2024年1月10日发(作者：)

BBC地平线系列之《药物依赖》

245第1集:人的一生要吃四千粒药

Over the course of your lifetime, 在你的一生中

you're likely to be prescribed more than 14,000 pills. 医生可能给你开了超过一万四千颗药丸

Tiny little spheres of 这种小小的粉末压片

crushed powder with almost magical effects, 有着魔法般的功效

pills that will possibly save 药物可以拯救生命

and extend your life by decades. 并将寿命延长数十年

Any medicine actually is a miracle. 实际上 任何药物都是一种奇迹

If you really think about what a medicine does, 只要你想想药物的工作原理

that you can design a small chemical 人居然能研制出一种化学药品

to interfere with a biological process to 调控生物进程 进而治疗疾病...

I mean, it is just astonishing that you ever get there. 我们能做到这一点真的令人嗔目结舌

These miraculous pills 这些神奇药物得以出现

often owe as much to serendipity as science. 所需的运气与研究并重

We started with a drug that we hoped would be effective in angina 我们研制这种药的初衷 是为了治疗心绞痛

and we ended up with a medicine 最后却发现这种药物

that was highly effective in erectile dysfunction. 对治疗阳痿非常有效

This accidental nature of drug discovery means little is known 这种药物发现的偶然性表明

about what they can do until we all take them. 在服用药物前我们对它知之甚少

In many ways you learn as much about 即便投放市场之后

your medicine after it's launched as you knew before. 你对药物许多方面的了解也并无增加

246第2集:依靠药物过日子

Our relationship with pills 我们和药物的联系

starts from the very beginning of our lives, 从生命的最初开始

from the medicines handed to us by our parents. 从父母递给我们药片时就开始了

I used to get so upset having to 以前必须吃这些止痛药

take these pain killers because I didn't want to, 总让我很烦恼 因为我不想吃

so my mum, I was probably about five, 我当时大概五岁 所以我妈

and my mum used to snap them in half 把它们掰成两半

and tip the actual medication into orange squash for me. 把药倒到橙汁里给我喝

My mum gives me my tablets every day. 我妈妈每天都给我吃药

As we grow up, we begin to pop pills for everything. 随着我们长大 我们开始凡事依赖药物

There are the antibiotics we take to fight off disease, 我们服用抗生素 去抗击疾病

more than one course every two years of our lives. 每两年还要吃不止一个疗程

The 28,000 pain killers we each take 有28000种止痛药供人挑选

to make us feel better. 用于减少痛苦

Pills to stop us having babies. 还有帮人避孕的药片

I actually got pregnant on the pill. 我其实是靠吃药帮助才怀孕的

So... 所以

Medicines to carry us through middle age. 帮人度过中年综合症的药物

Statins. 抑制素

Even tablets to extend our youth 甚至还有帮我们延缓衰老

and improve our performance in bed. 提升床上战斗力的药物

247第3集:葛兰素史克

This is a temple to modern science - 这是现代科学的一座神殿

the pharmaceutical labs at GSK. 葛兰素史克公司的制药实验室

But modern drug discovery relies 但现代药品的发现

more on an automated lottery than careful design. 更依赖于运气而不是精心的设计

This store of chemical compounds 这个化合物仓库

is the company's crown jewels. 就是公司的核心所在

This is where their new drugs come from. 这就是新药物的来源地

In here is a library of 这里是超过两百万的

over two million nameless chemical compounds. 未命名化合物的仓库

The scientists know very little about them. 科学家们对它们了解甚少

They could be highly toxic, 它们可能有剧毒

or they could be harbouring a life-saving drug. 也可能是治病救人的良药

It really is trying to find a needle in a haystack. 这实际上是海底捞针

It is about getting the samples out, 我们需要取出样品

processing them, screening them 进行加工 筛选

and hoping we find that that chemical compound 希望能发现一种化合物

that is active against those disease areas. 能够对某种疾病有效

248第4集:药物合成

A known disease molecule, called the target, 一种已知的疾病分子 我们称为靶分子

is introduced to each of the two million compounds, one by one, 逐一加入到这两百万化合物中

to see if anything happens. 去观察是否有反应

With the two million or so compounds, 在这两百万的化合物中

we might get a few 我们可能会发现

compounds that are active against that target. 一些化合物对靶分子有效

We then have to take that one or two hits 然后我们得抓住这一个或两个的机会

and the chemists will make hundreds, maybe thousands, of samples 化学家根据它们的母核结构

related to that original 合成出成千上万的类似物

structure to try and improve the activity 以期提高其活性

and most importantly try 最重要的是

to negate any safety or undesirable effects. 消除一切危险的和预期外的功效

We have to screen those over and over 我们必须一遍一遍地筛选

again to make sure that we're going in the right direction. 确保我们的方向正确

After hundreds of millions of tests, 在数以万计的测试后

just a handful will make it through to trials on people. 只有少量的药品

会进行人体测试

In all, it takes about 1 billion and 15 years' work 总的来说 需要10亿的投入和15年的工作

to find the winning compound that can become a licensed drug. 才能找到一种可以获批投产的化合物

The journey to a medicine is an epic journey. 寻找药物的旅程是宏大的

That whole process from idea through to a drug approved 从想法的形成到药品审批通过的整个过程

is one littered with failure. 失败一直如影随形

249第5集:使人注意力集中的药

His newfound ability to concentrate 他现在能够集中注意力

is largely thanks to a drug called methylphenidate, 多亏了这种叫哌醋甲酯的药

best known to most of us by a brand name - Ritalin. 大家更熟悉的是它的商品名 利他林

It takes about 30-40 minutes for it to work, 大概30到40分钟就能发挥药效

and it's not like Liam suddenly goes docile. 当然也并非利亚姆突然就变温顺

It just basically does have a calming effect on him. 它只是有种镇定的功效

He doesn't seem to be as hyperactive 他不再过度亢奋

on the medication and he is able to sit quietly, 服药期间他可以安静地坐着

be able to focus on things like his homework 可以集中精力在他的作业上

or just, just basically have 或者 只是...

a more normal life, really. 只是过上正常一点的生活

And, as for thousands of other children, 如同对成千上万其他孩子一样

Ritalin has had a remarkable effect on Liam. 利他林对利亚姆非常有效

I feel calm. 我感觉很镇静

I don't feel like excited. 没有觉得很激动

I feel energy because I 我以前觉得精力充沛

can just run around all day if I wanted to 如果我愿意我可以跑一天

but I'm just calm now. 但我现在只是觉得很镇静

And I'm excited as well. 也有点兴奋

250第6集:从药物中获利

Liam, there's cars coming. Straight here now! 利亚姆 有车来了 赶紧过来

And this is Ed. 这位是埃德

I've just finished my law exams for this year. 我刚考完了今年的法律考试

I've got a triathlon coming up in two days' time 我这两天还得参加铁人三项

and I've got a couple of jobs 而且我还有一堆工作

on the go at the minute so things can be quite hectic. 最近忙个不停 所以事情很忙乱

It does sometimes feel like 有时候我感觉

there aren't quite enough hours in the day. 一天的时间并不够用

Don't, Liam! 不要 利亚姆!

