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CHRONIC FATIGUE IMMUNE DYSFUNCTION SYNDROME

(CFIDS)

慢性疲劳免疫失调综合症

(简称：CFIDS)

Also Referred to as:

YEAST SYNDROME or YEAST RELATED ILLNESS

也被称为:

酵母菌综合症 或 酵母菌相关疾病

By Elmer M. Cranton, M.D.
Copyright ? 2007 Elmer M. Cranton, M.D.

作者：埃尔默 M. 克兰顿，医学博士
版权所有? 2007 埃尔默 M. 克兰顿

Terminology varies widely between different practitioners and differing theories of cause. The acronym "CFIDS" will be used in this article to refer to a clinical syndrome which can cross the boundaries and involve, more or less, any of the below:

因医生或理论的不同所用术语可能并不一样

本文中所引用的缩写名词 CFIDS 指的是一种临床症状，它包括但不限于以下：

CHRONIC FATIGUE IMMUNE DYSFUNCTION SYNDROME — CFIDS — CHRONIC FATIGUE SYNDROME — CANDIDA ALBICANS SYNDROME — CANDIDIASIS — MYALGIC ENCEPHALITIS — EPSTEIN-BARR SYNDROME — FOOD ALLERGY — MONILIA — ENVIRONMENTAL ILLNESS — SICK BUILDING SYNDROME — ECOLOGICAL ILLNESS — CHEMICAL SENSITIVITY — ALLERGIC TENSION FATIGUE SYNDROME — HYPERACTIVITY SYNDROME — ATTENTION DEFICIT DISORDER — DYSLEXIA — ASTHMA — HYPOGLYCEMIA — POST FLU SYNDROME —  MERCURY TOXICITY  — HEAVY METAL TOXICITY

慢性疲劳免疫失调综合症 — CFIDS — 慢性疲劳症状 — 白假丝酵母综合症 — 念珠菌症 — 肌痛性脑炎 — EB综合症 — 食物过敏 — 念珠菌 — 环境疾病 — SICK BUILDING SYNDROME — 生态疾病— 化学敏感性 — 过敏性紧张疲劳综合征 — 兴奋过度 — 精力不足 — 阅读障碍 — 哮喘 — 低血糖 — 流感后遗症 —  水银中毒 — 重金属中毒

INTRODUCTION

A variety of widely diverse symptoms, seemingly unrelated, affecting many different parts of the body, are now believed to be caused, at least in part, by an overloaded immune system and immunologic dysfunction. A stressed-out and malfunctioning immune system is felt to be an important and treatable cause of many the above listed conditions. Chronic fatigue and nervous tension are almost always present.

介绍

很多各样的症状看起来似乎没什么关系，它们影响着许多身体的不同部分，然而现在至少可以在一个方面确信的是，它们是由于免疫系统超负荷或者是免疫系统失调导致的。一个精疲力竭故障重重的免疫系统被认为是上面所述的种种病情可治疗的关键所在，慢性疲劳和神经紧张通常同时存在。

A number of case histories are presented in the patients own words on another page.

这里有一页病人自己讲述的病情历史报告（点击左侧链接进入）。

The treatment plan described here was empirically developed by the author over many years and has brought relief to hundreds of patients who been treatment failures elsewhere. Benefits have sometimes been dramatic and complete, after attempts with many other therapies had failed.

这里所讲述的治疗计划是经过作者多年的经验所总结而成，他缓解了数以百计的病人，其中有痊愈的、也有效果卓越的，这些病人曾经尝试过许多其他的治疗却并无效果。

慢性疲劳在工业化国家继续保持着增长势头，于此相关的免疫功能失调正在成为一个流行病。而20世纪后期以来，食物过敏、环境问题、营养、药物以及生活方式这些因数正是促进这个增长的主要原因。

It has been observed that over 60% of Americans needlessly suffer from some form of delayed food allergy, food intolerance or environmental sensitivity, causing chronic health problems, as partially outlined in the list below. Food and chemical sensitivity are associated with a large number of chronic conditions, either as a cause or a  contributing factor. These include:

据观察，有超过60%的美国人不必要的患有某种形式的延时食物过敏，食物过敏和环境敏感所带来的慢性健康问题，部分概述列在下表。食物和化学物质的敏感性与大量的慢性疾病相关，既有主要原因也有次要原因，它们包括：

• Anxiety (acute or chronic)
• Arthritis (osteoarthritis especially)
• Asthma
• Nasal and sinus congestion
• Attention Deficit Disorder
• Learning and behavior disorders
• Bed wetting
• Bloating
• Bronchitis
• Celiac Disease
• Non-tropical sprue
• Ulcerative colitis
• Chronic Fatigue
• Constipation
• Cystic fibrosis
• Depression
• Diarrhea
• Gastritis
• Headaches
• Hyperactivity Disorder
• Inflammatory Bowel Disease
• Insomnia
• Irritable Bowel Syndrome
• Itchy skin problems
• Malabsorption
• Migraine
• Sleep disturbances
• Water retention
• Weight control problems
• Sexual dysfunction
• Infertility
• Menstrual disorders
• And many more

• 焦虑
• 关节炎
• 哮喘
• 鼻窦炎
• 精力不足
• 学习和行为混乱
• 尿床
• 肿胀
• 支气管炎
• 腹腔疾病
• 非热带口炎性腹泻
• 溃疡性结肠炎
• 慢性疲劳
• 便秘
• 胆囊纤维症
• 沮丧
• 痢疾
• 胃炎
• 头痛
• 混乱
• 肠炎
• 失眠
• 肠动
• 皮肤瘙痒
• 吸收不良
• 偏头痛
• 睡眠不安
• 保水性
• 体重问题
• 性功能失调
• 不育
• 月经失调
• 许多其他……

The diagnosis as listed above may be correct but treatment can often be easier and more successful by also following this protocol. Symptoms of autism and Down's syndrome can also be helped.

以上所列举的诊断可能是正确的，然而如果能够遵行这里的方法那么治疗将更容易、更成功，对于自闭症和唐氏综合症也可以得到帮助。

Symptoms of CFIDS are commonly misdiagnosed as neurotic or psychosomatic. A variety of  diagnostic terms are used to describe this variable constellation of symptoms, or syndrome. A common denominator, collectively referred to as CFIDS, is immunologic dysfunction, often accompanied in women by hormonal imbalance. Premenstrual symptoms and fertility problems can be related.

慢性疲劳免疫失调综合症（CFIDS）常常被误诊为精神病患者或者心理相关疾病。有许多医用名词来描述这些症状，统称为CFIDS，往往伴随着女性荷尔蒙失调，经前综合症和生育问题也常于此相关。

Great improvement in hundreds of patients has followed the treatment program described below. Because there are no specific laboratory tests to confirm a diagnosis in advance, medical history and response to a trial of therapy remains the only way to make the diagnosis.

在遵行下述的疗法后，巨大的疗效发生在数以百计的病人身上。这里不需要任何化验确认之前提及的那些诊断，因为病史和反应依然是做出诊断的唯一方法。

This paper and the program of therapy described is unproven and anecdotal by strict scientific criteria. Conclusions herein are based on the author's personal observations and success in treating hundreds patients with symptoms of CFIDS. Many of those patients had failed to respond to multiple prior treatment programs. What is described here is eclectic, based on experience with patients. Much was learned from the patients themselves and not from medical schools or elaborate scientific research.

本文以及所描述的疗法从严格科学的角度讲可以说是未经证明的偏方。此处的结论都是基于作者个人的观点以及有此类症状的数百个病人的成功治疗。这些病人在之前的多项治疗并无效果。这里的所描述是基于患者的经验，不拘一格。许多知识都是从病人自身学到，而不是来自于医学院或精心科研。

This treatment regimen often works in practice. It is safe and inexpensive, relative to the cost of the many prior unsuccessful treatments. Not all patients respond. Significant improvement occurs in only about half of patients. Unfortunately, it is not possible to know in advance who will respond and who will not. Of the non-responders, many would not follow instructions or found it impossible to avoid offending substances in their diet or environment.

相比那些之前不成功的治疗来说，这个养身疗法可行、安全、廉价。并非所有的病人都有效果，明显的改进只发生在大约一半的病人身上。然而不幸的是，我们并不能提前知道谁有效还是谁无效。对于那些无效的人而言，有许多人是因为不能遵行指示而行或者做不到改变其饮食和环境来规避有害物质。

Nothing in medicine is 100% effective. The scientific basis for the observations, recommendations, and conclusions in this paper is hypothetical. Blinded placebo controlled studies have not been done. Most physicians would consider the conclusions and recommendations in this paper as experimental at best and pure quackery and exploitation at worst. Medical insurance commonly often refuses to reimburse the costs.

世上没有百分百疗效的药物。本文的意见、建议和结论的科学依据是假设。绝大多数医师会认为本文的结论和建议是经验主义、江湖医术或是骗人的把戏。医疗保险通常会拒绝报销这些费用。

The most frequent and incapacitating symptom in patients with CFIDS is fatigue, without an evident cause. Depression or other mental dysfunction is commonly present, but may be an effect of the underlying illness rather than the primary diagnosis. Physical examination and laboratory tests are seldom diagnostic.

