能够治疗创伤后应激障碍的药物
日期:2020-04-26 17:18

(单词翻译:单击)

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About 10% of people who go through a traumatic experience end up developing post-traumatic stress disorder, or PTSD.

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大约10%有过创伤经历的人,最终会发展成创伤后应激障碍(PTSD)A;69dPET1&7

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This condition is characterized by periods of intense fear, intrusive memories, and feelings of helplessness.

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这种病症的特点是阵发性的体验到强烈的恐惧,侵入性记忆和无助感su~yvDvfvoyvA*II-

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And while there are ways to treat it, it would be awfully nice if we could just prevent these symptoms from developing in the first place.

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虽然有很多治疗方法,但如果我们能从一开始就阻止这些症状的发展,就太好了VuI!DVw,uw^A9d^)

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I know, I know. Right now, you're probably saying to yourself, "Wishful thinking, Anthony!

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我知道,现在,你可能在自言自语:“安东尼,这真是一厢情愿!

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Let's just get rid of all the trauma in the world!"

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让我们摆脱世界上所有的创伤吧!”

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But hear me out. According to some research, there might actually be a way to prevent PTSD from developing — without totally changing society.

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但听我把话说完hs,wXm^0XTRlNi;,。根据一些研究,在不完全改变社会的情况下,也许有办法能阻止创伤后应激障碍的发展YCCbA&IlnQz0F2q(.X

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It's not quite ready yet, but there's some promising evidence in its corner.

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还没完全准备好,但已经有一些令人鼓舞的迹象了mIV.itl&Li%r|m#8

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And maybe the best part? This treatment is one of the most common drugs in the world.

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最好的部分是什么呢?这种疗法用的是世界上最常见的一种药物QP.-my4@AtQz8jWP-

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It's called hydrocortisone.

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名叫氢化可的松(n;U)fEgc!1jFR)EL

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It's a medicinal version of the human stress hormone cortisol, and it's been used for decades in everything from allergy creams to arthritis medications.

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它是人类应激激素皮质醇的药物版本+P-t,L#6%GV。几十年来,被广泛应用于从治疗各种过敏性疾病的药膏,到治疗关节炎的药物中iK3fk_vZ0HH0!3!QHt

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But even though it's been used for years, we didn't know it might be helpful for PTSD until the late '90s.

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但即使它已经使用多年了,直到90年代末我们才知道它可能有助于治疗创伤后应激障碍A,W#;nN390Y*ro[HJ@

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Around then, a researcher noticed that hospital patients who had received hydrocortisone for septic shock also seemed to have better mental health outcomes.

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在那期间,一位研究人员注意到,接受氢化可的松治疗感染性休克的患者,似乎在心理方面更健康o]z^2h(@*vcQ&atP8Rj

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And eventually, a follow-up study backed this up.

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最终,一项后续研究证实了这个观点Zs(NUdDhWla

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It looked at people who had potentially-traumatic major surgery.

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该研究考察那些经历过存在潜在创伤的重大手术的患者dK*e!V;P80

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And it found that those who'd received hydrocortisone had fewer PTSD symptoms and a higher quality of life six months later.

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研究发现,那些使用氢化可的松的患者在六个月后,体验到更少的创伤后应激障碍症状和更高的生活质量+kPJrm@B2bqO

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Since then, many studies have investigated this with similar results.

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从那时起,许多研究都对此进行了调查,并得出了类似的结果D94gudhHX5WF~Ua*#v~

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But, unfortunately, this doesn't mean that psychiatrists can just start giving out hydrocortisone shots to all their patients.

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但是,不幸的是,这并不意味着精神科医生可以开始给所有患者使用氢化可的松了2pvn9&pjd-

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Based on the research, these injections are only particularly effective during a tiny window: They work best within about 12 hours after someone experiences a trauma.

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根据这项研究,药物只在很短的时间内有效:即在某人经历创伤后12小时内效果最佳R39*wl6-.a

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Still, if you can hit that window, you can potentially reduce or prevent future PTSD symptoms.

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尽管如此,如果你能抓住时机,就可以潜在地减少或预防未来出现创伤后应激障碍的症状E]rOYa1Fe2%Kp+xOc

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The reason why this window exists — and why hydrocortisone seems to help at all — might have to do with how our brains make fear-related memories.

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存在这样一段时间,以及氢化可的松似乎有所帮助的原因,可能与我们的大脑如何制造与恐惧相关的记忆有关IhhLq6,La_LlJ7c[

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When we experience something scary or traumatic, certain parts of our brain — including the amygdala and hippocampus — get to work.

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当我们经历一些可怕的创伤事件时,大脑的某些部分,包括杏仁核和海马体就会开始工作]2VwgXh~4adRnXgE=

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They start making new connections and short-term memories about what scared us and what we were doing at that time.

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它们开始建立新的连接,并对我们当时的恐惧和行为产生短时记忆%1ZwbS,xh5J8ZB0B*p

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Then, later, the brain solidifies these short-term memories into long-term memory.

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随后,大脑将这些短时记忆固化成长时记忆56ifj)C;7;_*

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This process is known as fear conditioning.

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这个过程被称为恐惧条件反射+Nf6ldCDh3K;DTyr.O

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Of course, when something scary happens, our bodies aren't just making memories.

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当然,当可怕的事情发生时,我们的身体不仅是在制造记忆5&MoW5l@3eP%8j

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They're also going through a physical response, which includes producing stress hormones like cortisol.

