基層(GP, Family Dr.)的教育是否不當?--從疼痛治療與減肥藥說起

[李誠民]

http://articles.mercola.com/sites/artic ... ogram.aspx

Story at-a-glance
New physicians are learning shockingly little about how to treat pain, despite it being one of the most common, and most debilitating, medical conditions around
Most European medical schools have no required courses on pain, but even when compulsory pain courses are in place, they represent just 12 hours of the six-year program
Pain education in North American medical schools has also been called limited and fragmentary
With no other knowledge of how to treat pain, most physicians treat it with prescription painkillers, and now we have a new epidemic of prescription drug abuse and related deaths
Seek a physician who is knowledgeable about the root causes of pain and offers non-toxic remedies for relief

• 連勝文的姊姊--連惠心代言第三期人體實驗的減肥藥- 威力纖 Cetilistat(Cetilistat is a drug designed to treat obesity. It acts in the same way as the older drug orlistat (Xenical) by inhibiting pancreatic lipase, an enzyme that breaks down triglycerides in the intestine. Without this enzyme, triglycerides from the diet are prevented from being hydrolyzed into absorbable free fatty acids and are excreted undigested...),;台灣如何發展生技產業?!---只有等代工中國大陸的生產原料(基因技術-Genetic tech.),…
以前有欣樂氛(Synerphrine)減肥藥__美國暢銷diet drink(減肥飲料),台灣只有查到中醫師做減肥,才可能知道,台灣還在減肥界流行::
台灣基層醫師(GP?Family Doctor)似乎對減肥知識也很少,只知醫美(台大醫學院有課程?!)::
-“Chronic pain affects 100 million Americans – that’s more than the number impacted by diabetes, heart disease and cancer combined.1 Most suffering from pain turn to their family physician for help, but many leave the office with nothing more than a prescription for painkillers in hand.”……美國將來的醫師(家庭醫師)將不知道如何治療疼痛!!!美國有一億人被慢性疼痛困擾,我相信台灣人民至少超過10%人或多或少有疼痛的困擾!!!!

….APPEAL (Advancing the Provision of Pain Education And Learning) study revealed that new physicians are learning shockingly little about how to treat pain, despite it being one of the most common, and most debilitating, medical conditions around……
, 歐洲六年醫學院學生只有12小時的強制的疼痛課程::
….undergraduate medical schools in Europefound that even when compulsory pain courses are in place, they represent just 12 hours of the six-year program – or 0.2 percent.
美國醫學院並沒有疼痛課程,只有82%醫學院有12小時疼痛課程::
most of the schools actually have no required courses on pain that all students must take. This means that 12 hours of pain study represents a best-case scenario; at 82 percent of medical schools without compulsory pain courses, the students may be receiving even less… or no pain training at all.

提供疼痛課程的醫學院也只有小於五小時的教育::
Even at those schools offering pain curriculum, the education amounted to less than five hours.4 Those researchers similarly concluded:
“Significant gaps between recommended pain curricula and documented educational content were identified. In short, pain education [in US and Canadian medical schools] was limited and fragmentary. Innovative and integrated pain education in primary medical education is needed.”

美國CDC調查::服用鴨片類止痛劑—Hydrocodone&Oxycodone 死亡人增加了四倍(1999-2009),而我們台灣醫師對非法藥物—鴨片, 嗎啡, 可代因, 海洛因等止痛藥一點觀念都缺乏?甚至大麻是否應使用在醫療用途上,也是缺少公共討論觀念,但卻非常氾濫!!!
The latter has been called the fastest-growing drug problem in the US by the Centers for Disease Control and Prevention (CDC), as the number of deaths from opioid painkillers like hydrocodone and oxycodone rose nearly four-fold between 1999 and 2009.

USA Today recently reported, more US states are now taking action to try and stop this growing problem:6
• Alabama has instituted three new laws that give more medical personnel access to the state’s prescription monitoring program database, as well as tighten regulations on pain management clinics and making ‘doctor shopping’ to get multiple prescriptions punishable by jail time
• Indiana instituted new oversight powers to the state attorney general on pain management clinics and is considering mandatory annual drug screening of people prescribed opioids
• Kentucky now requires pain clinics to be licensed and mandates that physicians check electronic prescription records before writing opioid prescriptions
• Washington state has set dosage limits for physicians who prescribe pain medications, and prescriptions over a certain amount must be approved by a pain specialist
• New York has a requirement that physicians and pharmacists check the state’s drug-monitoring program database before prescribing opioids

Painkillers (opioids) like morphine, codeine, oxycodone, hydrocodone and fentanyl are one of the most commonly abused drug classes. These drugs are not only addictive, they can lead to slowed breathing and death if too much is taken, and the risks are compounded if you add alcohol to the equation.
Hydrocodone, a prescription opiate, is synthetic heroin. It's indistinguishable from any other heroin as far as your brain and body is concerned. So, if you're hooked on hydrocodone, you are in fact a good-old-fashioned heroin addict.
Worse, pain-killing drugs like fentanyl are actually 100 times more potent than natural opioids like morphine, making the addictive potential and side effects associated with prescription drug use much higher