CFIDS病人最常见的症状就是疲惫，却找不到明显的原因。抑郁症或者其他精神功能障碍也常常相随，相对主要诊断结果而言，这更可能是一个潜在的疾病，体检和化验常常不能提供正确的诊断。

Adverse reactions to many otherwise desirable and nutritious foods (so-called food allergy) are common. Sensitivity to chemical fumes, perfumes, solvents, and other substances is also very common. Respiratory allergy, nasal and sinus congestion, and hay fever may or may not be present. Digestive tract symptoms, urinary symptoms, and musculoskeletal pain are common.

食物的不良反应非常普遍（也就是所谓的食物过敏）。化学烟雾、香水、溶剂和其他物质的敏感性也十分常见。呼吸过敏、鼻窦炎、还有花粉症这些症状可能有或者没有，而消化道相关、泌尿系统症状和肌肉骨骼疼痛等症状却是常见的。

By reducing stress on the immune system, and by keeping that stress to a minimum for several months, many patients who have suffered with symptoms for many years have found relief. Significant reduction of immune system stress and relief of related symptoms can be accomplished by following the treatment program described below. A hypothetical mechanism of action is offered, but the treatment protocol is based on observations of what works in practice, not on theory.

通过减轻免疫系统的压力并保持到最低限度数月，许多常年遭受那些症状的病人得到了缓解。可以通过下面所讲的疗法来实现对免疫系统明显的减压。这个方法是基于对病人的观察实践，而不是基于理论。

There is no easy way to do this. Because of the non-specific nature of symptoms, a thorough initial evaluation with laboratory testing are important to rule out other unsuspected causes. But there are no reliable tests that can be done in  advance, to diagnose specific sensitivities.

然而，要完成这些并非易事，因为不是特别明确的症状，为了排除其他的可能原因，一个彻底的生化检验十分重要。然而事先却没有可靠的检验可以诊断具体的敏感性。

On many occasions, patients who may have found partial relief based on blood tests, skin tests, adrenal tests, etc., have subsequently discovered up to 40% false positives and/or 40% false negative results from testing alone. They usually find that there is much more to their problems by following the full protocol described below―a program that is as useful for diagnosis as it is for treatment.

在很多情况下，病人可能在验血、皮试、肾上腺皮质功能测试等之后发现有高达40%的假阳性或40%的假阴性的单独测试。在经历下面的疗法以后他们通常发现更多的问题，这个方法不论治疗还是诊断都有用处。

YEAST AND FUNGUS

Yeast and other microscopic fungal organisms compose a normal part of the body's internal ecology. They are normally well tolerated by a healthy immunity. If they increase in number, however, they cause additional stress to the immune system. Is is widely recognized that mold, including yeast and fungi, are among the most allergic of environmental exposures.

酵母菌和真菌

酵母和其他真菌微生物是人体内生态系统的一部分。一个健康的免疫系统通常可以和它们友好共存。然而，如果它们的数量增加，就会给免疫系统带来额外的压力。霉菌，包括酵母菌和真菌，是最容易引起过敏问题的，这是被广泛认可的。

It is a medical fact that every healthy person will react allergically to Candida albicans, a common yeast, also called Monilia. A clinical test for normal immunity requires injecting a small amount of Candida (Monilia) yeast extract under the skin and observing for a raised, red allergic reaction over several days. If that reaction does not occur, the patient is diagnosed as "anergic," indicating that the immune system is not functioning. In other words, a healthy human body is expected to react allergically to Candida yeast unless immunity is paralyzed or non-functional. This universal reactivity to Candida albicans is evidence that the presence of yeast in the body creates stress to the immune system.  If Candida increases, immune stress increases.

这是一个医学事实，就是每一个健康的人都会对白假丝酵母（一个普通的酵母菌，也称作念珠菌）产生过敏。临床试验表明，对一个正常的免疫体皮下注射少量的假丝酵母菌提取物，就会看到突起、红色的过敏反应，并会持续几天。如果一个病人没有这样的反应，那么就诊断为‘无变应性的’，表明他的免疫系统不正常。换句话说就是，除非免疫系统瘫痪或不正常，一个健康的身体就应该对假丝酵母菌产生过敏反应。这种对白假丝酵母菌的反应就是酵母菌在体内会对免疫系统带来压力的证据。如果假丝酵母菌增加，免疫压力也随着增加。

For purposes of simplification, all species of yeast and fungus, which grow in the human body, are collectively lumped together in this paper as "yeast."

为了方便，本文将那些在人体内的所有种类的酵母菌和真菌统称为酵母菌。

Many pharmacological, dietary, environmental and life-style factors encourage growth of yeast in body's of people in industrialized countries. When yeast overgrowth becomes obvious, it is easily diagnosed as an infection and treated appropriately with anti-fungal medicines. More commonly, however, yeast colonization increases, especially in the large intestine, but is not adequate to diagnose an infection. It is an ecological imbalance in the body that adds to total load on the immune system.

在工业国家，许多药物、饮食、环境和生活方式等因素都鼓励着体内的酵母菌的生长。当酵母菌过度增长以至于很明显，就很容易诊断为真菌感染并给予适当的抗菌药物。然而，更为广泛的是，酵母菌更多的在大肠内繁殖，以致不被诊断为感染。这是体内的生态不平衡，而且这个负担又加到了免疫系统的身上。

Treatment with a combination of prescription medicines to eliminate yeast from the body, combined with other dietary and lifestyle strategies to remove other stresses from the immune system, can successfully treat CFIDS in many cases. This program has helped hundreds of Dr. Cranton's patients who had previously been unresponsive to treatment elsewhere.

利用处方药物将酵母菌从身体排除，并结合其他饮食和生活方式来消除对免疫系统的压力，在许多情况下可以有效治疗CFIDS。这个疗法已经帮助了Carnton手下数以百计的病人，他们经历过其他无用的治疗。

Yeast overgrowth is partly iatrogenic (caused by the medical profession) and can be caused by antibiotics and cortisone medications. A diet high in sugar also promotes overgrowth of yeast. A highly refined and chemicalized diet now common in industrialized nations not only promotes growth of yeast, but is also deficient in many of the essential vitamins and minerals needed by the immune system. Chemical colorings, flavorings, preservatives, stabilizers, emulsifiers, etc., add more to stress on the immune system.

酵母菌的过度繁殖一部分是因为医生的治疗而引起的，也有可能是因为抗生素和可的松之类的药物导致，高糖的食物也是一个因素。高提炼高加工的食物如今在工业国家十分普遍，它们不仅仅增加了酵母菌，而且还缺乏免疫系统所需的维生素和矿物质。色素、调味剂、防腐剂、稳定剂、乳化剂等物质都给免疫系统带来了负担。

The most effective and long-lasting treatment for CFIDS has proven to be a four-pronged approach: (1) a combination three anti-fungal medicines, taken together; (2) a diet that avoids many commonly eaten foods to which the immune system is often sensitized; (3) avoidance of environmental pollutants, fumes, fragrances, food additives, etc. and, (4) supplemental vitamins, minerals and trace elements to support immunity. That program reduces stress on the immune system in many ways while providing nutritional support. It has been found most effective to continue treatment for several months to allow normal immunity to recover and allow normally present bacteria to repopulate the digestive tract after yeast have been eliminated.

经过验证，对于CFIDS最为有效和持续的治疗方法是基于以下4个方面：1）同时服用三种抗真菌的药物组合；2）良好的饮食结构，避免那些给免疫系统带来负担的食物；3）避开环境污染物、烟雾、香水、食物添加剂等；4）补充维他命，矿物质和微量元素以帮助免疫系统。这套程序在很多方面为免疫系统减压，最为有效的是持续这样的治疗数月之久，以帮助免疫系统恢复正常，在酵母菌被剔除之后普通细菌再生与体内。

Most of what the author writes about this condition stems directly from experience treating patients. The existence of and treatment for CFIDS is still considered controversial in medical centers.

这里作者所写的多数源自治疗病人的经验。在医学界关于CFIDS的治疗依然存在争议。

OCCULT FUNGAL PATHOGENS

Yeast and fungal infections of the skin, mouth, nails, vagina, and digestive tract have long been recognized and are easy to diagnose, but a relationship has only recently been discovered between yeast colonization, often sub-clinical and otherwise unapparent, with a wide variety of disabling symptoms.(1-8)

神秘的真菌病原体

酵母菌和真菌，常见于皮肤、口腔、鼻子、阴道以及消化道感染，已经是一个普遍认识，而且认为易于诊断，然而最近才有发现酵母菌常见于亚临床和其他许多不明显的功能性疾病中。

Yeast and molds belong to a broad family of plant life called fungus. Mildew, bread mold, and mushrooms are also types fungus. All yeast are fungi (plural of fungus) but all fungi are not yeast. The terms "yeast," "fungus" and "mold" are often used interchangeably. They all share allergic potential and immunological properties.

