溶。事实上青蒿素制剂有多种，即有注射的针剂，也有口服的片剂和直肠给药的栓剂。认为口服没有疗效是错误的。
对中药青蒿汤的疗效，估计有很多国内文献证明有效，但一时查不到。非洲的研究发现48位疟疾患者服药后4天内有44位疟原虫血症消失，症状明显改善。德国图宾根大学的Heide也发现，服用青蒿汤后青蒿素的血药浓度能达到治疗效果，随机双盲试验表明7天用药后治愈率达74%（奎宁为91%）。但易复发，因此推荐合并用药。
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.
--------------------------------------------------------------------------------
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.
--------------------------------------------------------------------------------
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、辨症和辩证
净凡皙说，“上世纪50年代中医们为了迎合统治者的治国哲学擅自将“辨症”改成“辩证”，就这样“辩证”成了中医的终极理论。中医们擅自修改中医立足的基本理论，这样毫无严谨治学的原则，毫无学术道德的行为实在让人不齿”。
首先要说的是，此处“辩证”中的“辩”是个错别字，应为“辨”。何祚庥老先生曾说中医很不光彩、冒充科学，就是把“辨证施治”偷偷改成“辩证施治”，实际上是他老人家的误解。中医正规教材里都写为“辨”。所谓“辩证”，不是偷改，而是少数人的误用。
这一段也说明净凡皙根本就不了解中医。中医“辨证”的说法古已有之，不是到50年代才有。张仲景的《伤寒杂病论》中有大量章节题为“辨某某证”，如“辨太阳病脉证”、“辨太阴病脉证”。“辨”为动词，“证”为名词，与“唯物辩证法”中的“辨证”（都是动词）根本就不是一个意思。著名反中医人士余云岫在《我国医学革命之破坏与建设》中也通篇都是用“证”而非“症”，如“虽药不对证，或仅授以汤水之类，亦能愈病”、“不知诊断疾病、认识证候之道途”、“小儿瘰疬，即属此证”，等等。
事实上，中医既有“辨症”，也有“辨证”，还有“辨病”。按中医界的说法，所谓“病”，是对某疾病全过程的特点与规律所作的病理性概括；“证”，系机体在疾病发展过程中的某现阶段的病理性概括，是对疾病当前本质所作的判断；“症”，即“症状”的简称，包括自觉的症状与他觉的体征，是机体有了病变所具体表现的现象，是诊病、辨证的主要依据。净凡皙对中医的评论，是把自己对中医的无知强加于中医的意淫，这种“毫无严谨治学的原则，毫无学术道德的行为实在让人不齿”。
可笑的是，净凡皙匿名发文，不知是从哪冒出来的一个网名，偏偏脱裤子放屁，煞有介事地在署名后加上“文责自负”。出了文责，找谁负？怎么负？
