{"id":7739,"date":"2017-01-16T00:00:00","date_gmt":"2017-01-15T16:00:00","guid":{"rendered":"\/\/www.afterroberto.com\/?guid=c70b06ad1a8fbfdaee44c29787faa79f"},"modified":"2018-08-21T15:37:49","modified_gmt":"2018-08-21T07:37:49","slug":"%e7%9c%bc%e7%b4%85%e7%b4%85-%e8%85%b0%e8%83%8c%e7%97%9b%ef%bc%9f-%e5%b0%8f%e5%bf%83%e9%8a%80%e5%b1%91%e7%97%85%e8%81%b2%e6%9d%b1%e6%93%8a%e8%a5%bf%ef%b9%97","status":"publish","type":"post","link":"\/\/www.afterroberto.com\/%e7%9c%bc%e7%b4%85%e7%b4%85-%e8%85%b0%e8%83%8c%e7%97%9b%ef%bc%9f-%e5%b0%8f%e5%bf%83%e9%8a%80%e5%b1%91%e7%97%85%e8%81%b2%e6%9d%b1%e6%93%8a%e8%a5%bf%ef%b9%97\/","title":{"rendered":"\u3010\u6709\u7247\u3011\u773c\u7d05\u7d05 \u8170\u80cc\u75db\uff1f \u5c0f\u5fc3\u9280\u5c51\u75c5\u8072\u6771\u64ca\u897f\ufe57"},"content":{"rendered":"

\u3010\u660e\u5831\u5c08\u8a0a\u3011\u4e0d\u5c11\u4eba\u90fd\u6709\u8170\u75db\u3001\u819d\u75db\u3001\u624b\u6307\u95dc\u7bc0\u75db\u7b49\u300c\u5c0f\u6bdb\u75c5\u300d\uff0c\u89ba\u5f97\u662f\u5c0f\u4e8b\u800c\u5ffd\u7565\uff0c\u4f11\u606f\u4e00\u4e0b\u5c31\u6703\u5eb7\u5fa9\uff0c\u4f46\u6c92\u60f3\u904e\u53ef\u80fd\u662f\u5176\u4ed6\u75be\u75c5\u7684\u300c\u8b66\u865f\u300d\u3002<\/p>\n

\u9280\u5c51\u75c5\uff0c\u4fd7\u7a31\u725b\u76ae\u766c\uff0c\u770b\u4f3c\u662f\u76ae\u819a\u554f\u984c\uff0c\u4f46\u8fd1\u5e74\u6108\u4f86\u6108\u591a\u7814\u7a76\u767c\u73fe\uff0c\u60a3\u8005\u540c\u6642\u51fa\u73fe\u591a\u7a2e\u5171\u75c5\u7e8f\u8eab\uff0c\u95dc\u7bc0\u75bc\u75db\u3001\u5fc3\u8840\u7ba1\u75be\u75c5\u3001\u6291\u9b31\u3001\u8679\u819c\u708e\u7b49\u3002\u56e0\u6b64\u4e0d\u8981\u5ffd\u7565\u9019\u4e9b\u300c\u8b66\u865f\u300d\uff0c\u53ca\u65e9\u6c42\u91ab\u4ee5\u5168\u9762\u63a7\u5236\u75c5\u60c5\u3002<\/p>\n

