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長青通訊 第十四期 EHVA Newsletter No. 14

長青健康素食推廣中心發行 二OO一年六月


本期目錄

本季服務及工作報告

服務及工作項目 服務人次 義工人次 義工時數
老人中心示範午餐 60 12 100
中、英文老人中心演講 420 30 160
素食及推拿錄影 0 30 180
身體調養班 40 8 40
寶健推拿班 100 20 100
健康素食食譜研發 0 30 120
公共教育與宣導 3600 50 400

長青園遊會通告

今年度的長青園遊會定在10月7日於老地方- Napredak Hall, San Jose舉行。今年的主題是「老吾老,以及人之老。」,我們除了延續去年重陽敬老的特色,免費提供餐點及推拿服務給華裔的長輩們外,更將我們友誼的手伸向主流社會。我們計劃邀請四佰位其他族裔的長輩們。

今年的素食研發重點是放在適合各族裔長輩們吃的素食上,而所用材料更須在一般超級市場都買得到。同時,文宣、食譜及現場接待與敬老活動也需要配合英語或雙語的服務。今年我們仍舊秉持免費招待長輩,並提供定點接送的服務。

由於人數的增加,我們需要更多義工,尤其是能懂雙語的義工〈在此長大的青少年是蠻適合的人選,又可拿社會工作學分,為此,我們計劃在8/19舉辦一場青少年健康理念夏令營,希望家長們多多鼓勵孩子們參加〉。

另外,經費也是一大挑戰,八佰位長輩們的免費餐點、禮物及交通就需約兩萬元,值此經濟不景氣之時,也正是我們展現凝聚力及最有效闡揚健康素食理念的時候。希望各界慷慨解囊,雪中送炭,義助這次的活動並參與這次這麼有意義的盛會。 訂購園遊會餐券、登記長輩免費餐券或捐款贊助者請洽王小姐(408-996-1635)或唐小姐(408-263-9799)。

《長青素食五年回顧》來了!

本中心《長青素食五年回顧》已出刊,內容包括:長青簡介、《長青通訊》及素食譜彙編、石鴻英大夫演講稿、活動照片精選等。每本15元,購買5本以上,每本10元。郵寄請另付郵費(美國境內每本2元、國外5元)。請填妥「訂購回條」,附上費用,寄本中心,我們將會安排領書或按址郵寄。

《感謝與祝福 陳尤美》

「誰知盤中飧,粒粒皆辛苦。」自長青成立以來尤美不但參與研發並推廣素食,幾乎所有的文書、文宣及出版品都出自她手,“長青素食五年回顧”堪稱是她嘔心瀝血之作,大家有目共睹。由於孩子們都將上大學,尤美打算搬回台灣與夫婿團聚。雖然我們有百般的不捨,但是家庭團聚更重要。在此特別感謝尤美多年來對本中心的付出與貢獻,她的細心與負責令人印象深刻,她對長青的執著更是令人感動。我們預祝她一切順利,並希望她在太平洋的彼岸能繼續護持
長青、發揚長青。

養生食療 西瓜皮飲

石鴻英大夫

西瓜為葫蘆科一年生草本植物,西瓜果實的外皮,其性微寒,味甘,具有清熱、解暑生津、利尿的作用。臨床上,西瓜皮對於小便不利、腎炎水腫,有一定程度的輔助效果。比較西瓜皮和西瓜汁,二者的功效基本相同,唯西瓜皮的作用較為緩和,但是持續作用較強。

民間流傳感冒頭熱消熱的方法,是將西瓜皮當帽子,戴在頭上數小時,其鎮熱效果亦佳。

西瓜飲的作法:

取西瓜皮,切成碎片,煮水當茶喝。

推拿班及調身班開班通知

新開授的「長青保健推拿班」將於7/22及8/25開班,其中8/25一班將以英文授課,歡迎年輕朋友及外籍朋友參加。另「長青身體調養班」也將於九月開班。歡迎踴躍參加。請洽吳素真(408-252-0397)、鄞淑純(408-272-7145) 、沙敏(夜650-969-5125)、張志中(日650-968-6698)索取簡章報名表。

