宿醉(专业版)
宿醉是轻度急性酒精中毒。由于短时间大量饮酒,导致神经系统功能紊乱状态而表现的异常意识和行为。
其他名称:降低酒精伤害
英文名称:Hangover ,Reducing the risks of Alcohol
根据美国国立酒精滥用和中毒研究所(NIAAA)饮酒量定义,1次饮酒量(One Drink)为:啤酒355ml(酒精含量约5%),或葡萄酒148ml(酒精含量约12%),或中度酒45ml(酒精含量约40%)。
一般防止宿醉的饮酒量为:
乙醛是一种毒素和致癌物,也是宿醉的罪魁祸首:
营养与草本综合干预
以下是基于循证医学和循证营养学有关文献综合的结果。
有助于防控宿醉的营养和草本补充剂,主要包括如下:
1.维生素B族:
慢性酒精中毒会导致维生素B吸收受损,并众所周知会导致维生素B1(硫胺素)缺乏,从而导致严重的神经和心血管问题1-3。苯磷硫胺是一种合成的脂溶性硫胺素,被发现在人体内比水溶性硫胺补充剂具有更高的生物利用度4-6。在动物研究中,在急性酒精中毒后提高硫胺素水平方面,苯磷硫胺比硫胺素更有效2,7。
一项对84名严重酒精性多发性神经病患者进行的为期八周的随机对照试验发现,每天320mg的苯磷硫胺治疗四周,然后每天120mg治疗四周,可以改善神经病变症状6,8。另一项研究表明,苯磷硫胺治疗可以减轻长期严重饮酒障碍男性的精神痛苦9。
烟酰胺核糖是维生素B3的一种形式,作为NAD+(烟酰胺腺嘌呤二核苷酸)的前体,NAD+是许多代谢过程的必要辅因子10,11。酒精代谢中NAD+的消耗,导致NAD+/NADH比率降低,被认为是酒精毒性的一个促成因素12。研究发现,补充烟酰胺核糖可提高人体血液中NAD+的浓度11,并在动物研究中证明了其神经保护作用10。
维生素B6和相关化合物也可以抵消饮酒的一些负面影响13。酗酒者叶酸水平较低,这可能是由于小肠吸收减少所致;肝脏代谢和叶酸潴留的改变;尿液中叶酸排泄量增加;并且在摄入酒精后干扰叶酸代谢14。因此,经常饮酒的人应该考虑补充叶酸。
2.半胱氨酸和N-乙酰半胱氨酸:
L-半胱氨酸是一种半必需氨基酸,与谷氨酸和甘氨酸一起合成内源性抗氧化剂谷胱甘肽。N-乙酰半胱氨酸(NAC),一种经常用于补充剂的半胱氨酸衍生物,也可以转化为谷胱甘肽。NAC似乎可直接与乙醛结合,并可能减少饮酒后血液中乙醛的增加15,16。
一项在19名健康男性中进行的随机安慰剂对照试验发现,600–1200mg剂量的L-半胱氨酸可以减少饮酒后的宿醉、恶心和头痛,并减轻压力和焦虑。该研究的作者认为,L-半胱氨酸甚至可能降低酒精成瘾的风险,因为有成瘾倾向的人可能会寻求用更多的酒精来“治愈”宿醉症状17。在动物研究中,NAC被发现可以降低酒精毒性18。一项小鼠研究发现,NAC和维生素C的组合改变了解毒酶的活性,并减少了酒精引发的自由基的产生19。在一项大鼠研究中,给予NAC可降低大脑和肝脏组织中酒精诱导的氧化应激水平20。一项针对斑马鱼的研究表明,NAC可以防止酒精引起的行为改变和氧化应激21。
3.谷胱甘肽:
谷胱甘肽是一种重要的解毒化合物和抗氧化剂,存在于全身细胞中,并高度集中在肝脏中22。酒精会降低肝脏中的谷胱甘肽水平,这会导致肝细胞损伤,并导致酒精性肝病的发展23。在一项大鼠研究中,在饮酒前服用谷胱甘肽两周,可以更有效地清除酒精和乙醛,并降低血液中的峰值水平。即使是在酒精暴露后给予高剂量谷胱甘肽的大鼠,其酒精和乙醛的清除速度也比仅给予水的对照大鼠更快,氧自由基水平也更低24。