酵母菌和霉菌都属于植物中菌类大家族。霉菌、发面的酵母、蘑菇都属于菌类。所有的酵母菌都属于真菌，而真菌不一定是酵母菌。酵母菌、真菌、霉菌这三个名词通常可以作为同义词交替使用。他们都有潜在的免疫相关的属性。

The most widely present single-cell fungal organism (yeast) is Candida albicans (formerly called Monilia), which exists quite normally in low concentrations on the skin and inside the digestive, respiratory and reproductive organs. Because Candida is a normal constituent of human micro-ecology, the mere presence of  Candida is not sufficient to make a diagnosis of "infection." It is always present.

当前最为普遍的单细胞真菌生物体（酵母菌）就是白假丝酵母（学名：念珠菌），通常聚集在皮肤、消化系统、呼吸道以及生殖器官上。假丝酵母菌是人体微生态系统的一个普通成员，少量的假丝酵母菌不足以称为‘感染’。它们常在。

A healthy person will tolerate normally present Candida. However, yeast and other fungi release many bioactive and allergenic substances into the body, which increase to exceed tolerance as yeast increase. These substances can be toxic, allergic, and hormonal in nature.

一个健康的人可以容许正常数量的假丝酵母菌的存在。然而，酵母菌和其他真菌释放出许多可以引起过敏的生物活性物质来，当酵母菌增加的时候就需要更多的忍受。这些物质可能是有毒的、过敏的或者会刺激荷尔蒙。

Substances released by yeast include:

1) Allergens, which react classically, causing symptoms of itching, hives, skin rashes, nasal congestion, cough, bronchitis, irritable bowel, and asthma. More than 70 distinct allergic molecules have been found to be produced by Candida albicans.(4)

酵母菌所释放的物质包括：

1) 过敏原，也就是常见反应，皮肤瘙痒、皮疹、鼻子堵塞、咳嗽、支气管炎、肠颤、哮喘。目前明确的有超过70中可以引起过敏的物质是由假丝酵母菌产生的。

2) Fungal poisons (mycotoxins) include aflatoxin, ergot poisoning and mushroom poisoning. The list ofknown mycotoxins is very long and not widely recognized.(9) Dr. Iwata, in Japan, has icataloged many toxins produced by Candida albicans, which poison the nervous and immune systems.(10) Acetaldehyde (similar to formaldehyde) is also secreted by Candida albicans and is one potential cause of yeast-related symptoms.(11) Immune system abnormalities have long been associated with Candida.(12) Other incurable diseases of unknown cause, presumed immunologic, such as psoriasis and multiple sclerosis, have been reported to improve, sometimes dramatically, following anti-fungal therapy.(13-14)

2) 真菌毒素，包括黄曲霉毒素、麦角菌毒、蘑菇菌毒。真菌毒素的种类相当多，而且也没有被广泛认识。在日本，伊瓦塔博士分类出了许多有白假丝酵母菌所产生的毒素，可以破坏神经系统和免疫系统。假丝酵母菌也会分泌出乙醛（类似于甲醛），这是产生酵母菌相关症状的潜在物质。长久以来，免疫系统的异常问题都与假丝酵母菌有着关连。其他未知原因不能治愈的疾病，例如牛皮癣、多发性硬化症，也可以推测为免疫相关，因为有报告证明抗真菌疗法对他们有效，有时效果明显。

3) Hormonally active molecules are also produced by Candida. Symptoms related to the female reproductive system, including PMS, cystic breast disease, infertility, and reduced sex drive, have been reported to improve following treatment with anti-fungal medications. Those observations are evidence for interference with normal hormonal function by yeast and fungus overgrowth.

3) 激素活性因子也是由假丝酵母菌生产的。女性生殖系统相关的症状，包括经前综合症、囊性乳腺病、不孕不育、性欲减少，在使用抗真菌疗法后有效。这些例子都是真菌过度繁殖所带来荷尔蒙失调的证据。

There are many different strains of Candida albicans. Different strains produce widely different toxins, allergens and hormone-like substances. Patients also vary widely in their sensitivity and response to those substances. This results in a wide diversity of ill-defined yeast-related symptoms in CFIDS. The seemingly neurotic nature of many such complaints has delayed more widespread recognition of this clinical syndrome. Response to therapy of CFIDS following anti-fungal medications does provide evidence for a direct causal relationship between yeast and symptoms.

白假丝酵母菌有许多不同的种类，不同种类生产不同的毒素、过敏原、激素类的物质。病人对这些物质也有着不同的过敏反应。这就导致了如CFIDS所列举的各种各样的真菌相关症状。许多此类申诉被视为神经病，而这推迟了更广泛的承认这一临床综合征。对于CFIDS所采用的抗真菌疗法的效果为酵母菌和症状的关联提供了证据。

Many physicians are unaware of lasting adverse effects caused by routinely prescribed medications such as antibiotics. Antibiotic therapy for minor colds and runny noses is a common practice. People routinely receive multiple courses of broad-spectrum antibiotics throughout life or are injected with long-acting corticosteroid medicine for joint or muscle pain.

许多医生并不清楚一些日常药物例如抗生素所产生的持续的副作用。抗生素治疗小感冒、流鼻涕是常见做法。人们习惯于日常使用各类抗生素或者因为关节痛、肌肉痛就注射皮质类固醇药。

Once established, sub-clinical colonization with yeast in the body may persist unrecognized for many years. Antibiotics, such as tetracycline, can greatly increase yeast in the colon after only a few days.

一旦确立了，亚临床病人可能多年都不会意识到酵母菌在他的体内。诸如四环素之类的抗生素可以在几天内极大的增加酵母菌在结肠中的数量。

Yeast is well recognized to cause vaginitis in women, diaper rash and thrush in infants. Yeast and fungus are also common causes of other skin infections including athlete's foot, jock itch, ringworm, paronychia, intertrigo, anal itching, seborrhea (dandruff), tinea versicolor and onychomycosis (causing fingernail and toenail deformities). Those conditions are rarely considered serious, although many women troubled by persistent or recurrent vaginitis would state otherwise.

人们通常知道酵母菌导致女性的阴道炎、尿布疹、以及幼儿鹅口疮。酵母菌和真菌常见于皮肤感染（包括足癣、股癣、轮癣、甲沟炎、擦烂红斑、肛门瘙痒、皮脂溢-头皮屑、花斑癣、甲霉菌病-导致手指甲和脚趾甲变形）。这些情况很少被认真对待，当然那些有持续性或者复发性的阴道炎困扰的妇女另当别论。

It is not widely recognized that those conditions often occur in patients with previously weakened immune system, resulting in lowered resistance to yeast infection. The most common and overlooked site for yeast proliferation is the large intestine. Constipation is commonly caused by yeast. Yeast in the colon release large amounts of allergens, toxins and other hormonally active substances into the circulation, without raising a suspicion of where the problems are coming from.

然而大家并没有认识到这些情况往往发生在之前免疫系统脆弱的病人身上，他们没有足够的力量抵抗酵母菌的感染。最常见也最容易忽视的酵母菌繁殖的地方就是大肠。便秘常常是酵母菌引起的。在结肠里面，酵母菌释放出大量的过敏原、毒素以及其他激素活性物质进入循环，却不引起人的怀疑。

IF THIS IS SO COMMON, WHY IS IT NOT MORE WIDELY RECOGNIZED?

It is common in the history of medicine that recognition of a safe and effective therapy may not occur until an accepted scientific rationale is found to fully explain observed benefits.(15) Highly effective therapies have been rejected in the past, sometimes for decades, merely because they were innovative and did not fit with currently accepted theories.(16)

它如此常见，为何没有广泛为人所知？

在历史上十分常见的是，直到所发现的科学依据能够完全解释那些益处，一个安全有效的疗法通常不为大家所认知。在过去高效的疗法常常被拒绝，有时会被埋没数十年，只不过因为这些疗法太过创新而不为那个时代的理论所容。

Clinical experience and observation of benefit should be the "gold standard" on which patient care is based. Patients should not be deprived of a safe and effective treatment only because the scientific basis has not been fully researched and proven.(16,17) If thorough medical evaluation shows no other plausible cause for symptoms of CFIDS, a trial of anti-fungal therapy with dietary and environmental avoidance of potentially offending substances will cause no harm.

好还是不好，应当以病人所关心的临床表现来作为“黄金标准”。病人不能仅仅因为学术上没研究透彻就被剥夺了那些安全有效的治疗。如果一个彻底的医学评估都不能指明CFIDS的合理原因，那么病人尝试一下抗真菌疗法、配合控制饮食和规避环境问题的方法也没有什么坏处。

There are no definitive tests to diagnose CFIDS in advance of treatment. Response to therapy, as described in this paper, is the only practical way to confirm a treatable condition, which would otherwise remain untreated.