石大夫談養生        長髮為伊留

毛髮是皮膚角質化所形成的角質蛋白質附屬物。它基本的功能就是保護皮膚,兼具保暖的作用,尤其在頭部,它的效果最為明顯。

洗髮、梳髮學問大

「身體髮膚,受之父母,不可損傷也」,是聖賢的明訓,表示我們民族對頭髮的重視,自然有一套完整的方法來保護頭髮。因此無論洗髮、梳髮、養髮、髮型、髮飾都有講究。從現在生理衛生的觀點來研究,也是非常符合科學務實的精神和要求的。以洗髮來說,古代雖然沒有洗髮精,也無肥皂,那麼將如何除去油垢呢?其實方法是很簡單的,那就是將茶樹的茶子將油壓出後,剩下的茶磚,用來洗髮。由於它具有乳化、吸油、除油的作用,當然可以將頭髮洗乾淨。不僅於此,它本身還具有清熱、涼血的作用,可以改善髮根濕熱的環境,進而達到清爽頭皮,改善循環,達到護髮的作用。適當的刺激,除了有利於頭皮的循環,還有強化頭髮的效用。所以梳頭的方法和髮型,就變得非常重要了。我們的祖先無論男女,髮型的設計都是順髮根方向而設計。梳頭呢?也是根據同樣的原則。梳子的種類,無論材料,基本上細密排列,就是配合根根不漏,整齊有緒的原則。也唯有這樣的設計,才能收到預期的效果。至於梳頭的方式則採取隨順髮根走向的原則。我們的頭髮,基本上是以耳根平行的頭頂中線做劃分線,劃分線住額頭方式,頭髮往前伏生。反之,則往後腦方向伏生。至於劃分線的兩側,則往耳朵方向伏生。前後左右方向定位以後,髮型、梳髮的原則,自然就清楚了。梳頭在舊社會是件非常重要的事,因為它還具有解壓的作用。當人情緒緊張時,臉紅耳赤、頭皮充血是很自然的生理反應 ( 交感神經興奮 )。如何降壓呢?利用梳頭就是有效而且方便的方法。晚清權傾一世的某宦臣,聽說就是梳頭功夫高,而得以親近當時的執政者。

毛髮生長的原理與現象

一般而言,一個成年人頭皮的毛髮最密時,約保持在十萬根左右。頭髮是由皮內毛囊生長出來的蛋白質,而毛囊必須依靠營養份和水份來維持頭髮的生長。就毛囊組織本身而言,它的活力可分為活動期 ( 2 – 5 年) 和休止期 ( 3 – 4 月),兩者交互發生。活動期間,每天長出 0.3 – 0.5 mm,直到休止期才停止,繼而開始脫落。由於生長期的時間差距相當的大 ( 2 – 5 年),表示除了個人遺傳體質外,尚有很多的因素對它都有影響。有的人對頭髮保養的很好,所以頭髮可以留得很長,尤其是一頭烏溜溜的秀髮,更令人羨慕。但是,也有的人卻無法如願以償,頭髮不但容易脫落,髮質形容枯槁,不但外形受影響,有的人甚至因此造成心理的障礙,畢竟,剃光頭和禿頭是不一樣的,前者出於自願或環境,後者卻是無可奈何。尤其是對情緒的困惱,早已被列入精神醫學的範疇了。

頭髮也需營養

祖國醫學認為「髮為血之餘」,表示頭髮的保養必須有充分的養分。血中的養分不足,自然沒有餘力去滋潤頭髮,這是最基本的看法。難怪在80 年代時,有種以中草藥製造的生髮液產品 ( 註: xxx 生髮水,主成份以補氣補血的強壯中草藥為主 ),曾風行一時。問題是它應用在僻遠貧困的鄉村區成效斐然,只是到了經濟繁榮的大都市,或是工業化的先進國家,則成效不彰,甚至適得其反。前者並不難解釋,因為透過中草藥補氣養血的刺激作用,有助於頭髮的營養吸收及補充,對於營養不足地區的人,應用之自然有效。後者,營養供應不缺,過度的刺激,反而更容易造成髮根生長環境的汙染,影響正常的發育。

為什麼過多營養或不當的過度刺激會影響頭髮的正常發育呢?什麼是所謂的溼熱現象呢?精神緊張容易造成面紅耳赤,頭皮部份也是如此。頭皮大量充血,溫度自然較高,進而刺激脂溢現象劇增,阻塞毛囊,影響營養吸收及廢物代謝循環,後果可想而知。營養越豐富,刺激越強烈,又沒有一套好的疏通辦法,阻塞的問題自然越嚴重。於是頭皮屑開始增多,頭皮油大量分泌,整個頭部經常處於油溼狀態,每天如果不洗頭,就會感到不舒服,這就是所謂的溼熱現象。其結果就是開始掉頭髮,頭髮的生長期提前結束,休止期相對延長,進而生髮組織功能衰退,禿頭的問題開始出現。

大多數的人或許以為禿頭是遺傳的問題,其中又以男性的比例較高。事實上,在高度工業化的社會,禿頭的人越來越多,而且,不止是父子遺傳,還有的是上一代不禿頭,下一代開始禿頭;不單男性如此,女性也開始遭遇同樣的困惱。更嚴重的是,有進一步年輕化的趨勢。禿頭的方式除了傳統前禿以外,還增加了所謂丹頂禿,那就是在頭頂上大量脫髮,且頭皮呈現紅的顏色。這些都是許多人關心,並希望早日預防或抑止的課題。

護髮需知

以下所列是 一些有效的方法,提供參考:

  1. 均衡飲食: 過油、過糖、過鹽、過蛋白質容易形成溼熱體質,自當避免。加重五穀雜糧、蔬菜的攝取,避免辣椒、大蒜、芥末、花椒等刺激物,若喝酒也要降低濃度,少量為宜。
  2. 保持規律性生活:充分睡眠是頭髮保養最基本的原則。早睡早起,定時定量,吃東西細嚼慢嚥,每天運動 15 - 30 分鐘,活動筋骨。
  3. 工作壓力是現代人日常生活所面對最大的刺激。求新求快求變,生活節奏快到讓人感到窒息。雖然生活水準提高了,物質享受增加了,但是持續性的緊張、焦慮,以至於心不安,似乎是人人所不可避免的情緒遭遇。經濟有所謂景氣循環,企業也如此。當不景氣來臨時,企業開始裁員,每幾年就要面臨一次,如此生活壓力怎麼能夠不高。至於想要換行或改行的念頭升起時,又被迫於考慮時間成本和再教育成本的風險性,也是高的嚇人,於是左右猶豫,內心的壓力將轉為煎熬。身心是一體的,身體的好壞會影響心情的變化。同樣的,心理的遭遇也會對身體產生壓迫。緊張容易造成消化系統紊亂,就是一個很好的例子。所以,心不安則身不安。持續性的焦慮,對頭髮產生最大的影響,就是頭皮屑多,脂溢旺盛,加速落髮,甚至提早形成禿頭,就是這個道理。既然工作壓力是不可避免的,如何保持愉快的心情,將壓力轉為積極的人生觀,建立自我生命的尊嚴,避免隨波逐流,因無自我肯定而造成自我摧殘的命運,將是一個不容忽視的重要課題。
  4. 保持人群互動的良好關係:人越是緊張,越需要朋友的互相鼓勵。只是友誼的建立,需要時間來培養。人進入社會後,同事就是朋友最好的來源。只是時下社會競爭強,而公司內部人事變動又快,有時,就連在公司能服務多長,都未能確定。在這種情形,如何能取得和朋友之間的互信,進而交心,這都是很困難達成的。唯有打開胸懷,接納朋友,以誠相待,才是信心建立的開始。
  5. 師法古意:養髮、護髮、蓄髮,成就頭髮。髮型越單純越好,跟著潮流變化,固然是一種時髦,但是因此而失本,那可是大大不划算。壓力大者,宜勤洗頭,去油污,保持氣血循環通暢。將苦茶油 1/4 量配合洗髮精 3/4 量,均勻混合,用來清洗頭髮的效果是很好的。除此,薄荷、冬桑葉、野菊花、蒲公英、丹皮、紅花、桂枝、防風,取等量加水,濃縮到 20% 的萃取液,和等體積的日用洗髮精混合,用來清洗頭髮的效果也很好。梳頭也是很重要的,學習古人順勢而梳為本,而後照顧髮型為標。千萬不要本末倒置,那就得不償失了。
  6. 洗髮時宜用溫水,用毛巾乾燥溼髮,對頭髮也是一種保護。如果一定要用吹風機,風速宜慢為第一要義,溫度如果控制在低熱範圍更好。

問題一白頭髮是否與掉頭髮有直接關係?

答案: 頭髮顏色與黑色素的含量多寡有關,黑色素越高,頭髮越黑。反之,含量越低則髮色呈褐黃或金黃色。至於白頭髮,表示其黑色素含量幾近於零,或少到不能發生呈色作用。一般而言,它與掉頭髮無直接關係,尤其在青壯年這個階段的人而言。

問題二生髮水是否有效?坊間時有新產品介紹,是否可靠?

答案:下回分解。

上期答案二揭曉:

問題:傳統的柲方,用蛋清加檸檬汁幾滴敷臉,是否有效?還有臉皮太乾了,又該如何得救?

答案:蛋清加檸檬汁敷臉,具有護膜、軟化及清垢作用。一般用此法敷面15 分鐘後,將臉洗乾淨,可收到滑嫩、固形效果,是一種傳統的保健法。

臉皮太乾了,俗話說油流乾了,當然應以人工方式加強臉面的潮溼度。像水溶性為主的 facial lotion 就是最佳產品。同時,禁止濃妝厚抹,更是應謹守的原則。

P.S. : 古方曾提到用精油護乾臉,唯禁忌較多。有興趣讀者可書信提出,如此方便回答。♁
 

Care and nourishment for women after childbirth (a) – 做月子:火鳳凰重生?

Translated by Yu-Jen Huang

( Chinese version, by Dr. Hung-Ying Shih, was published on EHVA Newsletter (10), June, 2000 )

Why does a woman need special care and nourishment in the month after childbirth?

Taking special care and nourishment is a Chinese tradition for postpartum women.

Although methods may differ slightly from region to region, they all emphasize “hot nourishment” or “warm nourishment” to the body aiming to supplement nutrients and to strengthen the body functions.

According to our ancestors' experiences, postpartum women need rest to avoid the following diseases: headaches, body ache, physical weakness, pregnancy marks, hemorrhoids, and etc. If they are not careful during this time, they might suffer permanent illness in the future. Therefore, there are many taboos:

  1. Don't wash hair for fear of headaches.
  2. Don't touch cold water to avoid attack by cold air in local areas.
  3. Don't expose yourself to the wind to avoid catching cold.
  4. Don't take showers.
  5. Don't eat cold or raw food.
  6. Don't read books or magazines.
  7. Don't do strenuous work…

In another word, women are not allowed to do anything during this period after childbirth. Many Chinese women grow up under the shadow of these taboos.

Yet, the practices in the United States are very different for postpartum women. They can wash their hair, take showers, drink cold milk, eat fresh fruits, start exercising, and go back to work sooner.

Why are the approaches so different? It is caused by the differences in life styles, physical constitutions and cultures.

