Category Archives: 疾病


Isn’t it humbling that we have no cure for the world’s most common illness? Yes, the common cold, globally the #1 cause of sick days and doctor visits, still stampedes across the world, blissfully immune to any Eastern or Western prescriptions. As a family doctor, I’m always a bit frustrated that I can’t offer much to these patients, at least in terms of Western allopathic medicines. So, I decided to scour the literature again to see if any new research has shown benefits from herbals and supplements. And the good news is yes: there may actually be a couple of supplements which can help you get better, quicker. Here’s my advice below. (Please note that this research is for treating, and not preventing, colds and flu.)

Evidence-Based Literature Search

When it comes to supplements and natural therapies, I use only a tiny handful of resources that I consider trustworthy. All are certified by the Health on the Net Foundation as sources of trustworthy medical information. All these sites would review only the best, most unbiased research, which usually means the gold standard of all research: placebo-controlled, randomized controlled trials. I strongly recommend that everyone use HONCode’s search engine anytime you’re looking for medical advice, especially regarding supplements. For example, you’ll never see the anti-vaccine snake-oil salesman Dr. Mercola on their list. Here are my favorite medical resources, and their evaluations of therapies for the common cold:

A graphical image and time line for cold symptoms. Note how the cough is always the last to improve…

Let’s break it down into the supplements that have the most evidence:

  • Zinc: This seems to have the most support, especially higher doses (>75 mg daily) of lozenges containing zinc gluconate or zinc acetate. Some good studies show reduction in cough, runny nose, headache, sore throat and overall time of illness. But side effects are common, especially nausea and a bad taste in the mouth. Also, definitely do not do the zinc nasal sprays, which have clear evidence to permanently cause loss of smell. The data suggests you should stick with lozenges and not pills. I see a few brands of logenzes up to 30 mg each, which at three times a day would help. I see a few popular brands with only 5 mg zinc each, which seems far too low to work. I wouldn’t advise using these for children.
  • echinaceaEchinacea: This is probably the one you’ve heard about, and the evidence is encouraging — but not totally clear. Some “double-blind, placebo-controlled studies have found that various forms and species of echinacea can reduce the symptoms and duration of a common cold, at least in adults. The best evidence is for products that include the above-ground portion of E. purpurea rather than the root.” But it’s very difficult for me to recommend a proper dose, as studies have used multiple regimens via drops, pills and teas, also using many types of echinacea, as well as different combinations of root and plant. Here’s a useful list of test results from ConsumerLab showing which brands in the USA have proper amounts of the herb.
  • andrographisAndrographis peniculata: An Indian herb very popular in Ayurvedic medicine and now in Europe, I think this actually has some good evidence.  A handful of double-blind, placebo-controlled have shown benefit in reducing the duration and severity of cold symptoms, especially cough. An excellent meta-analysis of herbals from Germany showed significant improvement in severity and duration of a cough, especially via liquid formulation. The usual dose seems to be 48-500mg of the andrographolide aerial parts, usually divided three times a day. You can find a good list of andrographis brands on I keep reading about a Swedish patented combination with eleutherococcus and sambucus (Kan Jang Plus), but I don’t see it sold anywhere in the USA.
  • pelargonium-409238_960_720.jpgPelargonium sidoides (Umckaloabo): This is an interesting herbal, very popular in Europe and perhaps should be more popular here in the USA. That same German meta-analysis I mentioned above found strong evidence that it helped with cough, fevers, and sore throat — including for children as young as one year old, although the German independent Institute for Quality and Efficiency in Health Care says it shouldn’t be used for children under six years. The Cochrane Library also reviewed this herb and concluded, “P. sidoides may be effective in alleviating symptoms of acute rhinosinusitis and the common cold in adults, but doubt exists.” As with andrographis, the liquids and syrups were better than tablets. I see on iHerb a series of pelargonium products called Umcka with good reviews.
  • Probiotics: Probiotics actually have pretty good evidence that taking them for months, especially over the winter, can markedly improve both the frequency and the severity of colds — for kids and for adults (as does vitamin D). That’s great news! But for symptom relief during a cold, the evidence is much more scant. I couldn’t find one good study for this; none of the groups above recommend probiotics as treatment.
  • Vitamin C: Here’s another super popular supplement, which many people swear by. But again the evidence isn’t conclusive, and the few studies that do show a benefit show only mild improvement. Still, at least it seems safe for adults and children, and evidence is even stronger as a preventive during the cold seasons.