For very different reasons, 虽然原因不同

both Ed and Liam have found benefits from the same drug. 埃德和利亚姆都从同种药物中获益

Aged five, Liam was diagnosed 五岁的时候 利亚姆被确诊为

with attention deficit hyperactivity disorder, ADHD. 注意力不足过动症 简称ADHD

Come on, your hot chocolate's ready. 来吧 你的热巧克力好了

Now, five years later, 现在 五年过去了

Liam's life has been transformed. 利亚姆的生活有了很大改变

Here you go. 到你了

Thank you. One, two, three, four, five. Excuse me. 谢谢 一二三四五 打断一下

Whose go is it next? 下一个到谁

Mine? No it was me, 我 不是我 是你

251第7集:治疗各种疾病的药物

Despite the minute success rate, 尽管成功几率微乎其微

the potential rewards are enormous. 但潜在的回报却是巨大的

We hope there would be chemicals in here 我们希望这其中 有一种化学成分

that would be the future cures for all sorts of disease areas. 可以在未来治愈所有疾病

It would be nice to think that here 想象一下就在这里

we do have the cures for cancer, AIDS, Malaria, 能找到种药物 治愈癌症 艾滋病 疟疾

any of the world Health Organisation top priorities. 及所有世卫组织高度关注的疾病 那该多好

If drugs are not designed but discovered, 倘若药物并非设计 而是偶然发现得来

then it should come as no surprise that 那么 只有我们亲身尝试后

we only find out what they really do to us when we take them. 才知道它真正的效用也并不奇怪

Give me your hand. Give me your hand. Liam! 把手给我 把手给我 利亚姆

This is Liam. 这是利亚姆

Aged five, he was disruptive, hyperactive and unable to focus. 五岁 过度活跃 没办法集中

252第8集:药物的副作用

Now without the medication, 如果没有药物帮助

you could ground Liam and he would go back the next day 你可以给利亚姆禁足 但第二天

and do the same thing that he'd been grounded for. 他会又会重犯让他禁足的错误

With medication it just enables him to consider the consequences, 在药物的帮助下 他可以去更清楚地

a little bit more clearly, of his actions. 考虑行动的后果

It was only by accident 研究人员是在偶然间

that researchers discovered drugs like Ritalin 发现像利他林这种药

could help children with behavioural problems concentrate better. 可以帮助有行为问题的儿童更好地集中精力