The necessity of special care for postpartum women from medical perspectives

According to medical research, the base temperature of a woman during pregnancy is higher than normal. The closer to the due date, the higher the temperature is. At the final stage, she will experience thirst, dry tongue and sensitivity to heat. This is caused by the increased metabolism rate. The pregnant woman has to assist the metabolism of the fetus. The faster the fetus grows, the more workload the mother's body takes on and the body temperature becomes higher. This causes the mother to feel irritated by heat.

The following phenomena are observed at the later stage of the pregnancy. (1) The symptom of the allergic nasal disease (caused by coldness of the body) will disappear due to increased circulation. (2) Some women will develop gestation hyperthyroidism or gestation diabetes resulting from the body's adjustment to the accelerated functions.

During pregnancy, the woman experiences a series of interrelated physical changes: (a) the body's micro circulation increases; (b) the body temperature keeps at a slightly higher level for a long period of time; (c) pores open naturally; (d) the resistance ability of the skin decreases and (e) related tissues change accordingly.

After the child is born, the woman's body changes from two metabolic systems to one, and the body temperature begins to drop. Organs and tissues cannot adjust to the change immediately. In general, it takes about a month for the body to adjust the change. The woman will become sensitive to wind and cold if her body temperature drops too fast. This is because the degree of contraction of pores and outer skin tissues cannot match the rate of the drop of the body temperature. If she was born with weak physical constitution, lacks physical exercises, lives in an environment with insufficient heating, or has an imbalanced vegetarian diet, her body will become cold/damp type. On the other hand, if she eats a lot of meat without considering the balance in the food, her body will become damp/heat type. Taking special care for the woman after childbirth will be very helpful in correcting the body constitution.

If the woman has been doing exercise regularly, has paid attention to have a balanced diet and lived in a modern house with quality heating system, she might be doing fine without following our ancestor's rules.

There is no right or wrong to the different approaches. The key is to understand the rationale and to choose the approach that accommodates the person.

The basic principles of nourishment for women after childbirth

“Warm nourishment” and “hot nourishment” are two basic healthcare methods for the postpartum women. Both methods are based on prevention. They supply the nutrition, maintain the vitality of body functions, and further improve the body constitution. According to our ancestors' observation, only the postpartum women can benefit the most from rest and nourishment. This is due to their greatly improved ability to absorb and assimilate nutrients. After this period, the effects will decrease gradually.

It is better to extend the period from one month to ninety days for easy assessment since the clinical results of any changes won't show until a quarter later. For example, change of physical constitution will become noticeable in the autumn if the ninety-day nourishment is completed in the spring.

In the beginning of this period, we suggest hot nourishment for the women so that her body temperature will decrease gradually. Her internal organs will adapt to the change of the body temperature to avoid any side effects caused by abrupt changes. Later, we can decide whether to continue hot nourishment or switch to warm nourishment in order to improve the individual's body constitution.

In choosing hot nourishment or warm nourishment, the objective factors like sweating, heartbeat, blood pressure need to be first considered. Subjective factors such as sensitivity (to cold weather), cold extremities and frequent urination should be evaluated with objective consequences in order to make the right choice.

Diet

From the nutritional point of view, protein content should be increased in the diet during this period. Protein content is high in animal based proteins, eggs and milk products. As for vegetarians, the source of protein comes mainly from peas and beans, with limited varieties and tastes. Brewer's yeast or spirulina can be used as alternatives. The protein in spirulina is twenty times more than that of soybean. It can be easily digested and is less likely to cause allergy. Nuts can also be considered for their high contents in both protein and fat. However, they might cause allergic reactions or indigestion problems. For easy digestion, nuts should be cooked in boiling water first and then mashed.

Sesame oil and fermented glutinous rice products can be added to the diet for slowing down the drop rate of the body temperature. However, excessive amounts will hinder the process of reshaping the body figure and reducing pregnancy wrinkles.

Herbs are used to improve the body functions. The different selection of herbs depends on their ability to revitalize, balance and sustain the body. Hot and spicy seasonings like peppercorn, chili pepper and mustard, which improve the circulation of upper body, are not recommended. Although the woman will feel heat instantly after taking these seasonings, the phenomenon lasts only for a short period of time. She then gets tired afterwards due to the loss of her Qi (life force).

Other herbs such as Pao Fu Zi (processed aconiti), Rou Gui (cassia) and Gui Pi (cinnamon) have great heat-producing ability and sustainability. They can balance the organs of the lower body part. However, excessive amount of these herbs will cause overheat and over dryness of the body.

Ren Shen (ginseng), Dang Gui (angelicae sinensis), Chuan Qiong (rhizoma ligustici), and Huang Qi (astragalus membranaceus), Gui Yuan (longanae arillus), Hong Zao ( red jujube), Gou Ji Zi (lycium), Dang Sen (codonopsis pilosular) are warm and considered mainstream ingredients for nourishment. For example, the “Eight treasures Concoction” is made of the famous “Four ingredients Decoction”: Dang Qui (angelicae sinensis), Chuan Qiong (rhizoma ligustici), Bai Shao (paeoniae alba), Shou Di (rehmanniae praeparata) and the “Four gentlemen Concoction”: Dang Sen (codonopsis pilosulae), Bai Shu (rhizoma atractylodis macrocephalae), Fu Ling (poria), Gan Cao (liquorice). The “Eight treasures Concoction” provides warm and hot nourishments and nurtures both Qi and blood.