My Bottom Line

For immune boosting,  don’t forget the most important advice: get a good’s night sleep; eat a lot of anti-oxidant foods; and stay well hydrated.

In terms of supplements, I think it’s appropriate for adults (not kids) to try some of the above supplements — and the sooner, the better, within 24 hours of your symptoms starting.

For what it’s worth, here’s my plan for myself and my wife the next time we get a cold: we’re going to continue our usual vitamin C + zinc bursts, usually using Airborne effervescent tablets, three times a day. Emergen-C and Wellness Formula also are similar, all three with a ton of vitamin C, some zinc and an assortment of herbals, many of which are mentioned above. I’m also adding andrographis 400mg twice a day and also pelargonium; and I’ll continue doubling up on my probiotic supplement, despite the lack of evidence. (One small note: last week my wife tried andrographis for the first time and had a horribly itchy rash for days. I was fine.)

In general, for children, I’m still hesitant about using any of these herbals for children under 6 years old, and I remain cautious about what I use with my own kids, both under 4 years of age. I still like probiotics during a cold, and I’m a big fan of honey for cough for all ages above one year, which studies show works better than any OTC syrup. I’m encouraged with the European studies using pelargonium and also ivy/primrose/thyme syrups, some of which are partially included in American brands like Zarbees. For more age-specific advice, please look at the recommendations in my previous article about curing a cough.

What herbals and supplements have you used? Please leave comments below.


This is a Chinese translation of my article I Have Prediabetes: Now What?.




diabetes food prediabetes为何糖尿病前期如此重要?



  • 1. 身体质量指数(BMI)超过25;
  • 2. 缺乏足够的体育锻炼;
  • 3. 食物的选择和分量并不理想。





1. 减肥。体重增加和肥胖是2型糖尿病的主要风险因素,因此减肥应排在糖尿病前期人群生活方式改变计划的榜首。如果您正处于糖尿病前期,您的目标应该是减重5~10%。

2. 锻炼。锻炼也许不是立竿见影的减肥方法,但运动中肌肉细胞能摄取血液中的葡萄糖,从而降低血糖、帮助控制血糖水平。这对糖尿病前期和糖尿病患者来说都至关重要。至于运动量需要达到多少,医生通常建议每周做150分钟中等强度的运动,当然只要动起来总比不动要强。近期研究表明,更短而激烈的运动也能够起到帮助作用。

3. 健康饮食。选择健康的食物也是控制血糖的关键。其实,糖尿病/糖尿病前期的问题并不是糖的问题,而是淀粉和碳水化合物的问题。说到健康饮食您可以会立即想到“我需要戒掉甜食”,不,罪魁祸首其实是您吃掉的淀粉——面包、面条、土豆和米饭等等。几个简单的方法:

  • 带颜色的优于白色的。白面包和面粉的膳食纤维含量极低,而膳食纤维有助于调节您的肠道健康和饭后血糖值。如果您喜食这类食物,可以尝试切换成全麦的意大利面、面包和米饭。
  • 控制食物分量。摄入的卡路里值也很关键,您实际摄入的热量值也许比想象的要多。
  • 少喝汽水、啤酒和果汁。这些饮料热量很高,又没什么营养价值。一些饮料内的人工代糖还会增加肝脏和胰腺负担。这类不健康的饮料、特别是汽水中的碳水化合物,是导致儿童和成人肥胖及糖尿病的主要原因。






本文节选自圣西睿智医生于2013年7月8日发表在他的博客myhealthbeijing.com上的文章I Have Prediabetes: Now What?。如果您希望与圣西睿智医生预约咨询,请致电北京和睦家医院全科,电话:(010) 5927 7500。