These drugs were originally designed 这些药在50年前

50 years ago for the treatment of adults with depression. 是为治疗成人的抑郁症而设计的

It's only now 然而直到现在

we are beginning to understand how they work. 我们才开始了解它的作用机理

ADHD is believed to be caused by an imbalance ADHD是由于大脑中

of key chemical messengers in the areas 控制注意力和工作记忆区域里的

of the brain that control attention and working memory. 关键化学递质不平衡引起的

Ritalin appears to make these 利他林似乎能让这些

messengers more effective, helping to restore attention. 递质更加强效 进而帮助恢复注意力

Like all drugs, Ritalin comes with a cost. 和所有药物一样 利他林也有副作用

It can cause a loss of appetite and insomnia. 它可能引起食欲降低和失眠

But now another benefit has 但现在又发现了它的另一个功效

been revealed from which we could all profit. 可以惠及我们所有人

253第9集:增强剂

Initially when I took the Ritalin, I didn't feel any difference. 起初我吃它 并没有感觉到不同

Only really afterwards did I actually 等到一段时间过后

notice that I felt slightly more focused than I usually do. 才发现我比平时更集中精力

I found it really difficult to kind of get into that mental state 我发现要进入那种

where I kind of felt I could just sit and do nothing. 干坐着不干活的精神状态很困难

I found myself looking for things to occupy my attention. 我发现自己在找东西来占据注意力

Ritalin can work as a cognitive enhancer. 利他林也可以用作认知增强剂

If a person without ADHD takes it, 如果一个没有患ADHD的人服用它

it can make them cleverer. 它可以使他们更聪明

It's a discovery not lost on the country's academic elite. 这个发现并没有被学术精英们忽视

Here at Cambridge University, students are abusing Ritalin 在剑桥大学 学生们滥用利他林

or its close relative, modafinil, to help them get ahead. 或者它的类似物莫达非尼 来增进学业

A few of my friends do what they call modafi-vising. 我的一些朋友服用他们所谓的莫达聪明剂

It can keep them up for 24 hours and they can keep on going. 它可以使他们24小时保持兴奋

I think they feel pretty shocking after it, 我想他们过后肯定会很心烦意乱

but if you need to do a lot of work in a short amount of time, 但如果要在短时间里完成大量工作

then that's one way I've heard it can be done. 这就是我所知道的有效方法

254第10集:药物的好处

People who do take Ritalin, I think they see 我认为服用利他林的人

the benefits of it and it does help them with their revision. 看到了它的好处 它的确帮助他们复习

My friends that do, tend to do pretty well but I, 我的那些服用过的朋友表现更出色一些

I like to think that's because they're quite clever. 但我还是愿意相信是因为他们天资聪颖

Ed wasn't taking Ritalin for illicit gain. 埃德服用利他林 并非出于不当目的

He took it at the behest of this woman. 他是在这位女士的委托下服用的

Barbara Sahakian is Professor of 芭芭拉·萨哈金

Clinical Neuropsychology at Cambridge University. 是剑桥大学临床神经心理学的教授

She's researching what drugs for 她在研究治疗ADHD的药物

those with ADHD can do to the brains of the healthy. 对健康人大脑的作用

Well, we knew that the drug worked as a cognitive enhancer 我们知道这个药可以用作

for conditions like attention deficit hyperactivity disorder, 多动症儿童的认知增强剂

but would they also work in, 但对没有问题的健康人

in healthy people who didn't have any problems? 它也能有作用吗

Could we actually boost cognition 我们真的可以

in somebody who was you know functioning well? 提高健康人的认知能力吗

Ed was one of her research volunteers. 埃德是自愿受试者之一

They were each given Ritalin 他们每个人都服用利他林

and put through a variety of intelligence tests. 并进行一系列的智力测试

255 道德争强论、

Professor Sahakian found the drug had 萨哈金教授发现这种药物

also boosted levels of chemical messengers in healthy brains, 也可以提高健康大脑内化学递质的水平

increasing their concentration levels too. 进而也提高他们的专注性

We were a bit surprised that 我们有一些惊讶于

in healthy people you could boost cognition. 它也可以提高健康人的认知能力

It reveals ADHD is not a black and white disorder. 这表明 注意力不集中症状并不绝对

It's a spectrum, a spectrum we are all on. 它只是个范围 人人都可能有点

Some people are very impulsive, 有些人很冲动

other people are not impulsive at all. 有些人却一点也不

I think we all know friends of 我想我们都认识这样一些朋友

ours who might do something that we wouldn't do 他们会做出我们不会做的事情

and then it's a question of if we go 只要我们将范围扩大

further up that spectrum, that we may start to find somebody 我们就会开始发现

who is actually not functioning very well 有些人并不是很健康

because their impulsive behaviour or their lack of attention 因为他们的行为冲动或缺乏注意力

is very bad and therefore they do actually need a treatment. 是不好的表现 他们亟需治疗

This potential to make us all cleverer 这种使人变聪明的潜在可能性

opens an ethical minefield. 引发一场道德上的争论

256 药物滥用

If you want to do well, 如果你想要表现好

I feel that should be a personal achievement 我认为就应该靠个人努力

as opposed to enhanced by artificial mechanisms. 而不是通过来人为的机制来提高

If a lot of people took it, 如果大量的人服用它

then people would have to 那么人们就必须服用

take it to be able to compete with their peers. 这样才能和同龄人竞争

To be perfectly honest, doing what it does, if it was legal, 坦诚地说 如果这么做是合法的

and it was safe, everyone would be doing it. 并且安全的 那么每个人都会服用

Already it's being put to use among professionals. 现在一些专业人士已经开始服用了

Professors are using it to help them work, 教授们用它们来帮助工作

and surgeons are looking at it 外科医生们服用它

as a way of staying alert during long and complex surgery. 是为了在长时间复杂手术中保持敏锐

But for Professor Sahakian 但是对于萨哈金教授

the question remains 依然存在一个问题

will it actually make our lives better? 它真的能改善我们的生活吗

Suppose we took cognitive enhancing drugs 假如我们服用提高认知的药物

and we got all our work done in a short period of time, 我们在短时间内把工作做完

we could go home, spend time with our 我们就可以回家 和家人在一起

family and improve our work/life balance. That would be great. 改善工作与家庭之间的平衡 那很不错

But it's more likely with the 但是 当今社会

type of society that we seem to be moving towards 正朝向无休止地工作发展

that it will be this 24/7 因此更有可能出现的情况是

society so we'll take these drugs so we can 我们服用这些药物

work longer, so we can travel more and do 是为了让做工作时间更长 旅行更

多

more work so it will 然后做更多的工作

disrupt our work/life balance even more. 因此会使工作与生活的平衡变得更糟

第13集:257畅销药物

I'm always looking for ways that I can squeeze more in. 我一直都在想办法挤出更多的时间

At one point I did think I'm going 有时候 我真的认为

to have to give up eating, sleeping or one of my jobs. 我会废寝忘食 或是放弃一项工作

It did cross my mind actually that 我的确有过这样的想法

if I could get my hands on something like that again, 如果我能再一次服用那种药物

it would be, maybe to my advantage. 也许 也许会增加我的优势

I'm not sure about a pill 我不会用这种药

that would make you more intelligent. 这种能让人变聪明的药物

We're happy being on the thick side. 我们就这样笨笨的也挺开心的

Yeah, being a bit thick's OK. 是的 笨一点也挺好的

We'd like to think our drugs are designed 我们都一厢情愿地认为

for exact purposes, 药物是为特定目的而设计的

but they're not as targeted as we think. 但是它们并不像我们想象的那么有准头

We only discover where in our bodies 当我们服药的时候

they work when we take them. 我们仅仅知道它的作用部位

It turns out Ventolin inhalers, 实际上 喘乐宁气雾剂

a treatment for asthma, 一种治疗哮喘的药物

can also prevent premature labour, 同样可以预防早产

and arsenic, a notorious poison, 砒霜 一种毒药

is making a comeback as a treatment for leukaemia. 正在白血病治疗中崭露头角

Even the fastest-selling drug 即便有史以来最畅销的药物

of all time is not used for what it was designed. 它现在的用途也并非当初设计的初衷

《药物依赖》第12集:滥用药物

If you want to do well, 如果你想要表现好

I feel that should be a personal achievement 我认为就应该靠个人努力

as opposed to enhanced by artificial mechanisms. 而不是通过来人为的机制来提高

If a lot of people took it, 如果大量的人服用它

then people would have to 那么人们就必须服用

take it to be able to compete with their peers. 这样才能和同龄人竞争

To be perfectly honest, doing what it does, if it was legal, 坦诚地说 如果这么做是合法的

and it was safe, everyone would be doing it. 并且安全的 那么每个人都会服用

Already it's being put to use among professionals. 现在一些专业人士已经开始服用了

Professors are using it to help them work, 教授们用它们来帮助工作

and surgeons are looking at it 外科医生们服用它

as a way of staying alert during long and complex surgery. 是为了在长时

间复杂手术中保持敏锐

But for Professor Sahakian 但是对于萨哈金教授

the question remains 依然存在一个问题

will it actually make our lives better? 它真的能改善我们的生活吗

Suppose we took cognitive enhancing drugs 假如我们服用提高认知的药物

and we got all our work done in a short period of time, 我们在短时间内把工作做完

we could go home, spend time with our 我们就可以回家 和家人在一起

family and improve our work/life balance. That would be great. 改善工作与家庭之间的平衡 那很不错

But it's more likely with the 但是 当今社会

type of society that we seem to be moving towards 正朝向无休止地工作发展

that it will be this 24/7 因此更有可能出现的情况是

society so we'll take these drugs so we can 我们服用这些药物

work longer, so we can travel more and do 是为了让做工作时间更长 旅行更多

more work so it will 然后做更多的工作

disrupt our work/life balance even more. 因此会使工作与生活的平衡变得更糟

258第14集:治疗心绞痛的药

It started life as UK 92480, 这个编号为UK92480的化合物

one of millions of compounds 来自辉瑞制药公司的新药仓库

in the stores at the drug company Pfizer. 是千百万个化合物中的一员

They were looking for a new drug for angina, 当时专家们正在寻找治疗心绞痛的新

something that would relax blood vessels 一种能够放松心脏

around the heart. 周围血管的药物

After screening hundreds of 在筛查过无数的化合物之后

