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脱氢表雄酮联合维生素C输注治疗在慢性疲劳综合征(CFS)临床控制中的价值。II. 以对新型维生素C输注治疗的反应为特别参考对CFS患者的特征描述

The value of the dehydroepiandrosterone-annexed vitamin C infusion treatment in the clinical control of chronic fatigue syndrome (CFS). II. Characterization of CFS patients with special reference to their response to a new vitamin C infusion treatment.

作者信息

Kodama M, Kodama T, Murakami M

机构信息

Kodama Research Institute of Preventive Medicine, Nagoya, Japan.

出版信息

In Vivo. 1996 Nov-Dec;10(6):585-96.

PMID:8986468
Abstract

This study is a counterpart of the pilot study on the clinical management of chronic fatigue syndrome (CFS) by the combined use of the old (annex-free) and the new (dehydro-epiandrosterone- annexed) vitamin C infusion treatments with and without oral intake of erythromycin and chloramphenicol. We were motivated to start this clinical study by 2 reasons: i) we have made a success in the clinical management of autoimmune disease and allergy by use of the old megadose vitamin C infusion treatment, and we therefore took up CFS as a good candidate for vitamin C infusion treatment; ii) In 1995, we received a total of 313 chronic pneumonia patients whose clinical course showed a good fitness to the criteria of CFS. We assessed the nature of the disease by investigating the clinicoepidemiological aspect of our patients on the one hand and the response of the disease to both the old and new vitamin C infusion treatments with and without the use of 2 antibiotics on the other hand. Results are summarized as follows: a) the analysis of the medical records of our outpatients revealed that chronic type pneumonia epidemic in Nagoya Japan, with its onset of January 1995, showed no sign of its extinction by the end of May 1996. The patient population contained no patients under 15 years of age, and showed a distinct female predominance in the patient number (207 females versus 106 males). In 1995, we also experienced a simple cold epidemic with its onset of January 1995 (162 males and 224 females). The majority of simple cold patients were under 25 years of age in both sexes. b) A chronic type pneumonia patient was distinguished from a simple cold patient in 2 respects: firstly the former required prolonged medical care (over 1 month) resulting in an incomplete cure and return to medical care upon the recurrence of disease, whereas the latter required short-term medical care (mostly within 1 week) ending up with complete cure. Secondly, the former required the long term use of 2 antibiotics (erythromycin and chloramphenicol) together with regular practice of the old and new vitamin C infusion treatments for disease control, whereas the latter recovered from the disease after the short time use of a set of conventional cold remedies. c) The clinical manifestations of our chronic pneumonia patients showed good fitness to the criteria of CFS. d) CFS was distinguished from autoimmune disease-allergy complex by the method of clinical control: the former required the long-term use of 2 antibiotics together with regular practice of the old and new vitamin C infusion treatments, whereas the latter was controllable by the single use of the old vitamin C infusion treatment. e) The combined use of the old and new vitamin C infusion treatments rather than the single use of the old vitamin C infusion treatment was more effective for the control of CFS-a finding which suggests that deficient activities of both endogenous glucocorticoid and endogenous androgen in a CFS patient are somehow related to the genesis and further development of CFS. f) Evidence was available to indicate that the sole use of the new vitamin C infusion treatment may induce a state of gonadal steroid excess together with various other problems in the recipient. The maintenance of a good balance between the old vitamin C infusion set (glucocorticoid-inducer) and the new vitamin C infusion set (inducer of both glucocorticoid and gonadal steroids) in their use was of prime importance for the successful control of CFS. g) The historical significance of CFS epidemic in 1995, and in Nagoya-Japan, is discussed in the light of the new infection concept.

摘要

本研究是一项对照研究,涉及通过联合使用旧的(无附件)和新的(脱氢表雄酮附加型)维生素C静脉输注疗法,并搭配或不搭配口服红霉素和氯霉素,对慢性疲劳综合征(CFS)进行临床管理。开展这项临床研究有两个动机:其一,我们通过使用旧的大剂量维生素C静脉输注疗法,成功实现了自身免疫性疾病和过敏症的临床管理,因此将CFS视为维生素C静脉输注疗法的理想候选病症;其二,1995年,我们共接收了313例慢性肺炎患者,其临床病程与CFS的标准高度契合。我们一方面通过调查患者的临床流行病学情况来评估疾病的性质,另一方面研究疾病对旧的和新的维生素C静脉输注疗法(搭配或不使用两种抗生素)的反应。结果总结如下:a)对我们门诊患者病历的分析显示,日本名古屋1995年1月开始的慢性肺炎流行,到1996年5月底仍未消退。患者群体中没有15岁以下的患者,且女性患者数量明显占优(207名女性对106名男性)。1995年,我们还经历了一场始于1995年1月的普通感冒流行(162名男性和224名女性)。大多数普通感冒患者在两个性别中均为25岁以下。b)慢性肺炎患者与普通感冒患者在两个方面有所区别:首先,前者需要长期医疗护理(超过1个月),导致治愈不完全,疾病复发时需再次就医,而后者需要短期医疗护理(大多在1周内),最终完全治愈。其次,前者需要长期使用两种抗生素(红霉素和氯霉素),并定期进行旧的和新的维生素C静脉输注疗法以控制疾病,而后者在短期使用一套传统感冒药后即可康复。c)我们慢性肺炎患者的临床表现与CFS的标准高度契合。d)通过临床对照方法,CFS与自身免疫性疾病 - 过敏复合物相区分:前者需要长期使用两种抗生素,并定期进行旧的和新的维生素C静脉输注疗法,而后者通过单独使用旧的维生素C静脉输注疗法即可控制。e)联合使用旧的和新的维生素C静脉输注疗法比单独使用旧的维生素C静脉输注疗法对控制CFS更有效——这一发现表明,CFS患者体内内源性糖皮质激素和内源性雄激素的活性不足与CFS的发生和进一步发展存在某种关联。f)有证据表明,单独使用新的维生素C静脉输注疗法可能会在接受者体内引发性腺类固醇过量状态以及各种其他问题。在使用中保持旧的维生素C静脉输注组合(糖皮质激素诱导剂)和新的维生素C静脉输注组合(糖皮质激素和性腺类固醇诱导剂)之间的良好平衡对于成功控制CFS至关重要。g)根据新的感染概念,讨论了1995年在日本名古屋发生的CFS流行的历史意义。

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