在治疗之前，没有哪个测试能明确诊断你是CFIDS患者。按照本文所讲的疗法而行观其反应，是验证这个疗法对你有无效果的唯一可行之路。

HISTORY

In the late 1970's Dr. C. Orian Truss, an allergist in Birmingham, Alabama, first published and lectured on the wide variety of CFIDS symptoms associated with Candida albicans.(4-6,11) Dr. Truss successfully treated many hundreds of chronically fatigued, allergic and depressed, seemingly neurotic patients. His patients experienced great improvement following prolonged treatment with oral nystatin, an anti-yeast medicine. Dr. Truss' patients suffered with a wide variety of symptoms which had often not responded to many other treatments.

历史

在1970年代末，奥里安.特斯博士，一个亚拉巴马州伯明翰市的过敏症专业医师，首次公开演讲关于各种CFIDS症状与白假丝酵母菌之间的关联。特斯博士成功的治疗了数百位慢性疲劳过敏病人，他们看似神经质病人。在持续口服抗真菌药物制霉菌素治疗后他们得到了明显的改进。特斯博士的病人有着多种不同的症状，他们曾对其他很多治疗并无效果。

Patients of Dr. Truss' who improved with his therapy reported the following types of medical histories:

按照特斯博士的疗法，那些取得疗效的病人有过以下病历：

1. Having been treated, sometime many years previously, for acne with prolonged courses of tetracycline or other antibiotics.

1. 长期使用过四环素或其他抗生素治疗过痤疮，其中有的是许多年的。

2. Multiple courses of antibiotics for urinary tract infections, sore throats, ear infections, bronchitis or sinus trouble;

2. 多个疗程的抗生素治疗泌尿感染、咽喉炎、耳朵感染、支气管炎以及鼻窦炎之类。

3. Use of oral contraceptives;

3. 使用过口服避孕药

4. Treatment with cortisone-type medicines or injections.

4. 注射过可的松类的药物

Dr. Truss was the first to describe this syndrome of "yeast-related illness," characterized by the following symptoms, with varying severity and in different combinations (I now classify these symptoms more broadly as CFIDS):

特斯博士是第一位提出“真菌相关疾病”症状的人，特征症状列举在以下，这些症状有着不同的严重等级或者组合（现在我已经将这些症状统称为CFIDS）：

1. Nervous symptoms, including fatigue, headache, dizzy spells, anxiety, "nervous tension," panic attacks, depression, schizophrenia, insomnia, irritability, impaired memory and "spaced out" feelings. Complaints of nervousness, depression and unexplained fatigue were the most commonly present symptoms.

1. 神经性的，包括疲劳、头痛、昏花、忧虑、紧张、惊恐、沮丧、神经分裂、失眠、易怒、记忆力受损、隔离等感受。发牢骚、消沉和莫名的疲惫是最常见的症状。

2. Reproductive tract symptoms, including premenstrual syndrome (PMS), infertility, cystic mastitis (painful breast lumps), pelvic pain, painful intercourse, recurrent vaginitis, prostatitis, reduced sex drive and impotence. Patients had often received repeated courses of antibiotics for infections of the bladder or prostate.

2.生殖道症状，包括经前综合症、囊性乳腺炎（令人十分痛苦的胸部肿块）、骨盆疼痛、性交疼痛、再生性阴道炎、前列腺炎、性欲减少、阳痿。病人们经常因为膀胱或前列腺炎症而不断重复使用各样的抗生素。

3. Digestive tract symptoms, including unexplained and chronic abdominal pain, canker sores in the mouth, esophagitis, indigestion, heartburn, constipation (often alternating with diarrhea), anal itching, gas, bloating, spastic colon, and intolerances to common foods. Multiple surgical procedures had sometimes been performed, without benefit until anti-yeast therapy was prescribed. A persistent coating on the tongue was a common finding.

3. 消化道症状，包括莫名的肚子疼、口腔溃疡、食道炎、消化不良、心口痛、便秘（常与拉稀交替）、肛门瘙痒、屁多、肚子胀、结肠痉挛、厌食。有时就算做了多个外科手术也没有啥用，直到采用了抗真菌疗法。舌苔上有持久的绒毛是一个常见症状。

4. Other chronic and resistant symptoms, including unexplained muscle and joint pain; arthritis; headaches; visual disturbance; difficulty thinking, remembering and concentrating; recurrent sore throats; swollen or painful glands (lymph nodes); low grade fevers of unknown origin; sensitivity to heat or cold; hair loss; numbness or tingling in the face or extremities; persistent nasal congestion; cough; and respiratory allergies. Many patients were abnormally sensitive to a variety of environmental exposures, including tobacco smoke, perfumes, sprays, formaldehyde, petrochemical products, exhaust fumes and other odors. They became "spacey" or felt ill breathing the chemical odors in shopping malls, fabric stores or shoe stores. They reacted adversely to many common and nutritious foods, especially the grains, sugar, and milk products.

4. 其他的慢性抵抗症状包括：莫名的肌肉和关节疼痛、关节炎、头痛、视觉障碍、思考困难、记忆力和注意力衰退、再生性的嗓子疼、腺体疼痛或肿起（淋巴结）、无缘无故的低烧、冷热敏感、脱发、面部或手脚发麻、持续性鼻塞、咳嗽、呼吸过敏。许多病人对一些环境问题异常敏感，比如抽烟、香水、喷雾剂、甲醛、石化产品、废弃和其他气味。在超市、服装店和鞋店购物的时候，当吸入这些化学气体的时候他们就感到很不舒服。他们会对许多常见的和营养过敏，尤其是五谷、糖和奶制品。

Much to their distress upon seeking medical advice, such victims of CFIDS are often told, "Your physical examination and laboratory studies are all normal. Your symptoms are "psychological." In other words, "you're imagining your illness." Physicians and family alike would consider such patients to be "hypochondriacs." Victims of CFIDS would go from doctor to doctor, year after year, with no benefit.

当他们因着以上诸多痛苦而寻求医疗建议的时候，医生一般都会告知他们：你的体检和化验都正常，你的症状是“心理上的”，换句话说就是，“你自己想象出的病”。医师和家人可能都会认为病人是‘忧郁症患者’。CFIDS的受害者可能年复一年的不断求医，却并无所获。

William G. Crook, M.D., a pediatric allergist from Jackson, Tennessee, subsequently published confirmatory reports to support Dr. Truss' original observations.(2,3,7,8,15)

来自美国田纳西州杰克逊的儿科过敏医师威廉.克努克，他随后发表了支持特斯博士观点的证明报告。

Patients included all age groups and both sexes. Children with learning disabilities, dyslexia, hyperactivity, attention deficit disorder, food allergies, drug abuse and a variety of delinquent and emotional disorders, had often received repeated courses of antibiotics for recurrent ear infections, bronchitis and other conditions―including prolonged courses of tetracycline for acne.

此病无视性别年龄，遍及男女老少。孩子们有学习困难、阅读障碍、兴奋过度、注意力不足、厌食、滥用药和行为情感混乱之类的问题，他们曾经为了治疗经常性耳部感染、支气管炎而不断的服用抗生素，有的为了治疗痤疮而长期使用四环素。

Even patients who had been committed to mental hospitals have been helped by anti-fungal therapy. Other puzzling immunologic diseases, including multiple sclerosis, rheumatoid arthritis and lupus erythematosus, have responded better when attention was given to reduction of yeast and immune stress. A wide spectrum of allergic disorders, from classical hay fever to chronic, delayed-onset type of food allergy and petrochemical sensitivity, have improved following anti-yeast therapy.

对于那些甚至被送到了精神病院的病人，也从抗真菌疗法中得到了帮助。其他免疫相关的疑难杂症（包括多发性硬化症、风湿性关节炎、全身性红斑狼疮），当把治疗的注意力转移到降低酵母菌为免疫系统减压上也有所改善。广谱的过敏性疾病，从花粉症（枯草热）到慢性、迟发性的食物过敏和化学过敏，抗真菌疗法都能有所改善。

The use of allergy injections has been eliminated in many cases. Injection therapy has never been of much help in food allergy. Avoidance and anti-yeast therapy are the most effective long-term programs. Tolerance to previously offending foods and exposures often improved after several months of anti-fungal therapy.

在很多方面，过敏注射剂的使用已经被淘汰了。对于食物过敏注射疗法从未有很大的帮助。抗真菌疗法是最有效的长期治疗。在经过数月之久的抗真菌治疗后，对之前不好的食物的忍耐性就提高了。

DIAGNOSIS

Unfortunately, there exists no reliable laboratory test to prove or disprove the presence of CFIDS. Yeast and fungus are normally present in everyone. Because of the ubiquitous nature of yeast, cultures and microscopic smears are not of much use.

诊断

很不幸，并没有可靠的化验来证明你是否是CFIDS患者。酵母菌和真菌通常都存在于每个人的体内。因为酵母菌无处不在，所以微生物化验并不常用。

A thorough examination prior to therapy is important to insure that an otherwise treatable condition is not being overlooked. Response to a course of therapy will then confirm or refute the diagnosis of CFIDS. Many laboratory tests are available to assess antibodies and immunity. In practice, however, those laboratory tests do not predict which patients will respond to this therapy. Because testing is expensive (and often too new for routine reimbursement by medical insurance) a trial of therapy may be the most reliable and also the most cost-effective way to diagnose and manage CFIDS.

