How to Stop Headaches Using Science-Based Approaches

Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.

欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。

I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。

Today we are discussing headaches.

今天我们要讨论的是头痛。

Headaches are something that everybody will suffer at some point in their lifetime.

头痛是每个人一生中都会经历过的事情。

Now, of course, some people suffer from headaches far more often than others, and for many people, headaches can be incredibly debilitating, limiting their ability to work, to socialize, to sleep, to exercise, essentially to live life in any kind of normal way.

当然，现在有些人比其他人更频繁地遭受头痛的困扰，对于许多人来说，头痛可能会令人难以置信地衰弱，限制他们的工作、社交、睡眠、锻炼的能力，基本上限制他们以任何正常方式生活的能力。

As we'll soon discuss, there are many different kinds of headache.

正如我们很快将讨论的，头痛有许多不同类型。

We have migraine headaches, tension headaches, cluster headaches.

我们有偏头痛、紧张性头痛、丛集性头痛。

Today we'll review all the different types of headaches, and what the underlying biology of each and every one of those types of headaches is, as well as, fortunately, the many excellent treatments that exist for the different types of headache.

今天，我们将回顾所有不同类型的头痛，以及每种类型头痛的潜在生物学原理，以及幸运的是，针对不同类型的头痛有许多优秀的治疗方法。

In fact, what we'll soon discuss is that by understanding which type of headache you have, and a little bit about the underlying biology of each different type of headache, it becomes quite straightforward to select the best treatment options for you to, for instance, provide relief from frequent and recurring tension headaches, cluster headaches, even sinus headaches, the sorts of headaches that are associated with sinus infections and colds, where the sinuses get clogged up and you experience headache.

事实上，我们很快将讨论的是，通过了解您患有哪种类型的头痛，以及了解每种不同类型头痛的基本生物学原理，为您选择最佳的治疗方案就变得非常简单，例如，缓解频繁和反复出现的紧张性头痛、丛集性头痛，甚至鼻窦性头痛，即与鼻窦感染和感冒相关的头痛，鼻窦堵塞而您会感到头痛。

So while today's episode focuses on all aspects and types of headaches, it will have tremendous relevance for everybody.

因此，虽然今天的节目重点关注头痛的各个方面和类型，但它对每个人都具有巨大的相关性。

So for those of you that experience headache every once in a while, or only when you're sick or have a sinus headache, or for those of you that suffer from debilitating migraines, today's conversation actually has a bit of optimism woven into it, meaning there are excellent treatments for each and every one of the different types of headaches.

因此，对于那些偶尔会感到头痛的人，或者只有在生病或患有鼻窦性头痛时才感到头痛的人，或者对于患有使人衰弱的偏头痛的人来说，今天的谈话实际上带有一点乐观的成分，这意味着每种不同类型的头痛都有很好的治疗方法。

And I was quite impressed and excited to learn when researching this episode, that the treatments for headache range from, of course, prescription drug treatments and over-the-counter medications of the sort of type that most of us have heard about, ibuprofen, acetaminophen, and so forth, so-called anti-inflammatory drugs.

在研究这一集时，我印象深刻且兴奋地得知，头痛的治疗方法当然包括处方药治疗和我们大多数人都听说过的非处方药，布洛芬、对乙酰氨基酚等所谓的抗炎药。

But it turns out there are many natural treatments for headaches that when compared to those over-the-counter drugs, and even some prescription drugs, appear to be easily as effective, and in many cases more effective than the typical drug treatments, many of which can carry side effects.

但事实证明，有许多治疗头痛的自然疗法，与非处方药甚至某些处方药相比，似乎很容易有效，并且在许多情况下比典型的药物治疗更有效，其中许多药物可能会带来副作用。

That is, the drug treatments carry side effects, whereas the natural treatments appear to not carry side effects.

也就是说，药物治疗有副作用，而自然疗法似乎没有副作用。

Now, of course, any time we have a discussion about natural treatments, there are likely to be some eye rolls out there and people thinking, "Oh, this is going to be a bunch of woo science." Well, far from it.

当然，现在，每当我们讨论自然疗法时，可能会有一些人翻白眼，人们会想，“哦，这将是一堆吸引科学的东西。”嗯，还差得很远。

As you'll soon learn today, each and every one of the treatments for each and every one of the different kinds of headaches is grounded in a solid biological understanding of why that particular treatment ought to work and does work.

正如您今天很快就会了解到的那样，针对每种不同类型头痛的每一种治疗方法都基于对为什么该特定治疗方法应该有效并且确实有效的扎实的生物学理解。

So for instance, you'll learn that some headache arises because of muscular pain, other headache arises because of excessive vasodilation.

例如，您会了解到一些头痛是由于肌肉疼痛而引起的，另一些头痛是由于血管过度舒张而引起的。

The arteries and blood vessels get bigger and wider, and so there's a pressure and a swelling within the cranium, that people experience as a headache.

动脉和血管变得越来越大、越来越宽，因此颅骨内会出现压力和肿胀，人们会感到头痛。

And it turns out that many of the more natural treatments out there can address either the muscular pain issue or the vasodilation issue, or other issues and underlying mechanisms for headache.

事实证明，许多更自然的治疗方法可以解决肌肉疼痛问题或血管舒张问题，或解决头痛的其他问题和潜在机制。

So again, while headaches are very intrusive, irritating, and in some cases debilitating, there is certainly light at the end of this tunnel, meaning by the end of today's episode, each and every one of you will have an array of excellent treatment options that you can choose from in order to address and provide relief from any of the different types of headache.

再说一遍，虽然头痛非常具有侵入性、刺激性，在某些情况下还会使人衰弱，但隧道的尽头肯定有光明，这意味着到今天的节目结束时，你们每个人都将有一系列优秀的治疗方案可供选择，以解决和缓解任何不同类型的头痛。

Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford.

在开始之前，我想强调一下，这个播客与我在斯坦福大学的教学和研究角色是分开的。

It is, however, part of my desire and effort to bring zero cost to consumer information about science and science-related tools to the general public.

然而，我的愿望和努力的一部分是向公众提供有关科学和科学相关工具的零成本消费者信息。

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

为了与这个主题保持一致，我要感谢今天播客的赞助商。

Let's talk about headaches.

我们来谈谈头痛吧。

And as we are soon going to learn, there are different types of headaches, and different types of headaches arise from changes in different types of tissues in the head area, and indeed in the neck area as well.

我们很快就会了解到，头痛有不同类型，不同类型的头痛是由头部区域（甚至颈部区域）不同类型组织的变化引起的。

Now, one of the key things to understand is that if you want relief from a headache, you need to understand which tissue is mainly involved in creating that type of headache.

现在，需要了解的关键事情之一是，如果您想缓解头痛，您需要了解哪些组织主要参与产生此类头痛。

So for instance, many people suffer from what are called tension headaches.

例如，许多人患有所谓的紧张性头痛。

Now, tension headaches are a little bit of a misnomer because many people might think, "Oh, tension, I'm under a lot of tension and stress, and therefore I get tension headaches."

现在，“紧张性头痛”这个词有点用词不当，因为很多人可能会想，“哦，紧张，我承受着很大的紧张和压力，因此我会得紧张性头痛。”

And indeed, stress can cause tension headaches, but tension headaches are really the sort of headache that you feel around the top part of the head, not the very top, but sort of where you would put a headband, so above the eyes and around the head.

事实上，压力会导致紧张性头痛，但紧张性头痛实际上是一种你在头顶部感觉到的头痛，而不是最顶部，而是在你戴头带的地方，所以在眼睛上方和头部周围。

It doesn't have to be experienced all the way around the head.

不必从头到尾都经历它。

But the main underlying reason, that is the tissue system that mainly underlies tension headaches, is the muscular system.