4.维生素E:
适度饮酒已被证明会导致男性25和绝经后女性26的维生素E状况恶化。一项大鼠研究发现,饮酒尤其会消耗γ-生育酚27。γ-生育酚是组成维生素E家族的八种化合物(四种生育酚和四种生育三烯酚)之一;γ-生育酚是食物中最常见的维生素E形式28。
一些动物研究表明,维生素E治疗可降低慢性酒精诱导的炎症、氧化应激和组织损伤的标志物29-31。一个动物模型表明,维生素E可以防止急性酒精暴露后的氧化应激和谷胱甘肽耗竭,同时使用甲基硒代半胱氨酸(硒的一种形式)治疗可以增强这种作用32。另外两项动物研究发现,生育三烯酚可以预防酒精相关的神经毒性33,34。
5.硒:
微量矿物质硒对于谷胱甘肽过氧化物酶抗氧化系统的正常功能是必需的,在酒精性肝病患者中观察到硒水平较低35。动物研究结果表明,过量饮酒会导致血液和肝脏硒水平下降,导致谷胱甘肽活性降低和氧化应激加剧36。其他研究表明,补充硒可以防止这些负面影响37,20,32。
6.维生素C:
维生素C通过防止酒精喂养小鼠肝脏的氧化应激,显示出抗宿醉的潜力。与未服用维生素C的酒精喂养小鼠相比,服用维生素C使酒精喂养后的肝脏谷胱甘肽水平恢复到正常水平,并减弱了酒精诱导的氧化应激38。其他对大鼠的研究表明,维生素C可以保护神经元39、肾脏和血管免受酒精相关的组织损伤40,41。
7.水飞蓟:
水飞蓟素(水飞蓟果提取物)含有黄酮类化合物的混合物,其中50-70%通常是水飞蓟宾42。水飞蓟素和水飞蓟宾主要用于治疗肝脏疾病43。早期临床研究表明,水飞蓟提取物可以减少酒精性肝硬化造成的损害。水飞蓟素和水飞蓟宾可以提高谷胱甘肽水平,动物研究表明,它们可以激活被酒精消耗的解毒酶,改善线粒体功能,并缓解与酒精相关的肝损伤42-44。水飞蓟素还可以通过减少神经系统中的炎症和氧化应激来保护神经元45。
8.磷脂酰胆碱:
聚烯基磷脂酰胆碱(Polyenylphosphatidylcholine,PPC)是在动物研究中发现的磷脂的混合物,用于减少自由基产生并防止酒精诱导的肝细胞氧化损伤23,46,47。在一项研究中,PPC防止了酒精诱导的肝脏S-腺苷甲硫氨酸(SAMe)的耗竭,SAMe与大鼠肝脏谷胱甘肽水平的保持有关48。磷脂酰胆碱是PPC中的一种特殊磷脂,已被发现可预防酒精诱导的狒狒肝纤维化和肝硬化49。
在一个参与临床试验的慢性饮酒者亚组中,PPC治疗减轻了试验期间肝酶和胆红素的增加。这些标志物是肝损伤的指标,参与者在饭前每天三次服用1.5g PPC50。
9.镁:
饮酒会迅速引发包括大脑和肝脏在内的组织中的镁流失。在酒精的影响下,这种镁在尿液中流失,导致血清镁含量下降的趋势51-53。由此导致的镁供应的总体减少会导致血管收缩,并可能有助于解释过量饮酒与高血压、心脏问题和中风之间的关联53,54。一份临床报告描述了五名患有酒精引起的头痛和宿醉的患者的低血镁水平,并成功地通过静脉注射镁进行了治疗55。在动物实验中,一种名为苏糖酸镁的专利镁制剂可以提高大脑中的镁水平。这可能代表了一种对抗酒精诱导的脑镁消耗的策略,尽管这尚未在临床试验中得到证明56。
10.益生菌:
慢性过量饮酒与小肠细菌过度生长和大肠细菌数量的变化有关。此外,酒精会增加肠道内壁的通透性,使细菌毒素被吸收,从而引起肝脏和其他组织的炎症。事实上,这些影响现在被认为是导致酒精性肝病的主要因素57-59。用益生菌恢复肠道微生物组已被证明可以预防酒精性肝病的进展60-62。