在治疗之前，为了避免忽略别的治疗方案一个彻底的检验很重要。有许多化验可以检验抗体和免疫系统，然而事实上，这些化验结果并不能预测这个疗法是否对他有效。而且因为化验的价格昂贵（而且常常太新的化验都超出了医疗保险的涵盖范围），所以最现实的是尝试一下这个最经济有效的疗法，通过一个疗程的效果可以确认是否是CFIDS。

The most reliable predictor of response is the typical past medical history and symptoms. Several case histories will demonstrate this. In addition to factors described above, a diet high in sugars, including natural sugars such as fruits, fruit juice and honey, etc., is common. Yeast grow more rapidly in the presence of sugars and simple carbohydrates. Symptoms often worsen following sugar intake. So-called "hypoglycemia" frequently has an element of CFIDS and will improve following anti-yeast treatment.

对于效果最可靠的预测是基于既往病史和其症状。这里有几个案例可供参考（点击左侧链接）。除了之上所讲的因素，另外一个就是饮食高糖，包括天然糖份诸如水果、果汁和蜂蜜之类。酵母菌在有糖和简单碳水化合物的环境下会繁殖更快。当吃糖之后，病情常常恶化。所谓的“低血糖”常常属于CFIDS，在使用抗真菌疗法之后也能有所改善。

Adverse and allergic reactions to prescription and non-prescription medications, chemical fumes, solvents, perfumes, shopping-mall odors, and even nutritional supplements are a common complaint. Presence of those symptoms increases the likelihood of benefit from this therapy.

对处方和非处方药物、化学气体、溶剂、香气、超市的气味甚至营养品的过敏性表现是一个常见反应。也有这些症状的，就加增了这个疗法有效的可能性。

Response to treatment remains the most reliable way to confirm or disprove a suspected diagnosis of CFIDS. Diagnosis can only be suspected from the medical history, after other types of illness have been excluded by a thorough medical evaluation and by lack of response to other therapies.

治疗的结果依然是验证是或者不是CFIDS的最可靠方法。只能通过病史怀疑诊断，在彻底的医疗评估和其他疗法的无效来排除其他疾病后。

COEXISTING VIRAL INFECTION

Persistent and chronic viral syndromes have been well-documented in patients with CFIDS. Those include Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), Coxsackie-B, and other viruses. Laboratory tests are available for many viruses, and both alpha interferon and interleukin-2 (IL-2) tend to be elevated in the presence of viral replication. It is postulated that some symptoms of CFIDS may be caused by increased alpha interferon and IL-2.(18-21)

共存病毒感染

那些有持续慢性病毒综合症的CFIDS病人被良好的记录了档案。包括EBV、CMV、HHV-6、柯萨其-B以及其他病毒。许多病毒都可以通过化验的方法测定，α干扰素、白细胞介素-2在病毒复制的过程中会升高，可以假定CFIDS的某些症状与这两项指标的升高有关。

If immunity is impaired, increased susceptibility to viral infection is expected. Many viruses normally lie dormant throughout life. They only become active if the body's defenses are weakened. For the most part, the only good defense against viral infections is a healthy immune system. The treatment program described below can benefit CFIDS by removing immune stress, allowing immunity to become stronger. Although chronic viral syndromes and CFIDS may co-exist, not all patients with CFIDS have viral problems.

如果免疫系统受损，对病毒感染的敏感性也会增加。许多病毒通常在一身之中都处于睡眠状态，他们仅仅在身体的防御能力脆弱的时候才会激活。对于多数情况而言，良好的病毒防御系统就是一个健康的免疫系统。以下讲述的疗法可以让CFIDS患者减去免疫压力，让免疫系统变得强壮。尽管慢性病毒综合症和CFIDS可以共存，然而并非所有的CFIDS病人都有病毒问题。

The presence or absence of a diagnosable viral syndrome does not seem to alter potential benefit from this therapy. Viral testing is also expensive and is therefore not routinely performed prior to therapy.

病毒综合症的有无并不会改变这个疗法的潜在功效。病毒测试比较昂贵也不为这个疗法日常采用。

Both viruses and fungal organisms create stress to the immune system. It is therefore quite probable that one can predispose to the other. Any treatment which strengthens natural immunity can improve either condition. In that way anti-fungal therapy may hasten recovery from a chronic viral syndrome.

病毒和真菌生物体共同对免疫系统创造压力。这也是为什么有病毒的容易患真菌，有真菌的易感染病毒。任何能够健壮免疫系统的疗法都能够改善其状况，这样抗真菌疗法就可能促进病毒综合症病人的康复。

TREATMENT

1. DIET

During the first three months or more of treatment a so-called "Cave Man Diet" or rare food diet is recommended. Bear in mind, however, that after two months of elimination combined with triple anti-yeast medicines, many foods that would have previously caused symptoms will be better tolerated.

治疗

1. 饮食

在开始的三个月或者更久的治疗过程中，一个所谓的‘洞人饮食’，也就是模仿石器时代猎人的饮食，一个纯健康的饮食结构。然而记住，在使用了2个月的抗真菌的三药组合后，那些之前导致症状的那些食物需要禁止。

Simple carbohydrates are restricted. Even natural sugars, fruits and fruit juices are reduced, since they promote the growth of yeast. Many nutritious foods that are more stressful to the immune system are eliminated. Equally nutritious but rarely eaten foods are substituted. Foods eliminated for several months include milk products (all dairy and everything containing dairy products) and all grains (including wheat, corn, rye, rice, barley, etc.) and most other frequently eaten foods. Of the so-called "junk foods," chocolate, cola, candy, pastries and other sweets are eliminated. Food intolerances can be quite individual but these eliminated foods have been the most common food allergens in clinical practice. Regardless of the reason, this program works in practice.

简单的碳水化合物要严格控制。甚至是原糖、水果和果汁都要少吃，因为它们会增加酵母菌的数量。那些对免疫系统有负担的营养品需要剔除，那些少吃而有营养的食物可以作为替代品。需要停止数月的食物包括奶制品（所有奶以及含奶制品）、谷物（小麦、玉米、黑麦、大米、大麦等）还有许多其他常吃的食物。那些所谓的“垃圾食品”，巧克力、可乐、糖果、糕点和其他的甜品都应当禁止。食物控制是相当个人的事情，但是临床表明那些剔除的食物是最常见的食物过敏原。不论你信不信，这就是事实。

The following foods should be minimized:

1. Refined and simple sugars, including table sugar, honey, syrup, molasses, fruit juices and dried fruit. Small servings of unsweetened fresh fruit may be consumed in limited amounts--up to three moderate servings per day.

以下食物要尽量少吃：

1. 各种糖，包括桌上的糖、蜂蜜、糖浆、糖蜜、果汁、干果。无糖的水果可以限量的使用——每天最多三份。

2. Breads and bakery products, which contain wheat, rye, corn and yeast, are eliminated. Rice, oats and barley are somewhat better tolerated, but most patients respond better if they avoid all grains for several months. Potatoes are better tolerated as a substitute for grains. Sweet potatoes and yams are highly nutritious and are the best grain substitutes that are least likely to cause problems.

2. 面包和面包房的各类制品，它们含小麦、黑麦、谷物和酵母，需要禁止。大米、燕麦、大麦稍微要好一些，但是多数病人反馈如果能回避各种谷物数月将会更好。土豆有更好的耐受性，可以作为谷物的替代品。甜土豆和山药都是高营养品，是最佳的谷物替代品，不会产生问题。

3. Other foods stressful to the immune system that might will slow recovery include mushrooms, chocolate, cola (even diet cola drinks), chemical flavorings, colorings and sweeteners, and alcoholic beverages. An occasional patient must temporarily restrict all carbohydrates to as little as 25 to 50 grams per day before improvement begins. As improvement progresses, intake of unrefined, complex carbohydrate may be increased to a more desirable level.

3. 其他的有些食物会对免疫系统产生压力，减慢疗效进程，这些食物包括：蘑菇、巧克力、可乐、化学调味剂、色素、甜味剂、酒精饮料。病人必须暂时严格限制所有的碳水化合物，越少越好，在取得疗效前最好控制在25克～50克每天。随着不断的改善，就可以更多食入一些未精炼的、复合碳水化合物。

The most frequently eaten foods are those which are most likely to cause or aggravate symptoms. The immune system becomes sensitized by prolonged and repeated exposures. Symptoms may be triggered by either protein and carbohydrate foods. Fats are less likely to be bothersome. Sensitivity should be suspected to favorite foods, especially if they are craved and eaten frequently. Sensitivities to foods can best be diagnosed by testing for provoked symptoms after strict dietary elimination until symptoms improve.

