Essentials: Control Pain & Heal Faster With Your Brain
This transcript is not final and may contain errors.
本成绩单并非最终版本，可能包含错误。
A final, human-proofread version will be available soon.
经过人工校对的最终版本很快就会发布。
Andrew Huberman: Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science based tools for mental health, physical health, and performance.
安德鲁·胡伯曼（Andrew Huberman）：欢迎来到胡伯曼实验室要点，在这里我们回顾过去的剧集，寻找针对心理健康、身体健康和表现的最有效、最可操作的基于科学的工具。
I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology.
我是安德鲁·胡伯曼，是一名神经生物学和眼科教授。
at Stanford school of medicine.
在斯坦福大学医学院。
Let's continue our discussion about neuroplasticity, this incredible feature of our nervous system that allows it to change itself in response to experience.
让我们继续讨论神经可塑性，神经系统的这一令人难以置信的特征使其能够根据经验而改变自身。
And even in ways that we consciously and deliberately decide to change it.
甚至我们有意识地、有意地决定改变它。
Most people don't know how to access neuroplasticity.
大多数人不知道如何获得神经可塑性。
And so that's what this entire month of the Huberman lab podcast has been about.
这就是休伯曼实验室播客整个月的内容。
We've explored neuroplasticity from a variety of different perspectives, We talked about representational plasticity.
我们从各种不同的角度探讨了神经可塑性，我们讨论了表征可塑性。
We talked about the importance of focus and reward.
我们讨论了专注和奖励的重要性。
We talked about this amazing and somewhat surprising aspect of the vestibular system, how altering our relationship to gravity.
我们讨论了前庭系统这个令人惊奇且有些令人惊讶的方面，如何改变我们与重力的关系。
And in addition to that, making errors as we try and learn can open up windows to plasticity, but we have not really talked so much about directing the plasticity toward particular Thus far, we really haven't talked yet about how to undo things that we don't want.
除此之外，在我们尝试和学习的过程中犯错误可以打开可塑性的窗口，但我们还没有真正讨论过如何将可塑性引向特定的方向。到目前为止，我们实际上还没有讨论如何撤消我们不想要的事情。
And so today we are going to explore that aspect of neuroplasticity and we are going to do that in the context of a very important and somewhat sensitive topic, which is pain and in some cases injury to the nervous system.
因此，今天我们将探讨神经可塑性的这一方面，我们将在一个非常重要且有些敏感的主题的背景下进行探讨，即疼痛以及在某些情况下对神经系统的伤害。
We, as always here on this podcast are going to discuss some of the science we get into mechanism, but we also Really get at principles.
一如既往，我们在这个播客中将讨论我们所涉及的一些机制科学，但我们也真正了解原理。
Principles are far more important than any one experiment or one description of mechanism and certainly far more important than any one protocol because principles allow you to think about your nervous system and work with it in ways that best serve you.
原则比任何一项实验或一种机制描述都重要得多，当然也比任何一项协议都重要得多，因为原则允许您思考您的神经系统并以最适合您的方式使用它。
So let's start our discussion about pain and the somatosensory system.
那么让我们开始讨论疼痛和体感系统。
The somatosensory system is as the name implies involved in understanding touch.
顾名思义，体感系统参与理解触觉。
Physical feeling on our body and the simplest way to think about the somatosensory system is that we have little sensors and those sensors come in the form of neurons, nerve cells that reside in our skin and in the deeper layers below the skin.
我们身体上的物理感觉以及思考体感系统的最简单方法是，我们几乎没有传感器，而这些传感器以神经元的形式出现，这些神经细胞驻留在我们的皮肤和皮肤下方的深层中。
We have some that correspond to and we should say respond to mechanical touch.
我们有一些对应于机械触摸，我们应该说对机械触摸做出反应。
So, you know, pressure on the top of my hand or a pinpoint or other sensors, for instance, respond to heat, to cold.
所以，你知道，我的手顶或针尖或其他传感器上的压力，例如，对热、冷做出反应。
Some respond to vibration with a huge number of different receptors in our skin.
有些通过我们皮肤中大量不同的受体对振动做出反应。
And they respond Take that information and send it down those wires that we call axons in the form of electrical signals to our spinal cord and then up to the brain and within the spinal cord in brain, we have centers that interpret that information that actually makes sense of those electrical signals.
他们做出反应 获取该信息并将其以电信号的形式沿着我们称为轴突的电线发送到我们的脊髓，然后到达大脑，在大脑的脊髓内，我们有解释该信息的中心，这些中心实际上可以理解这些电信号。
And this is amazing because none of those sensors has a different unique form of information that it uses.
这是令人惊奇的，因为这些传感器都没有使用不同的独特形式的信息。
It just sends electrical potentials into the nervous system pain.
它只是将电势发送到神经系统疼痛中。
And the sensation of pain is incredible.
疼痛的感觉令人难以置信。
Believe it or not a controversial word in the neuroscience field.
不管你信不信，这在神经科学领域是一个有争议的词。
People prefer to use the word nociception.
人们更喜欢使用“伤害感受”这个词。
Nociceptors are the sensors in the skin that detect particular types of stimuli.
伤害感受器是皮肤中检测特定类型刺激的传感器。
It actually comes from the Latin word nocera, which means to harm.
它实际上来自拉丁语nocera，意思是伤害。
And why would neuroscientists not want to talk about pain?
为什么神经科学家不想谈论疼痛？
Well, it's very subjective.
嗯，这是非常主观的。
It has a A mental component and a physical component, we cannot say that pain is simply an attempt to avoid physical harm to the body.
它有精神成分和身体成分，我们不能说疼痛只是为了避免对身体造成身体伤害。
And here's why they actually can be dissociated from one another.
这就是为什么它们实际上可以彼此分离。
And there's a famous case that was published in the British Journal of Medicine, where a construction worker I think he fell is how the story went.
《英国医学杂志》上发表了一个著名的案例，故事的经过是一名建筑工人摔倒了。
And a 14 inch nail went through his boot and up through the boot.
一根 14 英寸的钉子穿过他的靴子，向上穿过靴子。
And he was in excruciating pain just beyond anything he'd experienced.
而他所承受的痛苦是他从未经历过的。
He, he reported that he couldn't even move in any dimension, even a tiny bit without feeling excruciating pain.
他，他报告说，他甚至无法在任何维度移动，哪怕是一点点，都会感到剧烈的疼痛。
They brought him to the hospital.
他们把他带到医院。
into the clinic, into the hospital, they were able to cut away the boot and they realized that the nail had gone between two toes and it had actually not impaled the skin at all.
走进诊所，走进医院，他们把靴子切掉，发现钉子已经进入两个脚趾之间，实际上根本没有刺穿皮肤。
His visual image of the nail going through his boot gave him the feeling, the legitimate feeling that he was experiencing the pain of a nail going through his foot, which is incredible because it speaks to the power of the mind in this pain scenario.
钉子穿过靴子的视觉形象给了他一种感觉，一种合法的感觉，他正在经历钉子穿过脚的疼痛，这是令人难以置信的，因为它说明了在这种疼痛场景中心灵的力量。
And it also speaks to the power of the specificity.
这也说明了特异性的力量。
It's not like he thought that his foot was on fire.
他并不认为自己的脚着火了。
He thought because he saw a nail going through his foot, it was going through his boot, but he thought it was going through his foot that.
他想，因为他看到一颗钉子穿过他的脚，所以它正在穿过他的靴子，但他认为那是穿过他的脚。
It was sharp pain of the sort that a nail would produce.
这是钉子所产生的那种剧痛。
It really speaks to the incredible capacity that these top down, these, you know, higher level cognitive functions have in interpreting what we're experiencing out in the periphery, even just on the basis of what we see.
这确实说明了这些自上而下的、更高层次的认知功能在解释我们在外围经历的事情方面具有令人难以置信的能力，甚至只是基于我们所看到的。
So why are we talking about pain during a month on?
那么为什么我们要谈论一个月内的疼痛呢？
Neuroplasticity.
