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宿醉系列6 - 宿醉的症狀、機轉及處置
9種經過醫生
測試和檢驗
有效防治宿醉的方法
喝酒後宿醉實際上有一個醫學術語,
即“veisalgia”。
Veisalgia是由
挪威語的:kveis,“過度放縱後的不適”,
與希臘語:ἄλγος álgos,“痛苦”所組成。
宿醉是指
飲用酒精飲料後產生許多不舒服的生理及心理影響,
其特徵是有明顯的不適,
而且時間會超過24小時以上。
常見的症狀有:
頭痛
嗜睡
注意力不集中
口乾
頭暈
無力
腸胃不適
出汗
噁心
過度興奮和恐慌
在宿醉期間你所感覺到的不適
大多數歸結為兩個因素:
1.脫水
2.乙醛
乙醛(Ethanal),又稱醋醛,屬醛類,
是一種具有分子式CH3CHO或MeCHO的有機化合物。
乙醇在被氧化後生成為乙醛
且被認為是宿醉的成因。
你不知道的事實!
醫生們通常不以節制而出名的-各種調查都指出,
醫務人員的酒精使用率較高。
Bakhshi S, While A. Health Professionals’ Alcohol-Related Professional Practices and the Relationship between Their Personal Alcohol
Attitudes and Behavior and Professional Practices: A Systematic Review. International Journal of Environmental Research and Public
Health. 2013;11(1):218-248. doi:10.3390/ijerph110100218
但是為了大家的安全,
我們還是要適度飲酒。
經常有人問到醫生如何預防宿醉,
以及醫生用來治療自己宿醉的方法。
以下整理了一系列基於證據的宿醉預防方法,
以確保你度過一個美好的夜晚,
並且減去第二天的宿醉!
1
食物
喝酒前先
餵飽肚子
2
水分
喝酒前、
中、後
多喝水
3
速度
調整喝酒
速度變慢
4
避免混酒
避免深色
烈酒與
雞尾酒
5
避免氣泡
酒
避免啤酒
香檳及氣
泡混酒
6
NSAIDs
服用
Ibuprofen,
Nurofen
7
維生素B6
降低宿醉
症狀50%
8
補充品
多刺梨狀
仙人掌提
取物
9
靜脈注射
水分補充
預防和減
輕嚴重宿
醉的症狀
1.喝酒之前大吃一頓
飲酒前1-2小時,應吃大餐,
以減緩血液對酒精的吸收。
研究表明,空腹喝酒時,
血液酒精濃度(blood alcohol concentration, BAC)
可能高達30%。
Paton A. Alcohol in the body. BMJ. 2005;330(7482):85-87. doi:10.1136/bmj.330.7482.85
酒精的吸收率(箭頭)受酒精濃度的影響
酒精的吸收速率取決於幾個因素。
例如,當空著肚子喝酒且酒精濃度為20%至30%時,
這是最快的。
因此,雪利酒的酒精濃度約為20%,血液中酒精含量的增加
比啤酒更快( 3-8%),而烈酒(40%)會延遲胃排空並抑制吸收。
因此,雪利酒的酒精濃度約為20%,
血液中酒精含量的增加比啤酒更快( 3-8%),
而烈酒(40%)會延遲胃排空並抑制吸收。
酒精的吸收率(箭頭)受酒精濃度的影響
用二氧化碳充氣的飲料(例如威士忌加蘇打水和香檳)
可以更快地進入系統。
酒精的吸收率(箭頭)受酒精濃度的影響
食物,特別是碳水化合物,會阻礙吸收:
血液濃度可能達不到空腹時血液濃度的四分之一。
搭配食物或在烈酒的情況下將酒精稀釋後飲用,
可以達到最佳的酒精愉悅效果。
2.喝酒前、喝酒中和喝酒後大量喝水
應該是最有效的方法。
因為酒精會導致脫水。
防止宿醉的最簡單方法
是在每一種含酒精的飲料之間喝一整杯水-
當使用這種方式足夠補充水分時,應該很少喝醉。
如果你喝得太高而忘了在喝酒時補充水,
請務必事先喝一品脫水(473.176473 毫升)。
另外,如果你的朋友已經喝醉了,
請確保在他睡覺之前,讓他盡可能多地喝水。
通過這樣做,
我已經拯救了不少朋友避免了令人討厭的宿醉。
3.放慢喝酒的速度
限制你的酒精攝入量為每小時一杯-
你的身體大約需要60分鐘來代謝每杯。
飲酒的速度越快,酒精中的毒素在被代謝之前
就越會待在你體內更多的時間。
這些毒素在第二天更有可能影響你的腦組織
並引起嚴重的宿醉頭痛。
其次,延長喝一杯酒的時間可以減少攝入的酒水總量。
喝完酒的次日是否會遭受宿醉,
實際上都取決於你所喝酒的累積量。
喝幾杯
才不會引起宿醉?