但最主要的根本原因，即主要引起紧张性头痛的组织系统，是肌肉系统。

There are a lot of muscles on the skull, believe it or not.

不管你信不信，头骨上有很多肌肉。

Of course, on the neck, and they allow you to move your neck and head, but there are a lot of muscles that lie parallel to the skull, and oftentimes those muscles will undergo excessive amounts of constriction.

当然，在颈部，它们允许您移动颈部和头部，但是有很多肌肉与头骨平行，并且通常这些肌肉会受到过度的收缩。

Now there are, of course, muscles in the jaw that can also lead to headache and jaw ache and things of that sort, and neck aches and headaches.

当然，下颌的肌肉也会导致头痛、下颌疼痛等类似症状，以及颈部疼痛和头痛。

So what we're really pointing out here is that the muscles are a key player in the formation of different types of headache, tension headache in particular.

因此，我们在这里真正要指出的是，肌肉是不同类型头痛（尤其是紧张性头痛）形成的关键因素。

But of course, muscles and muscle tension can be involved in the other types of headaches as well.

当然，肌肉和肌肉紧张也可能与其他类型的头痛有关。

Okay, so I just want to highlight muscular issues as one particular source of the ache in headaches.

好吧，我只想强调肌肉问题是头痛疼痛的一个特殊根源。

The other tissue that can be prominently involved in generating the ache of a headache are the so-called meninges.

另一种与头痛产生显着相关的组织是所谓的脑膜。

Now the meninges, in addition to being a fun word to say, are a bunch of tissues that line the outside of the brain and reside between the brain and the skull.

现在，脑膜除了是一个有趣的词之外，还是排列在大脑外部、位于大脑和头骨之间的一堆组织。

So you might think, okay, between the brain and the skull, there's probably just a little bit of fluid, and the brain is right up next to the skull, but it turns out that's not the case.

所以你可能会想，好吧，在大脑和头骨之间，可能只有一点点液体，而且大脑就在头骨旁边，但事实并非如此。

The brain is actually encased in a very thick, very durable sac or casing that's wrapped around it tight like Saran Wrap.

大脑实际上被包裹在一个非常厚、非常耐用的囊或外壳中，像保鲜膜一样紧紧地包裹着它。

It actually has a name, which is dura, D-U-R-A.

它实际上有一个名字，那就是硬脑膜，D-U-R-A。

And so you can remember dura, durable.

所以你可以记住硬脑膜，耐用。

And having done some surgeries, many surgeries before on brains of different types ranging from human, even though I'm not a neurosurgeon as a clinician, ranging from human to other types of species, what you find is that the dura is exceedingly durable.

在对从人类到其他类型的不同类型的大脑进行过一些手术之后，即使我不是神经外科医生，从人类到其他类型的物种，你会发现硬脑膜非常耐用。

Getting through this thing really requires a very sharp razor blade.

解决这个问题确实需要一把非常锋利的刀片。

So the brain is actually sitting in a very fibrous-like sac that you simply could not open up with your fingertips under any conditions.

所以大脑实际上位于一个非常纤维状的囊中，在任何情况下你都无法用指尖打开它。

It's really durable.

它真的很耐用。

The meninges are in that general area and also encasing the brain, and the meninges provide an additional buffer between the brain and the dura and the skull.

脑膜位于该一般区域中并且还包围大脑，并且脑膜在大脑与硬脑膜和颅骨之间提供额外的缓冲。

So again, you don't want to think about the brain as just sitting right next to the skull.

再说一次，你不想把大脑想象成就位于头骨旁边。

It's close by, but there are a bunch of other thin fibrous tissues, many of which are very thin and fragile, and others of which, such as the dura, that are very, very strong because they're very fibrous.

它就在附近，但还有一堆其他薄纤维组织，其中许多非常薄且脆弱，而其他组织，例如硬脑膜，非常非常坚固，因为它们的纤维含量很高。

Almost like a if you've ever felt, for instance, the sail of a sailboat, you might think, "Oh, it's just this big flapping sheet in the wind." It is anything but a sheet in the wind.

举例来说，如果您曾经感受过帆船的帆，您可能会想：“哦，这只是风中飘动的大床单。”它只不过是风中的一张纸而已。

It is a very, very strong and durable material.

它是一种非常非常坚固耐用的材料。

Now, the proximity of the dura and the meninges to the brain, and the fact that everything is wrapped very tightly together, and the fact that there's a lot of vasculature, so that would be arteries, blood vessels, and capillaries, are all in that area on the top of the brain and throughout the brain.

现在，硬脑膜和脑膜离大脑很近，所有的东西都紧紧地包裹在一起，而且有很多脉管系统，比如动脉、血管和毛细血管，都在大脑顶部和整个大脑的那个区域。

The fact that all of that is in very close proximity and wrapped really tight in this very durable sac is one of the reasons why when blood vessels or arteries or both become dilated, they open, there creates a pressure between the brain and those tissues.

事实上，所有这些都非常接近并且非常紧密地包裹在这个非常耐用的囊中，这就是为什么当血管或动脉或两者都扩张时，它们会张开，在大脑和这些组织之间产生压力的原因之一。

And because there isn't much distance between the tissues like the dura and the meninges and the skull, there's also pressure that allows for the brain to literally sneak up or, I should say, give the impression that your brain is expanding up against your skull.

由于硬脑膜、脑膜和颅骨等组织之间的距离并不大，因此也存在压力，使大脑能够悄悄地向上移动，或者，我应该说，给人一种大脑正在向颅骨扩张的印象。

So the point here is that while muscular tension can give rise to headache, the other thing that can give rise to headache is so-called vasodilation, the expansion or the widening of the arteries, blood vessels, and capillaries.

所以这里的要点是，虽然肌肉紧张会引起头痛，但引起头痛的另一种情况是所谓的血管舒张，即动脉、血管和毛细血管的扩张或加宽。

And one of the reasons why that gives rise to headache is because there's simply not a lot of space for that expansion to go.

令人头疼的原因之一是因为根本没有足够的空间可供扩展。

It doesn't allow anything except for the brain to push up against that very durable tissue and that very durable tissue to push up against the skull.

除了大脑推动非常耐用的组织和非常耐用的组织推动头骨之外，它不允许任何东西。

And even though the brain itself doesn't have pain receptors, that's right, the brain itself doesn't have pain receptors.

即使大脑本身没有疼痛感受器，没错，大脑本身也没有疼痛感受器。

That is why a neurosurgeon can take off a piece of skull and can probe around in the brain with an electrode and the person is completely unaware.

这就是为什么神经外科医生可以取下一块头骨，并用电极在大脑中进行探测，而患者却完全没有意识到。

And in order to get through the skull, of course, that little skin flap has to be removed from the skull, and that requires a little bit of topical anesthetic.

当然，为了穿过头骨，必须从头骨上去除那个小皮瓣，这需要一点局部麻醉。

But really, you don't need any anesthetic to go into the brain itself because there aren't pain receptors on the brain itself.

但实际上，你不需要任何麻醉剂进入大脑本身，因为大脑本身没有疼痛感受器。

However, the tissue surrounding the brain, such as the dura, the meninges, and the vasculature that then reaches up, believe it or not, into the skull.

然而，无论你相信与否，大脑周围的组织，例如硬脑膜、脑膜和脉管系统，都会向上延伸到头骨中。

The vasculature doesn't actually stop right beneath the skull.

脉管系统实际上并不停在头骨正下方。

Actually, blood vessels get into the skull, and there are actually portals by which blood can move within the skull itself.

事实上，血管进入头骨，并且实际上有一些门户，血液可以通过这些门户在头骨本身内流动。

Well, what that means is that since all of the tissues are very close by and very compact with respect to one another, any increase in the size of the portals that allow movement of blood there, and the fact that there are what are called nociceptors, N-O-C-I, nociceptors, these are essentially pain receptors.