神经可塑性。
Well, it turns out that the pain system offers us a number of different principles that we can leverage to a ensure that if we are ever injured, we are able to understand the difference between injury and pain because there is a difference that if we're ever in pain, that we can understand the difference between injury and pain, that we will be able to interpret our pain.
事实证明，疼痛系统为我们提供了许多不同的原则，我们可以利用这些原则来确保如果我们受伤了，我们能够理解受伤和疼痛之间的区别，因为如果我们曾经感到疼痛，我们可以理解受伤和疼痛之间的区别，我们将能够解释我们的疼痛。
And during the course of today's podcast, I'm going to cover protocols that help eliminate pain from both ends.
在今天的播客中，我将介绍有助于消除两端痛苦的协议。
Ends of the spectrum from the periphery at the level of the injury and through these top down mental mechanisms, believe it or not, we're going to talk about love.
无论你相信与否，从伤害的外围到这些自上而下的心理机制，我们将谈论爱。
A colleague of mine at Stanford who runs a major pain clinic, um, is.
我在斯坦福大学的一位同事经营着一家大型疼痛诊所，嗯，是的。
Working on and has published quality peer reviewed data on the role of love in modulating the pain response.
致力于研究并发表了关于爱在调节疼痛反应中的作用的高质量同行评审数据。
So what we're talking about today is plasticity of perception, which has direct bearing on emotional pain and has direct bearing on trauma.
所以我们今天要讲的是感知的可塑性，它与情绪痛苦有直接关系，也与创伤有直接关系。
So let's get started in thinking about what happens.
那么让我们开始思考会发生什么。
With pain and I will tell you just now that there is a mutation, a genetic mutation in a particular sodium channel.
伴随着痛苦，我刚才会告诉你，有一个突变，一个特定钠通道的基因突变。
A sodium channel is one of these little holes in neurons that allows them to fire action potentials.
钠通道是神经元中的这些小孔之一，使神经元能够激发动作电位。
It's important to the function of the neuron.
它对神经元的功能很重要。
It's also important for the development of certain neurons.
它对于某些神经元的发育也很重要。
And there's a particular mutation.
并且有一个特殊的突变。
There are kids that are born without this sodium channel 1.
有些孩子出生时就没有这种钠通道 1。
7.
7.
If you want to look it up, those kids experienced no pain.
如果你想查一下，那些孩子没有经历任何痛苦。
No pain whatsoever.
没有任何疼痛。
And it is a terrible situation.
这是一个可怕的情况。
Um, they don't tend to live very long due to accidents.
嗯，由于事故，他们往往活不了多久。
It's a really terrible and unfortunate circumstance.
这是一个非常可怕和不幸的情况。
In fact, it's reasonable to speculate that one of the reasons, not all, but one of the reasons why people might differ in their sensitivity to pain is by way of genetic variation.
事实上，可以合理地推测，人们对疼痛的敏感度可能不同的原因之一（不是全部）是基因变异。
And how many of these sorts of receptors that they express people who make too much of this receptor.
产生过多这种受体的人表达了多少种此类受体。
Experience extreme pain from even subtle stimuli.
即使是细微的刺激也会感到极度疼痛。
So let's talk about some of the features of how we're built physically and how that relates to pain and how we can recover from injury.
那么，让我们来谈谈我们身体构造的一些特征，以及它们与疼痛的关系，以及我们如何从伤害中恢复。
I'd like to take a quick break and thank our sponsor, Eight Sleep.
我想稍微休息一下，并感谢我们的赞助商“八睡”。
Eight Sleep makes smart mattress covers with cooling, heating, and sleep tracking capacity.
August Sleep 生产具有冷却、加热和睡眠跟踪功能的智能床垫套。
Now, I've spoken before on this podcast about the critical need for us to get adequate amounts of quality sleep each night.
现在，我之前在这个播客上谈到过我们迫切需要每晚获得充足的优质睡眠。
Now, one of the best ways to ensure a great night's sleep is to ensure that the temperature of your sleeping environment is correct.
现在，确保一夜好眠的最佳方法之一是确保睡眠环境的温度正确。
And that's because in order to fall and stay deeply asleep, your body temperature actually has to drop by about one to three degrees.
这是因为为了入睡并保持深度睡眠，您的体温实际上必须下降约一到三度。
And in order to wake up feeling refreshed and energized, your body temperature actually has to increase about one to three degrees.
为了醒来时感到神清气爽、精力充沛，您的体温实际上必须升高约一到三度。
H Sleep makes it very easy to control the temperature of your sleeping environment by allowing you to program the temperature of your mattress cover at the beginning, middle, and end of the night.
H Sleep 允许您在夜间开始、中间和结束时对床垫套的温度进行编程，从而轻松控制睡眠环境的温度。
I've been sleeping on an 8Sleep mattress cover for nearly 4 years now, and it has completely transformed and improved the quality of my sleep.
我已经睡在 8Sleep 床垫罩上近 4 年了，它彻底改变并改善了我的睡眠质量。
8Sleep recently launched their newest generation of the pod cover, called the Pod 4 Ultra.
8Sleep 最近推出了最新一代的 Pod 保护套，称为 Pod 4 Ultra。
The Pod 4 Ultra has improved cooling and heating capacity.
Pod 4 Ultra 改进了制冷和制热能力。
I find that very useful because I like to make the bed really cool at the beginning of the night, even colder in the middle of the night.
我发现这非常有用，因为我喜欢让床在半夜变得非常凉爽，甚至在半夜变得更冷。
And warm as I wake up, that's what gives me the most slow wave sleep and rapid eye movement sleep.
当我醒来时温暖，这就是给我最慢波睡眠和快速眼动睡眠的原因。
It also has a snoring detection that will automatically lift your head a few degrees to improve your airflow and stop your snoring.
它还具有打鼾检测功能，可以自动将您的头部抬起几度，以改善气流并停止打鼾。
If you'd like to try an eight sleep mattress cover, go to eight sleep.
如果您想尝试八人睡眠床垫套，请选择八人睡眠。
com slash Huberman to save up to 350 off their pod for ultra eight sleep currently ships in the USA, Canada, UK, select countries in the EU and Australia.
com 大幅削减 Huberman 的折扣，为超八睡眠舱节省高达 350 美元，目前在美国、加拿大、英国、欧盟和澳大利亚的部分国家发货。
Again, that's eight sleep.
再说一遍，这是八点睡眠。
com slash Huberman.
com 斜线休伯曼。
So first of all, We have maps of our body surface in our brain.
首先，我们的大脑中有身体表面的地图。
It's called a homunculus.
它被称为人造人。
That representation is scaled in a way that matches sensitivity.
该表示以与灵敏度相匹配的方式缩放。
So the areas of your body that are most sensitive have a lot more brain real estate devoted to them.
因此，你身体最敏感的区域有更多的大脑空间专门用于它们。
Your back is an enormous piece of tissue compared to your fingertip, but your back has fewer receptors devoted to it.
与指尖相比，您的背部是一块巨大的组织，但您的背部专门用于其的感受器较少。
And the representation of your back in your brain is actually pretty small.
而你的背部在大脑中的代表实际上非常小。
Whereas the representation of your finger is enormous.
而你的手指的代表是巨大的。
So how big a brain area is devoted to a given body part is directly related to the density of receptors in that body part, not the size of the body part.
因此，特定身体部位的大脑区域有多大，与该身体部位的受体密度直接相关，而不是与身体部位的大小直接相关。
You can actually know how sensitive a given body part is and how much brain area is devoted to it through what's called two point discrimination.
通过所谓的两点辨别，您实际上可以知道特定身体部位的敏感度以及有多少大脑区域专门用于该部位。
You can do this experiment if you want.
如果你愿意的话，你可以做这个实验。
I think I've described this once or twice before, but basically if you have someone put, um, maybe take two pens and.
我想我之前已经描述过这一点一两次，但基本上，如果你有人放，嗯，也许拿两支笔。
put them maybe six inches apart on your back and, and touch while you're facing away.