那些最常吃的食物可能就会导致或者加重症状。随着不断重复的暴露出来，免疫系统越来越敏感。症状可能随时被蛋白质或者碳水化合物（糖）类食物触发。脂肪类的食物却没有那么让人讨厌。敏感性当从最喜爱的食物怀疑起，尤其是那些常常爱吃的食物。对于食物敏感性的诊断，最好的方法是在经过严格有效的饮食控制之后，再次尝试那个剔除掉的食物，看看是否会激起过敏性反应。

In order to consistently relieve and then provoke food-related symptoms, elimination should be preceded by a few weeks of daily consumption. Sensitivity tends to fade with avoidance.

为了保持先减缓然后激发食物相关的症状的一致性，清理工作必须领先于日常消耗前几个星期。敏感性将渐渐退去。

Sensitivity most often occurs to a number of different foods simultaneously, making diagnosis difficult. All of the reactive foods and environmental exposures must be avoided for long enough for symptoms to fade before provocative testing can be done.

敏感性通常同时发生在几种食物上，检测也就比较困难。所有的反应性食物和使免疫系统环境暴露的食物都应当禁止足够久的时间，直到激发测试时症状消退。

Impaired immunity predisposes to food and chemical sensitivity. So-called food allergy might be best considered a symptom of CFIDS and not the primary problem. All potentially reactive foods should be avoided during the initial period of treatment with anti-fungal medicines to remove as much stress as possible from a disordered immune system. Continued intake of just one reactive food can mask reactions to another food when it is added back. Only after most if not all symptoms have improved is it possible to do provocative testing for food allergy. The so-called "Rare Food Diet," also known as the "Cave Man Diet," has clinically been most successful in relieving symptoms.

Various blood and skin tests are promoted for food allergies, but false-positive and false-negative results are common. Blood testing can be accurate for the rapid onset type of allergy accompanied by hives that can occur with shell fish or grass pollen. Most food allergies come on slowly, they often require repeated exposures and tend to fade with elimination from the diet. Blood testing for that type of allergy has proven to be very unreliable, with a high percentage of both false positive and false negative results.  The only reliable test for sensitivity to a specific food or chemical is consistent improvement following elimination and reoccurrence of symptoms following a challenge. Onset of symptoms after exposure to a food allergen may not occur until hours or even days later, and often requires multiple exposures.

Food allergies tend to change as diet is changed. They are often not "fixed" allergies. The foods, which are eaten most, are most likely to cause symptoms. Sensitivity to those foods slowly fades after elimination. Allergic foods may again be tolerated after several months of avoidance while previously "safe" foods may begin to cause symptoms, as their frequency of consumption is increased.

Rotation of dietary foods, avoiding repeated consumption of botanically related foods more often than every fourth day, is sometimes helpful for severely allergic patients. After a course of anti-fungal therapy, especially the triple therapy as recommended here, reactive foods are often better tolerated.

Small traces of bakers' yeast or other types of yeast which occur in food may be tolerated, while the foods themselves, such as dairy or grain products, may cause symptoms. It is a common misconception that the yeast in bread and not the wheat is causing the problem.

Patients usually discover that they feel better and have fewer allergic symptoms if they limit consumption of milk products, wheat and corn throughout life. If eaten infrequently, they may not cause problems.

2. MEDICATION

Yeast and fungi can develop resistance to anti-fungal medicines, and a significant percentage of yeast and fungi in the body at any given time will be resistant to any one anti-fungal medicine. In clinical practice, it has been found more effective to combine more than one anti-fungal medicine simultaneously. Two or three of the following medicines are given together for one to two months. These medicines require a physician's prescription:

2. 药物

酵母菌和真菌可以发展出对抗真菌药物的耐药性，并且在体内有相当比例的酵母菌和真菌在任何时间都可能对其中一个抗真菌药物有耐药性。临床试验发现，相比单一使用某种的抗真菌药物，一个抗真菌药物的组合更为有效。使用以下药物中的两种或三种1～2个月。这些药物需要医师处方。

A. Nystatin: Brand names include Nilstat?, and Mycostatin? (available in powder, tablet, suspension, suppository and capsule forms). Generic forms of nystatin are also available but some sources can be bitter tasting and impure. Only the pure powder, available from compounding pharmacists,  is free of chemical colorings, additives, and allergens. Beware of receiving nystatin a foot powder instead of the pure pharmacologic grade for internal use.

A. 制霉菌素(一种抗霉菌药)，品牌药物包括Nilstat? 和 Mycostatin?。也有其他类型的制真菌素，只是可能苦一点也没那么纯。只有纯的粉剂才能回避化学色素、食物添加剂以及过敏原。当使用普通粉剂替代纯剂作为内服的时候需要注意这一点。

When the powder is taken directly into the mouth it is more effective and eliminates yeast in the mouth which can seed the intestine. The usual dose of nystatin powder is 1/4 teaspoon four times daily (which is equivalent to 4 tablets containing 500,000 units each four times per day). This is twice the dose customarily prescribed by most physicians. Nystatin is not absorbed from the digestive tract in any significant amount and is an extremely safe medication, even at higher doses. This dosage is what works best in practice.

直接将粉剂放入嘴巴会更有效果，这样可以清除口腔内的酵母菌，它们可以产子到肠内。制霉菌素通常的剂量是每次1/4茶匙，每日4次（这个量等同于4颗药片，大约包含500，000个单元体）。这个剂量是通常医师开出药方剂量的2倍。制霉菌素不会被消化道大量吸收，所以就算使用更高的剂量也是极为安全的。在病人身上这个剂量也最为有效。

Nothing should be taken by mouth for 20 to 30 minutes after taking the nystatin powder. This allows a coating to remain in the mouth and upper digestive tract for long enough to eliminate yeast in those locations. Prolonged administration is usually necessary―several months (occasionally a year or more) before full benefit is achieved.

当服用了制霉菌素粉剂之后20～30分钟内都不可吃其他任何东西。这样做是为了给口腔和上消化道提供一个保护层，有足够的时间去清除这些部位的酵母菌。在痊愈之前延长数月（有时是一年甚至更久）的治理通常是有必要的。

The "rare-food diet" is maintained throughout the time of anti-fungal therapy and for several weeks thereafter. Gradual improvement is usually observed during the second and third month of therapy―although sometimes sooner. This program requires patience. After improvement plateaus out, and symptoms are much improved, medicines are discontinued. The greatest improvement may not occur until after the anti-fungal medicines are stopped.

If symptoms return, anti-fungal medicines may again be prescribed for a month at at a time and the more allergenic  foods again eliminated until improvement can persist without medication. Lasting benefit has been seen much more frequently after two or three anti-fungal medicines are given together. When improvement is maintained for at least a month without medication, a more normal diet may gradually be resumed, doing provocative testing for each added food for sensitivity as described above. Eliminated foods are added back one at a time to test for continued sensitivity.

If antibiotic therapy should become necessary for treatment of a serious bacterial infection, which would not otherwise resolve spontaneously, it is advisable to subsequently resume the anti-yeast program for a month or more, but only after antibiotics are discontinued. Administration of anti-fungal medication simultaneously with antibiotics could theoretically promote the growth of resistant fungal organisms against which no therapy would be effective.

Broad-spectrum antibiotics such as ampicillin, tetracyclines, and the cephalosporins are more likely to cause yeast overgrowth. Treatment with topical antibiotics on the skin or the use of less potent antibiotics, such as penicillin-VK, sulfisoxazole, and nitrofurantoin, are not as likely to reactivate yeast overgrowth.

Nystatin powder should be stored in a refrigerator if kept for a prolonged period, although a few weeks at room temperature will not cause a problem. Nystatin slowly takes on a bitter taste at room temperature. Nystatin should not be exposed to high temperatures or left in a parked automobile on a hot, sunny day. Taste and bitterness normally vary somewhat from batch to batch. Nystatin is one of the least toxic of prescription drugs. It is safer to use than most non-prescription products. Nystatin merely coats the interior of the mouth, throat, esophagus, stomach and intestine, preventing yeast from multiplying.

Mild side effects may occasionally occur during anti-yeast therapy, including nausea and skin rashes. Most such symptoms are the result of yeast die-off and not from the nystatin itself. Some patients may experience a temporary increase in the symptoms, such as fatigue and depression during the first few weeks of treatment with anti-fungal medicines. This phenomenon has been attributed to a yeast "die-off" effect or Herxheimer's-like reaction and long-term benefits are not reduced. If the medicine is stopped too soon, yeast can easily recolonize.

Nystatin powder is preferred over tablets, capsules and suspensions because the pure powder contains no chemically derived coloring agents, binders, flowing agents, sugar or other potential allergens. The powder begins its work in the mouth and coats the upper digestive tract. Tablets and capsules do not dissolve until they reach the stomach or lower and are therefore less effective. Commercially available nystatin suspensions marketed as prescriptions for the treatment of thrush in the mouth contain very little medication and it suspended in a solution of sugar. The pure powder is thus much more effective.