嗯，这意味着，由于所有组织都非常接近并且彼此非常紧凑，因此允许血液在那里流动的门户尺寸的任何增加，以及存在所谓的伤害感受器、N-O-C-I、伤害感受器的事实，这些本质上是疼痛感受器。

Because of the presence of pain receptors in the tissues around the brain, when there's an increase in the size of those vascular portals, the arteries, capillaries, and vessels, we experience that as intense pain and pressure.

由于大脑周围组织中存在疼痛感受器，当这些血管入口、动脉、毛细血管和血管的尺寸增加时，我们会感受到剧烈的疼痛和压力。

And fortunately, there are excellent treatments for dealing with that intense pain and pressure.

幸运的是，有很好的治疗方法可以应对剧烈的疼痛和压力。

But keep in mind that the intense pain and pressure that is the consequence of vasodilation, that is the widening of these different vascular portals, is very different than the type of pain that arises from muscular tension, as is the case with tension headache.

但请记住，血管舒张（即这些不同血管入口的扩大）导致的剧烈疼痛和压力与肌肉紧张引起的疼痛类型有很大不同，如紧张性头痛。

Okay, so now we have two sources of pain, that is the ache in headache, and there are two more that we need to think about in trying to better understand the different types of headaches that we'll discuss and in terms of trying to understand which are going to be the best treatments for the different types of headaches.

好的，现在我们有两个疼痛来源，那就是头痛，为了更好地理解我们将要讨论的不同类型的头痛，以及试图了解哪些是不同类型头痛的最佳治疗方法，我们还需要考虑两个来源。

And those are neural and inflammatory responses.

这些是神经和炎症反应。

So let's talk about the neural type first.

那么我们先来谈谈神经类型。

There is a type of headache that many people unfortunately suffer from.

许多人不幸患有一种头痛。

We'll get into this in a bunch more detail in a moment.

我们稍后会更详细地讨论这个问题。

Those are called cluster headaches.

这些被称为丛集性头痛。

Cluster headaches are headaches that arise not from the surface.

丛集性头痛是指非表面原因引起的头痛。

People don't experience them as kind of a tightening of the forehead and the neck and the jaw, but rather it feels as if the headache is coming from deep within the head, and in particular, from behind the orbit of one or the other eyes, and sometimes both eyes.

人们不会感觉到前额、脖子和下巴收紧，而是感觉好像头痛来自头部深处，特别是来自一只或另一只眼睛的眼眶后面，有时是两只眼睛。

For those of you that have ever experienced cluster headaches, they are extremely painful.

对于那些曾经经历过丛集性头痛的人来说，这是非常痛苦的。

Even the more, or I should say, the relatively more minor cluster headaches are extremely painful, and the severe ones are exceedingly painful.

甚至，或者应该说，比较轻微的丛集性头痛是极其痛苦的，严重的则是极其痛苦的。

Cluster headaches arise from deep, or we get the sensation that they are rising from deep within our head as opposed from the surface inward because they are neural in origin.

丛集性头痛是从深处产生的，或者我们感觉它们是从我们头部深处升起的，而不是从表面向内升起的，因为它们起源于神经。

And there's a particular nerve pathway called the trigeminal nerve that often is the origin of these cluster headaches that people experience behind the eye.

有一种称为三叉神经的特殊神经通路，通常是人们在眼后经历的丛集性头痛的根源。

The trigeminal, as the name suggests, has three branches.

三叉神经，顾名思义，有三个分支。

Tri.

三。

Okay?

好的？

So there's a branch that essentially extends to the eye.

所以有一个分支基本上延伸到眼睛。

There's also a branch that extends to the mandible, right to the lip, and there's a branch that extends more or less to the nasal area.

还有一个分支延伸到下颌骨，一直延伸到嘴唇，还有一个分支或多或少地延伸到鼻部区域。

And so this trigeminal nerve becomes inflamed or in other ways is hyperactivated in some cases, and that causes the deep pain below the eye because it is that first branch of the trigeminal nerve, which is the ophthalmic branch, which tends to be activated first.

因此，在某些情况下，三叉神经会发炎或以其他方式过度激活，这会导致眼睛下方的深部疼痛，因为它是三叉神经的第一个分支，即眼科分支，往往首先被激活。

So people start feeling as if there's a pain behind their eye, in particular on one side.

因此，人们开始感觉眼睛后面有疼痛，尤其是一侧。

Oftentimes, there's lacrimation, which is tearing up.

很多时候，会流泪，流泪。

There can be some nasal discharge.

可能会有一些鼻涕。

Another common symptom of this type of headache, that is the cluster headache, is that the pupils sometimes will become very small, the pupils of the eyes, and they won't dilate, even in darkness.

这类头痛的另一个常见症状，那就是丛集性头痛，就是瞳孔有时会变得很小，眼睛的瞳孔，即使在黑暗中也不会散大。

So there are a bunch of things that are going on on one or both sides of the face that seem to arise from deep within the head, or it's almost as if it's coming from the brain outward, and that's because it's neural in origin.

因此，脸部的一侧或两侧正在发生很多事情，这些事情似乎是从头部深处产生的，或者几乎就像是从大脑向外发出的，那是因为它起源于神经。

Okay, so we've got muscular origins of headaches, we've got meningeal origins of headaches, that is the stuff around the brain and as it relates to the vasculature, and we have neural origins of headaches.

好的，我们有头痛的肌肉起源，有头痛的脑膜起源，即大脑周围的东西，因为它与脉管系统有关，还有头痛的神经起源。

And of course, there's inflammation origins of headaches.

当然，头痛也是由炎症引起的。

Now inflammation is a term that gets thrown around a lot these days.

现在，炎症是一个经常被使用的术语。

People are talking about, "This reduces inflammation, and inflammation is bad." And I suppose in some cases and when inflammation is really widespread across the brain or body, it's bad.

人们在谈论，“这可以减少炎症，而炎症是有害的。”我想在某些情况下，当炎症在大脑或身体中广泛传播时，那就很糟糕了。

But I don't think any of us should think about inflammation per se as bad.

但我认为我们任何人都不应该认为炎症本身是一件坏事。

What I mean is inflammation is just one form of signaling in the body, which of course includes the brain.

我的意思是，炎症只是体内信号传导的一种形式，当然也包括大脑。

Inflammation of a tissue is one way in which a set of cells, so these could be, for instance, cells of the immune system, and we cover this in a detailed episode all about the immune system.

组织炎症是一组细胞发生的一种方式，因此这些细胞可能是免疫系统的细胞，我们将在有关免疫系统的详细章节中对此进行介绍。

If you'd like to check that out, you go to hubermanlab.com, just put into our search function immune system, and you can find that episode.

如果您想查看该内容，请访问 hubermanlab.com，只需输入我们的搜索功能免疫系统，您就可以找到该剧集。

By the way, all of our episodes are searchable by keyword at hubermanlab.com, and it'll take you to specific episodes and timestamps for the topics you're interested in.

顺便说一句，我们所有的剧集都可以在 hubermanlab.com 上通过关键字搜索，它会带您找到您感兴趣的主题的特定剧集和时间戳。

So for sake of this discussion about headache, inflammation is going to be the case when one particular tissue in and around the head area is releasing molecules, cytokines, which sometimes are called inflammatory cytokines, but there are also non-inflammatory or anti-inflammatory cytokines.

因此，为了讨论头痛，当头部区域内和周围的一个特定组织释放分子、细胞因子时，就会发生炎症，这些细胞因子有时被称为炎性细胞因子，但也有非炎性或抗炎性细胞因子。

But inflammatory molecules that are signaling to the rest of the body, "Hey, there's something going on here."