益生菌的使用可以通过增加紧密连接蛋白的表达和减少炎症细胞因子的表达,帮助逆转酒精诱导的肠道内壁损伤,并防止肠道微生物群的变化,这些变化可以通过肠-脑轴(Gut-brain)影响大脑中的神经递质信号传导60,61。
在一项临床试验中,66名患有酒精性精神病的男性接受了为期5天的益生菌补充剂治疗,无论是否进行标准的戒酒加多种维生素治疗。该益生菌含有0.9亿CFU的双歧杆菌和9亿CFU植物乳杆菌。仅经过五天的治疗,接受益生菌治疗的患者的肝损伤就得到了一定程度的缓解,肝酶(肝损伤标志物)水平的大幅降低就是明证。他们还展示了健康肠道细菌的恢复63。另一项针对117名住院患者的试验发现,与安慰剂和戒酒相比,戒酒并补充含有枯草芽孢杆菌和粪链球菌的益生菌7天,肠道细菌得到了更大的改善,细菌毒素和炎性细胞因子水平也有所降低64。
临床前研究表明,益生菌有助于保护肝脏免受酒精诱导的损伤60。研究发现,补充各种乳酸菌菌株可以增强抗氧化酶活性,减少活性氧的产生,防止酒精性脂肪性肝炎的发展,并减轻酒精诱导的肝脏氧化损伤,包括降低肝脏酶和炎症标志物的水平65,66。益生菌鼠李糖乳杆菌LGG还被发现通过激活AMP活化蛋白激酶(AMPK)和增加脂肪酸氧化来防止酒精诱导的脂质代谢变化60。
动物研究进一步支持益生菌在酒精恢复中的潜在作用,这些研究发现,补充乳酸杆菌和双歧杆菌可以通过几种不同的机制保护胃免受酒精引起的损伤。这些包括增加胃粘膜的产生和减少胃炎症67-69,降低肠道高渗透性70,以及防止与酒精相关的肝细胞炎症和损伤71-73。
11.硫辛酸:
硫辛酸是一种含硫化合物,可提高谷胱甘肽水平并中和某些类型的自由基74,75。硫辛酸还参与维生素C和E的回收和缓解炎症76,并已在实验室环境中显示出可增加乙醛脱氢酶的活性,乙醛脱氢酶可分解乙醛77,78。
在动物研究中,给予硫辛酸的大鼠和小鼠后饮酒的动机较低79,80,并且在饮酒前接受硫辛酸治疗的小鼠脑组织中的自由基水平较低;与单独饮酒治疗的小鼠相比,酒精诱导的行为问题较少81。
12.褪黑素:
褪黑激素是一种有助于调节昼夜节律和诱导睡眠的激素82,饮酒和戒酒似乎都会抑制褪黑激素的产生83,84。在一项动物研究中,在暴露于令人陶醉的酒精之前,给予褪黑激素七天的小鼠在宿醉期间的肌肉协调性更好85。
由于睡眠障碍似乎是酒精宿醉症状和严重程度的一个重要因素86,87,提高睡眠质量可能是褪黑激素减少某些宿醉症状的一种机制。此外,褪黑素还有许多其他作用,有助于防止宿醉和酒精引起的其他伤害:调节炎症反应,防止与氧气相关的细胞损伤,并可能具有镇痛作用88,89。
13.亚洲参:
亚洲参(包括红参或高丽参)是一种药用植物,历史上用于治疗疲劳、增加能量、增强耐力和复原力90,91。一项针对25名健康男性的研究比较了服用32mg溶解在水中的人参根提取物和100ml 80度威士忌与同等量威士忌加白开水的效果。与单独服用威士忌和水相比,参与者在服用人参和威士忌后疲劳、认知症状、口渴和胃痛更少92。
动物研究结果表明,人参及其成分通过抑制氧自由基活性和炎症,并可能通过提高体内酒精和乙醛的清除率,减少与酒精相关的组织损伤93。在小鼠中,即使是急性重度酒精暴露,用人参预处理七天也可以减少肝损伤94。
人参的重要活性成分人参皂苷在天然状态下吸收不良。然而,发酵后已被证明可将人参皂苷的生物利用度和血清浓度提高约15倍。因此,在考虑人参补充剂时,发酵人参制剂可能是一个更好的选择95。
14.姜黄素:
已知姜黄素具有强大的抗炎特性96。在一项初步研究中,七名健康男性饮酒时要么单独喝水,要么加入姜黄素和水的制剂。姜黄素组的血液乙醛水平明显较低97。此外,几项动物研究表明,姜黄素可以减少与酒精相关的氧化应激、炎症和组织损伤98-100。
15.牛磺酸:
牛磺酸是一种含硫氨基酸,在全身具有多种功能,包括中枢神经和心血管系统101。对暴露于大量酒精的小鼠补充牛磺酸和草药,可提高其酒精代谢率,延长醉酒时间,缩短恢复时间102。牛磺酸还可以预防大鼠在四周内大量饮酒后的高血压103。在另一项研究中,短暂暴露于单次高剂量酒精的斑马鱼,如果同时接受牛磺酸,其大脑酒精水平较低,焦虑行为也较少104。其他多种动物研究表明,牛磺酸可以通过减少氧化应激、炎症和组织损伤来预防酒精毒性105-107。
16.S-腺苷蛋氨酸(SAMe):
SAMe对细胞主要抗氧化剂谷胱甘肽的形成至关重要,也参与中和同型半胱氨酸(一种细胞毒素)的甲基化途径。酒精会破坏SAMe的形成,酒精性肝病患者的肝脏SAMe浓度会降低。幸运的是,已经发现补充SAMe可以改善酒精暴露动物和酒精中毒人类的肝功能23。使用动物模型进行的研究发现,SAMe除了促进谷胱甘肽合成外,还可以部分通过改善肝组织中的线粒体功能来保护肝脏免受酒精的毒性影响108。
17.白藜芦醇:
白藜芦醇是一种多酚化合物,存在于红酒和亚洲传统药用植物日本虎杖的根,以及花生、葡萄皮和蓝莓中109。大量动物研究表明,白藜芦醇可能有助于最大限度地减少长期饮酒引起的氧化应激、相关炎症和组织损伤110,111。在其他动物研究中,白藜芦醇预防了学习能力的丧失112,113以及慢性酒精暴露后观察到的氧化应激和炎症标志物的增加;更高剂量的白藜芦醇与更大的保护作用相关112。
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英文名称:Hangover ,Reducing the risks of Alcohol
定义
宿醉是轻度急性酒精中毒。由于短时间大量饮酒,导致神经系统功能紊乱状态而表现的异常意识和行为。因饮酒过量隔夜休息后,体内的酒精已经完全排净或转化,但仍有头痛、眩晕、疲劳、恶心、呕吐、胃部不适、极度口渴和认知模糊等症状。经常过量饮酒与许多健康风险有关,包括肝损伤、脑和神经损伤,以及胃、胰腺和心脏疾病等。由于酒精消费会产生有毒化合物并导致维生素缺乏症,最好不要喝酒,或者仅适度饮酒。根据美国国立酒精滥用和中毒研究所(NIAAA)饮酒量定义,1次饮酒量(One Drink)为:啤酒355ml(酒精含量约5%),或葡萄酒148ml(酒精含量约12%),或中度酒45ml(酒精含量约40%)。
一般防止宿醉的饮酒量为:
- 单日最高量为:男性4饮(相当于71g左右纯酒精),女性3饮(相当于53g纯酒精)。
- 每周累计最高量为:男性14饮,女性7饮。
宿醉原因
宿醉主因是过量饮酒,但发生宿醉可因人而异,有的饮少量酒即可发生,而有些人饮大量酒才引起宿醉。约80%酒精进入小肠并迅速被吸收到血液中,在肝脏通过乙醇脱氢酶转化为乙醛。乙醛是一种毒素和致癌物,也是宿醉的罪魁祸首:
- 引起恶心呕吐、头痛和疲劳等。
- 产生大量的自由基并引起全身性损伤,尤其在肝脏,在体内产生类似于由辐射中毒引起的效应。
- 酒精与脱水:饮酒产生更多尿液而引起脱水,表现为口渴、头痛和头晕。
- 酒精与炎症反应:酒精可能触发免疫系统产生炎性因子,导致相关症状,如食欲下降、思维异常、记忆力下降等。
- 酒精刺激胃黏膜:酒精可增加胃酸的产生并延迟胃排空,可能导致腹痛、恶心和呕吐。
