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糖的隐藏力量:替代抗生素治愈伤口

更新时间:2018-4-18 21:16:39 来源:纽约时报中文网 作者:佚名

The hidden healing power of sugar
糖的隐藏力量:替代抗生素治愈伤口

As a child growing up in poverty in the rural Eastern Highlands of Zimbabwe, Moses Murandu was used to having salt literally rubbed in his wounds when he fell and cut himself. On lucky days, though, his father had enough money to buy something which stung the boy much less than salt: sugar.

在津巴布韦东部高地农村地区长大的穷孩子穆兰多(Moses Murandu),从小习惯摔跤受伤或有割伤时,用盐来擦拭创面。不过有时走运的话,他父亲多花些钱能买对伤口刺激小得多的东西——糖。

Murandu always noticed that sugar seemed to help heal wounds more quickly than no treatment at all. So he was surprised when, having been recruited to come to work as a nurse for the UK’s National Health System (NHS) in 1997, he found that sugar wasn’t being used in any official capacity. He decided to try to change that.

穆兰多一直留意到,伤口上用糖时比什么都不用时愈合得较快。因此,1997年当他受雇在英国国民医疗服务体系(NHS)机构当护理师时,他很惊讶糖并没有被用作任何官方医疗手段,他有了改变这一现状的念头。

Now, Murandu’s idea finally is being taken seriously. A senior lecturer in adult nursing at the University of Wolverhampton, Murandu completed an initial pilot study focussed on sugar’s applications in wound healing and won an award from the Journal of Wound Care in March 2018 for his work.

如今,穆兰多的想法终于受到到重视了。穆兰多现是伍尔弗汉普顿大学(University of Wolverhampton)成人护理系的高级讲师,他完成了一项初步试验性研究。该研究主要聚焦于糖在伤口愈合中的应用,并在2018年3月获得了《伤口护理杂志》(Journal of Wound Care)的奖项。

In some parts of the world, this procedure could be key because people cannot afford antibiotics. But there is interest in the UK, too, since once a wound is infected, it sometimes won’t respond to antibiotics.

在世界上一些地方,这种治疗手段可能非常关键,因为那儿很多人买不起抗生素。在英国,这种方法也同样引发了关注。因为一旦伤口感染,抗生素有时并不起作用。

To treat a wound with sugar, all you do, Murandu says, is pour the sugar on the wound and apply a bandage on top. The granules soak up any moisture that allows bacteria to thrive. Without the bacteria, the wound heals more quickly.

穆兰多说,用糖来治疗伤口就是把糖洒在伤口上,再缠上绷带。糖分颗粒会吸走伤口上的水分,而细菌需要水分才能繁殖。没有了细菌,伤口便能更快愈合。

Evidence for all of this was found in Murandu’s trials in the lab. And a growing collection of case studies from around the world has supported Murandu’s findings, including examples of successful sugar treatments on wounds containing bacteria resistant to antibiotics. Even so, Murandu faces an uphill battle. Funding for further research would help him reach his ultimate goal – to convince the NHS to use sugar as an alternative to antibiotics. But a great deal of medical research is funded by pharmaceutical companies. And these companies, he points out, have little to gain from paying for research into something they can’t patent.

穆兰多在实验室的研究为此提供了依据,而越来越多来自全球各地的案例研究也支持他的发现,其中也包括许多用糖治愈抗生素耐药性伤口的成功案例。即便如此,穆兰多仍面临着艰巨的挑战——获得后续研究的资金支持以实现终极目标,说服英国国民医疗服务体系使用糖作为抗生素的替代方案。然而,大部分的医学研究由制药公司提供赞助。穆兰多认为,这些公司通常不会赞助他们无法获得药物专利权的研究,因为无利可图。

The sugar Murandu uses is the plain, granulated type you might use to sweeten your tea. In the same in vitro trials, he found that there was no difference between using cane or beet sugar. Demerara, however, wasn’t as effective.

穆兰多的研究中所使用的糖就是最普通的颗粒状砂糖,人们日常喝茶调味的那种。他也发现,体外试验时使用甘蔗糖或甜菜糖,本质上差别不大,而使用金砂糖(红糖的一种)效用则不显著。

The pilot showed that strains of bacteria grew in low concentrations of sugar but were completely inhibited in higher concentrations. Murandu started recording case studies in Zimbabwe, Botswana, and Lesotho (where he first trained in nursing). Included among them is a woman living in Harare.