但是炎症分子会向身体的其他部位发出信号，“嘿，这里发生了一些事情。”

There's either some intrusive object, and indeed, if you were to get a BB or a splinter into a particular skin area, there'd be a lot of inflammation.

要么有一些侵入性物体，事实上，如果你将 BB 或碎片放入特定的皮肤区域，就会出现很多炎症。

So it could be the introduction of a foreign physical object into an area that will cause inflammation.

因此，可能是将异物引入到某个区域，从而引起炎症。

It can be the presence of some sort of local toxin in that area.

可能是该区域存在某种局部毒素。

It could be a more systemic inflammation.

这可能是一种更全身性的炎症。

Nonetheless, inflammation in the neck and head area, or frankly, anywhere within the sinus area, so this would include the mouth, the nose, around the eyes.

尽管如此，颈部和头部区域的炎症，或者坦率地说，鼻窦区域内任何地方的炎症，所以这包括嘴、鼻子、眼睛周围。

Because the sinuses, many of us think of sinuses as just our nose, but actually if I were to show you a skull, a human skull or any other kind of skull, you'd be very, hopefully, intrigued to learn that the skull is just not one big piece of solid bone or a top with a jaw below it.

因为鼻窦，我们很多人认为鼻窦就是我们的鼻子，但实际上，如果我向你展示一个头骨，一个人类头骨或任何其他类型的头骨，你会非常有希望地知道头骨不是一大块实心骨头或下面有下巴的顶部。

It actually has all these small, what are called fenestrations, little holes and canals that run through the skull and through the depth of the skull, like little tubes.

它实际上有所有这些小孔，即所谓的开窗、小孔和管道，它们穿过头骨并穿过头骨的深处，就像小管子一样。

You've got them down here on your mandible.

你把它们放在你的下颌上。

You've got them above your lips.

你已经把它们放在嘴唇上方了。

You have them on either sides of your nose.

它们位于鼻子两侧。

Those are the sinuses.

这些是鼻窦。

The sinuses allow the passage of different fluids through the skull because the skull, even though it's bone, it's not a dead tissue, right?

鼻窦允许不同的液体通过头骨，因为头骨虽然是骨头，但它不是死亡的组织，对吗？

In a live person or animal, the skull is a very active, living tissue.

在活人或动物中，头骨是一个非常活跃的活组织。

Indeed, all bone is active living tissue, and it needs to be nourished with blood.

确实，所有的骨骼都是活跃的活组织，需要血液的滋养。

It needs to be nourished with cerebral spinal fluid in the case of the skull.

就颅骨而言，它需要脑脊液的滋养。

It needs to be nourished with all sorts of important things.

它需要用各种重要的东西来滋养。

So those sinuses oftentimes can become clogged, as is in the case with sinus headache, which we'll talk about in a little bit.

因此，这些鼻窦经常会被堵塞，就像鼻窦头痛的情况一样，我们稍后会讨论这一点。

But more generally, anytime there's inflammation of one given area of the body, so it could be a shoulder, it could be the neck, it could be the mouth, it could be the nose, or in the case of headache, it could be any portion of the head or neck.

但更一般地说，任何时候身体某一特定部位出现炎症，可能是肩膀，可能是颈部，可能是嘴，可能是鼻子，或者在头痛的情况下，可能是头部或颈部的任何部分。

What happens is inflammation, while it's a very efficient signal, it's much like the siren on an ambulance or a police car in that it sends out a very broad signal that's very clear something is wrong here and needs to be dealt with.

发生的是炎症，虽然这是一个非常有效的信号，但它很像救护车或警车上的警报器，因为它发出了一个非常广泛的信号，很明显这里出了问题并且需要处理。

It's not very specific.

这不是很具体。

So it's very robust, but it's not very specific.

所以它非常强大，但不是很具体。

So for instance, if there's a little bacterial infection or a little viral infection, the inflammation response to that site of infection tends to be far more widespread than the actual site of infection.

例如，如果有一点细菌感染或一点病毒感染，该感染部位的炎症反应往往比实际感染部位广泛得多。

It's a little bit different when you have a foreign object there, like a splinter or some other foreign object.

当那里有异物时，例如碎片或其他异物，情况会有点不同。

That tends to be a bit more localized.

这往往更加本地化。

And the immune system is always trying to limit the extent of inflammation by putting in different scar tissues.

免疫系统总是试图通过放置不同的疤痕组织来限制炎症的程度。

Indeed, a lot of the things that we think of as kind of gross pus, pustules and boils and things like that, I know it's a gross topic, are ways in which our body tries to restrict the amount of inflammation.

事实上，很多我们认为是恶心的脓液、脓疱和疖子之类的东西，我知道这是一个恶心的话题，都是我们的身体试图限制炎症程度的方式。

But the face area and the head itself are so heavily infused with blood vessels, and there's a constant profusion, as we say, of blood and cerebral spinal fluid and other things through this incredibly metabolically active tissue that we call our brain and our eyes.

但面部区域和头部本身充满了大量的血管，正如我们所说，通过我们称之为大脑和眼睛的新陈代谢活跃的组织，血液、脑脊液和其他物质不断大量流动。

Those are by far the most metabolically active tissues in our entire body.

这些是迄今为止我们整个身体中代谢最活跃的组织。

Even if we're running hundreds of miles in ultramarathons, your brain is still far more metabolically demanding than all the muscles of your body combined, no matter what the conditions.

即使我们在超级马拉松中跑数百英里，无论条件如何，您的大脑对新陈代谢的要求仍然远远高于您身体所有肌肉的总和。

Because of that, there tends to be a generalization or a spreading out of any inflammatory response.

因此，任何炎症反应往往会普遍化或扩散。

And that inflammatory response then can trigger the pain mechanisms or what we experience as pain mechanisms in the other three types of tissues that we talked about.

然后，炎症反应可以触发疼痛机制，或者我们在我们讨论的其他三种类型的组织中所经历的疼痛机制。

So for instance, if you have a systemic infection or you're experiencing inflammation of any kind and it has anything to do with or encroaches on the face or head area, that can easily and almost always spills over into activation of nerve cells.

例如，如果您患有全身性感染或正在经历任何类型的炎症，并且它与面部或头部区域有关或侵犯，那么很容易并且几乎总是会导致神经细胞的激活。

Can give rise to neural-based headache or to the meninges, and can give rise to meningeal headaches, and of course to the muscles and to muscular type headaches.

可以引起神经性头痛或脑膜性头痛，也可以引起脑膜性头痛，当然还有肌肉性头痛和肌肉型头痛。

So we've got muscular origins of the ache in headache.

所以我们找到了头痛疼痛的肌肉根源。

We have meningeal origins of the ache in headache.

头痛的疼痛有脑膜起源。

We have neural origins of the ache in headache.

头痛的疼痛有神经起源。

And we have inflammation-based origins of the ache in headache.

头痛疼痛的根源是炎症。

And that pertains to all the different types of headaches that we're going to talk about.

这涉及我们将要讨论的所有不同类型的头痛。

And it's important to keep in mind that there are these different sources of the ache in headache, and that sometimes they exist alone and sometimes they exist in combination.

重要的是要记住，头痛疼痛有不同的来源，有时它们单独存在，有时它们组合存在。

However, and this is an important however, all pain, or I should say all experience of pain as a perception, is going to be neural in origin.

然而，这一点很重要，所有疼痛，或者我应该说所有疼痛体验作为一种感知，都源于神经。

When we experience pain, whether or not it's a pin prick or a cut, stub our toe, we trip and fall, or a headache It is neural in origin.