\u4e00\u540d\u5e74\u7d0440\u6b72\u7684\u5973\u50b3\u9053\u4eba\uff0c\u6bcf\u65e5\u9700\u8981\u6b65\u884c\u4e09\u5c64\u6a13\u68af\u56de\u6559\u5802\u5de5\u4f5c\uff0c\u60a3\u4e0a\u9280\u5c51\u75c5\u3002\u98a8\u6fd5\u75c5\u79d1\u5c08\u79d1\u91ab\u751f\u4f59\u5609\u9f8d\u6307\u51fa\uff0c\u300c\u5979\u75c5\u767c\u4e86\u6578\u6708\uff0c\u4e5d\u6210\u76ae\u819a\u53d7\u5f71\u97ff\uff0c\u6709\u7d05\u3001\u589e\u539a\u3001\u812b\u76ae\u7b49\u5fb5\u72c0\uff0c\u53d7\u5f71\u97ff\u7bc4\u570d\u6975\u5927\u3002\u53e6\u5916\uff0c\u56e0\u8173\u8ddf\u548c\u819d\u95dc\u7bc0\u4ea6\u53d7\u5f71\u97ff\uff0c\u9700\u8981\u8f2a\u6905\u4ee3\u6b65\u300d\u3002\u7576\u5979\u4f86\u6c42\u8a3a\u6642\uff0c\u4e0d\u505c\u5730\u54ed\uff0c\u6709\u6291\u9b31\u5fb5\u72c0\uff0c\u4e0d\u9858\u610f\u4e0a\u73ed\u3002<\/p>\n

\u53e6\u4e00\u540d\u8001\u5a46\u5a46\u75c5\u4eba\uff0c\u56e0\u70ba\u819d\u75db\u5411\u9aa8\u79d1\u6c42\u8a3a\uff0c\u4ee5\u70ba\u662f\u52de\u640d\u9000\u5316\u9700\u8981\u66f4\u63db\u95dc\u7bc0\u3002\u7136\u800c\uff0c\u56e0\u70ba\u75c5\u60c5\u60e1\u5316\u901f\u5ea6\u5feb\uff0c\u4e0d\u4f3c\u662f\u4e00\u822c\u95dc\u7bc0\u9000\u5316\uff0c\u5f15\u4f86\u91ab\u751f\u61f7\u7591\uff1b\u518d\u7d93\u8a73\u7d30\u6aa2\u67e5\u624d\u767c\u73fe\u662f\u9280\u5c51\u75c5\u95dc\u7bc0\u708e\u3002<\/p>\n

\u767c\u75c5\u9ad8\u5cf0\uff1a20-30\u6b72\u53ca50-60\u6b72<\/p>\n

\u9280\u5c51\u75c5\u5728\u5168\u7403\u7684\u767c\u75c5\u7387\u70ba2%\u3002\u4f59\u5609\u9f8d\u6307\u51fa\uff0c\u9999\u6e2f\u7684\u767c\u75c5\u7387\u5247\u7d04\u70ba0.3%\u81f30.6%\uff0c\u800c\u767c\u75c5\u5e74\u9f61\u901a\u5e38\u5206\u5169\u500b\u9ad8\u5cf0\u671f\uff0c\u6700\u591a\u70ba20\u81f330\u6b72\u4e4b\u9593\uff0c\u9019\u500b\u5e74\u7d00\u75c5\u767c\u8207\u907a\u50b3\u56e0\u7d20\u6709\u8f03\u5927\u95dc\u4fc2\uff1b\u53e6\u4e00\u500b\u662f50\u81f360\u6b72\uff0c\u591a\u662f\u5f8c\u5929\u56e0\u7d20\u6fc0\u767c\u6240\u81f4\u3002\u9280\u5c51\u75c5\u65e9\u671f\u5fb5\u72c0\uff0c\u4e03\u6210\u4eba\u76ae\u819a\u6709\u812b\u76ae\u60c5\u51b5\uff0c\u300c\u4f46\u4ea6\u6709\u4e09\u6210\u60a3\u8005\u7684\u95dc\u7bc0\u3001\u7b4b\u8171\u9996\u5148\u53d7\u5230\u653b\u64ca\uff0c\u589e\u52a0\u8a3a\u65b7\u56f0\u96e3\u300d\u3002<\/p>\n