thousands of compounds, they ended up with UK 92480. 他们最终锁定了UK92480

But its trials in humans were a let-down. 人体实验结果却不尽如人意

It was about to be consigned 正当药物要被重新收回仓库时

back to the stores when the trial volunteers 受试者们开始不断索要药片

started coming back and reporting an unusual side-effect - 并反馈一种不同寻常的副作用

lots of erections. 阴茎勃起

Add the drug the relaxation's 加入药物之后 其松弛度变大

get larger but its trace is upside down. 不过药物作用曲线却是反过来的

By making a crude mock-up of the 通过制作人类性器官的粗略模拟模型

human sexual apparatus, senior scientist Chris Wayman 高级研究员克里斯·韦曼使用了

found an ingenious way to test this anecdotal evidence. 一种巧妙的方法来检验这种有趣的现象

259第15集:药物组合的神奇疗效

These are actually penile 组织浴槽中放置的

blood vessels that we have in a tissue bath. 是真的阴茎血管组织

Think of this as the brain. 把这个看作是大脑

This is the brain and the spinal cord. 这是大脑和脊髓

When you're becoming aroused, 当你性唤起时

your brain switches on. 大脑就会激活

We can mimic this by switching on 我们可以通过打开这些等同于

the equivalent of the central nervous system in the brain. 中枢神经系统的开关来模拟这一过程

It sends electricity down 它将电流传递到

to the tissue bath and across the tissues, 组织浴槽中 穿过组织

and when we pass an electric current across these 当电流通过小片的阴茎组织时

small pieces of penile tissue, they relax and 它们就会松弛下来

ultimately that's what happens during penile erection. 事实上 这就是阴茎勃起的过程

Relaxed penile blood vessels mean 阴茎血管松弛

more blood flow to the penis, and so an erection. 意味着更过血液流向阴茎

导致勃起

What Chris did was take penile blood vessels 克里斯从阳痿病人体内

from impotent men, 提取了阴茎血管组织

vessels that didn't respond 当大脑开关被打开的时候

when he flicked the brain switch, 血管组织并没有产生反应

and then added UK 92480 to the tissue bath. 随后将UK92480加入组织浴槽中

What was most amazing about this study 最不可思议的事情发生了

was that we saw a restoration of erectile response. 阴茎组织重新出现了勃起反应

It's very rare in any tissue preparation 在任何组织标本里 由功能障碍

to convert dysfunctional to normal function, and so now 到功能正常的转变都是很罕见的

we were really onto something 因此我们现在所经历的这一切

that could only be described as special. 只能用一个词来形容 特别

第16集:药物的神奇作用260

At the time there was no oral treatment 当时 并没有可以治疗

for erectile dysfunction. 勃起功能障碍的口服药物

No-one even really knew what caused the problem, but 甚至没有人知道是什么引起了这一问题

suddenly Pfizer had a potential treatment on their hands. 忽然 辉瑞公司找到了潜在的治疗方案

When this data was shared with the experts in the field, 当与此领域的专家分享这一数据时

the urologists, they were astounded. 那些泌尿科医师惊诧不已

I remember a meeting in America at 我记得是在美国泌尿医学会的一次会议上

the Urological Association where the room was packed 这一数据被公布于众

when this data was released 当时房间里挤满了人

because no-one had seen anything like this before. 因为从来没有人看过这样的结果

UK 92480 was renamed Viagra, UK92480被重新命名为伟哥

and within weeks of going on sale, 进入市场短短几周之内

tens of thousands of prescriptions 每天都会开出

were being written every day. 成千上万的伟哥处方

You would never have been able to 你一定不会预料到

predict that this was going to have beneficial effects 这种小小的药丸

on millions and millions of men throughout the world, 会成为全世界广大男性的福音

a little bit of science having 一个小的科学发现就可以对

effect on self-esteem, anxiety, depression levels 人们自尊 焦虑和抑郁程

度产生影响

and ultimately creating enhanced relationships. 并最终改善伴侣之间的关系

第17集:药物的伦理性261

But sometimes drug companies 不过有时候 制药公司

are not the first people to see that. 并不是最先意识到这一点的人

In the UK, one third of all women 在英国 三分之一的育年龄妇女

of reproductive age take the contraceptive pill. 都会服用避孕药物

Worldwide, a hundred million rely on it, 全世界 约有一亿人依赖这种药物

but it almost never reached the market. 但最初 它差一点未能进入市场

In the 1950s, research into contraception was illegal 在20世纪50年代 研发避孕药

in many parts of the world and where it was legal, 在许多国家是非法的 即便在合法国家

pharmaceutical firms feared a moral backlash. 制药公司也害怕遭遇道德问题

Despite this, independent researchers did discover 除此之外 独立研究人员也发现了

how to synthetically create female hormones. 合成制造女性荷尔蒙的方法

They realised giving these to women as a pill 他们意识到 给女性服用药物

would change their fundamental biology 可以改变她们的生理状态

and stop them ovulating, 使其停止排卵

preventing them from getting pregnant. 从而避免怀孕

Pharmaceutical companies were reluctant 制药公司当时对于这一项目的支持

to back the project, 并不情愿

so when one did get behind it, 所以当一个制药公司着手支持该项目时

the pill was brought to the market 这种药物只是作为

as a drug for heavy periods, 治疗月经过多的药剂进入市场

but women soon cottoned on to its real potential. 不过女人们很快发现了它的真实作用

第18集:更加谨慎的选择药物262

But Professor Wu is finding it 然而吴教授发现

hard to get the backing of a pharmaceutical company. 寻求制药公司的支持极为困难

It seems times have changed. 似乎时代已经不同了

We are now more wary of 现在的人们与50年前相比

meddling with our bodies than 50 years ago. 在调理身体方面变得更加谨慎

If the female contraceptive pill 如果女性避孕药物

was developed from scratch now, 也是现在刚刚出现的

it would probably come across exactly 或许也会遇到

the same difficulties as we are at the moment. 我们现在面临的这种问题

Professor Wu remains undaunted. 吴教授依旧很乐观

There is definitely a potential market for it, 这种药物一定有潜在的市场

and I think once a product like this is marketed, 我认为 一旦这种产品进入市场

it may well lead to changes in attitudes,social changes, 就会引起人们观念的变化和社会变化

similar to what happened with the female pill 就如同女性避孕药带来的变化一样

and then I think it is likely to lead to a much larger market 这种药物也许会拥有比制药公司

than the companies think there is at the moment. 目前预计的更广阔的市场

空间

There is one problem Professor Wu can't solve. 吴教授依然有一个无法解决的问题

263第19集:对抗抑郁症的药物

When it comes to pregnancy, 在怀孕这一问题上

the stakes will never be as high for men 女性所承担的风险

as they are for women, 远远大于男性

and with that comes a question of trust. 从而也会引发信任问题

I just don't think they'd do it. 我觉得他们不会吃药

I think it's something that men tend to rely 我认为男人们更倾向于让女人吃药

on women to do and take the responsibility of. 让女人来承担这些责任

No offence, guys. 无意冒犯 老兄们

If you met somebody, a man, and he just said, 如果说我遇见了一个男人 然后他说

"Oh, it's all right, I take the contraceptive pill," 没关系 我已经吃了避孕药

I'm not sure I'd be willing to believe that. 我不确定我会愿意相信他

But then I dare say there's 不过我敢说

some women that you can't trust to take it. 也有一些你不能相信的女人

I don't think it's just men. Well, absolutely, yeah. 我觉得不仅仅是男人 当然

I'd probably be standing over him 也许我会站在那里

watching him take 看着他把药吃下去

They can't even put socks on in the morning, you know, 他们连每天早上都

穿袜子都无法保证

how are they going to take a pill at the same time every day? 又怎么会每天在相同的时间吃药

Pills don't just affect our bodies. 药物不仅仅影响我们的身体

They can treat our minds, 它们也会作用于我们的意识

and sometimes finding a successful medicine for an illness 有时 找到一种成功治疗病症的药物

can even change the way we view ourselves. 可以改变我们看待自己的方式

Depression is a case in point. 抑郁症就是其中的一个例子

264第20集:百忧解

In the 1950s, 20世纪50年代

depression was a strictly private affair. 抑郁症绝对是一件隐秘的事情

Those that sought help got little in return. 那些寻求帮助的人几乎得不到回馈

The few drugs that were 只存在的寥寥数种药物

on offer were unlikely to lift your spirits. 却几乎无法改善人们的心情

You would have dry mouth, 你会遇到口干

blurred vision, problems passing urine. 视线模糊 排尿困难的问题

You'd feel knocked out and dopey. 你会觉得神志不清 反应迟钝

It would be barely better 这种状况比你

than the situation you were actually in to start with. 服药前的情况好不了多少

It all changed when a new wave of drugs came along. 一种新药物的到来 改变了这一切

Scientists had realised that a brain chemical, 科学家意识到 一种大脑中

的化学物质

serotonin, affects our mood. 血清素 影响着我们的情绪

If they could find a way to boost 如果他们能够找到一种

the amount of serotonin in the brain, 提高大脑中血清素含量的方法

it could improve our sense of wellbeing. 就能够提高我们的幸福感

They tested hundreds of compounds 他们检验了数百种化合物

and managed to create a new class of drugs 最终成功研制出了一种药物

that had a fraction of the 它消除了

side effects of the older anti-depressants. 传统抑郁症治疗药物的副作用

This group was termed 这组化合物被命名为

selective serotonin re-uptake inhibitors, 选择性血清素再吸收抑制剂

Soon they were known simply by the 很快人们便熟知了其商品名

brand name of the first one on the market, Prozac. 这也是市场上首次出现此类药物

265第21集:百忧解的副作用

Suddenly depression had become a treatable condition, 突然之间忧郁也可以通过治疗缓解了

and that made it more socially acceptable. 这也让抑郁症更为社会所理解

If you have an effective treatment for a condition, 如果你有治疗某种疾病的良药

people who suffer from 那些患有这种病的人

that condition will come out of the woodwork 便会从各地纷至沓来

and you'll find more often that, build it and they will come. 如果有效 他们还会来

By the 1990s, the number of 到19世纪末

people coming forward seeking treatment tripled. 寻求治疗的人数变成原来的三倍

Soon SSRIs were a solution to everything. 很快抗抑郁药SSRIs成为万用药方

Back in those days, if you came into a GP's surgery looking 那个时候 如果你去普通诊所看看

a little bit glum cos someone stole your bike or your dog died, 因自行车被偷或是狗死去而致的忧伤情绪