将它们放在您的背上，相距大约六英寸，然后在您背向另一侧时触摸。
And you, they'll ask you how many points they're touching you and you say, um, two, but if they move those closer together, say three inches, you're likely to experience it as one point of contact.
而你，他们会问你他们接触了你多少个点，你说，嗯，两个，但如果他们将这些点移得更近，比如说三英寸，你可能会体验到它作为一个接触点。
Whereas on your finger, you could do that, play that game all day.
而在你的手指上，你就可以做到这一点，玩一整天的游戏。
And as long as there's a millimeter or so spacing, you will know that it's two points as opposed to one.
只要有一毫米左右的间距，你就会知道这是两个点而不是一个点。
And that's because there's more pixels, more density of receptors.
那是因为像素更多，受体密度更高。
This has direct bearing to pain because it says that areas of the body that have denser receptors are going to be more sensitive to pain than to others.
这与疼痛有直接关系，因为它表明身体上具有更密集受体的区域对疼痛比其他区域更敏感。
So, just as a rule of thumb, areas of your body that are injured, that are large areas that have low sensitivity before injury, likely are going to experience less pain.
因此，根据经验，身体受伤的区域（受伤前敏感性较低的大面积区域）可能会经历较少的疼痛。
And the literature shows will heal more slowly because they don't have as many cells around to produce inflammation.
文献显示愈合速度会更慢，因为周围没有那么多细胞来产生炎症。
And you might say, wait, I thought inflammation is bad.
你可能会说，等等，我认为炎症是不好的。
Well, one of the things I really want to get across today is that inflammation is not bad.
嗯，我今天真正想了解的一件事是炎症并不坏。
Inflammation out of control is bad, but inflammation is wonderful.
炎症失控固然不好，但炎症却是美妙的。
Inflammation is the tissue repair response.
炎症是组织修复反应。
I thought it might be a nice time to just think about.
我想这可能是一个思考的好时机。
The relationship between the periphery and the central maps in a way that many of you have probably heard about before, which will frame the discussion a little bit better, which is phantom limb pain.
外围和中心之间的关系以你们许多人之前可能听说过的方式映射，这将使讨论更好一些，这就是幻肢痛。
Now, some of you are probably familiar with this, but for people that have an arm or a leg or a finger or some other portion of their body amputated.
现在，你们中的一些人可能对此很熟悉，但对于那些手臂、腿、手指或身体其他部位被截肢的人来说。
It's not uncommon for those people to feel as if they still have that limb or appendage or piece of their body intact.
对于这些人来说，感觉他们的肢体、附肢或身体的一部分仍然完好无损，这种情况并不少见。
And typically, unfortunately, the sensation of that limb is not one of the limb being nice and relaxed and, and, you know, and just there, the sensation is that the limb is experiencing pain.
不幸的是，通常情况下，该肢体的感觉并不是肢体的良好和放松，而且，你知道，就在那里，感觉是肢体正在经历疼痛。
Pain or is contorted in the specific orientation that it was around the time of the injury.
疼痛或在受伤时的特定方向上扭曲。
So if someone has a, you know, blunt force to the hand and they end up having their hand amputated, typically they will continue to feel pain in their phantom hand, which is pretty wild.
因此，如果某人的手受到钝器的作用而最终导致手被截肢，通常他们的幻手会继续感到疼痛，这是非常疯狂的。
And that's because the representation of that hand is still intact in the cortex, in the brain.
那是因为那只手的表征在大脑皮层中仍然完好无损。
And it's, you know, trying to balance its levels of activity.
你知道，它正在试图平衡其活动水平。
Normally it's getting what's called proprioceptive feedback.
通常它会得到所谓的本体反馈。
Proprioception is just our knowledge of where our limbs are in space.
本体感觉只是我们对四肢在空间中位置的了解。
It's an extremely important aspect of our somatosensory system, and there's no proprioceptive feedback.
这是我们体感系统极其重要的一个方面，并且没有本体感觉反馈。
And so a lot of the circuits start to ramp up their levels of activity and they become very conscious of the phantom limb.
因此，许多回路开始提高其活动水平，并且它们对幻肢变得非常敏感。
Now, um, before my lab was at UC San Diego.
现在，嗯，在我的实验室在加州大学圣地亚哥分校之前。
And when my colleagues was a guy, everyone just calls him by his last name, Ramachandran, who is famous for understanding this phantom limb phenomenon and developing a very simple but very powerful solution to it that speaks to the incredible capacity of top down modulation and top down modulation, the ability to use one's brain cognition and senses to control pain in the body is something that Everyone, not just people missing limbs or in chronic pain could learn to benefit from, because it is a way to tap into the, our ability to use our mind to control perceptions of what's happening in our body.
当我的同事还是个男人的时候，每个人都只叫他的姓氏拉马钱德兰（Ramachandran），他因了解这种幻肢现象并开发出一种非常简单但非常强大的解决方案而闻名，该解决方案说明了自上而下调制和自上而下调制的令人难以置信的能力，利用大脑认知和感觉来控制身体疼痛的能力是每个人，而不仅仅是失去四肢或患有慢性疼痛的人都可以从中受益的，因为这是一种利用我们使用思想的能力的方法控制对我们身体发生的事情的感知。
So what did Ramachandran do?
那么拉马钱德兰做了什么？
Ramachandran had people who were missing limbs.
拉马钱德兰有些人失去了四肢。
A limb put their intact limb into a box that had mirrors in it such that when they looked in the box and they moved their intact limb, the opposite limb, which was a reflection of the intact limb because they're missing the opposite limb, they would see it as if it was intact.
一个肢体将其完整的肢体放入一个装有镜子的盒子中，这样当他们在盒子中查看并移动其完整的肢体时，相对的肢体（这是完整肢体的反射，因为他们缺少相对的肢体），他们会看到它就好像它是完整的一样。
And as they would move their intact limb, they would visualize with their eyes.
当他们移动完整的肢体时，他们会用眼睛想象。
Um, The limb that's in the place of the absent limb.
嗯，代替缺失肢体的肢体。
So this is all by mirrors moving around and they would feel immediate relief from the phantom pain and he would tell them and they would direct their hand toward a Orientation that felt comfortable to them.
所以这一切都是通过镜子移动来实现的，他们会立即从幻痛中得到缓解，他会告诉他们，他们会将手伸向让他们感觉舒服的方向。
Then they would exit the mirror box.
然后他们就会退出镜盒。
I would take their, their, their hand out and they would feel as if the hand was now in its relaxed, normal position.
我会把他们、他们、他们的手伸出来，他们会感觉好像手现在处于放松、正常的位置。
So you could get real time in moments, remapping of the representation of the hand.
因此，您可以即时获得实时信息，重新映射手部的表示。
Now that's amazing.
现在这太棒了。
This is the kind of thing that all of us would like to be able to do if we are in pain, because.
这是我们所有人在痛苦时都希望能够做的事情，因为。
If you do anything for long enough, including live, you're going to experience pain of some sort.
如果你做一件事足够长的时间，包括生活，你就会经历某种痛苦。
And this, again, I just want to remind you isn't just about physical injuries and pain.
我想再次提醒您，这不仅仅是身体伤害和疼痛。
This has direct relevance to emotional pain as well, which we'll.
这也与情绪痛苦有直接关系，我们会的。
Of course, we'll talk about so the Ramachandran studies were really profound because they said a couple of things.
当然，我们会讨论拉马钱德兰的研究非常深刻，因为他们说了几件事。
One plasticity can be very fast that it can be driven by the experience of something.
一种可塑性可以非常快，可以由某种事物的经验驱动。
Just the visual experience.
只是视觉体验。
And so this may come as a shock to some of you.
因此，这可能会让你们中的一些人感到震惊。
And by no means am I trying to be insensitive, but pain is a perceptual thing.
我绝不是想变得麻木不仁，但疼痛是一种感性的东西。
As much as it's a physical thing, it's a belief system about what you're experiencing in your body.
尽管它是一个物理事物，但它是一个关于你在身体中所经历的事情的信念系统。
And that has important relevance for healing different types of injury and the pain associated with that injury.