当我们经历疼痛时，无论是针刺还是割伤、撞到脚趾、绊倒或摔倒，或者头痛，这些疼痛都是神经源性的。

It is the nervous system and nerve cells that are going to carry that signal that we perceive as pain.

神经系统和神经细胞将传递我们感知为疼痛的信号。

So as we talk about the different sources of pain and different types of headache, we will also talk about, of course, I think what most people are interested in today's discussion, the different treatments for the different types of headache and why each of those different treatments work.

因此，当我们谈论不同的疼痛来源和不同类型的头痛时，我们当然也会谈论我认为大多数人对今天的讨论感兴趣的内容，不同类型头痛的不同治疗方法以及为什么每种不同的治疗方法有效。

But by understanding a little bit about how pain arises in the nervous system, and certainly by understanding the different types of headaches.

但是，要了解一点关于神经系统中疼痛如何产生的知识，当然还要了解不同类型的头痛。

What is a tension headache?

什么是紧张性头痛？

I gave you some impression that it's running around your head like a headband in many cases, versus cluster headache, which starts deep below the eye.

我给你的印象是，在很多情况下，它就像头带一样围绕着你的头部，而不是从眼睛下方深处开始的丛集性头痛。

Often it feels as if it's emerging from deep in the brain, versus migraine, which we'll get into in a moment.

通常感觉好像它是从大脑深处出现的，而不是偏头痛，我们稍后会讨论偏头痛。

By understanding the different types of headaches, you should be able to quickly pinpoint what type of headache you have, what types of tissues are likely involved, and therefore, what types of treatments are going to most quickly and most completely relieve that type of headache.

通过了解不同类型的头痛，您应该能够快速确定您患有哪种类型的头痛、可能涉及哪些类型的组织，以及哪种类型的治疗可以最快速、最彻底地缓解该类型的头痛。

Okay, so for the next three to five minutes, and I promise no more, I'm going to explain how pain arises at the level of nerve cells.

好吧，在接下来的三到五分钟内，我保证不会再有更多，我将解释疼痛是如何在神经细胞层面产生的。

And I suppose this is one of those times when, if I had a highlighter pen that could go out across the microphones and speakers leading to your ears, I would use it here.

我想这是这样的时候，如果我有一支荧光笔可以穿过通向你耳朵的麦克风和扬声器，我会在这里使用它。

Because what I'm about to tell you is perhaps one of the most important things to understand about your nervous system, that is your brain and you, which is that while you have trillions of neurons, and we hear that you have trillions in different types of neurons in your brain, and they come in different shapes and sizes and do different things, and some make dopamine, and some make serotonin, and some make glutamate, and on and on.

因为我要告诉你的可能是了解你的神经系统最重要的事情之一，那就是你的大脑和你，也就是说，虽然你有数万亿个神经元，我们听说你的大脑中有数万亿个不同类型的神经元，它们有不同的形状和大小，做不同的事情，有些产生多巴胺，有些产生血清素，有些产生谷氨酸，等等。

The key distinction among different types of neurons, that is the three types of neurons that I believe everybody, scientist or no, everybody should understand exist, are some neurons, nerve cells, are what we call motor neurons in the sense that they control the contraction of muscles.

不同类型神经元之间的关键区别，即我相信每个人，无论是否是科学家，每个人都应该理解存在的三种类型的神经元，是一些神经元，神经细胞，是我们所说的运动神经元，因为它们控制肌肉的收缩。

Sometimes for walking, other neurons control the movements of your fingers.

有时，在行走时，其他神经元会控制手指的运动。

Scientists call those digits.

科学家称这些数字为数字。

Other ones, your toes.

其他的，你的脚趾。

They also control the beating of your heart, although that's a slightly different mechanism and slightly different type of tissue than is involved in generating motor movements of your limbs.

它们还控制心脏的跳动，尽管这与产生四肢运动的机制和组织类型略有不同。

These are neurons that we call motor neurons because their goal or their purpose, I should say, they don't really know what their goal or purpose is, but what they do is they make sure that muscles contract so that certain things happen in your body, like your heart beats or you move your limbs, you lift your eyelids or your eyebrows, rather, and so on and so forth.

这些神经元我们称之为运动神经元，因为它们的目标或目的，我应该说，它们并不真正知道自己的目标或目的是什么，但它们所做的是确保肌肉收缩，以便您的身体发生某些事情，例如您的心跳或移动您的四肢，您抬起眼睑或眉毛，等等。

Other types of neurons are what we call sensory neurons.

其他类型的神经元就是我们所说的感觉神经元。

They communicate the same way that motor neurons do.

它们的交流方式与运动神经元相同。

That is, they fire what we call action potentials, which are just electrical signals.

也就是说，它们发射我们所说的动作电位，这只是电信号。

They release neurotransmitters like any other neuron, but they respond to certain events in the environment or the environment within the body, but they are not responsible for generating muscular contractions.

它们像任何其他神经元一样释放神经递质，但它们对环境或体内环境中的某些事件做出反应，但它们不负责产生肌肉收缩。

So we call these sensory neurons.

所以我们称这些为感觉神经元。

Some sensory neurons sense light touch, other sensory neurons sense firm touch, other sensory neurons sense pain, other sensory neurons sense light brushing on the skin.

一些感觉神经元感知轻触，其他感觉神经元感知坚定的触摸，其他感觉神经元感知疼痛，其他感觉神经元感知皮肤上的光刷。

In fact, you have sensory neurons, believe it or not, that respond specifically to the light brushing of a hand across your skin, any region of your body.

事实上，无论你相信与否，你都有感觉神经元，它们会对手轻轻拂过你的皮肤、身体任何部位的动作做出专门的反应。

And if that particular region of your body happens to have hair on it and you stroke the skin in the direction that the hairs lay down, we experience that as pleasurable.

如果你身体的某个特定区域碰巧有毛发，并且你沿着毛发所在的方向抚摸皮肤，我们会感到很愉快。

Whereas if you stroke in the direction opposite to the way the hairs lay down, we experience that as not pleasurable.

然而，如果你以与毛发放置方向相反的方向抚摸，我们会感到不愉快。

So these sensory neurons respond in some cases, for instance, within the auditory system, they respond to sound waves.

因此，这些感觉神经元在某些情况下会做出反应，例如，在听觉系统内，它们会对声波做出反应。

In your eye they respond to photons of light, sometimes photons of light of particular wavelengths that we think of as red, green, blue, and so on.

在你的眼睛中，它们对光的光子做出反应，有时是特定波长的光的光子，我们认为这些波长是红色、绿色、蓝色等。

Sensory neurons don't move muscles, they respond to things in the environment and they exist within us.

感觉神经元不移动肌肉，它们对环境中的事物做出反应，并且存在于我们体内。

So we have sensory neurons that sense, for instance, pressure within our head or pressure within our gut, how full or empty our gut is.

因此，我们有感觉神经元，可以感知我们头部内的压力或肠道内的压力，以及我们的肠道有多满或多空。

Pain within our tissues, like our liver or any kind of other internal organ.

我们组织内的疼痛，例如肝脏或任何其他内脏器官。

So we've got motor neurons, sensory neurons, and then the last kind of neuron is what we call modulatory neurons.

所以我们有运动神经元、感觉神经元，最后一种神经元就是我们所说的调节神经元。

These are the ones that adjust the relationship between the sensory neurons and the motor neurons to determine whether or not we do anything in response to a sensory input.

这些神经元调整感觉神经元和运动神经元之间的关系，以确定我们是否对感觉输入做出反应。

That is, whether or not if a sensory neuron fires, sends an electrical potential, whether or not it will generate a motor change.

也就是说，无论感觉神经元是否放电、发送电势，是否会产生运动变化。

Let me give you a very simple example of this.

