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在cushing disease這個產品中，有1篇Facebook貼文，粉絲數超過7萬的網紅Dr 文科生，也在其Facebook貼文中提到， 直線抽擊偽科學系列《五》 - 你知道嗎？亂叫病人停類固醇可能會害死他 文科生早排又不爭氣去睇了素人父母page，發現素人父母對類固醇有莫名奇妙的hatred並把類固醇的副作用無限放大。這種不負責任的言論或會令病人擔心而自行停藥，引致嚴重後果。 ===========背景資料========...

cushing disease 在 Dr 文科生 Facebook 的最讚貼文

Dr 文科生 By Dr 文科生

2018-05-23 18:22:59 有 293 人按讚
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直線抽擊偽科學系列《五》 - 你知道嗎？亂叫病人停類固醇可能會害死他

文科生早排又不爭氣去睇了素人父母page，發現素人父母對類固醇有莫名奇妙的hatred並把類固醇的副作用無限放大。這種不負責任的言論或會令病人擔心而自行停藥，引致嚴重後果。

===========背景資料=========
類固醇大致分為兩大種
1. 糖皮質類固醇 (glucocorticoid)
2. 鹽皮質類固醇(Mineralcorticoid)

醫學界最常用的類固醇為糖皮質類固醇，因為他們具消炎、抑制免疫系統、調節糖、脂肪和蛋白質合成的效果。

類固醇是非常快速而且有效的藥物，所以在眾多疾病中都會使用。包括但不限於以下

1. 濕疹 (eczema)
2. 哮喘 (asthma)
3. 敏感 (allergy) 包括anaphylaxis
4. 慢性肺阻塞 (Chronic Obstructive Pulmonary Disease)
5. 血液及腫瘤類癌症(hematological malignancy)
6. 免疫及風濕科疾病(rheumatological diseases) 例如類風濕關節炎、銀屑病、紅斑狼瘡、sarcoidosis、polymyalgia rheumatic、polymyositis、dermatomyositis等
7. 免疫及腸胃科疾病 (autoimmune GI diseases) 例如克隆仕症(crohn’s disease)和潰瘍性結腸炎(ulcerative colitis)
8. 腦外科手術
9. 腦水腫
10. 內分泌科疾病例如Addison’s disease, congenital adrenal hyperplasia
11. 急性眼科疾病例如虹膜炎(uveitis)
12. 下刪幾十種嚴重疾病

類固醇適用的疾病非常廣泛，在還沒有類固醇的年代，其實很多病人因病情無法控制而死亡

但如此有效的藥物當然少不了副作用

長期使用高劑量類固醇的常見副作用包括但不限於以下
1. 皮膚變薄
2. Cushing syndrome
3. 糖尿病
4. 高血壓
5. 骨質疏鬆
6. 白內障
==============================
醫學從來都不是零風險，如果有人向你推介零風險零副作用的治療（例如順勢療法），只是因為該療法沒有臨床效果。如果劑量低到不會對人體生理(physiology)構成任何效果，自然不會副作用。

大家需要明白的一點是，在21世紀的今日醫學雖然昌明，但仍有很多疾病是需要靠副作用頗大的藥去治療。風險與利弊的平衡在治病中尢其重要。

一個負責任的人在推廣一個治療的時候應該和病人探討治療的利弊風險以及不治療的風險。而不是隨便post一段不知名而且沒有科學根據的短片然後暗示類固醇是奇毒無比的藥物並引導病人停藥。

服用高劑量類固醇的病人忽然停類固醇你知道有什麼後果嗎？你不知道？那又為什麼隨便引導別人停？服用高劑量類固醇後「必須」慢慢地減劑量(taper off)，因為腦部和腎上腺會突然失去類固醇後無法立即compensate，會引起腎上腺危機(adrenal crisis)，嚴重或會死亡。

腦外科手術和腦水腫都常常會用類固醇dexamethasone。如果你建議病健不要服用類固醇，你有何高見去控制腦水腫？你知道腦水腫如果不控制會有什麼問題嗎？不知道？答案比埋你， potential herniation and death。

從來沒有人強迫病人要服用類固醇，醫生是根據臨床醫學實證的數據在平衡風險利弊後建議類固醇作治療。如果真的很抗拒類固醇當然可以跟醫生討論轉藥，但重點是要有監察下減劑量以保安全。

但是，這種荒謬的自然療法或順勢療法推廣者美其名為病人福祉著想，現實卻拿病人健康「搞飛」，但求有一兩句sound bite可以中傷一下西方醫學再推廣自己的自然療法。

拜託，別再把自然療法或順勢療法稱為醫生/醫師，你們這班敗類連行醫資格都沒有，你們的所作所為只是在危害病人健康和安全。

#醫學界敗類
#類固醇如果使用恰當是一隻好藥
#順勢自然療法從來都無效
#請停止危害病人健康
#不負責任的素人父母

—————————————————————————

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#1. Cushing syndrome - Symptoms and causes - Mayo Clinic

Cushing syndrome occurs when your body has too much of the hormone cortisol over time. This can result from taking oral corticosteroid ...

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#3. Cushing's Disease | UCLA Pituitary Tumor Program

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#4. Cushing Disease / Cushing Syndrome | Brain Institute | OHSU

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#8. Cushing's syndrome - NHS

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#9. Cushing Syndrome (Disease): Symptoms, Causes, Diagnosis

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#13. Cushing's Syndrome: Signs, Causes, and Treatment - Healthline

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#14. Cushing's Disease | The Pituitary Foundation

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#16. Cushing Syndrome - Endocrine and Metabolic Disorders

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#17. Overview of the treatment of Cushing's syndrome - UpToDate

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#18. Cushings Disease In Dogs | VCA Animal Hospitals

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#19. Cushing's Disease: Clinical Manifestations and Diagnostic

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#28. Cushing's Disease | ScienceDirect

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#29. Cushing Syndrome (for Parents) - Nemours KidsHealth

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#31. Endogenous Cushing Syndrome - Medscape Reference

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#58. Effectiveness of Medical Treatment of Cushing's Disease

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#59. Cushing's Disease / Cushing's Syndrome

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#60. Cushing's Disease and Syndrome

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#62. Cushing's disease | You and Your Hormones from the Society ...

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#69. Cushing syndrome | Osmosis

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#70. The Basics - CSRF - Cushing's Support & Research Foundation

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#71. Management of Cushing disease - Nature

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#72. Cushing's Disease – Causes, Symptoms & Treatment

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#75. Cushing's Syndrome - Columbia University Department of ...

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#77. New discoveries offer possible Cushing's disease cure - Healio

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#78. Cushing's Disease | California Center for Pituitary Disorders

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#97. Cushing's Syndrome | Michigan Medicine

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