This was published in my health column in the New York Times Chinese edition《纽约时报》中文网撰稿 here. It’s a translation of my article on sunscreens.


sunscreens cancer SPF在防晒方面有哪些基本注意事项呢?家长们尤其需要保护家中的幼儿免受日晒伤害,事实上,已有很多研究显示,如果在童年严重晒伤过,创口起了水疱,那么这将是成年以后患黑色素瘤、鳞癌和基底细胞癌的主要致病风险。美国儿科医生学会(American Academy of Pediatrics)认为不满6个月的婴儿不应受太阳直晒,因为他们的皮肤特别白皙娇嫩。而对于大部分儿童和成年,使用防晒乳、适当的衣物、避免在早上10点-下午4点(或者参考你所在地的紫外线辐射指数)日照最强烈的时候外出,是避免伤害的最主要方式。

衣服有多么重要呢?对于任何年龄层的人来说,它都是防御日晒的第一道防线,但雪白的T恤的防晒指数(Sunburn Protection Factor, SPF)只有7,所以穿着这类衣服很容易晒伤。较厚的深色衣服则可提供SPF15甚至更高的保护。但我也很郁闷地十分了解一件事,那就是如果我整天在外游泳玩乐,就算是深色的T恤也不够。

在这种时候,防晒霜就能派上用场了。有研究表明,优质的防晒产品可以减少患皮肤癌,尤其是鳞状细胞癌的风险。一项澳大利亚研究显示,患上述癌症风险降低,有四成原因来自于使用了SPF16的广谱防晒产品。而防晒霜抵御更致命的黑色素瘤的证据事实上却并不是那么强有力,目前已知的最好的研究于2010年发表在《临床肿瘤学杂志》(Journal of Clinical Oncology)上。这项随机双盲试验在10年里,追踪了澳大利亚的1600人,而澳大利亚是全球皮肤癌最高发的地区。那些惯常使用防晒霜的人患侵袭性黑色素瘤的可能性减少了73%,不过随文章发表的编者按质疑了研究的统计显著性。虽然如此,我仍然同意这篇编者按的结论:“对于防晒产品在预防黑色素瘤效用方面虽存在疑问,但科研人员和医生不应就此止步,不再向人们建议使用防晒产品……除了使用防晒产品,人们还应避免受紫外线的过度照射,应穿着衣物使皮肤免受阳光直线,而室外娱乐场所也应设置防晒设施。除此以外,在使用防晒产品之余,人们也应对皮肤进行定期自查。”


购买广谱防晒产品:产品上注明SPF值50甚至70,并不意味着这个东西特别好,因为SPF评级系统衡量的只是阳光中的UV-B射线晒伤,并没有衡量UV-A射线。UV-A射线通常不会把你晒成个大红脸,但它要险恶得多,能渗透入你更深层的皮肤,带来更微妙但也更持续的癌前DNA损伤。因此在购买防晒乳时,你应该参考美国食品药品管理局的新规定,购买商标上注明“广谱”(broad spectrum)字样的产品。这表明它的配方可同时阻止UV-A和UV-B两种射线。

SPF30足矣,别浪费钱买SPF50或更高的产品:SPF15已算是个不错的起步产品,因为它能阻挡93%的UV-B射线,但我同意美国皮肤科学会(American Academy of Dermatology)的建议,通常使用SPF30的产品。SPF50或更高,看起来倒是挺炫,但从临床上来看所起到的额外防护作用相比SPF30的防晒霜,可谓微乎其微。SPF30可阻挡97%的UV-B,而SPF50只高出了一个百分点,至98%。事实上,欧盟认为这会对消费者产生巨大的误导,因此禁止所有产品标注超过SPF50,而美国食品药品管理局也在对这项姗姗来迟的禁令进行最终评估。




