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低剂量纳曲酮疗法有效吗?
最近有一个鲜为人知的药物被美国大电视台报道可能治疗癌症，国外有的网上也有热议。这个疗法叫做LDN，其中的N代表Naltrexone（纳曲酮），是美国1984年就批准的解毒药品，解毒使用剂量比较高。现在有人用低剂量治癌，而且有报道说效果不错。我没有直接经验，没有资格评论，只是咱们内部介绍一下有关信息。
纳曲酮不是新药
1984年美国FDA就批准用它治疗酒精、海落英和阿片瘾。近年发现它可以治疗多发硬化症（multiple sclerosis）。这个疾病的症状包括四肢无力甚至瘫痪，视力恶化甚至失明，非常难治。现在，它被继续推广到治疗艾滋病和癌症。因为是处方药，有记录可查，从2000年以来，已经开方25000份。
纳曲酮的化学结构与吗啡相似，但它对吗啡中毒者却有一种翻转作用。这个作用与剂量关系密切。如果只注射（肌肉或者静脉）0.4-0.8mg，会翻转吗啡的毒性。一种解释是它与吗啡竞争同一个受体，微量时对四型阿片受体发生抗拮。不论解释如何，现在用它在临床上对吗啡类镇痛药急性中毒进行解毒，解救呼吸抑制和其他神经中枢抑制，包括昏迷。
治疗癌症的机制解释
美国医生Dr. Bihari从1999年起用纳曲酮治疗了450位用标准治疗无效的癌症病人。他跟踪354人，报告说有86人的肿瘤缩小75%以上， 125 人病情稳定改善，总有效率60%。
它的药理主要有两个。一个是通过引起免疫系统的NK细胞数量激增，抑制和消灭癌细胞；一个是通过刺激Beta-内啡肽诱导癌细胞凋亡。
它的优点是没有一般化疗药物常见的副作用，如恶心、呕吐、脱发、乏力、口角炎和胃肠道吸收问题。因此有人建议有癌症风险的人用它预防癌症。（注：药厂的说明书介绍的副作用是指比这个低剂量疗法高几十倍时可能产生的，不适合本题）。
癌症病人自疗剂量
剂量是焦点。治疗癌症的建议剂量是4.5mg，确实低剂量。在美国有几家供应商专门提供低剂量的纳曲酮，所以比较方便癌症病人自疗。国内虽然纳曲酮不是什么稀缺药品，但是还没有用它治疗癌症的任何尝试。
需要更多科研支持
这个纳曲酮治疗酒精、海落英、阿片瘾，有FDA批准。现在扩展到治疗MS(多发硬化症)，也有较好的案例资料。进一步扩展到癌症和艾滋病，是新的课题。虽然低剂量纳曲酮国际会议在今年是第四届，但肿瘤学界的科研工作仍然落后。也许原因之一是这个药品太便宜，大约1天1美元，缺乏专利保护，难以获得药厂的支持。
目前科研论文进展到证明纳曲酮可以增加免疫系统的NK, CD4等可以杀灭癌细胞的保卫细胞，提升b-内啡肽（可诱发癌细胞凋亡）水平，研究者包括北卡洛来纳大学等的科学家。但是目前还没有比较可观的随机对照临床实验报告。
==== 汉译英 ====
Recently, a little-known drugs are major U.S. television reports may be the treatment of cancer, and some foreign countries also have hot-line discussion. This treatment is called LDN, where N on behalf of Naltrexone (naltrexone) is approved by the United States in 1984 on drug detoxification, detoxification using high doses. Now, some people with low-dose cancer, but it was reported that its effectiveness. I have no direct experience, not qualified to comment, but let's look at information within the description.
Naltrexone is not a new drug
In 1984 the U.S. FDA granted approval to use it to treat alcohol, sea Laying and opium addiction. In recent years, found that it can treat multiple sclerosis (multiple sclerosis). The disease symptoms include limb weakness or paralysis, vision deterioration, or even blindness, very difficult to treat. Now, it continue to be extended to treat AIDS and cancer. Because it is prescription drugs, there are records to be investigated, since 2000, 25,000 copies have been prescribing.
Of naltrexone and morphine chemical structure similar to morphine poisoning but it there is a flip effect. The role of the close relationship with the dose. If only the injection (muscle or a vein) 0.4-0.8mg, will flip the toxicity of morphine. One explanation is that it morphine competing for the same receptor, when four types of micro-opioid receptor antagonistic resistance occurs. Regardless of the explanation, it is now in clinical use it on morphine analgesic for acute poisoning detoxification, rescue respiratory depression and other central nervous inhibition, including coma.
Mechanism to explain the treatment of cancer
American doctor Dr. Bihari put into operation in 1999 naltrexone treatment of 450 with the standard treatment ineffective cancer patients. He tracked 354 people, the report said, 86 people more than 75% tumor shrinkage, 125 were in stable condition improved, the total effective rate 60%.
It has two main pharmacological. One is by causing the immune system, NK cells proliferation, suppression and eradication of cancer cells; one by stimulating Beta-endorphin-induced apoptosis in cancer cells.
The advantage is that no general common side effects of chemotherapy drugs, such as nausea, vomiting, hair loss, fatigue, and gastrointestinal absorption of angular cheilitis the problem. Therefore, it was suggested that a cancer risk of people use it to prevent cancer. (Note: the instructions described in pharmaceutical side effect is lower than that of high-dose therapy may arise several times, and not suitable for this question).
Self-treatment dose for cancer patients
Dose is the focus. The recommended dose of the treatment of cancer is 4.5mg, really low dose. Several suppliers in the United States dedicated to low-dose naltrexone, so easier to cure cancer patients. Domestic although naltrexone is not a scarcity of drugs, but it is not useful in any attempt to treat cancer.
Need for more research to support
The naltrexone treatment of alcohol, sea Laying, opioid addiction, there are FDA approved. Now be extended to treat MS (multiple sclerosis), also has good information on the case. Further extended to cancer and AIDS is a new task. Although the low-dose naltrexone, an international conference is the fourth this year, but the tumors are still lagging behind the research work of academics. One reason is that this drug may be too cheap, about 1 day 1 U.S. dollars, the lack of patent protection, lack of access to pharmaceutical companies for their support.
The current progress of research papers to permit Minna naltrexone can increase the immune system, NK, CD4, etc., may kill cancer cells in guard cells, to enhance b-endorphin (which can induce apoptosis in cancer cells) levels, researchers including the North Caro to na University scientists. However, there is no more significant report on randomized controlled clinical trials.
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发表于 2012-11-29 20:56:50
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