Dr. Sanjay Gupta, associate chief of neurosurgery at Grady Memorial Hospital and CNN's chief medical correspondent, reported:8
“ … after just a few months of taking the pills, something starts to change in the body. The effectiveness wears off, and patients typically report getting only about 30% pain relief, compared with when they started. Even more concerning, a subgroup of these patients develop a condition known as hyperalgesia, an increased sensitivity to pain.
As you might guess, all of this creates a situation where the person starts to take more and more pills. And even though they are no longer providing much pain relief, they can still diminish the body's drive to breathe.
If you are awake you may not notice it, but if you fall asleep with too many of these pills in your system, you never wake up. Add alcohol, and the problem is exponentially worse. People who take pain or sleeping pills and drink a couple glasses of wine are playing Russian roulette.”

As you might guess, all of this creates a situation where the person starts to take more and more pills. And even though they are no longer providing much pain relief, they can still diminish the body's drive to breathe.
If you are awake you may not notice it, but if you fall asleep with too many of these pills in your system, you never wake up. Add alcohol, and the problem is exponentially worse. People who take pain or sleeping pills and drink a couple glasses of wine are playing Russian roulette.”

非藥物的治療::
Emotional Freedom Technique (EFT):…… According to Dr. John Sarno, a psychiatrist who uses mind-body techniques to treat patients with severe low back pain, EFT has a greater than 80 percent success rate
Chiropractic adjustments: According to a study published in the Annals of Internal Medicine9 and funded by the National Institutes of Health, patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain free in 12 weeks compared to those who took medication.
Massage: Massage releases endorphins, which help induce relaxation, relieve pain, and reduce levels of stress chemicals such as cortisol and noradrenaline – reversing the damaging effects of stress by slowing heart rate, respiration and metabolism and lowering raised blood pressure.
Acupuncture: Researchers concluded that acupuncture has a definite effect in reducing chronic pain, such as back pain and headaches – more so than standard pain treatment.
Relearn proper posture: The Gokhale Method addresses the root cause of physical pain, which is typically caused by improper posture. The method teaches you to reclaim your primal posture, which is the way your body was designed to stand, sit and move.

一般食物—Supplement or hurb ::
Astaxanthin: One of the most effective oil-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than prescription drugs like NSAIDs
Ginger: This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice
Curcumin: Curcumin is the primary therapeutic compound identified in the spice turmeric. In a study of osteoarthritis patients, those who added only 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility
Boswellia: Also known as boswellin or "Indian frankincense," this herb contains powerful anti-inflammatory properties, which have been prized for thousands of years. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
Bromelain: This protein-digesting enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful. Keep in mind that most of the bromelain is found within the core of the pineapple, so consider leaving a little of the pulpy core intact when you consume the fruit.
Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used a topical preparation for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards.
Evening Primrose, Black Currant and Borage Oils: These contain the fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain
Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmit pain signals to your brain. 102-10-27

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台灣不是很流行甚麼遠絡療法？

[李誠民]

"台灣不是很流行甚麼遠絡療法？"---我知識沒有好(computure science?),您說的是否是遠距教學(療法),;那就要利用App?--就要討論到電磁波對人體影響的議題!!!---不 知我答覆錯了嗎?!

[k4210]

台灣不是很流行甚麼遠絡療法？

曾經瘋了一陣子,但現在又乏人聞問了.

[tibet]

"台灣不是很流行甚麼遠絡療法？"---我知識沒有好(computure science?),您說的是否是遠距教學(療法),;那就要利用App?--就要討論到電磁波對人體影響的議題!!!---不 知我答覆錯了嗎?!

李大, 是這個
http://www.enrac.com/tw/enrac_edu_intro_class_tw

[李誠民]

Holistic Medicine.An approach to medical care that emphasizes the study of all aspects of a person's health, including physical, psychological, social, economic, and cultural factors................或以前的--
Traditional (Hurb) Medicine傳統醫學(中西整合醫學?),...謝謝 Tibet先生教導(我看完了您的網站文章)!!!....但是我說的是GP&Family Dr.應該都是接受現代西方醫學教育,許多illicit drugs都是高文明國家__---中國, 印度, 雅瑪文明....等,西方所謂現代(工業)化國所不知的;;..........嗎啡, 鴨片, 大麻.....等等止痛藥都遭濫用!!!. ...如果有興趣就討論一下!!! 謝謝!

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不懂的上網學就好 靠大老有X用

[李誠民]

"不懂的上網學就好 靠大老有X用"......???....沒有基本知識與邏輯思考訓練(包過自我訓練), 上網有個屁用!!!..........

報一個 網站:阿里巴巴網站----羅漢果,增長些知識(常識)

老大?!不必了!!!

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也介紹衣各往站給你,比阿里篩八好多了

不懂的就打入 框框內

https://www.google.com