防晒产品的成份同样五花八门,当中有很多被批准的化合物,而这想必会加深你的疑惑。一些组织,尤其是总部位于美国华盛顿特区的独立环境健康研究和倡导组织“环境工作小组”(Environmental Working Group)声称在防晒产品中两种常见的成份羟苯并唑和棕榈酸视黄酯(维生素A派生物)对健康有害,因此不应出现在防晒乳中。比方说,这个组织的网页描述了羟苯并唑的危害,包括会“破坏荷尔蒙;在长期喂养研究中发现可影响生育,改变器官重量;增加光过敏机率;少量证据表明可改变新生儿出生体重,增加妇女子宫内膜异位可能性。”不过,目前没有任何国家的药物监管部门禁止使用这个成份,也没有大型医学机构认同这个组织的观点。这个组织所援引的研究主要都是在动物身上或试管中进行的,没有人体试验,也没有任何大型人体试验显示它可带来严重危害。美国、欧盟和加拿大都认为这两种化合物是安全的,而且在使用20多年后依然如此。美国儿科医学会就防晒霜发表的声明中,没有对这些化合物或其他食品药品监管局批准在防晒乳中使用的化合物提出任何警告。美国皮肤科学院(American College of Dermatology)去年夏天发表了一份更新版的声明,重申了对这两种成份的支持。

要是你对这些成份仍然心存顾虑,国内市面上还有上百种防晒产品完全不含这两种成份,而且仍能为你和孩子们提供完美的广谱防晒保护。羟苯并唑其实在防晒上的效果还不如其他化合物,比如阿伏苯宗,所以你可以寻找到替代品。而棕榈酸视黄酯也不是非要不可的成份,它并不能阻挡阳光,加入防晒剂中据说只是为了防止受日晒而导致皮肤老化。美国儿科医学会特别推荐含氧化锌或二氧化钛的产品,因为它们是物理防晒,不会被皮肤吸收。如果你希望得到更多消费者指引,可以阅读《消费者报告》(Consumer Reports)的独立测试结果,或参考《消费者调查》(Consumer Search)的防晒品成份指南,这份指南也对天然防晒用品进行了点评。

研究发现 荷尔蒙是导致减肥失败的一个主要“元凶”

obesity leptin ghrelin肥胖,现已成为全球一个主要的健康危机。无论医生还是肥胖病人都深知,减肥和保持减肥后的体重都是非常艰难的过程。令人遗憾的是,越来越多的证据解释了为何减肥之路如此坎坷:当你处于节食期间,你身体内的荷尔蒙就会处于一种“禁食”(饥饿)状态,即使你减到理想体重,这种“禁食”状态还会继续保持,不会恢复。人体内瘦素(leptin)和胃饥饿素(ghrelin) 这两大荷尔蒙的平衡使节食者总有饥饿感;90%以上的节食者减肥后出现反弹,反弹后的体重就成了肥胖患者的“新常态”体重。这个研究结果对于大多数人来说意味着两方面:

  • 肥胖者不能因为减肥效果不彰而妄自菲薄, 减肥在生物学上是很艰难的一件事;
  • 最好一开始就不让自己肥胖,因为一旦超重了,就很难恢复正常体重并且保持其不反弹。

关于这个另肥胖者感到气恼的说法,现已有人认真地做了研究,其中包括Gina Kolata在《纽约时报》上发表的众多关于肥胖问题的优秀文章之一。她去年还写了一篇非常不错的,很让人触动的文章,名叫“脂肪陷阱”,我强烈建议那些关注体重的朋友们去看一看。关于这个话题,我在3月8日的轻松调频(EZFM)节目中谈论过,有兴趣的朋友可以点击下面的链接来收听。


点击下面的箭头来收听播客(英文),或者 点击这里.


在“我的播客文档(my podcast archive)”里可以收听到我之前录制的所有播客。朋友们也可以在北京时间每周三早上7:35左右收听我在轻松调频(EZFM)91.5频道的Beijing Hour Program中的现场广播,这个广播节目是每周一至周五早7点至早8点由Paul James主持。轻松调频(EZFM)是中国国际广播电台中著名的双语广播电台,播出地点在北京,在国际上拥有多个广播电台和网络电台。

(Much thanks to Alice Liu  for this Chinese translation from the original blog post)