喝幾杯酒會引起宿醉沒有如此的“神奇的數量”,
因為每個人的酒精代謝方式都不一樣。
這是由於體重和肝酶的不同。
不過,一般來說
女性喝酒超過3-5杯可能會宿醉。
男性在四個小時的時間內喝5至7杯雞尾酒
幾乎總是會出現宿醉症狀。
4.喝顏色透明的烈酒,不要混合酒類
避免深色的烈酒,
而選擇清澈或透明的烈酒。
深色的烈酒(如紅酒和威士忌)的顏色來自同類物(congener),
同類物是在老化過程中產生的微粒。
與含更多同類物的深色飲料(如波特酒、白蘭地、威士忌
和紅酒)相比,含較少同類物(例如伏特加和杜松子酒)的
酒精飲料與宿醉的發生率和嚴重程度較低。
這可以解釋為什麼慢性酒精中毒患者
濫用伏特加和杜松子酒的比例過高。
便宜/低質量的酒有時也比高端烈酒包含更多同類物
(例如,三重蒸餾的灰雁伏特加酒)。
750ml $28.98 - $43.99
5.有節制地享用氣泡酒和調酒
為什麼像啤酒和香檳這樣的飲料酒精含量低,
卻仍然會相對快速地使你高呢?
答案是,含高量氣體的飲料,
如啤酒、香檳和混有蘇打水的調酒,
可以加快酒精被吸收到血液中的速度。
據推測,
飲料中的二氧化碳會迅速將酒精從胃中推入小腸。
6. NSAIDs (Ibuprofen, Nurofen 等)
非類固醇消炎藥
(Non-Steroidal Anti-Inflammatory Drug,
縮寫作NSAID),也譯作非甾體抗炎藥,
是一類具有解熱鎮痛效果的藥物,
在施用較高劑量時也具有消炎作用。
非類固醇類消炎藥物中,屬阿斯匹靈(Aspirin)、
伊布洛芬(Ibuprofen)、萘普生(Naproxen)最為著名,
在絕大多數國家都可作為非處方藥銷售。
我本身找不到任何強有力的研究來支持
將NSAID用作預防措施,但這是一個很常見的說法,
我不得不對此加以提及。
我也知道許多醫生朋友對它的有效性發誓。
一項很早的研究表明,
NSAID在降低宿醉症狀評分方面比安慰劑更有效。
Kaivola S, Parantainen J, Osterman T, Timonen H. Hangover headache and prostaglandins: prophylactic
treatment with tolfenamic acid. Cephalalgia : an international journal of headache. 1983;3(1):31-36.
doi:10.1046/j.1468-2982.1983.0301031.x
從理論上講,大腦中高水平的酒精會引起神經炎症,
這就是為什麼抗炎藥如伊布洛芬
可以起到幫助作用的原因。
請注意,
NSAIDS可能會進一步刺激你的胃壁。
因此,如果需要的話,請在睡覺前服用它們,
而不是在宿醉發作時的早晨服用。
上床睡覺前先吃兩片(200-400毫克)即可。
7.維生素B6
飲酒前服用維生素B6已顯示可將宿醉症狀的數量減少
約50%。 這是一項只有17名參與者的小型研究,
所以我對於研究結果半信半疑。
Khan MA, Jensen K, Krogh HJ. Alcohol-induced hangover. A double-blind comparison of pyritinol and placebo in preventing hangover
symptoms. Quarterly journal of studies on alcohol. 1973;34(4):1195-1201. Accessed July 23, 2019.
