我在上禮拜天(2021-8-28)發表伊維菌素中毒案例激增這篇文章時就已經預料,很快就會接到來罵我的電郵,而果不其然,隔天就接到這麼一個:「拿一堆新聞連結當做醫學報告在誤導,你也真會騙的(痛哭表情)1450無誤!」
我說的沒錯吧,所有與新冠疫情相關的資訊都已經被政治污染,就連伊維菌素的用或不用都有藍綠之分。只不過,很抱歉,偏偏我卻就是一個如假包換,完全沒有政治色彩的人。不信的話,請搜索我的網站。儘管裡面沒有任何一篇是出自於政治動機,或具有任何政治意圖,但有些卻還是被指責是藍的,有些卻還是被罵說是綠的,真的是非常公平。
不管如何,這幾天我也陸續接到幾個鼓吹或推薦使用伊維菌素的電郵,例如讀者《王》就寄來一篇新聞US judge orders hospital to treat Covid patient with ivermectin(美國法官下令醫院用伊維菌素治療新冠肺炎患者)(註:這位讀者只是通知我,不是鼓吹)。
這個新聞裡有這麼一段話:「此案件是全國範圍內法院贊同尋求使用伊維菌素的訴訟當事人的案件之一,儘管證據不足以證明其對新冠肺炎有效,並且由於濫用(包括攝入牲畜用的強度製劑)而導致求助於中毒控制中心的電話有所增加。」
一位好友也寄來一篇2021-8-29發表的文章東京都醫師會會長推薦使用伊維菌素治療,其中有這麼一段:「日前,東京都醫師會會長尾崎治夫博士,在新聞發布會上推薦使用伊維菌素治療中共病毒。布會上,尾崎治夫博士對比了非洲國家的病毒感染和死亡數據,結果顯示,在使用伊維菌素的非洲國家,病毒感染人數和死亡人數都顯著的低於不使用伊維菌素的非洲國家。因此,他建議,在獲得病人同意的情況下,完全可以使用伊維菌素來治療新冠病毒。」(註:這段文章所說的《日前》,指的是2021-8-13。請看東京都医師会が緊急会見)

可是呢,非洲國家聯盟(African Union)在2021-2-17就有發表Statement on the Use of Ivermectin for COVID-19(關於使用伊維菌素治療 COVID-19 的聲明)。它說:
1. 臨床前研究中沒有關於伊維菌素治療 COVID-19 效果的科學證據;
2. 沒有證據表明其對治療無症狀、輕度、中度或重度 COVID-19 患者的臨床療效; 和
3. 在大多數已發表的研究中,沒有關於使用伊維菌素治療 COVID-19 的安全性數據。
還有,雖然尾崎治夫是東京都醫師會的會長,但是,直至今日,不論是東京都,還是日本中央,都沒有採納他對於使用伊維菌素的建議。
來罵我的人說伊維菌素中毒案例激增這篇文章是拿一堆新聞連結當做醫學報告在誤導,但其實我根本就沒有說這些新聞連結是醫學報告。不管如何,我現在就請大家來看下面這些醫學報告。
我在公共醫學圖書館PubMed搜索《標題裡帶有ivermectin及文摘裡帶有covid》的論文,共搜到141篇論文。其中當然是有幾篇認為伊維菌素可以預防或治療新冠肺炎。但是,頂尖的《自然》期刊在2021-8-2發表Flawed ivermectin preprint highlights challenges of COVID drug studies(有缺陷的伊維菌素預印本凸顯了 COVID 藥物研究的挑戰)。它的副標題是《研究人員表示,該研究被從預印本平台撤稿,是抗寄生蟲藥物作為 COVID 治療機會的嚴重挫敗》。
事實上,支持使用伊維菌素的論文往往都會說細胞實驗顯示伊維菌素具有抑制新冠病毒的作用,但是,細胞實驗所用的伊維菌素濃度是臨床上人體使用的100倍。請看
Ivermectin and COVID-19: Keeping Rigor in Times of Urgency(伊維菌素和 COVID-19:在緊急情況下保持嚴謹)
Antiviral Effects of Ivermectin in COVID-19- Clinically Plausible?(伊維菌素在 COVID-19 中的抗病毒作用-臨床上合理嗎?)

信譽卓著的Cochrane Database Systematic Review(考科藍數據庫系統評價)在2021-7-28發表Ivermectin for preventing and treating COVID-19(伊維菌素用於預防和治療 COVID-19)。它的結論是:「根據目前極低到低質量的證據,我們不確定用於治療或預防 COVID-19 的伊維菌素的有效性和安全性。 已完成的研究很小,很少被認為是高質量的。 總體而言,現有的可靠證據不支持在精心設計的隨機試驗之外使用伊維菌素治療或預防 COVID-19。」
這篇論文的作者在2021-8-20又發表Evidence on the efficacy of ivermectin for COVID-19: another story of apples and oranges(伊維菌素對 COVID-19 療效的證據:又一個蘋果和柳橙的故事)。他們在最後說:「證據的綜合必須採用最高可信度的片段。 然而,當研究人員發布有問題的試驗或濫用既定的證據評估工具作為證據綜合質量的幌子時,可靠性就會受到威脅,尤其是在大流行期間試圖為不能被視為有效和安全治療方案的物質創造偽可信度。」
最後,有關伊維菌素的安全性,請看2021-4-20發表的Serious adverse reactions associated with ivermectin: A systematic pharmacovigilance study in sub-Saharan Africa and in the rest of the World(與伊維菌素相關的嚴重不良反應:撒哈拉以南非洲和世界其他地區的系統藥物警戒研究)。
後記:這篇文章發表後8個小時,我接到國家地理雜誌的電郵,才知道他們昨天發表了The shaky science behind ivermectin as a COVID-19 cure(伊維菌素作為 COVID-19 療法背後的搖搖欲墜的科學)。這篇文章的副標題是:研究尚無定論,錯誤信息氾濫。 但是,許多美國人現在將驅蟲藥視為預防和對抗 Delta 變種的首選藥物。
科學就是科學,實事求是,有多少證據説多少話,但是有些台灣人民是政治盲,動不動就把別人貼上藍或綠的標籤,要知道真正的科學是不能分藍綠的。感謝林教授的努力和敢言使大眾不被錯誤的訊息所害,加油!林教授。
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謝謝您的支持和鼓勵!