- 酒精导致血糖不足:酒精可引起血糖下降,引起疲劳、虚弱和情绪障碍,甚至颤抖和癫痫发作等。
- 酒精导致血管扩张,从而导致头痛。
- 酒精与睡眠:酒精可引起昏昏欲睡,但却阻止深度睡眠,并常在半夜觉醒,使人昏昏沉沉、疲惫不堪等。
风险因素
可能增加宿醉的严重程度,包括如下:- 年龄:20-35岁群体可能经历更频繁和严重的宿醉。
- 遗传因素:个体差异会影响酒精如何代谢。
- 空腹饮酒。
- 抽烟:吸烟与宿醉可能性和严重程度增加有关。
- 深色酒:颜色深的酒更易导致宿醉。
- 药物:许多药物可通过影响酒精代谢来影响醉酒和宿醉的风险。
症状
宿醉的症状包括如下:- 头痛、头晕,脑水肿
- 恶心、呕吐或胃疼
- 口干、口渴
- 疲劳和虚弱
- 易怒、焦虑或抑郁
- 注意力不集中
- 颤抖
- 心跳加速
- 血压升高,或降低
- 对光线和噪音敏感度增加
- 身体疼痛
- 功能性神经炎
并发症
经常发生宿醉可能产生以下问题:- 记忆下降
- 精力难集中
- 思维敏捷问题
- 慢性酒精中毒,或酒精滥用症状等
疗法
综合疗法包括如下:营养与草本综合干预
以下是基于循证医学和循证营养学有关文献综合的结果。
有助于防控宿醉的营养和草本补充剂,主要包括如下:
1.维生素B族:
慢性酒精中毒会导致维生素B吸收受损,并众所周知会导致维生素B1(硫胺素)缺乏,从而导致严重的神经和心血管问题1-3。苯磷硫胺是一种合成的脂溶性硫胺素,被发现在人体内比水溶性硫胺补充剂具有更高的生物利用度4-6。在动物研究中,在急性酒精中毒后提高硫胺素水平方面,苯磷硫胺比硫胺素更有效2,7。
一项对84名严重酒精性多发性神经病患者进行的为期八周的随机对照试验发现,每天320mg的苯磷硫胺治疗四周,然后每天120mg治疗四周,可以改善神经病变症状6,8。另一项研究表明,苯磷硫胺治疗可以减轻长期严重饮酒障碍男性的精神痛苦9。
烟酰胺核糖是维生素B3的一种形式,作为NAD+(烟酰胺腺嘌呤二核苷酸)的前体,NAD+是许多代谢过程的必要辅因子10,11。酒精代谢中NAD+的消耗,导致NAD+/NADH比率降低,被认为是酒精毒性的一个促成因素12。研究发现,补充烟酰胺核糖可提高人体血液中NAD+的浓度11,并在动物研究中证明了其神经保护作用10。
维生素B6和相关化合物也可以抵消饮酒的一些负面影响13。酗酒者叶酸水平较低,这可能是由于小肠吸收减少所致;肝脏代谢和叶酸潴留的改变;尿液中叶酸排泄量增加;并且在摄入酒精后干扰叶酸代谢14。因此,经常饮酒的人应该考虑补充叶酸。
2.半胱氨酸和N-乙酰半胱氨酸:
L-半胱氨酸是一种半必需氨基酸,与谷氨酸和甘氨酸一起合成内源性抗氧化剂谷胱甘肽。N-乙酰半胱氨酸(NAC),一种经常用于补充剂的半胱氨酸衍生物,也可以转化为谷胱甘肽。NAC似乎可直接与乙醛结合,并可能减少饮酒后血液中乙醛的增加15,16。
一项在19名健康男性中进行的随机安慰剂对照试验发现,600–1200mg剂量的L-半胱氨酸可以减少饮酒后的宿醉、恶心和头痛,并减轻压力和焦虑。该研究的作者认为,L-半胱氨酸甚至可能降低酒精成瘾的风险,因为有成瘾倾向的人可能会寻求用更多的酒精来“治愈”宿醉症状17。在动物研究中,NAC被发现可以降低酒精毒性18。一项小鼠研究发现,NAC和维生素C的组合改变了解毒酶的活性,并减少了酒精引发的自由基的产生19。在一项大鼠研究中,给予NAC可降低大脑和肝脏组织中酒精诱导的氧化应激水平20。一项针对斑马鱼的研究表明,NAC可以防止酒精引起的行为改变和氧化应激21。