这对于治疗不同类型的损伤以及与损伤相关的疼痛具有重要意义。
Now, this brings up another topic, which is definitely related to neuroplasticity and injury, but is a more general one that I hear about a lot, which is traumatic brain injury.
现在，这提出了另一个话题，它肯定与神经可塑性和损伤有关，但这是我经常听到的一个更普遍的话题，即创伤性脑损伤。
Many injuries are not just about the limb and the, The lack of use of the limb, but concussion and head injury.
许多伤害不仅仅是肢体和肢体无法使用，还有脑震荡和头部受伤。
But I want to talk a little bit about what is known about recovery from concussion.
但我想谈谈关于脑震荡恢复的已知信息。
And this is very important because it has improved.
这非常重要，因为它已经有所改善。
Implications for just normal aging as well and offset setting some of the cognitive decline and physical decline that occurs with normal aging.
对正常衰老也有影响，并抵消了正常衰老引起的一些认知衰退和身体衰退。
Typically after TBI, there's a constellation of symptoms that many people, if not all people with TBI report, which is headache, photophobia, that lights become kind of aversive, sleep disruption, trouble concentrating, sometimes mood issues.
通常，在 TBI 后，许多人（即使不是所有 TBI 患者）都会出现一系列症状，包括头痛、畏光、厌恶灯光、睡眠中断、注意力不集中，有时还有情绪问题。
There's, you know, a huge range.
你知道，范围很大。
And of course, the severity will vary, etc. It's.
当然，严重程度会有所不同，等等。它是。
Very clear that regardless of whether or not there was a skull break and regardless of when the TBI happened and how many times it's happened, that the system that repairs the brain, the adult brain is mainly centered around this lymphatic system that we call for the brain, the glymphatic system, that sort of like a sewer system that clears out Okay.
非常清楚的是，无论是否有颅骨骨折，无论 TBI 何时发生以及发生了多少次，修复大脑的系统，成人大脑主要集中在我们称之为大脑的淋巴系统，类淋巴系统，有点像一个可以清理的下水道系统。
The debris that surrounds neurons, especially injured neurons and the glymphatic system is very active during sleep.
神经元周围的碎片，尤其是受伤的神经元和类淋巴系统，在睡眠期间非常活跃。
And the glymphatic system is something that you want very active because it's going to clear away the debris that sits between the neurons.
类淋巴系统是你需要非常活跃的东西，因为它会清除神经元之间的碎片。
And the cells that surround the connections between the neurons called the glia, those cells are actively involved in repairing the connections between neurons when damaged.
围绕神经元之间连接的细胞称为神经胶质细胞，这些细胞在受损时积极参与修复神经元之间的连接。
So the glymphatic system is so important that Many people, if not all people who get TBI are told, get adequate rest.
因此，类淋巴系统非常重要，以至于许多人（即使不是所有患有 TBI 的人）都得到充分的休息。
You need to sleep.
你需要睡觉。
And that's kind of twofold advice.
这是双重建议。
On the one hand, it's telling you to get sleep because all these good things happen in sleep.
一方面，它告诉你去睡觉，因为所有这些美好的事情都发生在睡眠中。
It's also about getting those people to not continue to engage in their activity full time or really try and hammer through it.
这也是为了让这些人不再继续全职从事他们的活动，或者真正尝试并努力完成它。
The glymphatic system has been shown to be activated further in two ways.
类淋巴系统已被证明可以通过两种方式进一步激活。
One is that sleeping on one side.
一种是一侧睡。
Not on back or stomach seems to increase the amount of washout or wash through, I should say, of the glymphatic system.
我应该说，不在背部或腹部似乎会增加类淋巴系统的冲洗或冲洗量。
The other thing that has been shown to improve the function of the glymphatic system is a certain form of exercise.
另一种已被证明可以改善类淋巴系统功能的方法是某种形式的锻炼。
And I want to be very, very clear here.
我想在这里说得非常非常清楚。
I will never and I am not suggesting that people.
我永远不会，我也不会建议那些人。
Exercise in any way that aggravates their injury or that goes against their physician's advice.
以任何会加重伤害或违背医生建议的方式进行锻炼。
However, there's some interesting data that zone two cardio for 30 to 45 minutes, three times a week, seems to improve the rates of clearance of some of the debris after injury.
然而，有一些有趣的数据表明，每周 3 次、每次 30 至 45 分钟的第二区有氧运动似乎可以提高受伤后清除某些碎片的速度。
And in general injury or no to accelerate and improve the, Rates of flow for the glymphatic system.
一般情况下，损伤或没有加速和改善，类淋巴系统的流速。
It could be fast walking.
走路可能很快。
It could be jogging.
可以是慢跑。
If you can do that with your injury, safely could be cycling.
如果你能在受伤的情况下做到这一点，那么骑自行车就可以安全了。
And this is really interesting outside of TBI because what we know from aging is that Aging is a nonlinear process.
在 TBI 之外，这确实很有趣，因为我们从衰老中了解到，衰老是一个非线性过程。
It's not like with every year of life, your brain gets a little older.
并不是说随着年龄的增长，你的大脑就会变老一点。
It's a, it has, sometimes it follows what's more like a step function.
它是一个，它有，有时它遵循更像是一个阶跃函数。
Like you get these big jumps in, in eight in markers of aging, I guess that we could think of them as jumps down because it's a negative thing for most everybody would like to live longer and be healthier in brain and body.
就像你在衰老标志中出现八个大的跳跃一样，我想我们可以将它们视为跳跃，因为这对大多数人来说是一件消极的事情，因为每个人都希望活得更长，大脑和身体更健康。
And so.
所以。
The types of exercise I'm referring to now are really more about brain longevity and about keeping the brain healthy than they are about physical fitness.
我现在指的运动类型实际上更多的是关于大脑寿命和保持大脑健康，而不是关于身体健康。
So I think this is really interesting.
所以我认为这真的很有趣。
And if some of you would like to know the mechanism, or at least the hypothesized mechanism, there's a molecule called aquaporin 4 that is related to the glial system.
如果你们中的一些人想了解其中的机制，或者至少是假设的机制，有一种名为水通道蛋白 4 的分子与神经胶质系统有关。
So glia are the, I mean, glue in Latin, are these, are these cells in the brain, the most numerous cells in the brain, in fact, that in sheath synapses, but they're very dynamic cells.
所以神经胶质细胞是，我的意思是，拉丁语中的胶水，这些是大脑中的细胞，大脑中数量最多的细胞，事实上，在鞘突触中，但它们是非常动态的细胞。
Aquaporin 4 is mainly expressed by the glial cell called the astrocyte.
水通道蛋白 4 主要由称为星形胶质细胞的神经胶质细胞表达。
Astro looks like a little star, incredibly interesting cells.
Astro 看起来像一颗小星星，是非常有趣的细胞。
And the thing to remember is that the astrocytes bridge the connection between the neurons, the Synapse, the connections between them and the vasculature, the blood system and the glymphatic system.
需要记住的是，星形胶质细胞在神经元、突触之间以及它们与脉管系统、血液系统和类淋巴系统之间的连接之间架起桥梁。
So, This glymphatic system and the glial astrocyte system is a system that we want chronically active throughout the day as much as possible.
因此，这个类淋巴系统和神经胶质星形胶质细胞系统是我们希望尽可能全天长期活跃的系统。
So low level walking zone two cardio.
所以低水平步行区两个有氧运动。
And then at night during slow wave sleep is then really when this glymphatic system kicks in.
然后在晚上的慢波睡眠期间，这个类淋巴系统就真正开始发挥作用了。
So that should hopefully be an actionable takeaway provided that you can do that kind of cardio safely that I believe everybody should be doing who cares about brain longevity, not just people who are trying to get over TBI.
因此，如果你可以安全地进行这种有氧运动，那么这应该是一个可行的结论，我相信每个关心大脑寿命的人都应该这样做，而不仅仅是那些试图克服创伤性脑损伤的人。
I'd like to take a quick break and acknowledge our sponsor, AG1.
我想稍微休息一下并感谢我们的赞助商 AG1。
By now, many of you have heard me say that if I could take just one supplement, that supplement would be AG1.
