Ozonated autohemotherapy 臭氧大自血療法

在丁香園看到疼痛科有人貼出此帖，甚感興趣，臭氧與疼痛科發生關係，是在於椎間盤疾病時，操作微創手術，溶解突出的椎間板核的一個溶劑選項 ，其原理最重要的是臭氧有很強的氧化劑作用，對椎間板核主要成分具有消核溶蝕作用，消炎止痛則是可能的附加作用。

Minimally invasive oxygen-ozone therapy for lumbar disk herniation.AJNR Am J Neuroradiol. 2003 May;24(5):996-1000.

Sciatica: treatment with intradiscal and intraforaminal injections of steroid and oxygen-ozone versus steroid only.Radiology. 2007 Mar;242(3):907-13. Epub 2007 Jan 5.

甚麼時候是臭氧自血療法的適應症，只要正統醫學orthrodox medicine無法提供人們對醫療的需求，即是另類醫療出頭之時，不過前提是，do no harm，療效如何是另一回事，最重要的，不能對病人產生傷害，而治療時，也需誠實告知，

1. 所有正規醫療的選項與途徑
2. 不能保證或吹噓療效



稍微搜索了一下pubmed，一些主流雜誌對此甚少著墨，意外發現Lancet一篇對advanced chronic heart failure的長期治療觀察報告，她不用Ozone 或 ozonated autohemotherapy 而是以immunomodulatory therapy取代，不知道在主流雜誌談ozone是否有某些禁忌?

另一篇是spine發表的:

Intramuscular oxygen-ozone therapy in the treatment of acute back pain with lumbar disc herniation: a multicenter, randomized, double-blind, clinical trial of active and simulated lumbar paravertebral injection.Spine 2009 Jun 1;34(13):1337-44.

看起來是有效的，也就是在保守療法療效不佳下，又不想做手術治療(open or minimal invasive)，好像也可以先試試看這種 另類療法。

目前有RCT證實臭氧治療無效的疾病：AIDS, Peripheral arterial disease, Chronic heart failure， 園內預告此種療法可以通治 [百病]，大有 SGB(stellate ganglion block) block 第二的氛圍，而大多數號稱的療效，都沒有經過科學的RCT檢驗，因此，雖有興趣但卻不能狂熱，對於此帖的後續報導且拭目以待吧!

1. The use of ozone-treated blood in the therapy of HIV infection and immune disease: a pilot study of safety and efficacy, AIDS 5 (1991), pp. 981–984. 
2. A multicenter, randomized, double-blind, placebo-controlled study of immune modulation therapy in patients with symptomatic peripheral arterial disease: the SIMPADICO Trial. Presented at the American College of Cardiology 55th Annual Scientific Session; March 11–14, 2006; Atlanta, GA, USA.
3. Results of a non-specific immunomodulation therapy in chronic heart failure (ACCLAIM trial): a placebo-controlled randomised trial.Lancet. 2008 Jan 19;371(9608):228-36.

附錄作法：

Device-based immunomodulation therapy (IMT) is a point-of-care outpatient procedure in which a sample of whole autologous blood is exposed ex vivo to controlled amounts of oxidative stress. The VC7000A autologous blood treatment system (Celacade System, Vasogen, Mississauga, ON, Canada) consists of a treatment unit (model VC7001A) and a sterile, single-use, disposable cartridge (model VC7002). For each patient, venousblood (10 mL) was placed in 2 mL of sodium citrate (anticoagulant). The citrated blood sample was immediately transferred to the VC7002 cartridge, which was then inserted into the VC7001A device. The blood sample was exposed to oxygen/ozone gas mixture (ozone concentration of 15·35 g/m³) delivered at a flow rate of 240 mL per min, and ultraviolet light at a wavelength of 253·7 nm) at a temperature of 42·5°C for about 20 min. The treated blood sample was then removed from the system and immediately administered by intragluteal injection to the same individual from
whom the blood sample was obtained after an injection of local anaesthetic.

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