\u751f\u7269\u88fd\u5291\u6709\u6548\u7d13\u7de9\u6025\u6027\u767c\u4f5c<\/p>\n

\u96d6\u7136\u6578\u64da\u986f\u793a\uff0c\u9280\u5c51\u75c5\u5728\u9999\u6e2f\u7684\u767c\u75c5\u7387\u8f03\u4f4e\uff0c\u4f46\u4f59\u5609\u9f8d\u8a8d\u70ba\u6578\u64da\u672a\u5b8c\u5168\u53cd\u6620\u554f\u984c\u7684\u56b4\u91cd\u6027\uff0c\u56e0\u70ba\u4e0d\u5c11\u75c5\u4eba\u9003\u907f\u6c42\u8a3a\u3002\u300c\u904e\u53bb\u4e00\u76f4\u4ee5\u70ba\uff0c\u9280\u5c51\u75c5\u4eba\u56e0\u70ba\u76ae\u819a\u5916\u8868\u53d7\u5f71\u97ff\uff0c\u5c0e\u81f4\u6291\u9b31\uff0c\u60a3\u8005\u96b1\u85cf\u81ea\u5df1\u800c\u4e0d\u53bb\u6b63\u8996\u75c5\u60c5\uff1b\u4f46\u65b0\u7684\u7814\u7a76\u767c\u73fe\uff0c\u9280\u5c51\u75c5\u6703\u5f71\u97ff\u8166\u90e8\uff0c\u56e0\u800c\u51fa\u73fe\u6291\u9b31\u3002\u300d\u9664\u4e86\u6291\u9b31\uff0c\u8fd1\u5e74\u767c\u73fe\u9280\u5c51\u75c5\u6709\u4e0d\u5c11\u300c\u5171\u75c5\u300d\uff0c\u5982\u6307\u708e\u3001\u8679\u819c\u708e\u3001\u8840\u7ba1\u75c5\u8b8a\u7b49\uff0c\u300c\u8aa4\u5c0e\u300d\u75c5\u4eba\u548c\u91ab\u751f\uff0c\u56e0\u800c\u5ef6\u8aa4\u8a3a\u65b7\u548c\u6cbb\u7642\u3002<\/p>\n

\u9280\u5c51\u75c5\u8207\u514d\u75ab\u529b\u5931\u8abf\u6709\u95dc\uff0c\u7121\u6cd5\u6839\u6cbb\u3002\u4f46\u4f59\u5609\u9f8d\u88dc\u5145\uff0c\u73fe\u6642\u85e5\u7269\u6210\u6548\u4ea6\u4e0d\u65b7\u63d0\u9ad8\uff0c\u9664\u4e86\u6709\u50b3\u7d71\u7684\u514d\u75ab\u7cfb\u7d71\u8abf\u7bc0\u85e5\u7269\uff0c\u73fe\u6642\u6700\u6709\u6548\u662f\u4f7f\u7528\u751f\u7269\u88fd\u5291\u3002\u300c\u7d04\u5341\u591a\u5e74\u524d\u4fbf\u6709\u751f\u7269\u88fd\u5291\u6297\u816b\u7624\u58de\u6b7b\u56e0\u5b50\uff08anti-TNF\uff09\u3002\u8fd1\u5e74\u7814\u7a76\u767c\u73fe\uff0c\u63a7\u5236\u767d\u7d30\u80de\u4ecb\u7d20IL12\u3001IL23\u3001IL17\u6578\u91cf\uff0c\u53ef\u6e1b\u4f4e\u514d\u75ab\u7cfb\u7d71\u5c0d\u8eab\u9ad4\u7684\u653b\u64ca\uff0c\u6240\u4ee5\u65b0\u7684\u751f\u7269\u88fd\u5291\u90fd\u6703\u91dd\u5c0d\u6291\u5236\u767d\u7d30\u80de\u4ecb\u7d20\uff0c\u6e1b\u8f15\u767c\u708e\uff0c\u540c\u6642\u6e1b\u4f4e\u5176\u4ed6\u4f75\u767c\u75c7\u7684\u53ef\u80fd\u6027\u3002\u300d<\/p>\n