you'd be assessed as being 都会被诊断为抑郁

depressed and be given anti-depressants. 开出抗抑郁药的药方

Way overkill. Everyone now admits that was true. 使用太过度了 这已是如今人们的共识

In time, the tide began to turn against SSRIs. 不久 反对SSRIs的浪潮掀起

As more and more people took them, 随着越来越多的人服用这一药剂

some disturbing serious side effects began to emerge. 一些严重的 令人不安的副作用出现了

266第22集:服药后的焦躁

The risks are that approximately one in five people 大约有五分之一的人

will become much more anxious on these drugs, 服药后可能会感到焦躁

that one in 100 or so will go on to a suicidal act, 而一百人中会有一个人有自杀倾向

that one in the area of something like 500 to 600 people 每五百到六百人中会有一个人

may go onto complete suicide, 真的会自杀

who wouldn't have done so if they hadn't been on the pills. 而这些人如果

不服用此药就不会这样

One drug in particular came under scrutiny. 其中一种药接受了审查

The makers of the controversial anti-depressant drug Seroxat 颇具争议的抗抑郁药物塞乐特的制造者

have been criticised by the health care regulatory body 因其对服药后可能产生自杀倾向

for withholding information about the 这一信息的隐瞒

risk of suicidal behaviour associated with the drug. 而被医疗监管机构批评

In 2006, GSK, the makers of Seroxat, 2006年 塞乐特的制造商

one of these SSRIs, 葛兰素史克承认

admitted that Seroxat raised the risk of suicide eight times. 塞乐特使自杀倾向提高了8倍

Sadly, side effects from drugs are nothing new. 遗憾的是 药物副作用并不是新鲜事

Thalidomide was the great drugs disaster of the post-war era. 反应停事件是战后的一次药物灾难

267第23集:药物引发其它疾病

Given to expectant mothers 在19世纪50年代

with morning sickness in the late 1950s, 反应停用于缓解准妈妈们的晨吐问题

it was not long before its devastating side effect became clear. 但不久后其毁灭性的副作用便显现出来

It was withdrawn in 1961 它于1961年撤出市场

and brought with it new trials procedures 而且由此诞生了新的审判程序

that were supposed to prevent anything like it happening again. 以期防止这样的悲剧再次发生

But they haven't. 然而 事情并未如人愿

There are warnings that 有迹象显示

a drug used worldwide by millions of people 一种被全球几百万人使用的

with arthritis could 治疗关节炎的药物有可能

increase the risk of heart attacks and strokes. 增加心脏病和中风的发病几率

Doctors have been told to stop prescribing 一种广泛用于肥胖症治疗的药物

a drug commonly used in the battle against obesity. 其处方已经被叫停

The benefits no longer outweigh the considerable risks. 其潜在风险已超过药效

In the last five years, in the UK alone, 过去的五年里 仅在英国

eight drugs have been 就有八种药物

withdrawn from the market by the regulators. 被监管机构撤出市场

The anti-obesity drug, Rimonabant, 抗肥胖药物 利莫那班

was banned because it could cause suicide. 由于引起自杀倾向而被禁用

Vioxx, used to treat rheumatoid arthritis and menstrual pain, 万络曾用来治疗类风湿性关节炎和痛经

was withdrawn after it caused 140,000 在五年内引发14万人心脏病发作

heart attacks in five years. 而后被撤出市场

268第24集:是药三分毒

The discovery of undesired effects is, however, 然而 药物出现不理想的作用

intrinsic to the experimental nature of medicine. 也是源于药物试验性的本

质

Clinical trials are done on thousands of people, 临床试验在几千人身上进行

but some side effects are only found 然而有些副作用

when hundreds of thousands take them, 只有上百万的人服用以后

when the drug comes to the market. 也就是药物进入市场之后才会被发现

You might start picking up side effects 你可能会出现一些副作用

that you couldn't have anticipated, 可能是一些意料之外的

that you didn't know, that are relatively rare 你不了解的 很罕见的副作用

but nonetheless can sometimes be important. 却有可能很重要

Drug development is an ongoing clinical trial 药物发展就是在不断的进行临床试验

in which we all play a part. 我们都是试验的一份子

There's no such thing as a totally safe medicine. 是药三分毒

There's no such thing as a 根本没有一种药物

medicine that we know absolutely everything about 我们能了解它的一切

and therefore there is some uncertainty, and that persists. 因此有一些不确定因素 且将持续存在

Because this goes to the heart of what medicines are. 因为这源于药物的本质

When you make a medicine, 你在制造药物的过程

you're trying to disrupt a fundamental biological process. 你要试图打乱基本的生物进程

That's a pretty profound change. 这是个复杂的变化

269第24集:是药三分毒

The discovery of undesired effects is, however, 然而 药物出现不理想的作用

intrinsic to the experimental nature of medicine. 也是源于药物试验性的本质

Clinical trials are done on thousands of people, 临床试验在几千人身上进行

but some side effects are only found 然而有些副作用

when hundreds of thousands take them, 只有上百万的人服用以后

when the drug comes to the market. 也就是药物进入市场之后才会被发现

You might start picking up side effects 你可能会出现一些副作用

that you couldn't have anticipated, 可能是一些意料之外的

that you didn't know, that are relatively rare 你不了解的 很罕见的副作用

but nonetheless can sometimes be important. 却有可能很重要

Drug development is an ongoing clinical trial 药物发展就是在不断的进行临床试验

in which we all play a part. 我们都是试验的一份子

There's no such thing as a totally safe medicine. 是药三分毒

There's no such thing as a 根本没有一种药物

medicine that we know absolutely everything about 我们能了解它的一切

and therefore there is some uncertainty, and that persists. 因此有一些不确定因素 且将持续存在

Because this goes to the heart of what medicines are. 因为这源于药物的本质

When you make a medicine, 你在制造药物的过程

you're trying to disrupt a fundamental biological process. 你要试图打乱基本的生物进程

That's a pretty profound change. 这是个复杂的变化

270第25集:治病良药

You can't do that without producing some unwanted effects. 你不可能不产生预期外效果

So then the question is, 那么问题就是

what risk are you prepared to take for what benefit. 你愿意为药物的益处承担多大的风险

Side effects are not restricted 副作用不仅仅限于

to the dangers written on the back of the packets. 包装后面写的那些

For hundreds of thousands of people, 对于成千上万的人们来说

the thing that set out to be the solution 一开始本是治病良药

has become the problem itself. 后来却成为了问题所在

I'm thinking, "Oh, lovely", 我一开始想 "真好"

then I think, "I've got to have my tablets", 后来我想"我必须吃药"