3.谷胱甘肽:
谷胱甘肽是一种重要的解毒化合物和抗氧化剂,存在于全身细胞中,并高度集中在肝脏中22。酒精会降低肝脏中的谷胱甘肽水平,这会导致肝细胞损伤,并导致酒精性肝病的发展23。在一项大鼠研究中,在饮酒前服用谷胱甘肽两周,可以更有效地清除酒精和乙醛,并降低血液中的峰值水平。即使是在酒精暴露后给予高剂量谷胱甘肽的大鼠,其酒精和乙醛的清除速度也比仅给予水的对照大鼠更快,氧自由基水平也更低24。
4.维生素E:
适度饮酒已被证明会导致男性25和绝经后女性26的维生素E状况恶化。一项大鼠研究发现,饮酒尤其会消耗γ-生育酚27。γ-生育酚是组成维生素E家族的八种化合物(四种生育酚和四种生育三烯酚)之一;γ-生育酚是食物中最常见的维生素E形式28。
一些动物研究表明,维生素E治疗可降低慢性酒精诱导的炎症、氧化应激和组织损伤的标志物29-31。一个动物模型表明,维生素E可以防止急性酒精暴露后的氧化应激和谷胱甘肽耗竭,同时使用甲基硒代半胱氨酸(硒的一种形式)治疗可以增强这种作用32。另外两项动物研究发现,生育三烯酚可以预防酒精相关的神经毒性33,34。
5.硒:
微量矿物质硒对于谷胱甘肽过氧化物酶抗氧化系统的正常功能是必需的,在酒精性肝病患者中观察到硒水平较低35。动物研究结果表明,过量饮酒会导致血液和肝脏硒水平下降,导致谷胱甘肽活性降低和氧化应激加剧36。其他研究表明,补充硒可以防止这些负面影响37,20,32。
6.维生素C:
维生素C通过防止酒精喂养小鼠肝脏的氧化应激,显示出抗宿醉的潜力。与未服用维生素C的酒精喂养小鼠相比,服用维生素C使酒精喂养后的肝脏谷胱甘肽水平恢复到正常水平,并减弱了酒精诱导的氧化应激38。其他对大鼠的研究表明,维生素C可以保护神经元39、肾脏和血管免受酒精相关的组织损伤40,41。
7.水飞蓟:
水飞蓟素(水飞蓟果提取物)含有黄酮类化合物的混合物,其中50-70%通常是水飞蓟宾42。水飞蓟素和水飞蓟宾主要用于治疗肝脏疾病43。早期临床研究表明,水飞蓟提取物可以减少酒精性肝硬化造成的损害。水飞蓟素和水飞蓟宾可以提高谷胱甘肽水平,动物研究表明,它们可以激活被酒精消耗的解毒酶,改善线粒体功能,并缓解与酒精相关的肝损伤42-44。水飞蓟素还可以通过减少神经系统中的炎症和氧化应激来保护神经元45。
8.磷脂酰胆碱:
聚烯基磷脂酰胆碱(Polyenylphosphatidylcholine,PPC)是在动物研究中发现的磷脂的混合物,用于减少自由基产生并防止酒精诱导的肝细胞氧化损伤23,46,47。在一项研究中,PPC防止了酒精诱导的肝脏S-腺苷甲硫氨酸(SAMe)的耗竭,SAMe与大鼠肝脏谷胱甘肽水平的保持有关48。磷脂酰胆碱是PPC中的一种特殊磷脂,已被发现可预防酒精诱导的狒狒肝纤维化和肝硬化49。
在一个参与临床试验的慢性饮酒者亚组中,PPC治疗减轻了试验期间肝酶和胆红素的增加。这些标志物是肝损伤的指标,参与者在饭前每天三次服用1.5g PPC50。
9.镁:
饮酒会迅速引发包括大脑和肝脏在内的组织中的镁流失。在酒精的影响下,这种镁在尿液中流失,导致血清镁含量下降的趋势51-53。由此导致的镁供应的总体减少会导致血管收缩,并可能有助于解释过量饮酒与高血压、心脏问题和中风之间的关联53,54。一份临床报告描述了五名患有酒精引起的头痛和宿醉的患者的低血镁水平,并成功地通过静脉注射镁进行了治疗55。在动物实验中,一种名为苏糖酸镁的专利镁制剂可以提高大脑中的镁水平。这可能代表了一种对抗酒精诱导的脑镁消耗的策略,尽管这尚未在临床试验中得到证明56。