到目前为止，你们很多人都听我说过，如果我只能服用一种补充剂，那么该补充剂就是 AG1。
The reason for that is AG1 is the highest quality and most complete of the foundational nutritional supplements available.
原因是 AG1 是现有的基础营养补充剂中质量最高、最全面的。
What that means is that it contains not just vitamins and minerals, but also probiotics, prebiotics, and and adaptogens to cover any gaps you may have in your diet and provide support for a demanding life.
这意味着它不仅含有维生素和矿物质，还含有益生菌、益生元和适应原，可以弥补您饮食中可能存在的任何空白，并为高要求的生活提供支持。
For me, even if I eat mostly whole foods and minimally processed foods, which I do for most of my food intake, it's very difficult for me to get enough fruits and vegetables, vitamins and minerals, micronutrients, and nutrients.
对我来说，即使我主要吃天然食品和最低限度加工的食品（我的大部分食物摄入量都是这样做的），我也很难获得足够的水果和蔬菜、维生素和矿物质、微量营养素和营养素。
and adaptogens from food alone.
和仅来自食物的适应原。
For that reason, I've been taking AG1 daily since 2012.
因此，自 2012 年以来我一直每天服用 AG1。
When I do that, it clearly bolsters my energy, my immune system, and my gut microbiome.
当我这样做时，它明显增强了我的能量、我的免疫系统和我的肠道微生物组。
These are all critical to brain function, mood, physical performance, and much more.
这些对于大脑功能、情绪、身体表现等都至关重要。
If you'd like to try AG1, you can go to drinkag1.
如果你想尝试AG1，你可以去drinkag1。
com slash Huberman to claim a special offer.
com 大幅削减 Huberman 以获得特别优惠。
For this month only, January 2025, AG1 is giving away 10 free travel packs and a year's supply of vitamin D3 K2.
仅在 2025 年 1 月这个月，AG1 赠送 10 个免费旅行包和一年的维生素 D3 K2。
Again, go to drinkag1.
再次，去drinkag1。
com slash Huberman to claim the 10 free travel packs and a year supply of vitamin D3 K2.
com 大幅削减 Huberman 的奖金，以获取 10 个免费旅行包和一年的维生素 D3 K2 供应量。
Now I'd like to return a little bit to some of the subjective aspects of pain modulation because I think it's so interesting and so actionable that everyone should know about this.
现在我想稍微回顾一下疼痛调节的一些主观方面，因为我认为它非常有趣且可操作，每个人都应该了解这一点。
Our interpretation, our subjective interpretation of a sensory event is immensely powerful for dictating our experience of the event.
我们的解释，我们对感官事件的主观解释对于决定我们对该事件的体验非常强大。
The molecule adrenaline, when it's liberated into our body, truly blunts our experience of pain.
当肾上腺素分子释放到我们体内时，它确实会减弱我们对疼痛的体验。
We all know the stories of people, you know, walking, you know, miles on stumped legs.
我们都知道人们的故事，你知道，用残肢行走数英里。
Um, people doing all sorts of things that were incredible feats.
嗯，人们做了各种各样令人难以置信的壮举。
That allowed them to move through what would otherwise be pain.
这让他们能够克服原本会带来的痛苦。
And afterward they do experience extreme pain, but during the event, oftentimes they are not experiencing pain.
之后他们确实会经历极度疼痛，但在活动期间，他们通常不会经历疼痛。
And that's because of the pain blunting effects of adrenaline, adrenaline binding, a particular receptors actually shuts down pain pathways.
这是因为肾上腺素具有镇痛作用，肾上腺素结合，一种特定的受体实际上会关闭疼痛通路。
People who anticipate an injection of morphine immediately report the feeling of pain.
预期注射吗啡的人会立即报告疼痛感。
Loss of pain, their pain starts to diminish because they know they are going to get pain relief.
疼痛消失，他们的疼痛开始减轻，因为他们知道疼痛会得到缓解。
And it's a powerful effect.
这是一个强大的效果。
Now all of you are probably saying placebo effect, placebo effects are very real placebo effects and belief effects as they're called, have a profound effect on our experience of noxious stimuli like pain.
现在你们所有人可能都在说安慰剂效应，安慰剂效应是非常真实的安慰剂效应和所谓的信念效应，对我们对疼痛等有害刺激的体验有深远的影响。
And they can also have a profound effect on positive stimuli and things that we're looking forward to.
它们还可以对积极的刺激和我们期待的事情产生深远的影响。
One study that I think is particularly interesting here is from my colleague at Stanford, Sean Mackey.
我认为这里特别有趣的一项研究来自我在斯坦福大学的同事肖恩·麦基（Sean Mackey）。
They did a neuroimaging study.
他们做了一项神经影像学研究。
They subjected people to pain.
他们使人们遭受痛苦。
In this case, it was a heat pain.
在这种情况下，是一种热痛。
People have very specific thresholds to heat at which they cannot tolerate any more heat.
人们对热量有非常特定的阈值，一旦超过阈值，他们就无法忍受更多的热量。
But they explored the extent to which looking at an image of somebody, in this case, a romantic partner that the person loved, would allow them to adjust their pain response.
但他们探索了观看某人的图像（在本例中是该人所爱的浪漫伴侣）在多大程度上可以让他们调整疼痛反应。
And it turns out it does, they could tolerate more pain and they reported it as not as painful that response.
事实证明确实如此，他们可以忍受更多的疼痛，并且他们报告说这种反应并不那么痛苦。
That feeling of love internally can blunt the pain experience to a significant degree.
内心的爱的感觉可以在很大程度上减轻痛苦体验。
These are not small effects and not surprisingly, how early a relationship is, how new a relationship is directly correlates with people's ability.
这些都是不小的影响，毫不奇怪，关系的早熟程度、关系的新程度与人们的能力直接相关。
They showed to a.
他们向a展示了。
Use this love, this internal representation of love to blunt the pain response.
使用这种爱，这种爱的内在表现来减轻疼痛反应。
So for those of you that have been with your partners for many years and you love them very much and you're obsessed with them, terrific.
因此，对于那些与伴侣在一起多年、非常爱他们、痴迷于他们的人来说，太棒了。
You have a pre installed, I suppose it's not pre installed.
你已经预装了，我想它没有预装。
You had to do the work because relationships are work, but you've got a installed mechanism for blunting pain.
你必须做这些工作，因为人际关系就是工作，但你已经有一个固定的机制来减轻痛苦。
And again, these are not minor effects.
再说一遍，这些都不是小影响。
These are major effects.
这些都是主要影响。
And it's all going to be through that top down modulation that we talked about, not unlike the mirror box experiments with phantom limb that relieve phantom pain or some other top down modulation.
这一切都将通过我们谈到的自上而下的调制来实现，这与用幻肢减轻幻痛的镜盒实验或其他一些自上而下的调制不同。
And the opposite example is the nail through the boot, which is a visual image that made the person think it was painful when in fact it wasn't.
相反的例子是钉子穿过靴子，这是一种视觉图像，让人认为很痛苦，但实际上并不痛苦。
It was painful, even though there was no tissue damage, it was all perceptual.
很痛，虽然没有组织损伤，但都是知觉上的。
So the pain system is really subject to these perceptual influences, which is remarkable because really, when we think about the somatosensory system, it has this cognitive component.
因此，疼痛系统确实受到这些知觉的影响，这是值得注意的，因为实际上，当我们想到体感系统时，它具有这种认知成分。
It's got this peripheral component, but there's another component, which is the way in which our sensation or somatosensory system is woven in with our auditory.
它有这个外围组件，但还有另一个组件，这就是我们的感觉或体感系统与我们的听觉交织在一起的方式。
Autonomic nervous system independent of love.
自主神经系统独立于爱。
We're going to talk about something quite different, which is putting needles and electricity in different parts of the body.
我们将讨论一些完全不同的事情，即将针和电流放置在身体的不同部位。
So called acupuncture, something that for many people were.
