10 Findings That Contradict Medical Wisdom. Doctors, Take Note.
你应该了解的十大医学误区

You might assume that standard medical advice was supported by mounds of scientific research. But researchers recently discovered that nearly 400 routine practices were flatly contradicted by studies published in leading journals.

你可能会以为标准的医疗建议有大量科学研究做支撑。但研究人员近来却发现，近400项常规实践完全与发表在顶级期刊上的研究相矛盾。

Of more than 3,000 studies published from 2003 through 2017 in JAMA and the Lancet, and from 2011 through 2017 in the New England Journal of Medicine, more than one of 10 amounted to a “medical reversal”: a conclusion opposite of what had been conventional wisdom among doctors.

在2003年到2017年发表在《美国医学会杂志》(JAMA)和《柳叶刀》(The Lancet)杂志，以及2011年到2017年发表在《新英格兰医学杂志》(The New England Journal of Medicine)上的3000多项研究中，超过十分之一构成是“医疗逆转”：一项结论与医生的普遍认知相反的现象。

“You come away with a sense of humility,” said Dr. Vinay Prasad of Oregon Health and Science University, who conceived of the study. “Very smart and well-intentioned people came to practice these things for many, many years. But they were wrong.”

“你到头来会有一种羞愧的感觉，”这项研究的构想者、俄勒冈健康与科学大学(Oregon Health and Science University)的维奈·普拉萨德(Vinay Prasad)说。“多少年来，一些怀着好心的聪明人一直在这么做。但他们是错的。”

Some of those ideas have been firmly dislodged, but not all. Now Dr. Prasad and his colleagues are trying to learn how widespread are discredited practices and ideas.

这些理念中的一部分已被坚决摒弃，但不是全部。普拉萨德和他的同事目前正设法了解不可信的实践和理念有多普遍。

Here are 10 findings that contradict what were once widely held theories.

以下是10项与人们一度普遍持有的理论相悖的发现。

Peanut allergies occur whether or not a child is exposed to peanuts before age 3.

无论儿童是否在3岁前食用过花生，花生过敏问题都会发生。

Pediatricians have counseled parents to keep babies away from peanuts for the first three years of life. As it turns out, children exposed to peanuts before they were even 1 year old have no greater risk of peanut allergies.

儿科医生一直建议父母们不要让宝宝在3岁前食用花生。结果发现，即便1岁前食用过花生的儿童发生花生过敏的几率也并不会更大。

Fish oil does not reduce the risk of heart disease.

鱼油不会降低心脏病风险。

At one point, the notion that fish fats prevented heart trouble did seem logical. People whose diets contain a lot of fatty fish seem to have a lower incidence of heart disease. Fatty fish contains omega-3 fatty acids. Omega-3 supplements lower levels of triglycerides, and high levels of triglycerides are linked to an increased risk of heart disease. Not to mention that omega-3 fatty acids seem to reduce inflammation, a key feature of heart attacks.

鱼的脂肪有助于预防心脏问题的理念曾一度看似符合逻辑。饮食中包含大量多脂鱼的人患有心脏病的几率似乎更低。多脂鱼含有ω-3脂肪酸。ω-3补充剂可降低甘油三酯水平，而甘油三酯水平偏高与心脏病风险增大有关。更不用说，ω-3脂肪酸似乎可以减轻炎症这一心脏病发作的关键特征。

But in a trial involving 12,500 people at risk for heart trouble, daily omega-3 supplements did not protect against heart disease.

但涉及1.25万有患心脏病风险者的一项试验发现，每天服用ω-3补充剂没能预防心脏病。

A lifelike doll carried around by teenage girls will not deter pregnancies.

少女背仿真娃娃不会防止怀孕。

These dolls wail and need to be “changed” and “cuddled.” The idea was that girls would learn how much work was involved in caring for an infant. But a randomized study found that girls who were told to carry around “infant simulators” actually were slightly more likely to become pregnant than girls who did not get the dolls.

这些玩偶会哭嚎，需要给“换尿布”还要“抱抱”。这种想法认为，这样女孩们就能了解照顾婴儿需要做多少事情。但一项随机研究发现，被要求随身携带“模拟婴儿”的女孩，怀孕几率事实上比没有这些玩偶的女孩稍高一些。

Ginkgo biloba does not protect against memory loss and dementia.

银杏制品不会预防记忆减退和痴呆症。

The supplement, made from the leaves of ginkgo trees, was widely used in ancient Chinese medicine and still is promoted as a way to preserve memory. A large federal study, published in 2008, definitively showed the supplement is useless for this purpose. Yet ginkgo still pulls in $249 million in sales. Did people just not get the message?