Shan Zhu Yu Rou Drink – 山茱萸肉湯

Translated by Parkson Wong

(Chinese version by Dr. Hung-Ying Shih was published in EHVA Newsletter (10), June, 2000)

The sweet and sour taste of “shan yu rou〈山萸肉〉” drink is much like the favorite traditional summer drink, “sour plum drink〈酸梅湯〉”, but a lot healthier. Not only does it taste good, “shan yu rou” drink is a functional food that tonifies the kidney, increases the essence of body fluids and arrests spontaneous emission and sweat.

“Shan yu rou” (dogwood fruit) is the fruit of the deciduous tree shan zhu yu〈山茱萸〉. It is rich in nutrients such as vitamin A, gallic acid, maleic acid and tartric acid. It is also rich in “shan zhu yu” essence, which research found can promote diuresis and can lower blood pressure. “Shan yu rou” is one of the six ingredients used in the famous kidney strengthening herbal formula “lui wei di huang wan〈六味地黃丸〉”.

Ingredients:
“Shan yu rou” 3 1/3 oz.
“Guei hua” paste〈桂花醬〉  2 Tbsp.
Honey 3 Tbsp.
Licorice〈甘草〉 1 slice
Water 10 cups

Procedure:

Put all the ingredients into a large pot, and bring to boil over high heat. Reduce to low heat, and simmer for one minute. Turn off heat. Serve cold.Å

活動看板

本中心除了繼續對華人社區長輩們服務外,並積極拓展向主流社會長輩們介紹簡易老人食療與保健。除了近期排定的數場英文演講外,也在五月三十一日在Cupertino Senior Center示範健康素食午餐並由洪英傑講師介紹老人食療。與會的六十位美國長輩對品嚐的中西式主食與點心讚口不絕。並紛紛向本中心索取食譜。茲將近期排定的活動日期列出如下:

  • 4/26 及 5/24 舊金山華埠安老自助處
  • 5/16 Little House Senior Center, Menlo Park
  • 5/31 Cupertino Senior Center, Cupertino
  • 6/13 Belmont Senior Center, Belmont
  • 6/29 Hank Lopetz Senior Center, San Jose
  • 6/30 四街老人中心,聖荷西市
  • 7/10 San Jose Market St. Senior Center 3-4PM (speaker: Susan)
  • 7/11 Alma Senior Center, San Jose
  • 7/18 Veterans Memorial Senior Center, Redwood City
  • 7/25 Avenidas Senior Center, Palo Alto
  • 7/28 三街老人中心,聖荷西市

  • 8/27 Sunnyvale Senior Center, 10AM-1PM (English)

健康新知精選     為什麼需要保護你的肝﹖

呂錞銀 譯自 Consumer Reports on Health, Vol. 13,No.1

理由之一 : 即使像 Ibuprofen 和 Lipitor 這麼普通的藥物都可能傷害肝臟

一向被美國人忽略的肝臟開始受到重視。我們常在報章雜誌上, 看到一系列有關清肝,排肝毒補充劑的廣告。測肝功能的驗血也成為體檢中例行檢驗的一部份。

這些檢驗可以查出多種肝功能失調,特別是很多美國人得了而不自知的C型肝炎。研究報告發現許多藥物, 如止痛藥, 降膽固醇藥, 抗糖尿病的藥及荷爾蒙雌激素 (參照表一), 都會傷害肝臟。服用上述藥物者必須多做幾次肝檢查。患糖尿病, 膽結石, hemochromatosis 或是體重過重者, 因為他們的肝臟比較容易積存油脂, 定期做肝檢查是非常重要的。 

不幸的是很多醫生在詮釋報告上都有困難。以致造成誤診。健康的病人平添憂慮。做了很多難度高的追蹤檢查。而有嚴重問題的病人卻被忽略。

防止肝病須知:首先確定檢查報告解釋的正確性,再做追蹤檢查。如果肝真的有問題則需設法取得正確的治療。

肝: 身體的化學工廠

肝是個非常重要, 有多方面功能的器官。它能將食物中的碳水化合物及其它養份轉化成我們身體可以吸收 如葡萄糖之類的分子。肝幾乎能合成所有體內的蛋白質,包括酵素,血清(維持體液的平衡性)。它還可以製造: 能幫助消化及排除體內毒素的膽汁, 為細胞壁重要成份的膽固醇, 維生素A及凝血因子。 肝並能淨化血液。很多人以為肝的淨化功能在於它能過濾像酒精,藥物及其他化學品的毒素。而有以禁食或攝取一些補充劑以排除肝內毒素的想法。 這些印度傳統醫學的方法被美國很多非傳統醫學的醫療者所採用。但是現代醫學並不支持以上想法。他們不認為肝可以過濾毒素。匹茲堡毒物中心主任Ed Krenzelok 說“肝組織並不比其他組織容易藏毒素。肝的功用不在於能過濾毒素, 在於它能將毒素轉化成可以由膽汁或尿液排出的化合物”。