所谓的针灸，对很多人来说都是如此。
It's been viewed as a kind of alternative medicine, but now there are excellent laboratories exploring what's called electroacupuncture and acupuncture, and I think what you'll be interested in and surprised to learn is that it does work, but sometimes it can exacerbate pain, and sometimes it can relieve pain, and it all does that through very discrete pathways for which we can really Say this neuron connects to that neuron connects to the adrenals and we can tie this all back to dopamine because in the end It's the chemicals and neural circuits that are giving rise to these perceptions or these experiences rather of things that we call pain love Etc.
它被视为一种替代医学，但现在有一些优秀的实验室正在探索所谓的电针和针灸，我想你会感兴趣并惊讶地发现它确实有效，但有时它会加剧疼痛，有时它可以减轻疼痛，这一切都是通过非常离散的途径来实现的，我们可以真正说这个神经元连接到连接到肾上腺的神经元，我们可以将这一切都与多巴胺联系起来，因为最终正是化学物质和神经回路产生了这些感知或这些体验，而不是我们所说的痛苦、爱情等。
There are actually a lot of really good peer reviewed studies Supporting the use of acupuncture for in particular GI tract issues In recent years, there's been an emphasis on trying to understand the mechanism of things like acupuncture and acupuncture itself, but as a way to try and understand how these sorts of practices might actually benefit people who are experiencing pain or for changing the nervous system or brain body relationship in general.
实际上有很多非常好的同行评审研究支持使用针灸治疗特定的胃肠道问题近年来，人们一直强调尝试了解针灸等事物的机制和针灸本身，但作为尝试和了解这些做法如何真正有益于正在经历疼痛或改变神经系统或脑体关系的人的一种方式。
What I want to talk about in terms of acupuncture is the incredible way in which acupuncture illuminates the crosstalk between the somatosensory system, our ability to feel stuff externally, extra reception, internally interoception, and how that somatosensory system is wired in with, in communicating with our autonomic nervous system that regulates our levels of alertness or calmness.
我想谈论的针灸是一种令人难以置信的方式，针灸阐明了体感系统之间的串扰，我们感知外部事物的能力，额外的接收，内部内感受，以及体感系统如何与我们的自主神经系统沟通，调节我们的警觉或平静水平。
This takes us all back to the homunculus.
这让我们回到了侏儒。
We have this representation of our body surface in our brain.
我们的大脑中有身体表面的这种表征。
That representation is what we call somatotopic.
这种表征就是我们所说的体位（somatotopic）。
And what somatotopy is, is it just means that areas of your body that are near one another are represented by neurons that are nearby each other in the brain.
体位学是什么，它只是意味着你身体中彼此靠近的区域由大脑中彼此靠近的神经元代表。
The connections from those brain neurons are sent into the body and they are synchronized with meaning they cross wire with an end form synapses with some of the input from the viscera from our guts, from our diaphragm, from our stomach, from our spleen, from our Our heart, our internal organs are sending information up to this map in our brain of the body surface, but it's about internal information, what we call interoception, our ability to look inside or imagine inside and feel what we're feeling inside.
来自这些大脑神经元的连接被发送到身体中，它们与末端交叉连接形成突触，与来自内脏的一些输入形成突触，这些输入来自我们的内脏，来自我们的隔膜，来自我们的胃，来自我们的脾，来自我们的心脏，我们的内脏器官正在将信息发送到我们身体表面大脑中的这张地图，但它是关于内部信息，我们称之为内感受，我们观察内部或想象内部并感受我们内心感受的能力。
So the way to think about this accurately is that our representation of ourself.
因此，准确地思考这个问题的方法是我们对自己的表征。
Is a representation of our internal workings, our viscera, our guts, everything inside our skin and the surface of our skin and the external world.
代表我们的内部运作、内脏、内脏、皮肤内的一切以及皮肤表面和外部世界。
Those three things are always being combined in a very interesting, complex, but very seamless way.
这三件事总是以一种非常有趣、复杂但又非常无缝的方式结合在一起。
Acupuncture involves taking needles and sometimes electricity.
针灸需要使用针，有时还需要使用电。
And or heat as well and stimulating particular locations on the body.
或者也可以加热并刺激身体的特定部位。
And if somebody has a gastrointestinal issue, like their, their guts are moving too quick.
如果有人像他们一样有胃肠道问题，他们的肠子就会移动得太快。
They have diarrhea.
他们有腹泻。
You stimulate this area and it'll slow their gut motility down.
你刺激这个区域，就会减慢他们的肠道蠕动。
Or if their gut motility is too slow, they're constipated.
或者如果他们的肠道蠕动太慢，他们就会便秘。
You stimulate someplace else and it accelerates it.
你刺激其他地方，它就会加速它。
And, you know, hearing about this, if it sounds kind of.
而且，你知道，听到这个，如果听起来不错的话。
To a Westerner who's not thinking about the underlying neural circuitry, it could sound kind of wacky.
对于一个不考虑潜在神经回路的西方人来说，这听起来有点古怪。
But when you look at the neural circuitry, the neuroanatomy, it really starts to make sense.
但当你观察神经回路、神经解剖学时，它真的开始有意义了。
Intense stimulation of the abdomen, however, with this electroacupuncture has a very strong effect of increasing inflammation in the body.
然而，这种电针对腹部的强烈刺激具有很强的增加体内炎症的作用。
And this is important to understand because it's not just that stimulating the gut does this because you're activating the gut area.
理解这一点很重要，因为不仅仅是刺激肠道才能做到这一点，因为你激活了肠道区域。
It activates a particular.
它激活一个特定的。
Nerve pathway for the aficionados.
爱好者的神经通路。
It's the splenic spinal sympathetic axis if you really want to know and it's pro inflammatory Under most conditions, if, for instance, the person is dealing with a particular bacterial infection that can be beneficial, and this goes back to a much earlier discussion that we had on a previous podcast that we'll revisit again and again, which is that the stress response was designed to combat infection.
如果你真的想知道的话，那就是脾脊髓交感轴，它是促炎症的。在大多数情况下，例如，如果一个人正在处理可能有益的特定细菌感染，这可以追溯到我们在之前的播客中进行的更早的讨论，我们将一次又一次地回顾，即压力反应是为了对抗感染而设计的。
So it turns out that there are certain patterns of stimulation on the abdomen that can actually liberate immune cells from the body.
因此，事实证明，对腹部进行某些刺激模式实际上可以将免疫细胞从体内释放出来。
Our immune organs like our spleen and counter infection when you stimulate these pathways that Activate in particular, the adrenals, the adrenal gland epinephrine and the brain does as well.
当您刺激这些特别激活的途径时，我们的免疫器官（例如脾脏）可以抵抗感染，尤其是肾上腺、肾上腺素和大脑。
It binds to what are called the beta noradrenergic receptors.
它与所谓的β去甲肾上腺素受体结合。
Okay, so this is really getting kind of down into the weeds, but the beta noradrenergic receptors activate the spleen, which liberate cells that combat infection.
好吧，这确实有点深入人心，但β去甲肾上腺素能受体会激活脾脏，从而释放出抵抗感染的细胞。
That's the short term quick response.
这就是短期的快速反应。
The more intense stimulation of the abdomen and other areas can be pro inflammatory because of the ways that they trigger certain loops that go back to the brain and trigger the sort of anxiety pathways that exacerbates pain.
对腹部和其他区域的更强烈的刺激可能会引发炎症，因为它们会触发某些循环，这些循环会返回大脑并引发焦虑通路，从而加剧疼痛。
So one pathway stimulates norepinephrine and blunts pain.
因此，其中一种途径会刺激去甲肾上腺素并减轻疼痛。
The other one doesn't.
另一个则不然。
What does all this mean?
这一切意味着什么？
How are we supposed to put all this together?
我们应该如何将所有这些放在一起？
Well, there's a paper that was published in Nature Medicine in 2014.
嗯，2014 年《自然医学》上发表了一篇论文。
This is an excellent journal.
这是一本优秀的期刊。
That describes how dopamine can activate the vagus peripherally and nor norepinephrine can activate the vagus peripherally and reduce inflammation.