实验性研究表明,菌株可以在低纯度糖环境中繁殖,但高纯度糖会抑制菌株生长。穆兰多记录了在津巴布韦、博兹瓦讷、莱索托(他最初接受护理训练的地方)等国家的多个临床案例。其中的一个案例中,患者是一名住在哈拉雷(津巴布韦首都)的女性。

“The woman’s foot had been measured, ready to be amputated, when my nephew called me,” Murandu says. “She had had a terrible wound for five years, and the doctor wanted to amputate. I told her to wash the wound, apply sugar, leave it and repeat.

他介绍说,“我外甥给我打电话时,这位女患者已经做了残端测量,要进行截肢手术了。她的伤口非常严重,长达五年之久。医生建议截肢。我指导她先清洗伤口,然后在上面敷糖,留置一段时间,再重复。”

“The woman still has her leg.”

“这名患者的腿最终保住了。”

This, he says, is one example of why there is so much interest in his methods, particularly from parts of the world where people can’t afford antibiotics.

他说,这个案例也反映出为何“糖疗法”会在很多地方备受关注,特别是一些人们买不起抗生素的国家和地区。

In total, Murandu has now carried out clinical studies on 41 patients in the UK. He hasn’t yet published the trial results but has presented them at national and international conferences. One question he had to answer during his research was whether sugar could be used on diabetic patients, who commonly have leg and foot ulcers. Diabetics need to control the level of glucose in their blood so this isn’t an obvious healing method to use on them.

穆兰多在英国地区共开展了41宗临床案例研究。目前他还没发表试验结果,但已在一些英国或国际会议上做了相关分享。研究中,他无法规避的一个问题是,这种"糖疗法"是否也适用于糖尿病患者?糖尿病患者常患有腿部或足部溃烂,但他们又需要控制血糖值。表面上看,这种方法对糖尿病患者并不适用。

But he found that it worked for diabetics without sending their glucose levels soaring. “Sugar is sucrose – you need the enzyme sucrase to convert that into glucose,” he says. As sucrase is found within the body, it is only when the sugar is absorbed that it is converted. Applying it to the outside of the wound isn’t going to affect it in the same way.

但穆兰多发现,糖尿病患者也可以使用"糖疗法"且血糖水平不会升高。他说,“治疗中使用的糖是蔗糖(一种双糖),在酶的催化才会转化为葡萄糖(单糖)。”而蔗糖酶是人体体内才有的,糖被人体吸收后才会转化。将糖外用在伤口上,并不会产生同样的转化。

While Murandu continues his research on human patients, across the Atlantic US veterinarian Maureen McMichael has been using this healing method on animals for years.

穆兰多在英国继续其人类患者临床试验之时,在大西洋彼岸的美国一位兽医麦克迈克尔(Maureen McMichael)已用这种方法治疗动物好多年。

McMichael, who works at the University of Illinois Veterinary Teaching Hospital, first started using both sugar and honey on pets back in 2002. She said it was a combination of the simplicity of the method and the low cost that attracted her – especially for pet owners who couldn’t afford the usual methods of bringing the animal to the hospital and using sedation.

在伊利诺大学兽医学院附属医院工作的麦克迈克尔,于2002年首次在动物伤口上使用糖和蜂蜜。她说,这种疗法方法简单且价格低廉。对于付不起常规治疗方法的诊疗费与镇定剂等药物费用的宠物主人,非常有吸引力。

McMichael says that they keep both sugar and honey in their surgery and often used it on dogs and cats (and occasionally on farm animals). Honey has similar healing properties to sugar (one study found it to be even more effective at inhibiting bacterial growth), though it is more expensive.

麦克迈克尔谈到,他们一直在手术中使用糖和蜂蜜,经常用于猫、狗等宠物的治疗,偶尔也以此治疗农场牲畜。蜂蜜的治愈效用与糖相似。有一项研究表明蜂蜜比糖更能抑制伤口细菌繁殖,只是蜂蜜价格较贵。

“We have had some really great successes with this,” McMichael says. She gave an example of a stray dog that had come to them after being used as “pitbull bait”, hung from a harness and attacked by pitbulls being trained for fighting. The dog came in with up to 40 bite wounds on each limb – and was healed within eight weeks.