让我给你举一个非常简单的例子。

So for those of you listening, I'll just explain what I'm doing, and for those of you watching, you'll be able to see.

因此，对于那些正在听的人，我只会解释我在做什么，而对于那些正在观看的人，你们将能够看到。

I'm holding my hand out in front of me.

我把手伸到我面前。

If I were to touch the top of my hand with my fingertip, I can deliberately override, that is, I can modulate that more typical reflex, which is that when something touches us, if we're not aware of where it's coming from, we typically move away from that thing that touches us.

如果我用指尖触摸我的手顶，我可以故意覆盖，也就是说，我可以调节更典型的反射，即当有东西触摸我们时，如果我们不知道它来自哪里，我们通常会远离那个触摸我们的东西。

This is a very natural response.

这是一个非常自然的反应。

But we can decide we're not going to move away, we can decide to stay still, or we can decide to move toward the thing that touches us.

但我们可以决定不离开，我们可以决定保持静止，或者我们可以决定走向触动我们的事物。

But typically, if you were to walk up to somebody and you were to touch them, they'd either turn toward you on the side that you touched them or they'd step away.

但通常情况下，如果你走到某人面前并触摸他们，他们要么转向你触摸他们的一侧，要么走开。

It's rare that they're going to step into you.

他们很少会踏入你的内心。

But you could decide that you were not going to move away or you could step into the direction of touch, and that's because you have modulatory neurons that can adjust the conversation in a very context-dependent way as to whether or not the sensory neuron will cause motor neurons to contract or not.

但你可以决定你不会走开，或者你可以向触摸的方向迈进，这是因为你有调节神经元，可以以一种非常依赖于上下文的方式调整对话，以确定感觉神经元是否会导致运动神经元收缩。

Okay?

好的？

So we've got motor neurons, sensory neurons, and modulatory neurons, and you're probably thinking by now, "Why are we talking about this?

所以我们有运动神经元、感觉神经元和调节神经元，你现在可能在想，“我们为什么要谈论这个？

I thought we were going to talk about headache.

我以为我们要讨论头痛的问题。

I thought we were going to talk about treatments for headache." But this turns out to be very important because you could imagine, and in a moment I'll explain how, let's say you have tension headaches.

我以为我们要讨论头痛的治疗方法。”但这事实证明非常重要，因为你可以想象，稍后我将解释如何，假设你患有紧张性头痛。

You're somebody that has the classic symptoms of tension headache.

您是具有紧张性头痛典型症状的人。

Let me tell you what those are.

让我告诉你那些是什么。

These are headaches, again, that occur more or less in a kind of a headband-like fashion, or they tend to start there and exist around the head.

这些都是头痛，或多或少以类似头带的方式发生，或者它们往往从那里开始并存在于头部周围。

These are very common.

这些都很常见。

They can arise from a number of different sources.

它们可能来自许多不同的来源。

They can arise from sleep deprivation, they can arise from Excessive use of caffeine intake.

它们可能是由于睡眠不足引起的，也可能是由于过量摄入咖啡因引起的。

We'll talk about why that is.

我们将讨论为什么会这样。

They can arise from stress.

它们可能是由压力引起的。

They can arise from very low-level viral infections or bacterial infections, but we experience these as just as headaches where you've been thinking too hard or working too hard or life has been stressful.

它们可能是由非常低水平的病毒感染或细菌感染引起的，但我们所经历的这些就像头痛一样，是因为你想得太辛苦、工作太辛苦或生活压力太大。

They're often also associated with jaw pain and jaw tightness and neck tightness.

它们通常还与下巴疼痛、下巴紧张和颈部紧张有关。

So tension headaches, everything you'd imagine muscular tension could cause.

所以紧张性头痛，就是你想象的肌肉紧张可能导致的一切。

Well, if you want to treat tension headache, you could imagine that because all headache is neural, that you'd want to go after some sort of neural mechanism to treat them.

好吧，如果你想治疗紧张性头痛，你可以想象，因为所有头痛都是神经性的，所以你想要寻找某种神经机制来治疗它们。

But of course, we now know that there are three types of neurons.

当然，我们现在知道神经元分为三种类型。

There are motor neurons, sensory neurons, and modulatory neurons.

有运动神经元、感觉神经元和调节神经元。

So we have choices.

所以我们有选择。

We can say, okay, do we want to turn off the muscles in the head, jaw, and neck that are hypercontracted?

我们可以说，好吧，我们要关闭头部、下巴和颈部过度收缩的肌肉吗？

For instance, you want to take a muscle relaxer or relaxant, or would you want to try and change the sensory input itself?

例如，您想服用肌肉松弛剂或松弛剂，或者您想尝试改变感官输入本身吗？

Maybe don't change the way the muscles are behaving, but shut off the sensory part of it, your ability to sense it.

也许不要改变肌肉的行为方式，但要关闭它的感觉部分，即你感知它的能力。

There are certainly ways you can do that.

当然有一些方法可以做到这一点。

Or would you want to adjust the modulatory neurons?

或者你想调整调节神经元吗？

Would you want to make it such that you have the headache, but you don't perceive the headache?

你想让自己感到头痛，但自己却感觉不到头痛吗？

That is, you cut off communication between the sensor and the motor so that the muscles relax.

也就是说，您切断传感器和电机之间的通信，以便肌肉放松。

Turns out there are treatments and approaches for each and every one of those.

事实证明，每一种都有治疗方法。

Each and every one of those has different advantages and disadvantages, but as you can quickly see, we are going to have different types of headaches and different approaches to treating headache, but if you keep in the back of your mind that you have neurons that contract muscles to create movement or tension of muscles, remember, you can turn off those neurons and allow those muscles to relax.

每一种都有不同的优点和缺点，但正如你很快就会看到的，我们将有不同类型的头痛和不同的治疗头痛的方法，但如果你牢记你有收缩肌肉以产生肌肉运动或紧张的神经元，请记住，你可以关闭这些神经元并让这些肌肉放松。

You have sensory neurons that sense input and actually sense the pain, and you have modulatory neurons, which can allow you to adjust the relationship between the sensory neurons and the motor neurons.

你有感觉神经元，可以感知输入并实际感受到疼痛，还有调节神经元，它可以让你调整感觉神经元和运动神经元之间的关系。

And of course, some of you are probably screaming at me by now saying, "Wait, why would you ever want to deal with the motor neurons or the modulatory neurons?

当然，你们中的一些人现在可能会对我大喊大叫，“等等，你为什么要处理运动神经元或调节神经元？

Wouldn't you want to just go straight to the source and just cut off the pain?" Ah.

难道你不想直奔源头，斩断痛苦吗？”啊。

Well, the problem there is that many painkillers have other issues as well.

问题是许多止痛药还存在其他问题。

In particular, they can be sedative.

特别是，它们可以起到镇静作用。

Many of them can be habit-forming or even addictive.

其中许多可能会让人养成习惯，甚至上瘾。

And for many people, not all, but many people, they don't want to take drugs, whether or not they're over-the-counter or prescription drugs or even more natural supplement-based type treatments.

对于很多人来说，不是所有人，而是很多人，他们不想服用药物，无论是非处方药、处方药，还是更天然的补充剂型治疗。

And they would rather use, for instance, a behavioral approach in which they can modulate, they can deliberately turn off the communication between sensory neurons and motor neurons, and turns out those approaches exist as well.

例如，他们宁愿使用一种可以调节的行为方法，他们可以故意关闭感觉神经元和运动神经元之间的通信，结果证明这些方法也存在。

Okay.

好的。

So at this point, I promise you that I'm not going to give you any more of a biology lesson in terms of pain sensing and headaches as a more conceptual phenomenon.