I just want this uncomfortable feeling to start going, really. 我只想让这不适的感觉消失 真的

That's all I want it to do. 这就是我想要的

These used to be my best friends. 它们曾是我最好的朋友

They're not now. I hate them. 现在不是了 我很讨厌它们

Jo Palmer is addicted to pain killers. 乔·帕姆对止痛药上瘾

It changes your personality totally. 它可以完全改变你的性格

You know ,I hated the person 我很讨厌自己用药后

that was emerging from it and I still do. 变成的那个人 现在也这样

270第26集:药瘾

Jo's addiction started 18 years ago 乔 从18年前就开始上瘾

when she was prescribed 当时医生给她开了强效止痛药

strong pain killers to deal with chronic pain. 来治疗她的慢性痛

But by the time she'd been cured, 但当她被治愈时

she found she couldn't function without the drugs. 她发现自己已经离不开这种药了

Over the years, the addiction has taken over her life, 这些年来 药瘾已经毁了她的生活

causing pain itself, limiting what she can physically do. 上瘾引起疼痛 身体活动受到限制

Jo has struggled to 乔曾试图克服药瘾

overcome her addiction but she can't escape it. 但是她却摆脱不了

The problem is that she can score her drugs on the high street. 问题就在于止痛药随处可见

There is quite a lot of chemists when you look round, 你放眼望去会发现有很多药店

and you go in and you do it on a rota system, 你可以对照药剂师排班表去买

so one chemist thinks 所以每个药剂师

that you're just getting them once per week. 都以为你只是每周买一次

But then you drag people into it and you don't mean to. 但是后来你拉你朋友去买 你不是有意

But you, you know, when I asked my husband to get them for me, 但是 当我让我丈夫给我买药的时候

he honestly said to me, 他真的对我说

"I can't, I can't go in there and get them for you. 我不能 我无法进去为你买

"It would be like dealing to you. You know, 这就像是帮你买毒品 你知道吗

"This could be the one 这要可能会害死你

that kills you and I'd never forgive myself." 而我将永远无法原谅自己

271第27集:对止痛药上瘾

Jo is still battling her addiction. 乔仍在与她的药瘾作斗争

The drug she craves is 让她上瘾的药物就是

the codeine in extra-strength pain killers. 特效止痛药可待因

Codeine is an opiate, 可待因是一种鸦片

the same family of drugs as class A street drug heroin. 与一级毒品海洛因是同族的

As well as killing pain, 可待因可以止痛

codeine gives a feeling of calm, of wellbeing, 同时让人有镇静 幸福的感觉

that can be more attractive than the pain-killing itself. 这一点可能要比止痛更吸引人

It is incredibly easy to get addicted to pain killers 对止痛药上瘾简直轻而易举

and there's an epidemic, that's not too strong a word, 而且情况有蔓延趋势

of usually women out there, 这么说并不夸张

who are entirely dependent on codeine-based pain killers. 完全依赖于可待因止痛片的女性正在增加

But just like any drug, 但就像其他的药一样

you build up tolerance and 你体内会产生耐受

it's this that lies behind the addiction. 这就是成瘾的原因

The more you take, the less effect it tends to have. 你吃得越多 作用越小

So you start out taking a small dose. 你一开始吃很小的剂量

You need a bigger dose and a bigger dose 以后的药量会越来越大

and you finally end up in a sort of vicious circle 最后你就形成了恶性循环

where you have to keep increasing the dose over and over, 所以你要不断增加药剂的量

to get the same effect in terms of pain relief. 才能起到原来的止痛效果

272第28集:产生耐药性

I was at 70 a day. 我有过一天吃70片

If I gave it to you, or anybody else, 如果你或者任何其他人吃的话

it could kill you. 可能会出人命

Me, I'm not saying it can't kill me. 而我 我不是说这不会害死我

I am at risk of that, 我这是在冒险

but my body has been more used to it than you. 但是我的身体对它的忍耐性更强

It's not just pain killers. 不仅仅是止痛药

Many medicines have the power to lure us in. 很多药都有成瘾性

I had a situation where I kept waking during the night 我的问题是夜里总会醒

and I couldn't go back to sleep. 然后就睡不着了

I tried everything I could, 能试的办法我都试过

so basically I went to see the doctor 总之 最后我去看医生

and I explained to her what the problem was. 给她说明了我的情况

The tablets that she prescribed me was only a short-term thing, 她给我开的药方只是短期的

six to eight weeks, 六到八周

and I've been on them for about 20 years, something like that. 而我已经吃了差不多20年了

When I was on steroids, when I was a lot younger, 我服用类固醇的时候 那时年纪很小

I can always remember looking at them thinking, 我一直记着自己盯着那些药片 想着

"Can I actually give them up? When I'm in pain, 我真的能戒掉吗 我疼的时候

what am I going to do, what am I going to take?" 我该怎么办 我吃什么药

Gradually, as the years went by, 渐渐地 天长日久

I began to realise that I was seriously addicted 我开始意识到自己严重上瘾了

and I just needed more and more. I couldn't get off them. 我得吃越来越多

根本戒不掉

273第29集:成功戒药

I can remember my mum tipping them down the sink, saying, 我还记得妈妈把这药丢进水槽

"You can't have any more." 说"你不能再吃了"

And once I got it in my head that I could, 一旦我明白过来 我可以做到

I could do without them, I was fine. 不吃药我也能活 我也过得挺好的

I feel great now. I feel absolutely great. 我现在很好 非常好

I'm drug free. 我已经戒掉药瘾了

Jo reached rock bottom in 2006 乔在2006年陷入人生低谷

and has been trying to turn her life around since then. 从那时起 决定要改变自己的生活

She's on the slow road to recovery, 她在慢慢地戒药

battling against withdrawal symptoms 如果停药太快的话

of nausea, pain and anxiety if she cuts down too quickly. 会产生恶心 疼痛和焦虑等戒断症状

I've got it under control now, 我的情况已经控制住了

to about anything from ten to 20 a day, on average. 大概一天平均吃10到20片

Who's a good boy?! 谁最听话呀

"It's to keep off the withdrawals." 是为了避免戒断症状

Drop it there! Good boy! 放在这 真棒

I live day for day. 我每天都在努力

And I hope, one day, 我希望 有那么一天

that so many will go down to so many, and then go down. 我的服药量会越来越少

I don't ever give up trying. 我从没有放弃过努力

274第30集:万能药

But many people question whether codeine even needs to be 但是很多人提出质疑

in these over-the-counter drugs in the first place. 非处方药中是否有必要

加入可待因

One of the things about the over-the-counter pain killers 有一点值得提出的是 柜台出售的

that contain codeine with aspirin or paracetamol or ibuprofen 加了可待因的阿司匹林 扑热息痛 布洛芬

is the amounts of codeine in those tablets 其所含可待因的剂量

is not thought to be enough to have a real effect on the pain, 并不足以让人止痛

so you are probably no better off taking those tablets 所以吃了以后的效果并不比

than you are taking standard aspirin, ibuprofen or paracetamol. 单纯的阿司匹林 扑热息痛或布洛芬好