Nystatin powder is best placed on the tongue dry by inverting a half-teaspoon measuring spoon in the mouth and tapping the spoon against the upper teeth, then allowing the powder to mix with saliva. Rub it into the tongue and swish it around for several minutes in contact with the tissues in the mouth and throat, before swallowing.

Nystatin powder possesses two advantages over tablets and capsules. It is less expensive and it is effective against yeast in the mouth, throat and esophagus where the tablets and capsules have no effect. Patients with symptoms of sore tongue, canker sores, indigestion and heart burn (hiatal hernia or esophagitis) improve more quickly following treatment with nystatin powder―providing evidence that yeast overgrowth is at least partly responsible for those symptoms.

If saliva is not adequate, a small sip of water or juice may be used to swish the powder into the mouth, making a paste to coat the gums and tissues. Small children may object to the taste unless a small amount of fruit juice or applesauce is used to mask the taste of medicine. The more concentrated the nystatin, the more effective it will be.

Female patients may improve more rapidly with the simultaneous use of small doses of an anti-yeast vaginal cream, one-half applicator or less once daily at bedtime, when symptoms of vaginitis are present. Some yeast are normally present on vaginal tissues and even small numbers may increase symptoms in a highly sensitized patient. Keeping yeast colonization to a minimum throughout the entire body for several months lowers stress on the immune system and allows gradual recovery.

Vaginal creams and suppositories all contain a chemical preservative, which is potentially allergic. The creams themselves may cause allergic symptoms which mimic yeast. If either Sporanox? or Diflucan? is used together with nystatin, as described below, vaginal therapy is usually not necessary.

B. Sporanox? (generic name itraconazole): Is taken by mouth in capsule form and is fully absorbed in the upper digestive tract. Because it is absorbed, Sporanox is not as effective for reducing yeast inside the intestinal cavity and colon where there is no blood circulation. The usual dose is one 100-mg capsules daily with the largest meal of the day. Absorption is better with food in the stomach.

B. 斯皮仁诺?（常用名：伊曲康唑）：是一种口服胶囊，会被上消化道完全吸收。因为斯皮仁诺会被完全吸收，所以对减少肠内和结肠处的酵母菌，斯皮仁诺并没有多大效果，因为在那里并没有血液循环。通常的剂量是每天在饱餐之后立即服用100mg，随同食物被胃吸收的效果最佳。

Sporanox? is indicated in preference to Diflucan (described below) when skin or nails are affected by yeast or fungus. Sporanox is concentrated to a greater extent in skin and nails.

当皮肤或鼻子受到酵母菌和真菌的感染时，斯皮仁诺?相比大扶康?（下面会讲到）会更好些。斯皮仁诺?在皮肤和鼻子这些部位的作用更加明显。

C. Diflucan? (generic name fluconazole)is very similar to Sporanox?. Diflucan? seems to work somewhat better when vaginal yeast is a symptom. Concentrations of Diflucan? in body fluids are somewhat higher than Sporanox? but Diflucan? is not concentrated as much in skin and nails. Otherwise, in practice there does not seem to be much difference between Diflucan? and Sporanox?. It probably does not make much difference which one of the two medicines is used.

C. 大扶康?非常类似于斯皮仁诺，但大扶康?对于阴道酵母菌有更好的治疗效果。大扶康?更容易聚集于体液中，而不易在皮肤和鼻子这些部分。在实际应用中，大扶康和斯皮仁诺并没有太大的区别。

Either Sporanox? or Diflucan? is used as one of the three anti-fungal medicines administered in combination. But Sporanox? and Diflucan? are never prescribed together. (Nizoral? is no longer preferred because of greater potential for liver toxicity.)

斯皮仁诺或者大扶康都可以用于三种抗真菌药物组合之一，但是切记不可将斯皮仁诺和大扶康同时使用。（里素劳?也是一种抗真菌药物，但是因为它对肝脏潜在的毒性就不再被使用了）

D. Amphotericin-B is an anti-fungal drug which, like nystatin, is very safe and not absorbed systemically when taken by mouth. (An injectable form of amphotericin-B is quite toxic, however, and its use is restricted to treatment of life-threatening systemic fungal infections.)

D. 两性霉素-B是一种抗真菌片剂，如同制霉菌素，口服安全不会被全身吸收。（然而两性霉素-B的注射液是十分有毒性的，仅仅用于威胁生命的全身性真菌感染）。

The oral form of amphotericin-B is very safe and non-toxic. Amphotericin-B is a more potent anti-yeast medicine than nystatin. Oral forms of pure amphotericin-B are presently available at only a few specialized compounding pharmacies in the United States. It has been approved by the FDA for use by mouth and was marketed in the United States for many years in combination with tetracycline. That FDA approved product was named Mysteclin-F?. To treat yeast problems, you do not want the form that is combined with tetracycline.

口服的两性霉素-B是十分安全和无毒的。相比制霉菌素，两性霉素-B在对抗酵母菌上显得更加有力。纯的口服两性霉素-B目前仅在美国部分专业药房有售。两性霉素-B的口服药已经被FDA（食品药物管理局）机构认证，而且在美国作为四环素的组合药物销售多年。FDA所认证的商品名称为Mysteclin-F?. 但你并不需要和四环素组合的两性霉素-B来治疗酵母菌疾病。

Amphotericin-B in pure form for oral administration is can also be obtained at pharmacies in many other countries (often without a prescription). It is sold in France, on prescription only, under the brand name Fungizone?, in 250 mg capsules. In Germany and Switzerland the prescription form is called Ampho-Moronal?, as 100 mg tablets.

纯的两性霉素-B口服药也可以在许多其他国家的药方买到（通常不需要处方）。在法国销售的品牌名为Fungizone?，每片250mg规格的，需要处方。在德国和瑞士，他们的处方药叫做Ampho-Moronal?，每片100mg规格的。

Patients recover more quickly and often remain well without further medication when amphotericin-B is combined with nystatin and Sporanox therapy. The best form of amphotericin-B is a powder inside 250 mg capsules (Fungizone? is formulated in this manner). The capsules can be opened and emptied into the mouth four times daily, along with the nystatin, and mixed with the nystatin powder in the mouth.

当病人使用两性霉素-B与制霉菌素和斯皮仁诺组合治疗，通常可以恢复的更快保持的更好。最好的两性霉素-B就是250mg规格的胶囊（品牌Fungizone?）。可以打开胶囊倒入口中连同制霉菌素一起服用，一日四次。

Several US sources of Amphotericin-B and nystatin powder are listed on our webpage entitled "How to get Amphotericin-B".

左侧的链接中列举了在美国两性霉素-B和制霉菌素粉剂的几个来源。

E. "Triple therapy", the simultaneous daily administration of nystatin powder, amphotericin-B and either Sporanox? or Diflucan?, for one to two two months, has led to lasting improvement in a large percentage of patients who had previously been resistant to therapy. Patients should continue all three medicines for a month or two  and then continue with the dietary restrictions for another month or longer, for as long as progressive improvement continues to occur.

E. “三重疗法“，日常服用制霉菌素，两性霉素-B，斯皮仁诺（或大扶康）一个月到两个月，已经给相当比例的病人带来了持续性的改进，这些病人在之前的治疗并无效果。病人应当保持口服这三种药物1～2个月或更久，直到有很明显的改进。

INJECTION THERAPY

Skin testing with allergens and injection therapy with extracts containing reactive pollens, molds and dust is sometimes helpful, but allergies often resolve following this anti-yeast program without the need for injections. Injections have not been found to be of benefit in food allergy. The use of triple anti-yeast therapy, and the complete program described in this paper, have eliminated the use of skin testing and injection therapy. The same is true of other types of neutralization therapy or sublingual therapy. If this treatment plan restores more normal immunity, the allergies are no longer such a problem and other types of therapy become irrelevant.

注射疗法

皮肤过敏原测试与含有活性的花粉、霉菌、粉末的提取物注射治疗有时是非常有用的，但是通常使用抗真菌疗法后过敏症就治愈了，而并不需要注射。对于食物过敏症，注射治疗并没有明显作用。本文所讲的三重抗真菌疗法，已经将将皮试和注射治疗剔除了。对于其他的中和治疗和舌下含服治疗都是一样。如果这个治疗方案更好的修复了免疫系统，过敏症就不再是个问题，而且其他的治疗方法就显得并不恰当。

Stresses to the immune system are additive. Once a threshold for tolerance is exceeded, adverse reactions tend to occur to many different substances. When the immune system becomes stronger, the threshold for tolerance increases and so-called allergies are less likely.

所有的压力都叠加到免疫系统身上，一旦所能忍耐的上限被突破，不良反应就会出现并产生很多不同的物质。当免疫系统更加强壮，所能容忍的上限就会抬高，也就不会出现所谓的过敏反应。

Think of the immune system as a tired pack horse, which has been forced to carry an excessive load for many miles. When it finally collapses it is greatly weakened. It will not be able to tolerate a normal load until all of the load is removed and the horse is nursed back to health. The same principle applies to the immune system. By eliminating yeast, fungus, potentially allergic foods, chemical exposures, perfumes, insecticide residues, etc., from the body, the load is greatly reduced. After a period of rest, often requiring several months, immunity recovers to the point that a more normal diet and life-style can once more be enjoyed.