檢驗結果的詮釋

因為肝有多方面的功能,目前的血液檢查至少包含四種不同的肝測驗﹕ALT和AST肝酵素的化驗﹐這項化驗可測出肝細胞的病變;另一項ALP肝酵素及 bilirubin 的化驗,則可以測出肝的膽汁管是否有阻塞。醫生根據數據升高的程度及整體圖形來解釋肝測驗。如果檢驗結果異常, 則需看是否有其他問題: 從酒精, 藥物對肝的傷害到肝發炎, 遺傳性失調﹐膽或胰臟的問題, 甚至可能是癌症。因為問題包括的很廣。負責教育醫生肝檢驗的(波士頓新英格蘭醫學中心肝臟移植主任) Daniel Pratt說 “醫生常像陷入迷宮, 無從找出問題所在”。由於實驗的誤差。初步檢驗結果異常是相當普通的。對於沒有症狀的病人, 第一件事就是要重新做檢驗。

要能前後一致地解釋異常檢驗結果具相當大的挑戰性。如果初步檢查結果確定是異常則需做第二層次的檢驗。如超音波及其他針對肝病毒的驗血。這些進一步的檢驗結果很可能讓人混淆。舉例而言, B型肝炎的病毒有兩大類, 其危險性相差甚遠。此外很多醫生從未想到 hemochromatosis 或其他少見的病會使肝檢驗呈異常反應。

幫助醫生做正確的診斷

首先得告訴醫生你的一些可能導致肝病的行為,如酗酒,使用不合法藥物(即使那是很久以前短暫的嘗試)。

如果肝檢驗結果異常,務必請醫生重新檢查。要是有下列情況﹕(1)重檢結果異常,而你的醫生不進一步做第二層次的追蹤檢查。(2)檢驗結果的異常可能是由於某種嚴重的疾病或是病症己經拖延了三至六個月。您必須請教胃腸科或肝科醫生。肝科醫生可能會建議肝切片。肝切片的手術須要局部麻醉, 將針插入兩肋骨間。這個手術有輕微流血或發炎的危險性, 致命的可能性則非常小。如果是慢性濾過性病毒肝炎, 酒精肝病或肝癌﹐肝切片可以幫助醫生作正確的診斷﹔決定最好的治療方法﹔及控制疾病的蔓延。

表一: 威脅肝臟的藥物及草藥

下表列出的藥物會影響肝臟,長期服用者須做定期的肝檢驗。如果檢驗結果異常, 應該請教醫生是否得停止服用該藥物, 換另一種藥或減少劑量, 另外也列出一些可能傷害肝臟的營養補充劑。

藥物與補充劑

意見

非類固醇的消炎藥物 (Nonsteroidal anti-inflammatory drugs)

Ibuprofen (Advil)

每天服用者, 建議每三, 四個月做肝檢驗。服用過量的 Tylenol會傷害肝臟。服用普通劑量的Tylenol, 加上三杯酒也會傷害肝臟。

Ketoprofen (Orudus KT)

Naproxen (Aleve,Naprosyn)

Celecoxib (Celebrex)

Rofecoxib (Vioxx)

降膽固醇的藥物(Cholesterol-lowing drugs)

Atorvastatin (Lipitor)

服用藥物後, 四至六星期須做肝檢驗, 以後要做定期檢查。

Fluvastatin (Lescol)

Lovastatin (Mevacorl)

Pravastatin (Pravachol)

Simvastatin (Zocor)

Niacin (Niaspan, Nicolar)

抗糖尿病藥物(Antidiabetic drugs)

Pioglitazone (Actos)

因為可能會傷害肝臟, Rezulin 已經被禁用, 其他藥物目前還算安全。不過第一年每兩個月須做肝檢驗,以後做定期檢查。

Rosligliazone (Avandia)

降三甘油脂的藥物(Triglycerde-lowering drugs)

Fenofibrate (Tricor)

每四個月做肝檢驗

Gemfibrizol (Lopid, Gen-Fibro)

抗痙攣的藥物 (Anticonvulsants)

Carbamazepine (Carbetrol,Tegretol)

每三, 四個月做肝檢驗

Phenytoin (Dilantin)

Valproic acid (Depakote)

治療老人癡呆症的藥物

Tacrine (Cognex)

每三, 四個月做肝檢驗

荷爾蒙 (Hormones)

雌激素(用以防止骨質疏鬆及治療更年期症狀的Ogen,Premarin及避孕藥 Lo/Ovral,Triphasil)

雌激素有時會影響膽汁流動而引起黃疸, tamoxifen 會引起脂肪肝。建議每年做一次或兩次肝檢查

Tamoxifen (用以預防乳癌Nolvadex)

Methhotrexate (Folex,Rheumatrex)

治療皮膚病,風溼及癌症

如果累積服用劑量超過1.5公克,建議做肝切片,因為這些藥物會傷害肝臟,但無法從驗血中檢查出來。

營養補充劑

第一類: Chapparal, comfrey, germander, pennyroyal, 高劑量的維生素A (每天服用10,000 IUS 以上)及類固醇 (anabolic steroids).

每個人都得避免第一類的營養補充劑﹐肝檢查有異常結果者必須避免第二類營養補充劑。

第二類: 麻黃,gentian, senna, shark cartilage, scutellaria (skull cap) valerian.