They don't contain enough 其中所含可待因的剂量

codeine to give you any additional pain relief, 不能减轻病痛

but there is enough to get you hooked. 但却足以让你上瘾

Despite how dangerous pills can be, we still love them. 尽管药物很危险 我们还是很爱它

If I could invent a pill to do anything, 如果我能发明一种万能药

I'd quite like one that 我想要一种

could just put you to sleep for 15 minutes 让你只用睡十五分钟

and you'd be completely refreshed when you woke up. 醒来以后就会焕然一新的药

I'd invent one pill that covers the whole spectrum. 我想发明一种能治愈所有疾病的药

You just take one pill in the day and that's it. 一天只吃一片

You're good to go. 然后你就好了

275第31集:感染救星

If I could invent a pill, it 如果我能发明一种药物

would be a thin pill with no horrible side effects. 就发明一种没有可怕的副作用的减肥药

I think mine would just have to be a 我觉得我会发明

general one for any very, very severe illness that people get. 一种治愈严重疾病的药

Oh, that's nice, that's so much less selfish than me. 说的真好 你比我无私多了

If I would invent any pill, 如果我能发明药物的话

it would be something that would cure everything 我就会发明一种万能药

and it would 给它取名叫作

..infection curer. 感染救星

This love of pills is not without good reason. 人们对药物的喜爱也是合情合理的

They perform miracles on a daily basis, 只要每天按时服用就能创造奇迹

none more so than antibiotics. 尤其是抗生素药物

I believe they're magic, yes, antibiotics. 我认为抗生素是个奇迹

I'm all for those. 我对它完全认同

276第32集:细菌的反击

Each of us will turn to them an average of 60 times. 平均每个人有60次要用到抗生素

They have been credited with 它们已经被认为是

increasing our lifespan by almost a decade, 将人类寿命延长近十年的良方

but our relationship with nature's great miracle 但我们与自然界最伟大奇迹之间的关系

is getting more fraught. 却变得越来越令人担忧

For a long time, bacteria have been fighting back. 一直以来 细菌都在进行反击

Dr Vanya Gant has a patient 凡亚·甘特医生的一位病人

who is battling for her life. 正挣扎在生死边缘

A treatment she's been receiving 她所接受的癌症治疗

for cancer has left her vulnerable to infection 使她变得极易被感染

and now the antibiotics she's been given aren't working. 而现在 她所服用的抗生素不管用了

Back in the lab, he needs to find out why. 回到实验室里 他得找出原因

What I can see here are organisms called streptococci, 我现在能看见的有机体是链球菌

because they have a classic shape and a classic length, 因为它们的形状和长度都很典型

and they come in chains. 而且是链状结构

277第33集:抗生素杀死有机体

But that's not really quite enough 但是这些信息还不够

for me to know exactly what this bug is, 对我来说 必须清楚地知道这是什么

so we grow it on plates like this, 所以我要在培养皿里培养它

and each of these dots 每个像这样的菌落里

has about a half-billion organisms in it. 有将近五亿个有机体

These discs here have got antibiotics in them 这些小圆盘里含有抗生素

which leak out into the agar, 并会释放到琼脂中

and if you look at that one there, 如果你看那里

you can see there's a very, very, 你会发现这个很大一块区域

very, large zone of clearing 什么都没有

and that's because that antibiotic 这是因为

is killing that organism, 这种抗生素杀死了有机体

but if you look at all the others, 但若再观察其他的

there's no effect at all. 根本就没有效果

So this plate is telling us 所以这个培养皿告诉我们

that my patient has got a highly resistant organism, 病人体内生有高度耐药性有机体

and this explains why 这就解释了

she's not doing quite as well as she should, 为什么她没有像预期的那样好起来

so resistant to one, two, three, four, five antibiotics, 对这五种抗生素都有耐药性

sensitive to only one. 只对一种敏感

Our resistance to antibiotics 我们对于抗生素的耐药性

is a problem that's only getting worse. 是一个日趋严重的问题

278第34集:细菌对我们也有保护作

It may be that I could 有这样的可能

show you a plate like this in two years' time 两年以后再给你展示一下这个培养皿

where not only all six fail, 不仅仅这六个失效

but the one I've got up my sleeve and 而且 我正在研制的

in my head that I'm going to give her would also fail. 和即将研制的抗生素 也会失效

Organisms divide so fast, every 15 minutes, 有机体分裂很快 每十五分钟一代

that within a day or two days, 一两天之内

there will be billions of them. 就会产生几十亿后代

You need one to learn how 只要一个有机体

to get over the antibiotic and that's it. 能逃过抗生素的作用 就够了

It's game over. 你就玩完了

Nature wins on this occasion. 这种情况下 自然最大

Dr Gant has just one final antibiotic he can try. 甘特医生只剩最后一种抗生素可以尝试

But he also realises that with any antibiotic, 但他也知道使用任一种抗生素

there is a cost. 都是有代价的

They actually make us more vulnerable to disease. 实际它们上会使我们更易受到疾病侵害

Because bacteria also have the power to protect us. 因为其实细菌对我们 也有保护作用

We would not be here without bacteria. 我们不可能完全不携带细菌

We need them, we can't live without them. 我们需要它 离不开它

279第35集:消除了好细菌

Within three hours of being born, 出生后不到2小时

we have bacteria already starting to thrive 我们的肠道和皮肤带有的细菌

in our intestines and on our skin. 就开始繁殖了

They make essential food for us in our large bowel. 在我们的大肠生产必要的养分

They make us vitamins. 提供维生素

The natural state of affairs 这种进化了数百万年

that has evolved over millions of years 达到的自然状态

is one of an exquisitely fine balance 是我们身上的细菌

between the bacteria that live on and in us, and ourselves. 和我们本身之间的精巧平衡

Antibiotics that man has made 而人们制造出抗生素

have only been here for 70 years 只是从70年前才开始

and they are so powerful. 这些抗生素强大到

That balance can with one tablet 只需一颗药片

be completely wiped out. 这种平衡就完全被打破

Bacteria we carry with us 我们所携带的细菌

work alongside our immune system, 与我们自身免疫系统协同作用

helping us fight off nastier bacterial invaders. 帮助我们击退有害细菌的入侵

But a broad-spectrum antibiotic can't 但是广谱抗生素

distinguish the more helpful bacteria from the harmful. 无法分辨出细菌是有益还是有害的

They all get killed in the mix, 而是将它们全部清除掉

leaving you more vulnerable to other bugs. 使你更易受到其他病原的侵害

280第36集:越好的抗生素作用越小

The thing about antibiotics 抗生素的特别之处在于

is that they're not like any other drug, 它不像其他的药物

that every other drug you take is for you and your body. 其他的药物都是作用于人体

The antibiotics are not for you at all. 而抗生素却完全不是

They're aimed at the bugs, 它们作用于病原

and in fact, the better the antibiotic, 实际上 越好的抗生素

the less effect it has on you. 对人体的作用就越少

But for Dr Gant's patient, Kathleen, 但对于甘特医生的病人凯瑟琳来说

these risks are far outweighed by their life-saving potential. 相比其风险 它能救命是最重要的

Hi there! 你好

Hi, I've come to see how you are today. 我来看看你怎么样

Well, I feel a lot better today. 我今天觉得好多了

Fantastic, fantastic. In what way? 很好 很好 哪些方面有好转呢

I just feel more, erm, alert. 我觉得清醒很多

Getting back to normal, sort of thing. 身体渐渐恢复 差不多这样吧

The last one Dr Gant had left worked. 甘特医生的最后一根救命稻草起效了

In this lady's condition, 照这位女士的情况来看

'she would have probably had less than 10% chance of surviving' 如果我们没有对她使用抗生素

had we not had an antibiotic to treat her infection, 她存活的几率可能还不到百分之十

which is extraordinary, 现在来说是个不同寻常的

and that is close to a miracle. 近乎奇迹的效果

281第37集:抑制素

We can bring people back from the brink 我们能从生死边缘挽救人们的生命

who would almost certainly have died from their infection.' 挽救他们几乎被疾病夺去的生命

Despite this success, the question remains 尽管这次尝试成功了 问题依然存在

how long can this miracle keep working? 这样的奇迹还能持续多久

We're entering a revolution in medicine. 我们正在步入一个药物革命的时代

Today, pills don't just treat illnesses we have. 今天 药物不仅仅治疗我们的疾病

There are now pills for illnesses we may yet have, 还有用于预防疾病的药物