根據該研究,這是你需要做的:
飲酒前服用400 mg維生素B6,
三個小時後再服用400 mg維生素,到深夜時再服用400 mg。
記住這一點,祝你好運。 我從來沒有嘗試過這個。
8.多刺梨狀仙人掌萃取物
Prickly pear cactus
仙人掌屬(學名: Opuntia)
通常被稱為刺梨(prickly pear) ,
是仙人掌科的一個屬。
仙人掌屬植物多數生長在美洲,
只有少數品種生長在其他熱帶地區。
Wiese J, McPherson S, Odden MC, Shlipak MG. Effect of Opuntia ficus indica on symptoms of the alcohol
hangover. Archives of internal medicine. 2004;164(12):1334-1340. doi:10.1001/archinte.164.12.1334
刊登於2004年內科學文獻(Archives of Internal
Medicine)的一篇論文,名稱為「梨果仙人掌對酒精宿醉
症狀的影響。」(Effect of Opuntia ficus indica on
symptoms of the alcohol hangover.)
在一項雙盲交叉試驗中,
有64名參與者在飲酒前5小時
接受了多刺梨狀仙人掌提取物或安慰劑。
多刺梨狀仙人掌提取物並未減輕總體宿醉症狀,
但確實將嚴重宿醉的風險降低了50%。
假說是,與非甾體抗炎藥相似,
多刺梨狀仙人掌取物可作為抗炎藥,預防宿醉。
9.靜脈注射水分補充可預防和治療嚴重的宿醉
靜脈注射(Intravenous therapy,常縮寫為 IV)
是一種醫療方法,即把血液、藥液、營養液等
液體物質直接注射到靜脈中。
靜脈注射可分短暫性與連續性
短暫性的靜脈注射多以針筒直接注入靜脈,
即一般常見的「打針」。
連續性的靜脈注射則施以靜脈滴注,
連接軟喉的藥水樽會倒掛於架上,俗稱「(打)吊點滴」、
「(打)吊針」、「輸液」、「(打)吊瓶」、「輸水」
(中國大陸俗稱「掛水」,香港則稱「吊鹽水」),
為將留置針插入靜脈後固定,
然後接上可更換或補充的瓶裝或袋裝醫療液體。
靜脈輸液的工作原理是
直接補充血液中的流體和營養。
如果你願意花這筆錢,靜脈補水可能有效,
因為醫生可以為你量身定制適合你的需求。
不論是靜脈營養還是白蛋白,
其實兩者都是在醫生評估下,有必要時才會施打,
尤其兩種注射液打起來一點都不便宜。
若是病人以自費價施打,靜脈營養一大包約1000C.C.,
包括施打時的管路費用,一天就要價兩千多,白蛋白50C.C.也要一千多元,
沒有急性需求的情況下,醫護人員並不建議施打。
額外一點
法莫替丁可防止臉紅(可能也能防止宿醉)
法莫替丁(INN:famotidine),商品名稱為Pepcid,
是一種組胺H2受體阻抗劑,主要用於抑制胃酸的分泌,
並用於治療消化性潰瘍和胃食道逆流。
一個私人皮膚科醫生朋友總是在喝酒前服用法莫替丁。
他聲稱自己這樣做時從未臉紅過。 相反地,
當他忘了服用法莫替丁時,他總是會很快地臉紅。
乙醛刺激組胺的釋放。
組胺會使臉部血管擴張,引起臉紅。
40%的亞洲人處理乙醛的酶中有突變。
這會導致乙醛和組胺的大量堆積,從而引發臉紅。
法莫替丁是一種可抑制胃酸產生的抗組胺藥,
通常用於消化不良和胃酸反流。
Miller NS, Goodwin DW, Jones FC, et al. Combined antihistamine antagonism of the flushing reaction to alcohol.