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它们也在经历一种生理反应,包括产生应激激素,如皮质醇dFdQ,vTJsdi!Eiv]niDL

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Cortisol helps suppress non-essential functions, like digestion, during life-or-death scenarios.

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皮质醇有助于抑制非必要性功能,如消化、或在生死关头等情境下H&WK1su9Lum7I_6+LOmZ

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But it also has another job — one that might be a little counter-intuitive, given its role as a stress hormone

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但因为它是一种压力荷尔蒙,所以它还有另一个可能有点违反直觉的任务5j6AasSN+MbZoV~R7)i

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It's a key part of a negative feedback loop our bodies use to turn the stress response off.

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它是我们身体用来关闭压力反应的负反馈回路的关键部分cp16u+R,gw^lP[V

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Among other things, it helps the brain chill out and stop creating or storing those new fear memories.

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除此之外,它还能帮助大脑冷静下来,停止创造或储存那些新的恐惧记忆iutc;F_lhT+nJbZVBZ

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And that's where PTSD comes in.

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创伤后应激障碍就是从这里产生的&Tx^[#QbzH*f~hJ_e6

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This condition is often understood as a kind of runaway fear conditioning.

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这种情况通常被理解为一种失控的恐惧条件反射AmDtJ4FpY;5F#X_ONW

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The idea is that the brain associates certain cues with fear too strongly and initiates an extreme response.

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该观点是说,大脑将某些线索与恐惧联系得过于紧密,引发一种极端的反应Zc@MrJ%]B.|m

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And according to some studies, that might be because a person had low cortisol levels when they experienced a trauma.

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根据一些研究,这可能是因为一个人在经历创伤时皮质醇水平较低i~#@#p8Inb47)|

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Without enough of this hormone, their brains might have had trouble turning off their fear circuitry.

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如果这种激素不足,他们的大脑可能很难关闭恐惧回路CS|i^Z%dpO5!N254k

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They'd just keep building and storing those fear memories, until their brains initiate an extreme response whenever they recall what happened.

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他们只是不断地建立和储存那些恐惧记忆,直到大脑在回忆发生的事情时产生一种极端的反应*3OdacAmgHbciO^f&Q

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Now, there have been some inconsistencies in this research, and not every paper supports this hypothesis.

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针对此类研究存在一些不一致的地方,并非所有论文都支持这一假设R#km*2))6+0[!cE=mRvI

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But this connection has popped up enough that scientists are seriously investigating it.

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但是有关此种联结的证据已经足够多了,科学家们正在认真进行研究_U.bp%qbBm@kG58I-;O

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After all, it would explain why a timely injection of hydrocortisone would prevent PTSD symptoms from developing.

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毕竟,这可以解释为什么及时使用氢化可的松可以阻止PTSD症状的发展7EQi.LFR;4E[YE24psf

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We'll need to learn more before we can say anything for certain, because exactly how stress hormones affect memory can be complicated.

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在我们可以确定地阐述之前,还有很多东西要了解,因为压力荷尔蒙对记忆的影响记忆是复杂的O;1b39T;6n&c@Dv@6[

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But the more scientists have looked into it, the more there really does seem to be something there.

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但科学家们研究得越多,似乎就越有实际意义3--_Sz-VZn[G](

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That said, hydrocortisone isn't ready to be commonly used for PTSD just yet.

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也就是说,目前还没做好将氢化可的松普遍用于创伤后应激障碍的治疗4]QW)V1W(#fjLk0

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We still need high-quality trials to replicate previous findings, investigate inconsistencies, and nail down things like dosage, timing, and administration.

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我们仍然需要高质量的试验来复制先前的发现,调查不一致性,并确定诸如剂量、时间和给药等n4|gWwaxbx

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And even once we do that, there are some logistics to figure out, too.

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即使我们这样做了,还需要解决一些物流方面的问题Rpdfs6^6=G7Rv

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To work, hydrocortisone would need to be given to people really quickly after they experienced trauma.

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为了能发挥效用,需要在人们经历创伤事件后很快给他们使用氢化可的松&OB8YDu!AKD&U],9gPy

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So it would need to be ready and available in places like emergency rooms or ambulances.

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因此,需要准备就绪,急诊室或救护车中应该加以配备%!zP&uc+2I#(cl

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That would require some extra logistics, like specialized training to identify and follow-up with people at risk of developing PTSD.

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这将需要一些额外的后勤保障,如专业培训,以确定和跟踪那些有发展创伤后应激障碍风险的人[YpSe)b2K4.TjP8NA)47

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After all, you wouldn't want to just give this stuff to everyone who walked in the door.

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毕竟,你不会能给每个来的患者都开出这种药yjPA!yo+Tj%yJDNzO

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Cortisol is still a stress hormone so it has a lot of effects in the human body. High levels have been linked with sleep and digestive problems, and anxiety, for instance.

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皮质醇仍然是一种应激激素,所以它对人体有很多影响,例如,高剂量用药与睡眠、消化问题和焦虑有关1SOT_j!GTQJZt,,,

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But, even though there's still a fair amount to learn and unpack, the idea of being able to prevent PTSD at all is really exciting. And it gives us something to hope for.

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但是,尽管仍有相当多的东西需要了解和整理,但能预防创伤后应激障碍的想法确实令人兴奋,它给予我们希望ZxWT8|EGG;0=MY

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