a pill not for disease but for the risk of disease. 用以预防我们尚未得上的疾病

Chief among them is a new class of drugs 其中尤以一类药物最为盛行

known as statins. 就是抑制素

Millions of people could benefit from 如果能够控制血液中的胆固醇含量

taking a drug that cuts cholesterol levels in the blood. 那么 无数人将会受益

New research appears to show that a third 新的研究发现 三分之一的

of all heart attacks and strokes could now be avoided. 心脏病发作和中风现在可以避免

New research into the anti-cholesterol drugs known as statins 抑制素这种抗胆固醇药物的研究

offers hope to millions of heart patients. 带给许许多多的心脏病患者以希望

282第38集:救命良药

Statins have been heralded 抑制素被认为是

as the greatest discovery since antibiotics, 自抗生素以后最伟大的发现

and their ability to deal with cardiovascular disease 它们对于心脏血管类疾病的治疗

has made them the most prescribed medicine in the world. 使它们成为世界上最常用的处方药

In the UK alone, 仅仅在英国

six million adults pop one every day. 就有六百万成年人每天服用一粒

Statins are fantastic drugs, 抑制素是很了不起的药物

no doubt about it. They're life-savers. 这是毋庸置疑的 它们是救命良药

We may not be sure HOW they do that 我们不知道它是怎么做到的

but we know that they do. 但它就是做到了

So if you take a statin, 所以如果你服用抑制素

your cholesterol level will drop. 你的胆固醇水平就会降低

If you take a statin, 如果你服用抑制素

your risk of heart attack and stroke will fall. 你心脏病发作和中风的几率就会变小

undefined undefined

Statins reduce the amount of cholesterol, 抑制素可以降低胆固醇

also known as lipids, in the blood. 也就是血液里的脂质的含量

The Government recommends that statins be given 政府建议所有患过心绞痛 中风

to all those who have had a heart attack, a stroke or angina. 或者是心脏病发过的病人都服用抑制素

Mrs Parsons? Susan, come on in. 帕森太太 苏珊 进来吧

But now health officials are recommending statins be prescribed 但现在卫生官员建议

to those who are simply 可能心脏病发或中风的人

deemed to be at risk of a heart attack or stroke 也服用抑制素

because their cholesterol is raised above normal. 因为他们的胆固醇含量高于正常水平

283第39集:生活质量变糟

That means what's normal is critical, 这意味着多少才是正常至关重要

and the way that figure is arrived at is causing some concerns. 然而获得正常值的方法却令人担忧

"The "Normal" Level is one that 25-year-olds have. 所谓正常 就是指25岁人的血脂水平

This became the "Normal" Level on the 称这个为正常水平

basis that people with lipid levels such as 25-year-olds have 是建立在25岁的人不会心脏病发

don't go on to have a heart 或是中风

attack and don't go on to have a stroke. 这一假设前提上的

Setting the bar so low 年龄标准设置如此低

means most people fall into that category. 意味着大部分人都不在正常范围内

Almost anyone over the age of 几乎所有年龄超过30岁的人

30 will have what appears to be raised lipid levels, 都会有血脂上升的趋势

will have what appears to be abnormal lipid levels,' 也就是血脂水平异常

will have a lipid level that 成为需要医生治疗的

becomes a problem for the doctor treating them 血脂异常患者

for which the pill is the answer. 而治疗用药就是抑制素

This would not be a problem 这原本也没有什么问题

but for the fact that statins, like all drugs, 问题在于 抑制素和所有其他药物一样

can have side effects. 都有副作用

There's a huge number of people that go on these pills' 有大量服用这种药物的病人

whose lipid levels come down on the pills 他们的血脂水平降了下来

but whose quality of life gets worse. 但生活质量却变得更糟

284第40集:我们是药物的小白鼠

They complain about muscle pain, 他们会抱怨说肌肉酸痛

they complain about fatigue, 觉得疲劳

they complain about being forgetful. 会变得健忘

They complain about a range of different problem 反馈回来各种各样的问题

that are being caused by the drugs. 而这些都是药物引起的

You may have a choice - a shorter life 你有两个选择 英年早逝

or possibly a longer one that maybe isn't quite as much fun. 或是饱受折磨地长命百岁

I get side effects. 我就尝过副作用的厉害

You get a muscle problem where your muscles ache 你的肌肉会感到疼痛

and sometimes you get cramps, but there are benefits. 有时甚至会痉挛 但也不全是坏事

You know they, they contribute to less strokes, for instance, 你知道它们

会减少中风的几率

so how do you balance it out? 所以 你会怎么抉择呢

I don't know. 我不知道

We are the guinea pigs, without a doubt. 毫无疑问 我们就是小白鼠

But it's a trade-off many more of us may have to consider. 但我们中很多人必须要对它进行权衡

It has been proposed fairly recently that 最近被广为宣称的说法是

all men over the age of 50 and 所有超过50岁的男性

all women over the age of 60 和超过60的女性

should be taking a statin 都需要服用抑制素

no matter what their cholesterol levels are 不论他们的胆固醇水平如何

as a blanket prescription to reduce 都用一个通用的处方来降低

their risk of heart attack and stroke in future. 心脏病和中风的发作几率

285第41集:没病也吃药

For some, this widening of the net is just 对一些人来说 受众范围的扩大

symptomatic of the way the pharmaceutical industry is moving. 正代表了医药工业的前进方向

From about 20 years ago or so, 大约在二十年前

they moved from trying to produce drugs 他们开始从研发针对特定疾病的药物

that treated real illnesses to drugs that treated risk factors. 转向预防疾病的药物

Even those who soundly believe in the 即使是一些坚信抑制素疗效的人

benefits of statins are wary of how medicine is changing. 也对医疗产业的快速变化持谨慎态度

In decades gone by, you would be assessed by your doctor. 过去的几十年里

你的病情由医生诊断

You'd tell him your symptoms, 你告诉他你的症状

he'd do the examinations, he'd do the lab tests 他会做检查 做相关测试

and then you'd get the prescription and only then, 然后你才会得到处方

whereas now the idea seems to 但现在的理念成了

be that "You're alive, you're breathing, you're 52". 只要你活着 ，你到了一定年纪

You'd better start taking 你最好就要开始吃抑制素

the statins to lower your cholesterol level, 来降低胆固醇含量

"Not because it's good for you but because 不是因为这对你有好处

it's good for everybody and you are part of everybody." 而是对所有人都有好处 你也在其中

Now that must be a drug company's dream, 这一定是制药公司的梦想

because if you've got a 因为如果你有一种药物

pill that's not designed to treat sick people 其受众并不是患病的人群

but a pill that's designed for everybody, 而是所有人

286第42集:药物被当做一种肥料

What we've moved from is a world 我们所经历的改变

in which we thought that drugs were poisons 是从认为药物有毒害作用

and the art of medicine was to make sure 我们只在一种情况下服用药物

that the person had a reasonably serious condition 那就是病人出现严重病症

that posed risks, 严重到

that justified the risk we knew came with the pills, 我们不得不承担药物所带来的风险

to a world where the drugs are now viewed as fertilisers. 改变为 药物被我们视作一种肥料

They can do no harm if you 如果你适当使用

just sprinkle them around the place widely. 就不会带来伤害

I don't mind popping pills at all. 我完全不介意吃药

It doesn't bother me, it doesn't worry me. 我不觉得这有什么不好

I think I'm being kept alive artificially. 我觉得自己需要药物维持

I think the biblical span of life tells you that at my age, 我觉得 到了我这个年纪

one's usually, you know, gone. 很多人可能已经去世

I hate taking them, 我讨厌吃药

to be quite honest, if you want the truth. 老实讲 如果你真想知道

I really hate taking pills 我真讨厌吃药

at all because it's really against my grain 可是 我必须吃药

that, you know, I'm needing to take them. 这着实叫我觉得不情愿

By the time you're in your 70s, 等你到了70岁左右的年纪

you're likely to be taking at least five pills every day. 你每天至少要吃5颗药

287第43集:吃药就像喝威士忌

If it keeps me healthier than I 如果吃药能使我更健康

would otherwise be, and hopefully mentally alert, 头脑更灵活

then, you know, it's doing its job 那它就起到功效

and thank you very much. 我就不胜感激了

I believe in my heart that it's not good. 但我内心认为药物是不好的

I don't think it's a good thing. 我觉得吃药不是件好事情