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Professor, I am really sorry to hear about what happened. A lot like f the time, keyboard warriors show up not because they have a point, but they want to justify to themselves that they have a point. The story of ivermectin, just like colloidal silver, MMS and hydroxychloroquine before it, is one of over-inflated expectation based on too-little evidence.
It’s not supposed to be political, but people made it political. At the end of the day, people are dying over politics and their beliefs. But belief without evidence is faith. And faith has no place when it comes to science.
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Dear乘楓: Thank you for your excellent comment.
I am aware of the politicalization of health issues, particularly those relating to Covid-19; therefore, I feel at ease with politically charged comments.
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Thank you for your bravery, professor. We really need more people like you.
P.S.: I apologize for the typo in my response. I typed it with a cellphone. The autocorrect is too auto, but not correct at all! Sorry!
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引用通告: 伊維菌素對新冠肺炎療效佳?專家認為? | 科學的養生保健
引用通告: 伊維菌素治新冠無效,剛出爐的馬國衛生研究院臨床研究 | 科學的養生保健
引用通告: 伊維菌素的浪費支出,伊維菌素的論文被撤 | 科學的養生保健
引用通告: 伊維菌素:偏見、欺詐、死亡威脅 | 科學的養生保健
引用通告: 又一篇“重要的” 伊維菌素論文被撤 | 科學的養生保健
Dear professor Lin,
I found your website the other day when I was looking for information about the usefulness of probiotics, with the hope of finding a “cure" for my kid’s allergy. And I was relieved to see your articles debunking the misinformation about its effects. I was very glad to find this useful information provided by such an expert like you and immediately shared it with my friends and family, but unfortunately, the response I get from them makes me feel like, for some people, science is just a matter of personal opinion.
I don’t have any professional medical training background and have rather poor scientific knowledge but I know the least thing I can do when I am trying to find accurate information on the field that I don’t know of, is to find it from authorities and make well-informed decisions. And I think this is common sense. But it’s very unfortunate to find that not so many people are like this. It seems that many people only want to believe what they want to believe, and treat scientific facts as a sort of religious belief.
Anyway, I just want to say thank you to you for the books and the articles you wrote. Many of them have helped me from making stupid mistakes and set my troubled mind free a bit from the overwhelming conspiracies related to Covid-19. Finally, I admire your bravery and continued efforts in doing what you’re doing. If I were you, with two PhDs and an almost impeccable educational background, but still can’t convince people to believe what you say, I guess I would just swear to God and simply give up!!!
Best regards,
Your reader.
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Thank you for your support.
I am very much aware of what you said about people’s mindset and therefore would not fool myself to think that I can change that.
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但是同樣嚴謹的審查 review
有用在清灌一號的核准與推薦使用上嗎
很好奇
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https://professorlin.com/2021/05/19/%e6%b8%85%e5%86%a0%e4%b8%80%e8%99%9f%ef%bc%9a%e4%b8%96%e7%95%8c%e7%86%b1%e9%8a%b7%ef%bc%8c%e5%94%af%e7%8d%a8%e5%8f%b0%e7%81%a3%e8%b2%b7%e4%b8%8d%e5%88%b0%ef%bc%8c%e9%97%9c%e9%8d%b5%e5%9c%a8%e6%96%bc/
https://professorlin.com/2022/05/24/%e6%b8%85%e5%86%a0%e4%b8%80%e8%99%9f%ef%bc%8c%e7%99%82%e6%95%88%ef%bc%9f%e7%a7%91%e5%ad%b8%e8%ad%89%e6%93%9a%ef%bc%9f/
https://professorlin.com/2022/05/27/%e6%b8%85%e5%86%a0%e4%b8%80%e8%99%9f%ef%bc%9a%e7%99%82%e6%95%88%ef%bc%8c%e7%b3%bb%e7%b5%b1%e4%b8%8d%e5%90%8c/
https://professorlin.com/2022/06/16/%e6%b8%85%e5%86%a0%e4%b8%80%e8%99%9f%e4%b8%a6%e4%b8%8d%e6%98%afcovid-19%e7%94%a8%e8%97%a5%ef%bc%8c%e8%a1%9b%e7%a6%8f%e9%83%a8%e4%b8%ad%e9%86%ab%e8%97%a5%e5%8f%b8%e9%bb%83%e6%80%a1%e8%b6%85%e5%bc%b7/
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