Neumann N U
Fortschr Med. 1979 Apr 12;97(14):654-5, 657.
A very controversial debate, concerning the treatment of schizophrenic psychoses by means of hemodialysis, started approximately in 1977, when American scientists reported outstanding successes with this method. Until now there is no clear evidence of the underlying principle of effectiveness of this method. According to present experiences there are three theories. Already in 1960 there were reports of successful application of hemodialysis in acute schizophrenic psychoses. The authors, among other things, assumed the filtration of a toxic blood substance to be the therapeutic principle. Later, however, changes in the blood circulation during dialysis, especially the improvement of cerebral perfusion, were seen as the real therapeutic factor. The recently reported findings of abnormal endorphin in the dialysate fluid of schizophrenics, brought back the theory of detoxification. At the same time there were claims by different authors, that the positive results were only due to a "changed psychological situation" of the treated patients. Which of these three theories is correct can not be decided yet. Whether blood purification methods have anything to offer for the treatment of some types of schizophrenic diseases requires further research.
一场关于通过血液透析治疗精神分裂症性精神病的极具争议的辩论大约始于1977年，当时美国科学家报告了这种方法取得的显著成功。到目前为止，尚无明确证据证明该方法有效性的潜在原理。根据目前的经验，有三种理论。早在1960年就有关于血液透析成功应用于急性精神分裂症性精神病的报道。作者们认为，除其他外，血液中有毒物质的滤过是治疗原理。然而，后来透析过程中的血液循环变化，尤其是脑灌注的改善，被视为真正的治疗因素。最近报道的精神分裂症患者透析液中内啡肽异常的发现，使解毒理论再度兴起。与此同时，不同作者声称，积极结果仅仅是由于接受治疗的患者“心理状况改变”。这三种理论中哪一种正确尚无法确定。血液净化方法是否能为某些类型的精神分裂症疾病的治疗提供帮助，还需要进一步研究。