可以把免疫系统想象成一匹驮着500块砖的马儿，他必须承受这重担行很远的路。最终在它坍塌之时，他已经极度虚弱。在帮助马儿卸掉重担并医好它之前，这匹马儿再也难以承受曾经正常的担子。对于免疫系统，道理也是一样。首先从身体里面除去酵母菌、真菌、潜在的过敏性食物、化学物、香水、杀虫剂残留物，极大的减轻免疫负担。再经过一段时间的休息，通常需要数月，免疫系统就恢复到一个比较正常的饮食和生活方式，就能重新享受生命了。

OTHER TREATMENT MEASURES

Non-specific supportive measures include:

A. A healthy, active life-style, a nutritious diet with avoidance of refined and processed foods, avoidance of tobacco and avoidance of excessive alcohol are important. A good attitude also speeds recovery.

其他治疗措施

不具体的可行措施包括：

A. 一个健康、积极的生活方式，有营养的饮食，回避提炼和加工的食品，戒烟以及不可饮酒过度都很重要。良好的心态也能够加快恢复。

B. Nutritional supplementation with a balance of high-potency, hypoallergenic, yeast-free multiple vitamins, minerals, trace-elements, and anti-oxidants will insure optimal intakes of essential micronutrients and support immunity. Many nutrients essential for immunity (B-complex, selenium, zinc, vitamin C, vitamin E, and many others) are marginal to deficient in the diets of many Americans. DHEA 25-50 mg/day has been shown to help boost immunity.

B. 补充营养，通过摄入最佳剂量的微量元素来帮助免疫系统维持身体的平衡，包括高能效、低过敏、无酵母菌的多种维他命、矿物质、跟踪因子、抗氧化剂。免疫系统需要多种营养（维生素B群、硒、锌、维C、维E许多其他），而这些必须的营养在许多美国人的饮食中并不足够。经验表明每日25～50mg的DHEA对巩固免疫系统有帮助。

C. Avoidance of exposure to petrochemicals, fumes, perfumes, hair-sprays, insecticides, exhausts, and other potentially reactive substances, which stress immunity, will speed recovery. Careful avoidance of insecticide fumes and residues, which are quite toxic, and avoidance of musty, moldy areas in the environment, both at home and at work, will assist recovery.

C. 为了加快恢复，应当远离石化产品、烟熏、香气、头发喷雾剂、杀虫剂、废气以及其他潜在的化学反应物，这些物质会给免疫系统带来负担。还要特别当心杀虫剂的烟雾以及其残留物，它们是慢性毒药，当远离发霉物和发霉的环境，尤其是居住和办公环境。

DISCUSSION

CFIDS does not have a single cause such as Candida albicans or Epstein-Barr virus. Disordered immunity is the underlying common denominator, with many contributing factors, all adding together until a threshold of tolerance is exceeded. All people normally have Candida albicans in their bodies. A positive skin test for allergy to Candida is a medical test for a competent immune system. Every healthy person is sensitized.

讨论

CFIDS并没有一个唯一的因素导致，例如白假丝酵母菌或者EB病毒。失调的免疫系统通常是一个共同因素，与其他各类因素一起作用产生合力，知道免疫系统忍耐的上限被突破。所有的人通常在体内都存在白假丝酵母菌。假丝酵母菌的阳性测试是对免疫系统功能有效性的医学测试。每个健康的人对这个测试都应该起反应。

Everyone also harbors a variety of inactive viruses. Healthy immunity keeps them inactive. Only when immunity is impaired do Epstein-Barr and other viruses leave dormancy and multiply. Yeast and viruses are also kept in their proper place without symptoms if immunity is adequate.

每个人都有各种各样未被激活的病毒。健康的免疫系统维持这些病毒处于不活跃状态。仅仅当免疫系统受损后，EB病毒和其他病毒才会从睡眠中醒来并繁殖。当免疫力足够的时候，酵母菌和病毒会老实呆着而不引起反应。

For those reasons cultures for yeast, blood tests for yeast antibodies, skin tests and viral studies have thus far not been very useful in the diagnosis or treatment of CFIDS. If symptoms are typical, a trial of therapy is the easiest and most cost-effective way to determine if benefit will result. The form of treatment described in this paper has helped hundreds of patients who previously did not benefit from other types of treatment.

因为这些原因，对于酵母菌、酵母菌抗体的血检、皮试以及病毒研究对于CFIDS病人而言并不是十分有用。如果症状都很典型，那么就容易找到一个经济有效的疗法。本文所讲的疗法帮助了数以百计的曾经无助的病人。

The most common pitfall of this therapy is loss of patience, lack of persistence and stopping therapy before full improvement is realized. Initial benefits often take two to three months to begin. The so-called yeast "kill-off" effect and "withdrawal" from favorite and addictive foods may initially make symptoms worse. Patients become discouraged.

本疗法最大的弱点就是容易失去耐心，难以持之以恒直到痊愈。初始的效果往往需要2～3个月才开始显现。这个所谓的酵母菌‘杀光’效应，‘戒除’喜爱和上瘾的食物往往在开始的时候会带来更糟糕的症状。而这让病人更加气馁。

Patients who have been sick for a long time and who have failed to find benefit elsewhere are the ones who will be motivated to follow this program for the months required to achieve lasting benefit.

那些长期处于病态和在其他疗法上无助的病人，当运用这套疗法数月后而看见持续的疗效时会更加积极。

Case Histories

REFERENCES
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2) Crook WG: The coming revolution in medicine. Journal of the Tennessee Medical Association 1983; 76(3):145-149.
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9) Ciegler, A (ed): Microbial Toxins, Vol VI, Fungal Toxins. Academic Press, New York, 1971.
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参考文献：

1) Zwerling MH, Owens KN, Ruth NH: "酵母菌之思考"-- 假丝酵母菌的范围扩张. The Journal of the South Carolina Medical Association 1984, September; 454-456.
2) Crook WG: 正在来临的医药革命. Journal of the Tennessee Medical Association 1983; 76(3):145-149.
3) Crook WG: 酵母菌相关的免疫失调: 一个常见却未被认识的慢性疾病之源. Journal of Holistic Medicine 1984; 6(1):38-48.
4) Truss CO: 假丝酵母菌引起的组织受损: 心理的和神经学表现. The Journal of Orthomolecular Psychiatry 1978; 7(1):17-37.
5) Truss CO: 重建对假丝酵母菌的免疫力. The Journal of Orthomolecular Psychiatry 1980; 9(4):287-301.
6) Truss CO: 白假丝酵母菌在人体疾病中的角色. The Journal of Orthomolecular Psychiatry 1981; 10(4):228-238.
7) Crook WG: 酵母菌相关问题研究. 1986; Future Health, Inc., P.O. Box 846, Jackson TN 38302; 336pp.
8) Crook WG: 与白假丝酵母菌相关的忧郁症. JAMA 1984; 551:2928-2929.
9) Ciegler, A (ed): 微生物毒素, Vol VI, 真菌毒素. Academic Press, New York, 1971.
10) Iwata K, Uchida K, Yamaguchi H, et al: 白假丝酵母菌病理及其所生毒素研究, in Iwata K (ed): Yeast and Yeast-like Microorganisms in Medical Science. University of Tokyo Press, 1976, pp184-190.
11) Truss, CO: 慢性假丝酵母菌患者的新陈代谢异常研究: 乙醛猜想. The Journal of Orthomolecular Psychiatry 1984; 13(2):66-93.
12) Witkin SS: 再生性念珠菌症病人缺陷免疫系统响应. Infections in Medicine 1985 May/June:129-132.
13) Rosenberg EW, et al.: 克罗恩疾病和牛皮藓, 信件. New England Journal of Medicine 1983; 308(2):61.k
14) Crutcher N, et al.: 口服制霉菌素在治疗牛皮藓中的应用, 信件. The Archives of Dermatology 1984; 120: 435-436.
15) Crook, WG: 远程疾病与番茄中的假丝酵母菌感染有关吗？JAMA 1985; 2891-1892.
16) Goodwin JS, Goodwin JM: 番茄效应，被拒绝的高效疗法. JAMA 1984; 251(8):2387-2390.
17) Stollerman GH: 黄金标准, 评论. Hospital Practice 1985 January 30:9.
18) Hamblin TJ, Hussain J, Akbar AN, et al.: 单核细胞增生后慢性疾病的免疫原因. {Br Med J} 1982; 287:85-88.
19) Du Bois RE, Selly JK, Brus I, et al.: 慢性单核细胞增生综合症. South Med J 1984; 77:1376-1382.
20) Straus SE, Tosato G, Armstrong G, et al.: 成人EBV感染与持续性疾病和疲乏. Ann Intern Med 1985; 102:7-16.
21) Editorial. 乏力之病与EBV. Lancet July 19, 1986; ii:141-142.