2017原油技术分析:《洛杉矶时报》：慢性疲劳综合症之谜

《洛杉矶时报》：慢性疲劳综合症之谜

Most health professionals have finally acknowledged that it's a real and serious illness. But we still don't know what causes it.

大多数健康专家最终承认，这是一种确实而严重的疾病。但我们仍然不知道是什么原因引起的。

By Jay A. Levy and Daniel L. Peterson 

作者：瑞.A.莱维和丹尼尔.L.彼得森

September 30, 2011

2011年9月30日

Some doctors are beginning to believe that there may not be one single cause of chronic fatigue syndrome but a number of causes that all produce the same disturbance in the immune system. (Los Angeles Times) 

一些医生开始认为，慢性疲劳综合症的原因不是单个而是许多原因一起引起了免疫系统失调（《洛杉矶时报》）

For more than 100 years, medical literature has contained reports of a debilitating illness that causes prolonged fatigue, memory loss, headaches, cognitive problems and issues with digestion and sleep. Teddy Roosevelt, John Muir and Thomas Eakins all suffered from what was then known as neurasthenia.

     一百多年以来，医学文学涵盖了一些使人非常虚弱的疾病的报道，那些疾病会引起人慢性疲劳、记忆丧失、头痛、认知问题或者消化和睡眠问题。泰迪·罗斯福、约翰·缪尔和汤姆·艾金斯都忍受了当时被称为神经衰弱的折磨。

At that time, the recommended treatment for women was bed rest; men were advised to head to the Wild West. But neither treatment could be counted on to cure the disease.

    当时，给女性推荐的治疗是卧床休息，而男性则建议去西部荒原。但是不管哪种治疗对治神经衰弱都没有用。

Toward the end of the 20th century, doctors came up with the term chronic fatigue syndrome (or, in Europe, myalgic encephalomyelitis) to describe the set of symptoms that used to be called neurasthenia. But we still did not fully understand the illness, nor had we isolated its cause.

      到20世纪末时，医生们想出了慢性疲劳症的术语（或者欧洲的肌痛性脑脊髓炎）来描述那一系列曾被成为神经衰弱的症状。但是我们仍然不是很明白这种疾病，也没有找出是何种原因引起的。

Patients have suffered because of this failure to fully understand the disease. Sometimes, doctors attributed the symptoms to anxiety, depression or hypochondria. Employers have been less than sympathetic.

      病人因为此种疾病没有充分弄懂的失败而饱受疾病的折磨，进而充分了解了这种疾病。有时，医生将症状归于紧张、抑郁或者忧郁症。雇主们都不够有同情心。

Today, most health professionals have finally acknowledged that chronic fatigue syndrome is a real and serious illness. But its name, which focuses on just one of the disorder's many symptoms, has served to trivialize the condition, making it seem more psychological than physical and reducing interest in the disease among mainstream medical and scientific researchers.

      现在，很多健康专家最终承认，慢性疲劳是一种确实的严重疾病。但是它的名字只表现了许多失调症状的其中之一，因而小看了疾病的状况，让这种病看起来更多是精神上而非身体上，也降低了主流医学和科学研究的研究兴趣。

This low interest among researchers is unfortunate because most of the biggest unsolved problems with chronic fatigue syndrome are scientific ones. We need to learn what causes the illness and we need to use that information to develop tests to diagnose, prevent and treat it.

    研究员稀少兴趣令人遗憾，因为因为慢性疲劳综合症的尚未解决的绝大部分问题是科学问题。我们需要知道引起疾病的原因，然后用那些信息来开发诊断测试，预防和治疗疾病。

The current consensus is that chronic fatigue syndrome is probably caused by a disturbance to the immune system. In ways that are not entirely clear, this disturbance upsets the immune system for a prolonged period of time and leads the body to become hyper-responsive and produce a large outpouring of toxic substances, which then cause the fatigue, muscle aches, headaches and mental confusion associated with the disease.

     现在的共识是，慢性疲劳综合症可能是免疫系统干扰引起的。方法上还不是完全清楚，这种干扰持续地扰乱免疫系统，让身体过分敏感，产生出大量的有毒物质，这些有毒物质会引起疲劳、肌肉酸痛、头痛和与疾病相关的精神错乱。

Scientists have speculated that the chain of events that leads to this prolonged immune disorder begins when someone is exposed to a triggering agent — a toxic chemical, for instance, or a bacterial or viral infection. But identifying such an agent has proved difficult.

    科学家推测，当某人接触了一种触发药剂时——比如，一种有毒的化学药品，或者细菌感染、病毒感染——一系列事件导致长期免疫系统失调开始了。

One complication has been that by the time someone develops symptoms and seeks treatment, the underlying infection is no longer detectable, so there is no longer a way to identify the causative agent from blood tests.

    这时候，情况复杂了，那人症状显露，寻求治疗方法，潜在的感染就不再觉察得到，所以就没有一种方式能通过血液测试来识别病原体。

To complicate things even more, the over-responsive immune systems of people with chronic fatigue syndrome can activate co-infections, including Epstein-Barr virus, CMV and HHV-6, which make it even more difficult to identify the initial trigger.