10.益生菌:
慢性过量饮酒与小肠细菌过度生长和大肠细菌数量的变化有关。此外,酒精会增加肠道内壁的通透性,使细菌毒素被吸收,从而引起肝脏和其他组织的炎症。事实上,这些影响现在被认为是导致酒精性肝病的主要因素57-59。用益生菌恢复肠道微生物组已被证明可以预防酒精性肝病的进展60-62。
益生菌的使用可以通过增加紧密连接蛋白的表达和减少炎症细胞因子的表达,帮助逆转酒精诱导的肠道内壁损伤,并防止肠道微生物群的变化,这些变化可以通过肠-脑轴(Gut-brain)影响大脑中的神经递质信号传导60,61。
在一项临床试验中,66名患有酒精性精神病的男性接受了为期5天的益生菌补充剂治疗,无论是否进行标准的戒酒加多种维生素治疗。该益生菌含有0.9亿CFU的双歧杆菌和9亿CFU植物乳杆菌。仅经过五天的治疗,接受益生菌治疗的患者的肝损伤就得到了一定程度的缓解,肝酶(肝损伤标志物)水平的大幅降低就是明证。他们还展示了健康肠道细菌的恢复63。另一项针对117名住院患者的试验发现,与安慰剂和戒酒相比,戒酒并补充含有枯草芽孢杆菌和粪链球菌的益生菌7天,肠道细菌得到了更大的改善,细菌毒素和炎性细胞因子水平也有所降低64。
临床前研究表明,益生菌有助于保护肝脏免受酒精诱导的损伤60。研究发现,补充各种乳酸菌菌株可以增强抗氧化酶活性,减少活性氧的产生,防止酒精性脂肪性肝炎的发展,并减轻酒精诱导的肝脏氧化损伤,包括降低肝脏酶和炎症标志物的水平65,66。益生菌鼠李糖乳杆菌LGG还被发现通过激活AMP活化蛋白激酶(AMPK)和增加脂肪酸氧化来防止酒精诱导的脂质代谢变化60。
动物研究进一步支持益生菌在酒精恢复中的潜在作用,这些研究发现,补充乳酸杆菌和双歧杆菌可以通过几种不同的机制保护胃免受酒精引起的损伤。这些包括增加胃粘膜的产生和减少胃炎症67-69,降低肠道高渗透性70,以及防止与酒精相关的肝细胞炎症和损伤71-73。
11.硫辛酸:
硫辛酸是一种含硫化合物,可提高谷胱甘肽水平并中和某些类型的自由基74,75。硫辛酸还参与维生素C和E的回收和缓解炎症76,并已在实验室环境中显示出可增加乙醛脱氢酶的活性,乙醛脱氢酶可分解乙醛77,78。
在动物研究中,给予硫辛酸的大鼠和小鼠后饮酒的动机较低79,80,并且在饮酒前接受硫辛酸治疗的小鼠脑组织中的自由基水平较低;与单独饮酒治疗的小鼠相比,酒精诱导的行为问题较少81。
12.褪黑素:
褪黑激素是一种有助于调节昼夜节律和诱导睡眠的激素82,饮酒和戒酒似乎都会抑制褪黑激素的产生83,84。在一项动物研究中,在暴露于令人陶醉的酒精之前,给予褪黑激素七天的小鼠在宿醉期间的肌肉协调性更好85。
由于睡眠障碍似乎是酒精宿醉症状和严重程度的一个重要因素86,87,提高睡眠质量可能是褪黑激素减少某些宿醉症状的一种机制。此外,褪黑素还有许多其他作用,有助于防止宿醉和酒精引起的其他伤害:调节炎症反应,防止与氧气相关的细胞损伤,并可能具有镇痛作用88,89。
13.亚洲参:
亚洲参(包括红参或高丽参)是一种药用植物,历史上用于治疗疲劳、增加能量、增强耐力和复原力90,91。一项针对25名健康男性的研究比较了服用32mg溶解在水中的人参根提取物和100ml 80度威士忌与同等量威士忌加白开水的效果。与单独服用威士忌和水相比,参与者在服用人参和威士忌后疲劳、认知症状、口渴和胃痛更少92。