Alcohol and alcoholism (Oxford, Oxfordshire) Supplement. 1987;1:583-586. Accessed July 23, 2019.
2019年的一項研究表明:
在飲酒之前服用抗組胺藥可防止皮膚發紅。
該研究還發現,它可以在一定程度上防止宿醉。
開始飲酒前1小時,
你可以嘗試服用20 mg法莫替丁。
總結了9個防止宿醉的預防措施。
在此重申,無論你採取了多少這些措施,
如果你喝酒過多,最終還是會宿醉。

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9 doctor tried and-tested hangover prevention methods

Editor's Notes

  1. 宿醉系列6 - 9種經過醫生測試和檢驗有效防治宿醉的方法 Hangover Series 6- 9 Doctor Tried-And-Tested Hangover Prevention Methods
  2. 9 Doctor Tried-And-Tested Hangover Prevention Methods 9種經過醫生測試和檢驗有效防治宿醉的方法
  3. veisalgia from Norwegian: kveis, "discomfort following overindulgence", and Greek: ἄλγος álgos, "pain“ Veisalgia是由挪威語的:kveis,“過度放縱後的不適”,與希臘語:ἄλγοςálgos,“痛苦”所組成
  4. 宿醉是指飲用酒精飲料後產生許多不舒服的生理及心理影響,其特徵是有明顯的不適,而且時間會超過24小時以上。常見的症狀有頭痛、嗜睡、注意力不集中、口乾、頭暈、無力、腸胃不適、出汗、噁心、過度興奮和恐慌[1]。宿醉是由於脫水造成的[2]。
  5. Most of what you feel during a hangover are down to 2 factors: 1. Dehydration 2. Acetaldehyde, a toxic byproduct of alcohol circulating in your system. 喝酒後宿醉實際上有一個醫學術語,即“veisalgia”。 在宿醉期間你所感覺到的不適大多數歸結為兩個因素: 1.脫水 2.乙醛,是酒精在身體系統中循環所產生的有毒副產物。
  6. Doctors are not known for abstaining - various surveys have noted that medical professionals tend to have high rates of alcohol use [2]. 醫生們通常不以節制而出名的-各種調查都指出,醫務人員的酒精使用率較高[2]。
  7. But for the safety of everyone, we do drink moderately. I'm often asked how doctors prevent hangovers, and what we use to treat our own hangovers. Below I've compiled a list of evidence-based hangover prevention methods to ensure you have a good night out, minus the hangover the day after: 但是為了大家的安全,我們還是要適度飲酒。 我經常被問到醫生如何預防宿醉,以及我們用來治療自己宿醉的方法。 下面,我整理了一系列基於證據的宿醉預防方法,以確保你度過一個美好的夜晚,並且減去第二天的宿醉:
  8. Heavy meals 1-2 hours prior to drinking help to slow down alcohol absorption into your blood. Studies have shown that your blood alcohol concentration (BAC) can be up to 30% higher when you drink on an empty stomach [3]. 飲酒前1-2小時,應吃大餐,以減緩血液對酒精的吸收。 研究表明,空腹喝酒時,血液酒精濃度(BAC)可能高達30%[3]。
  9. 473.176473 毫升
  10. Also, if your friend is practically passed out at the end of the night, make sure that he drinks as much water as he can before hitting the sack - I've saved more than a few friends from a nasty hangover by doing this. 另外,如果你的朋友在深夜幾乎昏昏欲睡,請確保在睡覺之前,他盡可能多地喝水-通過這樣做,我已經拯救了不少朋友避免了令人討厭的宿醉。
  11. Limit your drinks to one every hour - your body takes about 60 minutes to metabolize each drink. The faster you consume alcohol, the more time alcohol toxins spend in your body before being metabolized. These toxins are more likely to affect your brain tissues and cause a bad hangover headache the next day [5]. 限制你的酒精攝入量為每小時一杯-你的身體大約需要60分鐘來代謝每杯。 飲酒的速度越快,酒精中的毒素在被代謝之前就越會待在你體內更多的時間。 這些毒素在第二天更有可能影響你的腦組織並引起嚴重的宿醉頭痛[5]。