这描述了多巴胺如何激活外周迷走神经，而去甲肾上腺素如何激活外周迷走神经并减少炎症。
What this means is that there are real maps of our body surface that when stimulated communicate with our autonomic nervous system, the system that controls alertness or calmness and thereby releases either molecules like norepinephrine and dopamine, which make us more alert.
这意味着我们身体表面存在真实的地图，当受到刺激时，它们会与我们的自主神经系统进行通信，该系统控制警觉性或平静性，从而释放去甲肾上腺素和多巴胺等分子，从而使我们更加警觉。
And blunt a response to pain and they reduce inflammation.
并减弱对疼痛的反应并减少炎症。
But there are yet other pathways that when stimulated are pro inflammatory.
但还有其他途径在受到刺激时会产生促炎症反应。
One of the things that bothers me so much these days and I'm not easily irritated, but what really bothers me is when people are talking about inflammation, like inflammation is bad.
这些天让我如此困扰的事情之一，我不容易被激怒，但真正困扰我的是当人们谈论炎症时，比如炎症是不好的。
Inflammation is terrific.
炎症太厉害了
Inflammation is the reason why.
炎症就是原因。
Cells are called to the site of injury to clear it out.
细胞被召唤到受伤部位以将其清除。
Inflammation is what's going to allow you to heal from any injury.
炎症可以让你从任何伤害中痊愈。
Chronic inflammation is bad, but acute inflammation is absolutely essential.
慢性炎症是不好的，但急性炎症是绝对必要的。
Remember those kids that we talked about earlier that have mutations in these receptors that for sensing pain, they never get inflammation.
还记得我们之前讨论过的那些孩子，他们的这些感受器发生突变，能够感知疼痛，但他们永远不会发炎。
And that's why their joints literally.
这就是为什么他们的关节确实如此。
Disintegrate.
瓦解。
It's really horrible because they don't actually have the inflammation response because it was never triggered by the pain response.
这真的很可怕，因为他们实际上没有炎症反应，因为它从来不是由疼痛反应触发的。
So, I think that the data on acupuncture are turning out to be very interesting.
所以，我认为有关针灸的数据非常有趣。
I'd like to take a quick break and thank one of our sponsors, David.
我想稍微休息一下并感谢我们的赞助商之一大卫。
David makes a protein bar unlike any other.
大卫制作的蛋白质棒与众不同。
It has 28 grams of protein, only 150 calories and 0 grams of sugar.
它含有28克蛋白质，仅150卡路里和0克糖。
That's right, 28 grams of protein and 75 percent of its calories come from protein.
没错，28克蛋白质，其75%的热量都来自于蛋白质。
These bars from David also taste amazing.
大卫的这些酒吧味道也很棒。
My favorite flavor is chocolate chip cookie dough, but then again I also like the chocolate fudge flavored one, and I also like the cake flavored one.
我最喜欢的口味是巧克力饼干面团，但话又说回来，我也喜欢巧克力软糖口味的，我也喜欢蛋糕口味的。
Basically, I like all the flavors.
基本上所有的口味我都喜欢。
They're incredibly delicious.
它们非常美味。
For me personally, I strive to eat mostly whole foods.
就我个人而言，我努力主要吃天然食品。
However, when I'm in a rush, Or I'm away from home, or I'm just looking for a quick afternoon snack, I often find that I'm looking for a high quality protein source.
然而，当我很匆忙，或者我不在家，或者我只是想吃点下午茶时，我经常发现我正在寻找高质量的蛋白质来源。
With David, I'm able to get 28 grams of protein with the calories of a snack, which makes it very easy to hit my protein goals of one gram of protein per pound of body weight each day.
有了 David，我就能用一份零食的热量获取 28 克蛋白质，这使得我很容易达到每天每磅体重 1 克蛋白质的蛋白质目标。
And it allows me to do that without taking in excess calories.
它使我能够在不摄入过多卡路里的情况下做到这一点。
I typically eat a David bar in the early afternoon or even mid afternoon.
我通常在下午早些时候甚至中午吃大卫酒吧。
If I want to bridge that gap between lunch and dinner, I like that it's a little bit sweet.
如果我想弥补午餐和晚餐之间的差距，我喜欢它有点甜。
So it tastes like a tasty snack, but it's also given me that 28 grams of very high quality protein with just 150 calories.
所以它尝起来就像是美味的零食，但它也为我提供了 28 克优质蛋白质，而热量仅为 150 卡路里。
If you would like to try David, you can go to davidprotein.
如果你想尝试 David，你可以去 david Protein。
com slash Huberman.
com 斜线休伯曼。
Again, the link is davidprotein.
同样，链接是大卫蛋白质。
com slash Huberman.
com 斜线休伯曼。
Before I continue, I just thought I'd.
在我继续之前，我只是想我会。
Answer a question that I get a lot, uh, which is what about Wim Hof breathing?
回答一个我经常遇到的问题，呃，那就是 Wim Hof 的呼吸怎么样？
Wim Hof, uh, also called AKA the Iceman, um, has his breathing.
Wim Hof，呃，也被称为“冰人”，嗯，有他的呼吸。
That's similar to, uh, Tumo breathing as it was originally called involves basically hyperventilating and then doing some exhales and some breath holds.
这类似于，呃，Tumo 呼吸，因为它最初被称为基本上是过度换气，然后进行一些呼气和屏气。
A number of people have asked me about it in, uh, in relation to pain management, the effect of doing that kind of breathing.
很多人问过我关于疼痛管理的问题，即这种呼吸的效果。
It's not a mysterious effect.
这并不是什么神秘的效果。
It liberates adrenaline from the adrenals.
它从肾上腺中释放肾上腺素。
When you have adrenaline in your system and when the spleen is very active, that Response is used to counter infection and stress counters infection by liberating killer cells in the body.
当你的系统中有肾上腺素并且脾脏非常活跃时，这种反应就会用来对抗感染，而压力则通过释放体内的杀伤细胞来对抗感染。
You don't want the stress response to stay on indefinitely.
您不希望压力反应无限期地持续下去。
However, things like Wim Hof breathing, like ice baths, anything that releases adrenaline will counter the stress The infection, but you want to regulate the duration of that adrenaline response.
然而，像维姆霍夫呼吸、冰浴等任何能释放肾上腺素的东西都会对抗压力感染，但你想要调节肾上腺素反应的持续时间。
Today, we've talked about a variety of tools, but I want to center in on a particular sequence of tools that hopefully you won't need.
今天，我们讨论了各种工具，但我想重点讨论希望您不需要的特定工具序列。
Presumably if you're a human being and you're active, you will need at some point, it's about managing injury and recovering and healing fast, or at least as fast as possible.
想必如果你是一个人并且你很活跃，那么你在某些时候会需要，这是关于管理伤害以及快速恢复和愈合，或者至少尽可能快。
It includes removing the pain.
它包括消除疼痛。
It includes, Getting mobility back and getting back to a normal life, whatever that means for you.
它包括，恢复行动能力并恢复正常生活，无论这对您意味着什么。
I want to emphasize that what i'm about to talk about next Was developed in close consultation with Kelly Starrett, who many of you probably have heard of before.
我想强调的是，我接下来要讨论的内容是与凯利·斯塔雷特（Kelly Starrett）密切协商后制定的，你们中的许多人可能以前听说过。
Kelly can be found at The Ready State.
凯利可以在“就绪州”找到。
He's a formally trained, so degreed and educated exercise physiologist.
他是一位受过正规训练、有学位、受过良好教育的运动生理学家。
He's a world expert in movement and tissue rehabilitation.
他是运动和组织康复方面的世界专家。
So I asked Kelly, I made it really simple.
所以我问凯利，我把事情说得很简单。
I said, okay, let's say I were to sprain my ankle or break my arm or injure my knee.
我说，好吧，假设我扭伤了脚踝、折断了手臂或弄伤了膝盖。
ACL tear or something like that or shoulder injury.
ACL 撕裂或类似的情况或肩部受伤。
What are the absolute necessary things to do regardless of situation?