这类用银杏叶制作的补充剂在古代中医中使用很普遍，如今仍作为保护记忆力的一种方式推广。2008年发表的一项大型联邦调查明确显示，这种补充剂起不到这样的作用。但银杏依然拉动着2.49亿美元的销售。人们难道还没明白吗？

To treat emergency room patients in acute pain, a single dose of oral opioids is no better than drugs like aspirin and ibuprofen.

在急救室医治急性疼痛患者时，一剂口服阿片类药物并不比阿斯匹林和布洛芬这类药好。

Yes, opioids are powerful drugs. But a clinical trial showed that much safer alternatives relieve pain just as well among emergency room patients.

的确，阿片类药物药效很强。但一项临床试验显示，对于急诊室患者，减轻疼痛尚有更安全且药效相当的替代选择。

Testosterone treatment does not help older men retain their memory.

睾丸酮治疗无助于年长男性保持记忆力。

Some men have low levels of testosterone and memory problems, and early studies had hinted that middle-aged men with higher testosterone levels seemed to have better preserved tissue in some parts of their brains. Older men with higher testosterone levels also seemed to do better on tests of mental functioning.

一些男性睾丸酮水平低，并有记忆问题，早期研究有迹象表明，睾丸酮水平较高的中年男性大脑部分区域的组织似乎保护得更好。睾丸酮水平较高的年长男性在心理功能测试中表现似乎也更好。

But a rigorous clinical trial showed that testosterone was no better than a sugar pill in helping older men avoid memory loss.

但一项严格的临床试验显示，在帮助年长男性避免记忆减退方面，睾丸酮并不比一粒糖片效果好。

To protect against asthma attacks, it won’t help to keep your house free of dust mites, mice and cockroaches.

让房间远离尘螨、老鼠和蟑螂无助于防止哮喘发作。

The advice from leading medical groups has been to rid your home of these pests if you or your child has asthma. The theory was that allergic reactions to them can trigger asthma attacks. But intensive pest management in homes with children sensitized to mouse allergens did nothing to reduce the frequency of their asthma attacks, researchers reported in 2017.

如果您或孩子有哮喘，一流医疗组织的建议一直是去除房间里的这些害虫。其理论是对它们的过敏反应可能会导致哮喘发作。但研究人员2017年报告称，家中有儿童对鼠类过敏原较为敏感的，进行密集的害虫管理对于减轻他们的哮喘发作毫无作用。

Step counters and calorie trackers do not help you lose weight.

计步器和卡路里追踪器对减肥没有帮助。

In fact, dieters may be better off without digital assistance. Among 470 dieters followed for two years, those who wore devices tracking the steps they took and calories they burned actually lost less weight than those who just followed standard advice.

事实上，节食者没有数字设备帮助可能反而更好。在对470名节食者跟踪两年后发现，比起只遵循标准建议的人，随身携带步数和卡路里追踪设备的人事实上减掉的重量更少。

Torn knee meniscus? Try physical therapy first, surgery later.

膝盖半月板撕裂？先尝试物理疗法，再去做手术。

An estimated 460,000 patients in the United States get surgery each year to fix knee cartilage that tears, often because of osteoarthritis. The tear is painful, and many patients fear that if it is not surgically treated, the pain will linger.

美国每年估计有46万名患者通过手术修复常因骨关节炎撕裂的膝盖软骨。撕裂很疼痛，许多患者担心如不接受手术治疗，痛感会一直持续下去。

But when patients with a torn meniscus and moderate arthritis were randomized to six months of physical therapy or surgery, both groups improved, and to the same extent.

但在让半月板撕裂和轻度关节炎患者随机接受六个月的物理疗法或手术治疗后发现，两组患者病情都有好转，好转的程度也一样。

If a pregnant woman’s water breaks prematurely, the baby does not have to be delivered immediately.

如果孕妇的羊水提前破了，不需要非得立即分娩。

Sometimes, a few weeks before a woman’s due date, the membrane surrounding her fetus ruptures and amniotic fluid spills out. Obstetricians worried that bacteria could invade what had been a sterile environment around the fetus, causing infection. Better to deliver the baby immediately, doctors thought.

有时，在预产期几周前，胎膜会破裂，羊水会随之突然溢出。产科医生担心细菌可能会入侵胎儿周围一直以来的无菌环境，从而导致感染。医生以为最好要立刻生下婴儿。

But a clinical trial found that if obstetricians carefully monitor the fetus while waiting for labor to begin naturally, the fetus is at no greater risk for infection. And newborns left to gestate were healthier, with less respiratory distress and a lower risk of death, than those who were delivered immediately after a break.