      甚至会让事情更复杂，患有慢性疲劳综合症的人的过分敏感的免疫系统会刺激交互感染，引发包括巴尔病毒、巨细胞病毒和人疱疹病毒6型等病毒，这使得更难识别最初的触发原因。

Some doctors are beginning to believe that there may not be one single cause of this syndrome but a number of causes that all produce the same disturbance in the immune system. But what those agents are and how they cause the disturbance are challenging questions.

    一些医生开始认为，可能这种综合征的原因不是单个而是一系列原因产生了免疫系统中的同种失调。但是到底是什么以及它们是怎样造成失调的，还是富挑战性的问题。

In the last few decades a number of viruses and bacteria have been fingered as possible culprits for causing chronic fatigue syndrome, but none ultimately stood the test of scientific scrutiny. The most dramatic example came two years ago when a group of researchers reported finding a mouse-related virus called XMRV, a pathogen in the same family as HIV, which causes AIDS. They believed they had identified this virus in the blood of a several patients with chronic fatigue syndrome, raising the hopes of patients everywhere.

      近几十年，大量的细菌和病毒被认为是引起慢性疲劳综合征的可能罪魁祸首，但是没有一个最后能通过科学细查的测试。最明显的是两年前的那个例子，一堆研究员报告说发现了一种和鼠相关的病毒，这病毒叫做异嗜性小鼠白血病病毒相关病毒 ，和引起艾滋的HIV病毒是同种病原体。他们认为，他们是在患有慢性疲劳综合症的一些病人的血液中识别出这种病毒，这燃起了各地患者的希望。

Unfortunately, before this claim had been fully validated, many patients embraced XMRV as the long-sought cause of this illness and began considering potential treatments. Because of the similarities between the mouse virus and HIV, some of them even started taking AIDS drugs.

      但遗憾的是，这项声明充分验证之前，许多的病人相信异嗜性小鼠白血病病毒相关病毒正是长期寻索的引起此种疾病的病因，开始考虑一些可能的治疗。因为鼠病毒与HIV病毒之间的很多相似性，一些病人甚至开始服用艾滋病药物。

Then, we found out the truth.

    然后，我们发现了真相。

In more than 10 follow-up studies, research in our UC San Francisco laboratories and elsewhere failed to find any evidence of XMRV in the blood of the chronic fatigue patients tested. Moreover, experiments indicated that this virus does not survive well in human blood, making it an unlikely source for a human infection. Other studies have suggested that the XMRV detected in the original studies may have come from contaminated lab materials.

      在超过10个的后续研究中，我国UC旧金山实验室和其他实验室的研究没有在被测的患有慢性疲劳综合症患者的血液里找到有异嗜性小鼠白血病病毒相关病毒（XMRV）的证据。另外，实验表明，这种病毒在人类血液中不能存活，也不可能引起人类感染。其他的研究也表明，在最初的研究中发现的异嗜性小鼠白血病病毒相关病毒（XMRV）可能是来自受污染的实验室材料。

So where does this leave the millions of people in the United States who suffer from chronic fatigue syndrome? Frustrated.

      这将美国成千上万的患有慢性疾病综合症的人置于何处？当然是失望沮丧中。

The medical community, and the agencies and foundations that fund medical research, have never given this illness the attention it deserves. That needs to change.

     医学界、代理机构以及基金会资助医学研究，给了这种疾病该有的而从未有过的关注。事情需要改变。

Some have suggested that a name change might help. Chronic fatigue immune dysfunction syndrome would be a more accurate name that would call attention to the fact that the disease is tied to a disturbed immune system.

      一些人认为换个名字可能有用。慢性疲劳症候群可能是一个更准确的名字，能引起对该疾病与干扰的免疫系统有关的事实的关注。

Next, we need to retrench, to reconsider the direction of research on this disease. We should embrace the fact that we still do not understand what causes it and that until we do, we will always be restricted in our ability to develop new ways of diagnosing, treating and preventing it. This will continue to be frustrating to patients and their families, but embracing science that is later disproved hasn't served sufferers well.

     接下来，我们需要紧缩开支，重新考虑这个疾病的研究方向。我们应该相信，我们仍然还不是很清楚引起的原因，我们应该要做点什么，寻找诊断、治疗和预防的新方法时会囿于自己的能力。我们还会继续让患者和他们的家人失望，相信科学随后会被证明是错的不会让患者好受。

Until we determine the causes and work out the best treatments for this debilitating condition, people with chronic fatigue syndrome will continue to suffer. In the meantime, we must increase support for basic research and for finding the best, evidence-based approaches for treating the disease.

     慢性疲劳综合症患者仍会继续受折磨，直到我们确定了这种虚弱病状的病因，找出了最好的治疗方法。同时，我们需要增加基本研究的支持，也需要找到最好的有根有据的方法去治疗疾病。

Jay A. Levy is a professor of medicine and director of the UC San Francisco's Laboratory for Tumor and AIDS Virus Research. Daniel L. Peterson is a physician in private practice in Nevada and treats patients with chronic fatigue syndrome.

      瑞.A.莱维是内科教授，也是UC旧金山肿瘤和艾滋病病毒实验室的负责人。丹尼尔.L.彼得森是内华达私人诊所的内科医师，治疗慢性疲劳综合症患者。