如果驗血結果,指數昇高,但又無法由追蹤檢查得到解釋,通常也必須做肝切片。現在醫生們的共識是: 指數必須高出正常兩倍以上, 才做肝切片。其他只須做週期性的檢查。建議請教另一位醫生的意見, 以確定是否有肝切片的需要。

您的醫生,尤其是專科醫生必須能很詳盡的解釋異常檢驗結果的重要性。有關肝檢驗的資料來源請見表二。未完待續•••♁

表二: 其他資料

  1. “The Liver Disorders Sourcebook” by Howard J. Worman, MD, $18.95.書店可買到或電800-323-4900
  2. Diseases of the Liver. Dr.Worman 為解釋肝檢驗及肝病症狀所設立的網站 (cpmcnet.columbia.edu/dept/gi/disliv.html)
  3. The National Library of Medicine 有關肝病及肝檢驗的完整資訊(www.nlm.nih.gov/medlineplus/liverdiseasesgeneral.html)

長青素食譜           義大利瓜

材 料: 意大利瓜 (Zucchini) 12 oz 皮薩草(Oregano) 2 茶匙
  黃南瓜 (Yellow squash) 8 oz ½ 茶匙
  洋菇 4 oz 2 湯匙
  甜紅椒 1/4個 2 瓣
  橄欖油 1湯匙 新鮮黑胡椒粉 ¼ 茶匙
準 備:
  1. 意大利瓜,黃南瓜洗淨,橫切片。
  2. 洋菇洗淨切片。紅椒洗淨切段。蒜切末。
做 法:
  1. 開大火,油熱,放入鹽,蒜末。爆香。放入意大利瓜片,黃南瓜片。炒幾下。
  2. 加兩湯匙水。加蓋。轉中火煮一分鐘。
  3. 加洋菇片。炒幾下。加兩茶匙皮薩草〈Oregano〉及¼茶匙黑胡椒粉,拌勻。關火。
  4. 加甜紅椒,拌勻。即可盛入盤中食用。
份 量: 6人份

EHVA Recipe Squash Delight

Ingredients: Zucchini 12 oz. Oregano 2 tsp.
  Yellow squash 8 oz. Salt 1/2 tsp.
  Mushroom 4 oz. Water 2 Tbsp.
  Red bell pepper 1/4 piece Garlic 2 cloves
  Olive oil 1 Tbsp. Fresh ground black pepper 1/4 tsp.
Preparation:
  1. Wash and slice zucchini and yellow squash.
  2. Wash and cut mushroom into thick slices.
  3. Wash and cut red bell pepper into small stripes.
  4. Mince garlic.
Procedures:
  1. Heat large pan over high heat. Add olive oil, garlic and salt. Stir-fry until fragrant. Add zucchini and squash, stir-fry.
  2. Add 2 Tbsp. of water, and reduce heat to medium-high. Cover and simmer for 1 minute.
  3. Add mushroom and stir-fry. Stir in 2 tsp. of oregano and 1/4 tsp. of black pepper. Turn off heat.
  4. Mix in red bell pepper. Ready to serve.
Servings: 6 persons

長青素食譜      南瓜 洋薏仁湯

材 料: 乾菇porcini ½ oz 洋薏仁 1 杯
  牛油(無鹽) 2 湯匙 Madeira wine 1 杯
  洋蔥 2 個 (小) 去皮蕃茄 1 罐 (28 oz)
  新鮮百里香(thyme) 1茶匙 素高湯 3 quart
  黑胡椒粉 1 茶匙 南瓜Butternut Squash 2個 (每個約1 ¼ 磅)
  鹽 (Kosher salt) 1 茶匙 Swiss chard ½ 把 (約12 oz)
準 備:

  1. 將蕃茄罐頭中的蕃茄切成 ½ 吋小塊,蕃茄汁留著備用。
  2. 南瓜切對半,去子後切成半吋小塊。
  3. Swiss chard 洗淨,把葉和莖分別切成半吋小段。
  4. 將菇沖洗一下,放入大碗中,沖入熱水〈沸水〉,加蓋,泡二十分鐘。泡軟後,拿出菇,切小段。將泡菇的水留下備用。
做 法:
  1. 開中火,將牛油置於大湯鍋,熔化後,加入洋蔥丁,炒軟至透明狀,約八分鐘。
  2. 加入1茶匙百里香,½茶匙鹽及½茶匙黑胡椒粉。將洋薏仁加入湯鍋,炒至略呈金黃且聞起來有些香味,約八分鐘。
  3. 將切好的菇放入湯鍋,炒幾下,加入1/2杯Madeira酒,轉中大火。煮至酒幾乎蒸發乾。轉中火,倒入泡菇的汁,煮至幾乎沒汁。約八分鐘。
  4. 將預存的蕃茄汁及素高湯放入湯鍋,再加入南瓜塊,½茶匙鹽及½茶匙黑胡椒粉,加蓋煮三十分鐘,加入chard的莖及蕃茄丁,再繼續煮二十分鐘至瓜軟。
  5. 食用前加入切好的Swiss chard葉子,及½杯的Madeira酒。約煮兩分鐘至Swiss chard軟,關火,即可食用。
份 量: 14-16人份