因此，在这一点上，我向您保证，我不会再给您上有关疼痛感知和头痛作为更概念性现象的生物学课程。

Instead, what I'd like to do next is talk about the different types of headaches, and I think this is something that's very important and not often discussed, except for those people out there that unfortunately suffer repeatedly from certain kinds of headaches like migraine or cluster or tension headache.

相反，我接下来想做的是谈论不同类型的头痛，我认为这是非常重要且不经常讨论的事情，除了那些不幸反复遭受偏头痛、丛集性头痛或紧张性头痛等某些类型头痛的人。

But I think for most people out there who experience headache, and again, that is everybody at some point experiences headache, rather than just think of headache as one thing, understanding the major types of headache and how they differ from and are similar to one another will really help you identify what the best source of treatments for those are.

但我认为，对于大多数经历过头痛的人来说，每个人都会在某个时候经历过头痛，而不仅仅是将头痛视为一件事，了解头痛的主要类型以及它们之间的区别和相似之处将真正帮助您确定治疗这些头痛的最佳来源。

So I'd like to talk about what the different types of headache are now.

所以我现在想谈谈头痛的不同类型。

The first type of headache we're going to discuss is the tension type headache.

我们要讨论的第一种头痛是紧张型头痛。

Again, tension type headaches tend to start off, not always, but tend to start off as more or less a halo or a headband around the forehead and the area above the eyes, often also include the jaw, the neck muscles, and can extend even into the upper back.

同样，紧张型头痛往往是从前额和眼睛上方区域周围或多或少出现光环或头带开始的，通常还包括下巴、颈部肌肉，甚至可以延伸到上背部。

Again, this can be caused by some low level of infection, but more often than not, tension type headaches are going to come on because of some chronic psychological stress, usually combined with lack of sleep, usually combined with lifestyle issues, and of course, without getting into a long discussion about it, anytime you have lack of sleep, you're going to have excessive stress.

同样，这可能是由一些低水平的感染引起的，但更常见的是，紧张型头痛会因为一些慢性心理压力而出现，通常与睡眠不足相结合，通常与生活方式问题相结合，当然，无需对此进行长时间的讨论，只要你睡眠不足，你就会承受过度的压力。

Anytime you have excessive stress, you're going to have to make sure you're offsetting that by getting proper sleep.

每当你压力过大时，你就必须确保通过充足的睡眠来抵消压力。

Most people don't when they're under excessive stress.

大多数人在压力过大时不会这样做。

By the way, we have excellent tools that are grounded in excellent science available to you at zero cost.

顺便说一句，我们拥有基于卓越科学的优秀工具，您可以零成本使用。

If you experience chronic stress or even short-term stress, we have a master stress episode of the Huberman Lab podcast.

如果您经历长期压力甚至短期压力，我们有 Huberman Lab 播客的主要压力剧集。

Again, just go to hubermanlab.com and all that's timestamped for you.

再次强调，只需访问 hubermanlab.com，所有内容都会为您加上时间戳。

Tension type headaches begin in a more or less a headband pattern, but can really extend to other tissues as well.

紧张型头痛或多或少以头带模式开始，但实际上也可以扩展到其他组织。

Not so often in the face, but really the head and often will start to climb up toward the top of the head.

不经常出现在脸上，但实际上是头部，并且经常会开始爬向头顶。

They are not always in this halo pattern.

他们并不总是处于这种光环模式中。

Sometimes they can be localized to one area, such as the back of the head or the front of the head or one side of the head more than others.

有时，它们可以局限于一个区域，例如头部后部或头部前部或头部的一侧比其他区域更多。

And that's often the case because of tension within muscles of the neck that tend to bias the ache towards one side of the head.

这种情况经常发生，因为颈部肌肉紧张，往往会将疼痛偏向头部的一侧。

The other type of headache that unfortunately is very common is migraine headaches.

不幸的是，另一种很常见的头痛是偏头痛。

Migraine headaches are defined generally as disorders of recurring attacks of headaches.

偏头痛通常被定义为头痛反复发作的疾病。

So people who get migraines often get them in a recurring fashion.

因此，患有偏头痛的人通常会反复发作。

Some people get them very often, other people get them less often, but migraines are very debilitating.

有些人经常得偏头痛，有些人则较少得，但偏头痛会让人非常虚弱。

The numbers, that is the prevalence of migraine, is still pretty debated.

这个数字，即偏头痛的患病率，仍然存在很大争议。

One thing that we know for sure is that females suffer from migraine headaches at a rate at least threefold higher than do males.

我们确信的一件事是，女性患偏头痛的比率至少是男性的三倍。

And surprisingly, this does not seem to have any direct hormonal origin because we're also going to talk about hormonal headaches.

令人惊讶的是，这似乎没有任何直接的荷尔蒙起源，因为我们还将讨论荷尔蒙头痛。

That is, headaches that relate to a dip in estrogen and progesterone in a particular phase of the menstrual cycle.

也就是说，与月经周期特定阶段雌激素和黄体酮下降有关的头痛。

That is the ovulatory cycle.

这就是排卵周期。

So there's a bit of a mystery here, and the mystery is why is it that migraine headaches occur at such greater frequency in females, even independently of the menstrual cycle?

所以这里有一点神秘，神秘的是为什么女性偏头痛发生的频率如此之高，甚至与月经周期无关？

So when you control for changes in hormones, that still appears to be the case.

因此，当你控制激素的变化时，情况似乎仍然如此。

And overall, migraines are very common.

总的来说，偏头痛很常见。

Now the numbers on migraine and just how common migraine is are extremely wide.

现在有关偏头痛的数据以及偏头痛的常见程度非常广泛。

This was a little bit frustrating for me in researching this episode You will find, for instance, that 17% of women suffer from migraines.

在研究这一集时，这对我来说有点令人沮丧。例如，您会发现 17% 的女性患有偏头痛。

You will also hear that 6% of males suffer from migraines.

您还会听说 6% 的男性患有偏头痛。

You will also hear that 43% of females suffer from migraine, that is recurring headaches that qualify as migraine headaches, and that 17% of men suffer from migraine headaches on a recurring basis, which is again, the definition of a migraine headache or one of the key definitions.

您还会听说，43% 的女性患有偏头痛，即反复出现的头痛，符合偏头痛的标准；17% 的男性患有反复出现的偏头痛，这又是偏头痛的定义或关键定义之一。

So all we can say for sure is that many, many millions of people, maybe even billions of people, suffer from migraine headaches.

因此，我们可以肯定地说，有数百万人，甚至数十亿人患有偏头痛。

It's kind of a staggering thing to contemplate, but we know it's extremely common, and we know that it's more prevalent in females.

这是一件令人震惊的事情，但我们知道它非常常见，而且我们知道它在女性中更为普遍。

In any of the studies that you will find that compare the overall prevalence of headache, it's going to be substantially higher in females than males.

在任何一项比较头痛总体患病率的研究中，您都会发现女性的头痛患病率明显高于男性。

Does not seem to be related to the ovulatory menstrual cycle.

似乎与排卵月经周期无关。

There are some interesting facts related to that that I'll just touch on for a moment.

有一些与此相关的有趣事实，我将暂时谈一下。

Pregnancy, for whatever reason, seems to be protective against migraine headaches.

无论出于何种原因，怀孕似乎可以预防偏头痛。

That is, women who suffer from recurring migraines before they get pregnant, when they get pregnant, and often after they give birth, they experience fewer migraine headaches.

也就是说，在怀孕前、怀孕时以及产后经常患有偏头痛的女性，其偏头痛的症状较少。

So there may be something hormonal.

所以可能有荷尔蒙的东西。

It may be something else.

可能是别的东西。

What do we know for sure?

我们确定知道什么？

We know that headache, that is the ache in headache, is neural.