\u4ee5\u4e0a\u8ff040\u6b72\u75c5\u4eba\u70ba\u4f8b\uff0c\u7531\u65bc\u5979\u75c5\u767c\u901f\u5ea6\u8f03\u5feb\uff0c\u6240\u4ee5\u4f59\u5609\u9f8d\u6c7a\u5b9a\u4f7f\u7528\u8d77\u6548\u8f03\u5feb\u7684\u751f\u7269\u88fd\u5291\uff0c\u300c\u50b3\u7d71\u514d\u75ab\u7cfb\u7d71\u8abf\u7bc0\u85e5\u7269\uff0c\u8981\u5169\u500b\u6708\u624d\u8d77\u6548\uff0c\u800c\u751f\u7269\u88fd\u5291\u4e00\u822c\u53ef\u5728\u5169\u500b\u661f\u671f\u767c\u63ee\u4f5c\u7528\uff0c\u9019\u500b\u75c5\u4eba\u7528\u85e5\u7d04\u5169\u5468\u4e4b\u5f8c\uff0c\u53ef\u4ee5\u6162\u6162\u884c\u8def\uff1b\u4e00\u500b\u6708\u5f8c\u53ef\u6b63\u5e38\u884c\u8d70\uff0c\u4e09\u500b\u6708\u5f8c\u76ae\u75b9\u5168\u90e8\u6d88\u5931\u3002\u6b64\u6642\u4fbf\u505c\u6b62\u6ce8\u5c04\u751f\u7269\u88fd\u5291\uff0c\u6539\u7528\u50b3\u7d71\u53e3\u670d\u85e5\uff0c\u81f3\u4eca\u6c92\u6709\u5fa9\u767c\u300d\u3002<\/p>\n

\u6587\uff1a\u52de\u8000\u5168<\/p>\n

\u5716\uff1a\u937e\u6797\u679d\u3001\u53d7\u8a2a\u8005\u63d0\u4f9b<\/p>\n

\u7de8\u8f2f\uff1a\u738b\u7fe0\u9e97<\/p>\n<\/p>\n

https:\/\/video3.mingpao.com\/201612\/HET20161213_01.mp4\u9280\u5c51\u75c5\u4e0d\u6703\u50b3\u67d3;https:\/\/video3.mingpao.com\/201612\/HET20161213_02.mp4\u9280\u5c51\u75c5\u5fb5\u72c0;https:\/\/video3.mingpao.com\/201612\/HET20161213_03.mp4\u9280\u5c51\u75c5 \u773c\u775b \u60c5\u7dd2\u4e00\u540c\u767c\u75c5;https:\/\/video3.mingpao.com\/201612\/HET20161213_04.mp4\u8ab0\u4eba\u9069\u7528\u751f\u7269\u88fd\u5291\uff1f;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170116\/news\/_16ya101.jpg\uff08\u5716\uff1a\u937e\u6797\u679d\uff09;<\/inline><\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】不少人都有腰痛、膝痛、手指關節痛等「小毛病」，覺得是小事而忽略，休息一下就會康復，但沒想過可能是其他疾病的「警號」。<\/p>\n

銀屑病，俗稱牛皮癬，看似是皮膚問題，但近年愈來愈多研究發現，患者同時出現多種共病纏身，關節疼痛、心血管疾病、抑鬱、虹膜炎等。因此不要忽略這些「警號」，及早求醫以全面控制病情。<\/p>\n

一名年約40歲的女傳道人，每日需要步行三層樓梯回教堂工作，患上銀屑病。風濕病科專科醫生余嘉龍指出，「她病發了數月，九成皮膚受影響，有紅、增厚、脫皮等徵狀，受影響範圍極大。另外，因腳跟和膝關節亦受影響，需要輪椅代步」。當她來求診時，不停地哭，有抑鬱徵狀，不願意上班。<\/p>\n