素高

材 料: 牛油(無鹽) 1 湯匙 芹菜 1 根
  橄欖油 1 湯匙 Swiss chard 1 把 (半磅)
  洋蔥 1 個 (大) 新鮮百里香(thyme) 數葉
  胡蘿蔔 1 個 (大) Parsley (flat leaf type) 數葉
  防風草根 parsnip 1 個 Bay leaf 1 片
準 備:
  1. 把洋蔥,胡蘿蔔,parsnips,芹菜洗淨,切塊。
  2. 把Swiss Chard洗淨,切約一吋小段。
做 法:
  1. 將牛油及橄欖油放在湯鍋堙A用中,小火熔之。將洋蔥放入湯鍋內,炒至軟且有點焦黃,約十五至二十五分鐘。
  2. 加入胡蘿蔔,parsnips及芹菜,炒至軟,約二十分鐘。
  3. 加入Swiss chard,一加侖的水,thyme,parsley,及Bay leaf。加蓋煮至滾。轉小火,不加蓋,煮一小時。離火,稍冷後過濾即可。此湯在冰箱內可保存三至四天,冷凍則可保存三個月。

EHVA Recipe Vegetable Barley Soup

(Adapted from “The Martha Stewart Living Cooking”)

Ingredients: Dried porcini mushrooms ½ oz Barley 1 cup
  Unsalted butter 2 Tbsp. Madeira wine 1 cup
  Onions 2 (small) Whole peeled tomatoes one 28 oz. can
  Fresh thyme leaves 1 tsp. Vegetable Stock 3 quart
  Black pepper 1 tsp. Butternut Squash 2 large (1 1/4 lb. Each)
  Kosher salt 1 tsp. Swiss chard 1/2 bunch (12 oz.)
Preparation:
  1. Drain tomatoes from can, but reserve the liquid. Cut tomatoes into half-inch pieces.
  2. Cut butternut squash in half, remove seeds. Then cut into half-inch pieces.
  3. Wash and drain Swiss chard. Chop stems into half-inch pieces. Chop leaves into half-inch pieces. Set aside separately.
  4. Place mushrooms in a large bowl, cover with very hot water. Let stand until soft, about 20 minutes. Remove porcini mushrooms and chop into small pieces. Strain the liquid and reserve.
Procedures:  
  1. Melt butter in a large pot over medium heat. Add onion, cook until soft and translucent, stirring often, about 8 minutes. Add thyme, 1/2 tsp. of salt, and 1/2 tsp. of pepper.
  2. Stir in barley and cook until it begins to brown and smells sweet, about 8 minutes.
  3. Add chopped porcini mushrooms to barley mixture. Add 1/2 cup Madeira wine; raise heat to medium-high. Cook until liquid is nearly evaporated.
  4. Add reserved porcinis liquid. Cook until liquid is almost completely reduced, about 8 minutes.
  5. Add reserved tomato liquid to barley, along with the vegetable stock. Add squash pieces, 1/2 tsp. of salt, and 1/2 tsp. of pepper. Simmer for 30 minutes. Skim foam occasionally.
  6. Add chard stems to barley mixture. Add tomatoes and simmer for another 20 minutes, or until the squash is tender.
  7. Just before serving, stir the chopped Swiss chard leaves into the soup. Add the remaining 1/2 cup of Madeira wine, and cook until the chard leaves is just tender, about 2 minutes. Season with salt, server hot.
Servings: 14-16 persons

Vegetable Stock

Ingredients: Unsalted butter 1Tbsp. Celery 1 stalk
  Olive oil 1Tbsp. Swiss chard 1 bunch (about 1/2 lb.)
  Onions 1 (large) Fresh thyme Several sprigs
  Carrot 1 (large) Fresh flat-leaf parsley Several sprigs
  Parsnip 1 Dry bay leaf 1 piece
Preparation:
  1. Wash and coarsely chop onion, carrot, parsnip and celery.
  2. Wash Swiss chard and cut into 1-inch pieces.
Procedures:   
  1. In a medium stockpot, melt the butter and oil, stirring occasionally, over medium-low heat.
  2. Add the onion, cook until caramelized, 15 to 25 minutes.
  3. Add the carrots, parsnips, and celery, cook until tender, about 20 minutes.
  4. Add the Swiss chard and one gallon of cold water, thyme, parsley, and bay leaf. Cover and bring to boil, then reduce heat, uncover and simmer for an hour.
  5. Remove from heat, let cool and strain the stock. Discard the vegetables. The stock can be refrigerated for 3 to 4 days, or frozen for up to 3 months

烹調錦囊 【作泡菜的秘訣】

泡菜開胃。做泡菜要注意以下幾點:(1)用上好的蘋果醋。(2)用高品質,新鮮的蔬菜。(3)用不含碘和澱粉的鹽(如Kosher salt 或 Pickling salt)。碘會使泡菜變黑,而澱粉會使泡菜汁變濁。(4)裝泡菜的容器最好用磁器,玻璃器皿或不袗鍋;不要用鋁或鐵製品。(5)水質也很重要,含鐵或硫的水會使泡菜變黑。
上期提到的醋蛋,一般用醋雞蛋較好(鴨蛋的膽固醇較高)。醋鵪鶉蛋可用於治下焦冷感。

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