无论情况如何，哪些事情是绝对必要的？
So the first one is a very basic one.
所以第一个是非常基本的。
That now you have a lot of information to act on, which is sleep is essential.
现在你有很多信息需要采取行动，其中睡眠至关重要。
And so we both agreed eight hours of sleep would be ideal, but if not at least eight hours immobile.
因此，我们都同意八小时的睡眠是理想的，但如果不是至少八小时不活动。
So that's a non negotiable in terms of getting the foundation for allowing for glymphatic clearance and tissue clearance, et cetera.
因此，在为类淋巴清除和组织清除等奠定基础方面，这是不容谈判的。
The other is if possible, unless it's absolutely excruciating.
另一个是如果可能的话，除非它绝对令人难以忍受。
When you just can't do it, a 10 minute walk per day, of course, you don't want to exacerbate the injury at least a 10 minute walk per day and probably longer.
当你实在做不到时，每天步行 10 分钟，当然，你不想加剧伤害，至少每天步行 10 分钟，甚至可能更长。
This is where it gets interesting.
这就是有趣的地方。
I was taught, I learned that when you injure yourself, you're supposed to ice something, you're supposed to put ice on it, but I didn't realize this, but When speaking to exercise physiologists and some physicians, they said that the ice is really more of a placebo.
我被教导，我了解到，当你伤害自己时，你应该冰敷某些东西，你应该在上面放冰块，但我没有意识到这一点，但是当与运动生理学家和一些医生交谈时，他们说冰实际上更像是一种安慰剂。
It numbs the environment of the injury, which is not surprising, and will eliminate the pain for a short while, but it has some negative effects that perhaps offset its use.
它会麻痹受伤的环境，这并不奇怪，并且会暂时消除疼痛，但它有一些负面影响，可能会抵消它的使用。
It actually can create some like clotting and sludging of the, of the tissue and fluids, which is bad because you want the macrophages and the other, Cell types, phagocytosing, eating up the debris and an injury and moving it out of there so that it can repair.
它实际上会产生一些组织和液体的凝块和淤泥，这是不好的，因为你需要巨噬细胞和其他细胞类型，吞噬作用，吞噬碎片和损伤，并将其移出那里，以便它可以修复。
So that was surprising to me, which made me ask, well, then what about heat?
这让我感到惊讶，这让我问，那么热量呢？
Well, it turns out heat is actually quite beneficial.
事实证明，热量实际上是非常有益的。
The major effects seem to be explained by heat, improving the viscosity of the tissues and the clearance and the profusion of, of, uh, Fluid, blood, lymph, and other fluids out of the injury area.
主要效果似乎可以通过热量来解释，改善组织的粘度以及损伤区域的液体、血液、淋巴液和其他液体的清除和丰富。
So all of this might sound just like common sense knowledge.
所以所有这些听起来可能就像常识知识。
I always just thought it's ice.
我一直以为是冰。
It's non steroid anti inflammatory drugs.
它是非类固醇类抗炎药。
It's things that Brock block prostaglandins.
布罗克正是通过这种物质来阻断前列腺素的。
So things like aspirin, ibuprofen, acetaminophen, those things generally work by blocking things like the, the they're called, uh, cock, the Cox, uh, Prostaglandin blockers and things of that sort things in that pathway, those sorts of treatments, which reduce inflammation may not be so great at the beginning when you want inflammation, they may be important for limiting pain so people can be functional at all.
像阿司匹林、布洛芬、对乙酰氨基酚，这些东西通常通过阻断诸如，呃，公鸡，考克斯，呃，前列腺素阻滞剂之类的东西来发挥作用，这些治疗方法在开始时可能不会那么有效，当你想要炎症时，它们可能对限制疼痛很重要，这样人们就可以发挥作用。
But the things that I talked about today really are anchored in three principles.
但我今天谈到的事情确实基于三个原则。
One is a.
一个是a.
That the inflammation response is a good one.
炎症反应是一种良好的反应。
It calls to the, to the site of injury, things that are going to clean up the injury and bad cells.
它召唤到受伤部位来清理受伤和坏细胞。
Then there are going to be things that are going to improve perfusion, like the glymphatic system, getting deep sleep, feet elevated, sleeping on one side, low level zone, two cardio, three times a week.
然后还有一些可以改善灌注的事情，比如类淋巴系统、深度睡眠、抬高脚、一侧睡、低水平区、两次有氧运动、每周三次。
Many people ask me about platelet rich plasma, so called PRP.
很多人问我关于富含血小板的血浆，即 PRP。
They take blood.
他们抽血。
They, Enrich for platelets and they re inject it back into people.
他们富集血小板，然后将其重新注射回人体。
Here's the deal.
事情是这样的。
It has never been shown whether or not the injection itself is what's actually creating the effect.
从未证明注射本身是否真正产生了这种效果。
The claims that PRP actually contains stem cells are very, very feeble.
PRP 实际上含有干细胞的说法是非常非常站不住脚的。
And when you look at the literature and you talk to anyone expert in the stem cell field, they will tell you that it's, The number of stem cells in PRP is infinitesimally small.
当您查看文献并与干细胞领域的任何专家交谈时，他们会告诉您，PRP 中的干细胞数量无限小。
Stem cells are an exciting area of technology.
干细胞是一个令人兴奋的技术领域。
However, there's a clinic down in Florida that was shut down a couple years ago for injecting stem cells harvested from patients into the eye for macular degeneration.
然而，佛罗里达州有一家诊所几年前因将从患者身上采集的干细胞注射到眼睛中以治疗黄斑变性而被关闭。
These were people that were suffering from poor vision.
这些人视力不佳。
And very shortly after injecting these stem cells into the eyes, they went completely blind.
将这些干细胞注射到眼睛后不久，他们就完全失明了。
And I'm not here to tell you that you should or shouldn't do something, but I do think that anything involving stem cells, one should be very cautious of the major issue with stem cells that I think is concerning is that stem cells are cells that want to become lots of different things, not just the tissue that you're interested in.
我并不是在这里告诉你应该或不应该做某事，但我确实认为任何涉及干细胞的事情都应该非常谨慎，我认为所关心的干细胞的主要问题是干细胞是想要变成许多不同事物的细胞，而不仅仅是你感兴趣的组织。
So if you damage your knee and you, you inject stem cells into your knee, You need to molecularly restrict those stem cells so that they don't become tumor cells, right?
因此，如果你的膝盖受伤了，你需要将干细胞注射到你的膝盖中，你需要从分子上限制这些干细胞，这样它们就不会变成肿瘤细胞，对吗？
A tumor is a collection of stem cells.
肿瘤是干细胞的集合。
One needs to approach this with extreme caution, even if it's your own blood or stem cells that you're reinjecting.
人们需要极其谨慎地对待这一问题，即使您重新注射的是您自己的血液或干细胞。
So I'm going to close there.
所以我要结束了。
I've talked about a lot of tools today.
我今天谈论了很多工具。
I've talked a lot about.
我已经谈了很多了。
somatosensation about plasticity, about pain, about acupuncture, some of the nuance of acupuncture, inflammation, stress.
关于可塑性、关于疼痛、关于针灸、针灸的一些细微差别、炎症、压力的体感。
We even talked a little bit about high intensity breathing.
我们甚至讨论了一些高强度呼吸的问题。
So as always, we take kind of a whirlwind tour through a given topic.
与往常一样，我们对某个特定主题进行了旋风式的游览。
Lay down some tools as we go.
边走边放下一些工具。
Hopefully the principles that relate to pain and injury, but also neuroplasticity in general today in the context of the somatosensory system will be of use to all of you.
希望与疼痛和损伤以及当今体感系统背景下的一般神经可塑性相关的原理对你们所有人都有用。
I don't wish injury on any of you, but I do hope that you'll take the information, do with it what you will.
我不希望你们任何人受到伤害，但我确实希望你们能接受这些信息，并用它做你想做的事。
Once again, thanks so much for your time and attention today.
再次非常感谢您今天的时间和关注。
And as always, thank you for your interest in science.
一如既往，感谢您对科学的兴趣。