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神奇的自然医生

时间:2011-01-11 19:12 点击:
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用蛆虫吃掉腐肉和水蛭来吸血可能被看成是很原始的治疗方式,但是却能最有效的治疗伤口,很少有其他治疗方法能够和这种经过2亿年的自然进化而来的方式相比。

今天,英国科学研究小组发布他们的研究结果,支持在高科技医疗保健领域使用蛆虫。他们发现,与常规治疗相比,把蛆虫放在伤口上,能够使伤口愈合速度加快五倍。

在一次考察蛆虫治疗伤口的临床效果的实验中发现,用幼蛆治疗腿部溃疡和用通常使用的水基药物治疗的效果一样快。这项研究还发现用幼蛆来做清创术,让它们吃掉死亡的组织,远远比普通清创术快。因此,建议在紧急手术如肢体嫁接手术中使用幼蛆来清洁创口。

在显微外科手术中,水蛭也非常有效。当肢体被重新嫁接时,由于不能够接好所有的经脉,会造成血液淤积,水蛭能够吸出这些淤血,它们一次就能够吸出是它们身体五倍重的淤血。

英国药物和保健产品监管署至今仍未签发执照准许在医学治疗中使用蛆虫和水蛭,而美国食物和药品监管局早在2005年就已经批准使用这两种无脊椎动物。

英国的两大水蛭和蛆虫提供商,都位于南威尔士,近年来销量大增。BIOPHARM是水蛭专业生产商,在过去15年中,年销量翻倍,达70000多条。

领导了蛆虫疗法研究项目的创伤治疗专家尼克.库伦教授,在今天的《英国医学》期刊上发表文章,称蛆虫能够在14天内清洁愈合伤口,而胶体清创则需要72天。她说有大量证据支持在国民健康服务(NHS)中增加蛆虫的使用。

这项实验得到了NHS的资助,涉及267名参加者,他们至少有一条腿经脉败坏发生溃疡,这在有深度血栓疾病的年长者中很常见。在清创术中,这些参加者们随机得到分散的幼虫、袋装幼虫(幼虫被包在薄纱袋中后,放在伤处)或胶体治疗,其后施以标准治疗。

卡尔彼得.邦德,BIOPHARM的助理经理说,近年来,目睹他的水蛭生意日渐增长,他毫不奇怪蛆虫使用的增加。这些生物已经进化了数亿年来做吸血和去除死亡组织的工作。

自然护士

蛆虫如绿蝇
早在印第安玛雅和土族部落及复兴时期,人们就已经开始使用蛆虫来治疗伤口。军医,包括拿破仑的医疗总长,观察到伤口上生蛆的士兵比其他受伤士兵恢复更快,更健康。在二十世纪初,随着抗生素的使用增长,人们渐渐不再使用蛆虫。

水蛭如医用水蛭
据记载,公元前200年就使用水蛭来治疗。据说,乔治华盛顿是在治疗中死于放血疗法。和蚯蚓一样,水蛭也是环节动物,水蛭有三个锋利的颚,每个颚有125颗牙齿,能在皮肤上留下类似于奔驰车标志的Y形咬痕。

水蛭能吸血六个多小时,并以此存活两年。水蛭的唾液中含有防止血液凝结的化学成分,把水蛭从伤口上移开后,伤口可能会流血数个小时。

译文:When it comes to wound healing, the maggot cleans up

Flesh-eating maggots and blood-sucking leeches might be considered moremedieval than modern, but if you want a wound treated with maximumefficiency, few therapies can compete with 200 million years of evolution.

A study by a team of British scientists, published today, lends support to theuse of the maggot in high-tech healthcare. They found that, left to graze onthe skin, maggots can clean wounds that fail to heal five times faster thanconventional treatments.

In a trial to investigate the clinical effectiveness of maggots for woundtreatment, the leg ulcers of patients treated with larvae were found to healjust as quickly as the water-based gel normally used. The study also showedthat the process of debridement — the removal of dead tissue, in this caseeaten by the maggots — occurred far faster, suggesting that larvae could beused to clean sites at high speed before urgent surgery, such as skingrafts.

Leeches have also been shown to be a highly effective tool in microsurgery.The excess blood that builds up when an appendage is reattached — because ofthe inability to link all the broken veins — is drained off with leeches,which can consume five times their weight in a single blood-sucking.

While the Medicines and Healthcare products Regulatory Agency (MHRA) has yetto issue licences for the medical use of maggots and leeches, the US Foodand Drug Administration passed both invertebrates for use in 2005.

Britain’s biggest leech and maggot providers, both based in South Wales, haveexperienced an increase in interest in recent years. At Biopharm, the leechspecialist, annual sales have doubled to more than 70,000 of the animals inthe past 15 years.

Professor Nicky Cullum, a specialist in wound care, who led the maggot therapystudy published in today’s , said that maggots had cleaned wounds in 14 days —compared with 72 days with gel treatment. She said there was anecdotalevidence of increasing maggot use in the NHS.

The trial, which received health service funding, involved 267 participantswho had at least one diseased vein leg ulcer — common in the elderly andthose who have suffered deep vein thrombosis. Participants were randomisedto receive loose larvae, bagged larvae — where the maggots are placed on theskin inside a gauze bag — or gel during the debridement, followed bystandard treatment.

Carl Peters-Bond, the assistant manager at Biopharm, said that he was notsurprised at increased interest in the use of maggots, having seen his leechbusiness grow steadily in recent years. “These are creatures that haveevolved over millions of years to remove blood or tissue — to do a job.

Nature's nurses

Maggot (such as Lucilia sericata) Use of maggots for woundhealing has been linked to Maya Indians and Aboriginal tribes, as well asduring the Renaissance. Military physicians, including Napoleon’ssurgeon-general, observed that soldiers whose wounds had become colonisedwith maggots experienced significantly less morbidity than other woundedsoldiers. Maggots were popular into the 1900s, but went out of vogue withthe rise of antibiotics

Leech (such as Hirudo medicinalis) Medical use was firstrecorded in 200BC, while George Washington is said to have died when toomuch blood was drained during an illness. The leech is a segmented wormrelated to the earthworm. The front suction cup has three sharp jaws, eachwith 125 teeth, that make a Y-shaped bite — leaving a mark compared to thebadge of a Mercedes-Benz.

The leech can feed for six hours or more, enough to last it for as long as twoyears. Leech saliva contains chemicals that prevent clotting, so a woundmight bleed for hours after the leech is removed

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