麦克迈克尔介绍道,“这种疗法的成功案例非常之多!”其中一个临床案例是一条被治愈的流浪狗。它是一种训练比特斗牛犬的诱饵犬,身子被吊起来,让一只受训的比特斗牛犬攻击。它被送来时,每条腿上多达四十处咬伤,但八周后它就痊愈了。

“She was a stray so there was no money for her. We treated her with both honey and sugar and she did fabulously,” McMichael says. “She’s all healed now.”

麦克迈克尔说: “因为它是一只流浪狗,没有主人付钱治疗。我们用蜂蜜和糖帮它敷伤口,它的恢复能力惊人,现在都已经痊愈了。”

As well as being cheaper, sugar has another upside: as more and more antibiotics are used, we are becoming resistant to them.

除了价格低廉外,“糖疗法”区别于抗生素治疗的另一个好处是,使用抗生素次数越多,人体产生的抗药性越强。

Back in the UK, tissue engineering specialist Sheila MacNeil of the University of Sheffeld has researched how naturally occurring sugars can be used to stimulate the re-growth of blood vessels. Her research stemmed from from her work on tumours, when she noticed that one particular small sugar derived from the breakdown of DNA (2-deoxy-D-ribose) kept cropping up. MacNeil’s team experimented by applying this sugar to the membrane surrounding chick embryos. According to MacNeil, the sugar stimulated double the number of blood vessels than would grow without it.

麦克尼尔(Sheila MacNeil)是英国谢菲尔德大学的一名人体组织工程学的专家。她的研究方向之一是人体自然产生的糖分如何促进血管再生。这个研究来自于她对肿瘤的研究。她发现某种从DNA分解提取出来的特殊糖分(2-脱氧-d-核糖)会不断再生。据麦克尼尔发现,团队实验人员将这种单糖放置于鸡胚胎薄膜中,它促进了血管细胞的再生,细胞数量比没有糖分的对照组要高出一倍。

But of course these types of naturally occurring sugars found in our bodies are a long way from the type of everyday sugar used by Murandu in his experiments. The “dream ticket”, MacNeil says, would be to find a sugar that could be used in both ways. She believes this is the next step research should take.

当然,我们身体中自然产生的这些糖与穆兰多研究中日常使用的糖的类型完全不同。麦克尼尔说,“最理想的结果”当然是能够找到一种既能治愈伤口又能促进细胞再生的糖。她认为这是下一步研究的目标。

Meanwhile in Wolverhampton, Murandu’s plan is to set up a private clinic using his sugar method. He hopes that one day sugar will be commonly used, not only by the NHS but also at public hospitals in some of the other countries where he has been working. He continues to get regular emails from around the world, asking for his advice – and guides patients remotely over email and texting. His far-away clients send him photos of their results along with their gratitude when they are healed.

目前在伍尔弗汉普顿大学的穆兰多计划开一家使用这种“糖疗法”的私人诊所。他希望未来糖作为伤口愈合剂不仅在英国国民医疗服务体系的机构里广泛使用,在他工作过的其他一些国家的公立医院也能得到应用。如今的他常常收到来自世界各地的邮件,征求诊疗意见。他也会通过邮件或短信的形式远程指导患者。远在其他地区的患者会在痊愈后发来疗愈的照片,并对他表示感激之情。

It is an ancient method and one used unofficially by many poor people in developing countries, but for Murandu it was only by coming to the UK that he realised the significance sugar could have in the medical world. He sees it as a blending of his local knowledge with the modern research facilities in Britain.

用糖治愈伤口是一种古老的疗法,也是许多发展中国家穷人非正式使用的方法。但对穆兰多来说,他到了英国才意识到糖在医学界的意义。他把这视作是他将故乡津巴布韦的“土智慧”与英国现代研究设施的一种结合。

“Like sugar, the knowledge came raw from Zimbabwe, was refined here – and is now going back to help people in Africa,” he says.

他说,“就像糖一样,这些知识是原在津巴布韦土生土长,但在英国‘提纯’,再回到非洲去帮助那里的人们。”

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