另一名老婆婆病人，因為膝痛向骨科求診，以為是勞損退化需要更換關節。然而，因為病情惡化速度快，不似是一般關節退化，引來醫生懷疑；再經詳細檢查才發現是銀屑病關節炎。<\/p>\n

發病高峰：20-30歲及50-60歲<\/p>\n

銀屑病在全球的發病率為2%。余嘉龍指出，香港的發病率則約為0.3%至0.6%，而發病年齡通常分兩個高峰期，最多為20至30歲之間，這個年紀病發與遺傳因素有較大關係；另一個是50至60歲，多是後天因素激發所致。銀屑病早期徵狀，七成人皮膚有脫皮情况，「但亦有三成患者的關節、筋腱首先受到攻擊，增加診斷困難」。<\/p>\n

生物製劑有效紓緩急性發作<\/p>\n

雖然數據顯示，銀屑病在香港的發病率較低，但余嘉龍認為數據未完全反映問題的嚴重性，因為不少病人逃避求診。「過去一直以為，銀屑病人因為皮膚外表受影響，導致抑鬱，患者隱藏自己而不去正視病情；但新的研究發現，銀屑病會影響腦部，因而出現抑鬱。」除了抑鬱，近年發現銀屑病有不少「共病」，如指炎、虹膜炎、血管病變等，「誤導」病人和醫生，因而延誤診斷和治療。<\/p>\n

銀屑病與免疫力失調有關，無法根治。但余嘉龍補充，現時藥物成效亦不斷提高，除了有傳統的免疫系統調節藥物，現時最有效是使用生物製劑。「約十多年前便有生物製劑抗腫瘤壞死因子（anti-TNF）。近年研究發現，控制白細胞介素IL12、IL23、IL17數量，可減低免疫系統對身體的攻擊，所以新的生物製劑都會針對抑制白細胞介素，減輕發炎，同時減低其他併發症的可能性。」<\/p>\n

以上述40歲病人為例，由於她病發速度較快，所以余嘉龍決定使用起效較快的生物製劑，「傳統免疫系統調節藥物，要兩個月才起效，而生物製劑一般可在兩個星期發揮作用，這個病人用藥約兩周之後，可以慢慢行路；一個月後可正常行走，三個月後皮疹全部消失。此時便停止注射生物製劑，改用傳統口服藥，至今沒有復發」。<\/p>\n

文：勞耀全<\/p>\n

圖：鍾林枝、受訪者提供<\/p>\n

編輯：王翠麗<\/p>\n

■有片睇<\/p>\n

想現場直擊家庭醫生睇醫生，可登入 www.mingpaohealth.com\/doc.htm<\/a><\/p>\n

https:\/\/video3.mingpao.com\/201612\/HET20161213_01.mp4銀屑病不會傳染;https:\/\/video3.mingpao.com\/201612\/HET20161213_02.mp4銀屑病徵狀;https:\/\/video3.mingpao.com\/201612\/HET20161213_03.mp4銀屑病 眼睛 情緒一同發病;https:\/\/video3.mingpao.com\/201612\/HET20161213_04.mp4誰人適用生物製劑？;https:\/\/health2.mingpao.com\/ftp\/Health2\/20170116\/news\/_16ya101.jpg（圖：鍾林枝）;<\/inline><\/p>\n","protected":false},"author":2,"featured_media":9777,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_lock_modified_date":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[3],"tags":[1476,1163,316,169,1088],"class_list":["post-7739","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-3","tag-video","tag-1163","tag-316","tag-169","tag-1088"],"publishpress_future_action":{"enabled":false,"date":"2026-11-22 08:49:32","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/7739"}],"collection":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/comments?post=7739"}],"version-history":[{"count":0,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/7739\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media\/9777"}],"wp:attachment":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media?parent=7739"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/categories?post=7739"},{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/tags?post=7739"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}