  12. Limit your drinks to one every hour - your body takes about 60 minutes to metabolize each drink. The faster you consume alcohol, the more time alcohol toxins spend in your body before being metabolized. These toxins are more likely to affect your brain tissues and cause a bad hangover headache the next day [5]. 限制你的酒精攝入量為每小時一杯-你的身體大約需要60分鐘來代謝每杯。 飲酒的速度越快,酒精中的毒素在被代謝之前就越會待在你體內更多的時間。 這些毒素在第二天更有可能影響你的腦組織並引起嚴重的宿醉頭痛[5]。
  13. Secondly, stretching out your drinks will reduce the total amount of booze consumed. Whether you suffer a hangover or not at the end of the day is really down to the cumulative amount of alcohol you drink. 其次,延長喝一杯酒的時間可以減少攝入的酒水總量。 不管你一天結束時是否遭受宿醉,實際上都取決於你所喝酒的累積量。
  14. 不過,一般來說,喝酒超過3-5杯的女性可能會宿醉。 對於男性來說,在四個小時的時間內喝5至7杯雞尾酒幾乎總是會出現宿醉症狀。
  15. Alcoholic beverages that contain less congeners (eg. vodka and gin) are associated with a lower incidence and severity of hangovers than darker beverages that contain more congeners (eg. port, brandy, whiskey and red wine) [6]. This may explain why patients with chronic alcoholism abuse vodka and gin disproportionately. 與含更多同類物的深色飲料(如波特酒、白蘭地、威士忌和紅酒)相比,含較少同類物(例如伏特加和杜松子酒)的酒精飲料與宿醉的發生率和嚴重程度較低[6]。 這可以解釋為什麼慢性酒精中毒患者濫用伏特加和杜松子酒的比例過高。
  16. Cheaper/low quality booze are sometimes also known to contain more congeners than higher end spirits (say, your triple distilled Grey Goose vodka). A former flatmate of mine polished off an entire bottle of Tesco Value vodka while still a broke-ass medical student. Of course he suffered a terrible hangover after - we still laugh at him about it today. 便宜/低質量的酒有時也比高端烈酒包含更多同類物(例如,三重蒸餾的灰雁伏特加酒)。 我的一位前室友當他仍然是個窮困的醫學生時候,迅速喝掉了整瓶Tesco 超市的伏特加酒。 當然,之後他遭受了可怕的宿醉-今天我們仍然笑他。
  17. The answer is that gassy drinks such as beer, champagne and soda mixers with your liquor speed up the rate of alcohol absorption into your bloodstream. It's hypothesized that carbon dioxide in the drink rapidly pushes alcohol from your stomach into your small intestine [3]. 答案是,含高量氣體的飲料,如啤酒、香檳和混有蘇打水的調酒,可以加快酒精被吸收到血液中的速度。 據推測,飲料中的二氧化碳會迅速將酒精從胃中推入小腸[3]。
  18. 仙人掌通常被稱為刺梨,是仙人掌科仙人掌科的一個屬。
  19. archives of internal medicine.内科学文献 Archives of Internal Medicine
  20. 靜脈注射可分短暫性與連續性,短暫性的靜脈注射多以針筒直接注入靜脈,即一般常見的「打針」。連續性的靜脈注射則施以靜脈滴注,連接軟喉的藥水樽會倒掛於架上,俗稱「(打)吊點滴」、「(打)吊針」、「輸液」、「(打)吊瓶」、「輸水」(中國大陸俗稱「掛水」,香港則稱「吊鹽水」),為將留置針插入靜脈後固定,然後接上可更換或補充的瓶裝或袋裝醫療液體。
  21. intravenous rehydration中文靜脈注射體液補充
  22. 若是病人以自費價施打,靜脈營養一大包約1000C.C.,包括施打時的管路費用,一天就要價兩千多,白蛋白50C.C.也要一千多元,沒有急性需求的情況下,醫護人員並不建議施打。
  23. 40%的亞洲人處理乙醛的酶中有突變。 這會導致乙醛和組胺的大量堆積,從而引發臉紅。