动物研究结果表明,人参及其成分通过抑制氧自由基活性和炎症,并可能通过提高体内酒精和乙醛的清除率,减少与酒精相关的组织损伤93。在小鼠中,即使是急性重度酒精暴露,用人参预处理七天也可以减少肝损伤94。
人参的重要活性成分人参皂苷在天然状态下吸收不良。然而,发酵后已被证明可将人参皂苷的生物利用度和血清浓度提高约15倍。因此,在考虑人参补充剂时,发酵人参制剂可能是一个更好的选择95。
14.姜黄素:
已知姜黄素具有强大的抗炎特性96。在一项初步研究中,七名健康男性饮酒时要么单独喝水,要么加入姜黄素和水的制剂。姜黄素组的血液乙醛水平明显较低97。此外,几项动物研究表明,姜黄素可以减少与酒精相关的氧化应激、炎症和组织损伤98-100。
15.牛磺酸:
牛磺酸是一种含硫氨基酸,在全身具有多种功能,包括中枢神经和心血管系统101。对暴露于大量酒精的小鼠补充牛磺酸和草药,可提高其酒精代谢率,延长醉酒时间,缩短恢复时间102。牛磺酸还可以预防大鼠在四周内大量饮酒后的高血压103。在另一项研究中,短暂暴露于单次高剂量酒精的斑马鱼,如果同时接受牛磺酸,其大脑酒精水平较低,焦虑行为也较少104。其他多种动物研究表明,牛磺酸可以通过减少氧化应激、炎症和组织损伤来预防酒精毒性105-107。
16.S-腺苷蛋氨酸(SAMe):
SAMe对细胞主要抗氧化剂谷胱甘肽的形成至关重要,也参与中和同型半胱氨酸(一种细胞毒素)的甲基化途径。酒精会破坏SAMe的形成,酒精性肝病患者的肝脏SAMe浓度会降低。幸运的是,已经发现补充SAMe可以改善酒精暴露动物和酒精中毒人类的肝功能23。使用动物模型进行的研究发现,SAMe除了促进谷胱甘肽合成外,还可以部分通过改善肝组织中的线粒体功能来保护肝脏免受酒精的毒性影响108。
17.白藜芦醇:
白藜芦醇是一种多酚化合物,存在于红酒和亚洲传统药用植物日本虎杖的根,以及花生、葡萄皮和蓝莓中109。大量动物研究表明,白藜芦醇可能有助于最大限度地减少长期饮酒引起的氧化应激、相关炎症和组织损伤110,111。在其他动物研究中,白藜芦醇预防了学习能力的丧失112,113以及慢性酒精暴露后观察到的氧化应激和炎症标志物的增加;更高剂量的白藜芦醇与更大的保护作用相关112。
更多内容可点击其个性化综合干预方案如下:
- 酒精伤害管理:
- 降低酒精伤害:
以及参阅本网如下专文了解更多有关的内容:
预防
遵循下列措施有助于预防宿醉或降低酒后损害:- 适度饮用:每日标准饮料是330ml啤酒,或150ml葡萄酒或45ml白酒。
- 先吃食物再喝酒:胃中食物可减少对酒精的吸收,或吃食物时饮酒也可。
- 慢慢喝酒:当血液中酒精上升时,消化道吸收酒精的效率就降低了。
- 避免同时饮用不同种类酒。
- 饮酒后喝茶:酒后喝些淡茶有益。绿茶也可促进酒精分解。
- 酒后多饮水:多喝水有助于稀释摄入的酒精浓度。
- 不吸烟,饮酒时或饮酒后吸烟可能加重宿醉和酒精伤害。
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参考来源:
美国梅奥诊所
www.mayoclinic.org
美国匿名戒酒者组织
http://www.aa.org
美国自我节制管理网
http://www.moderation.org
加拿大药物滥用中心
http://www.ccsa.ca
加拿大精神卫生网
http://www.mentalhealthcanada.com
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