我们知道头痛，即头痛中的疼痛，是神经性的。

So whether or not the origins are hormonal or whether or not the origins are inflammation or gut microbiome or some other feature of the body-brain axis, at this point, all we know is that neural pain or the experience of pain at the neural level is the final common pathway, and it's more prevalent in females.

因此，无论起源是否是激素，也无论起源是炎症、肠道微生物群还是身体-大脑轴的其他特征，目前我们所知道的是，神经疼痛或神经水平上的疼痛体验是最终的共同途径，并且在女性中更为普遍。

So as I mentioned, migraines tend to be recurring.

正如我所提到的，偏头痛往往会反复发作。

So some people get them once a week.

所以有些人每周接受一次。

Some people get them once a month.

有些人每月接受一次。

Some people get them far more frequently than that.

有些人患此病的频率远高于此。

They can be extremely debilitating.

它们可能会让人极度虚弱。

Oftentimes, people who experience migraine, because it is a recurring phenomenon, will know when a migraine is coming on.

通常，患有偏头痛的人会知道偏头痛何时发作，因为这是一种反复出现的现象。

They'll say, "My migraine is coming on." They kind of sense it coming.

他们会说：“我的偏头痛要发作了。”他们有点感觉到它的到来。

There's this notion of aura, and we'll talk about aura in a little bit.

这就是光环的概念，我们稍后会讨论光环。

Some people think of aura just as visual aura or the sense of kind of a haloing of light or the sense that there's something outside the body.

有些人认为光环就像视觉光环或一种光晕的感觉或身体之外有东西的感觉。

The actual definition of aura is that it's the experience that something is about to happen.

光环的实际定义是，某种事情即将发生的体验。

It's this kind of feeling of anticipation.

就是这种期待的感觉。

It's not déjà vu.

这不是似曾相识的感觉。

Déjà vu is different and very interesting in its own right, but different.

似曾相识（Déjà vu）是不同的，它本身就非常有趣，但又不同。

It's this feeling that something's about to happen.

正是这种感觉，有事情即将发生。

And the fact that aura is such a prominent feature of migraine headaches, or at least that people feel that the headache is coming on long before they feel the actual ache of the headache and the other debilitating symptoms, suggests that migraine has something of deep neural origin, that it arises from deep within the nervous system, spinal cord, and brain, and that it's not something like a tension headache that is going from outside in, the constriction of the muscles in the jaw and head.

先兆是偏头痛的一个显着特征，或者至少人们在感觉到头痛和其他衰弱症状之前很久就感觉到头痛，这一事实表明偏头痛具有深层神经起源，它起源于神经系统、脊髓和大脑深处，而且它不像紧张性头痛那样从外到内，下巴和头部肌肉收缩。

So migraine headaches are very different than tension headaches, even in terms of how they come on or their onset.

因此，偏头痛与紧张性头痛非常不同，甚至在发病方式或发作方面也是如此。

The other feature of migraine headaches that I think is important to note is that dilation of the vessels, remember the vasodilation, so the widening of those pipes that we call arteries, vessels, and capillaries, is a very prominent feature of migraine.

我认为值得注意的偏头痛的另一个特征是血管扩张，记住血管扩张，所以我们称之为动脉、血管和毛细血管的管道扩张，是偏头痛的一个非常突出的特征。

And fortunately, that allows for very particular types of treatment and ways of dealing with the pain specific to migraine headaches.

幸运的是，这允许采用非常特殊的治疗类型和方法来处理偏头痛特有的疼痛。

The other feature that's common in migraine headaches is so-called photophobia.

偏头痛的另一个常见特征是所谓的畏光。

Many of you are probably familiar with photophobia if you've ever been sleep deprived.

如果您曾经睡眠不足，那么你们中的许多人可能都熟悉畏光症。

Simply, if you're sleep deprived and you go outside in the morning, the light is going to seem very, very bright, much brighter than were you to have had a really good night's sleep.

简单地说，如果你睡眠不足，早上出门时，光线会显得非常非常亮，比你睡了一晚好觉时还要亮。

And that's because during sleep, there are all sorts of reset mechanisms in the brain.

那是因为在睡眠期间，大脑中有各种重置机制。

There's the washing out of metabolic debris and things in the brain, the so-called glymphatic washout, that's essential.

大脑中代谢碎片和物质的清洗，即所谓的类淋巴清洗，这是至关重要的。

There's also an adjustment of the neural tissue of the eyes, which as many of you have heard me say before, are actually two pieces of brain that have been extruded from the cranial vault.

还有眼睛神经组织的调整，正如你们很多人之前听我说过的那样，它实际上是从颅顶挤出的两块大脑。

So your eyes, yes, indeed, are two pieces of brain, the only two pieces of brain outside the cranial vault.

所以你的眼睛，是的，确实是两块大脑，是颅顶之外唯一的两块大脑。

And within your eyes, you have neurons and mechanisms that adjust the sort of sensitivity of your eyes to light and of your brain to light.

在你的眼睛里，你有神经元和机制来调整你的眼睛对光和大脑对光的敏感度。

And when you are sleep deprived or when you have a low-level viral infection or a cold or a flu of any kind, you tend to experience light as brighter than it actually is when you're rested or you're in the healthy state.

当您睡眠不足或患有低水平病毒感染或任何类型的感冒或流感时，您感受到的光线往往会比您休息或处于健康状态时的实际光线更亮。

So photophobia is something that's very, very common in migraine, and often the photophobia is a prominent feature of the experience that a migraine is coming on.

因此，畏光在偏头痛中非常常见，而且通常畏光是偏头痛发作的一个显着特征。

People will start saying, "Oh, it's just too bright in here." And normally they'd be able to tolerate that level of sunlight or of indoor lighting with no problem.

人们会开始说：“哦，这里太亮了。”通常他们能够毫无问题地忍受这种程度的阳光或室内照明。

So there are two aspects of migraine that I think are particularly important to understand for sake of the treatment, and that's the dilation of vessels.

因此，我认为为了治疗，了解偏头痛的两个方面特别重要，那就是血管扩张。

So if we want to treat migraine, we're going to have to think about things that can constrict blood vessels in the brain area, but we also need to think about photophobia.

因此，如果我们想治疗偏头痛，我们就必须考虑可以收缩大脑区域血管的东西，但我们也需要考虑畏光。

And not photophobia just as a symptom of migraine, but that maybe by adjusting our sensitivity to light, we can actually short-circuit some of the onset and subsequent pathology of the migraine.

并不是畏光只是偏头痛的症状，而是也许通过调整我们对光的敏感度，我们实际上可以缩短偏头痛的一些发作和随后的病理。

That is, if we can prevent photophobia partially or completely, can actually offset a lot of the ache of the migraine that would otherwise occur.

也就是说，如果我们能够部分或完全预防畏光，实际上可以抵消很多原本会发生的偏头痛的疼痛。

So that's an exciting avenue for addressing migraine headaches.

因此，这是解决偏头痛的一个令人兴奋的途径。

We'll get into photophobia and how to deal with that.

我们将讨论畏光症以及如何处理它。

We'll also talk about aura a little bit more in a few minutes.

几分钟后我们还将进一步讨论光环。

But for the time being, we've talked about tension headaches.

但目前我们讨论的是紧张性头痛。

We now talked about migraine headaches.

我们现在谈论偏头痛。

Again, keep in mind, knowing what kind of headache you have is essential.

再次请记住，了解您的头痛类型至关重要。

It's, I would say, indispensable for selecting the best treatment.

我想说，这对于选择最佳治疗方法是不可或缺的。

Many people out there will simply get a headache and decide, "Oh, I'm going to pop a couple of aspirin." Okay, what does aspirin do?

许多人只是感到头痛并决定，“哦，我要去服用一些阿司匹林。”好吧，阿司匹林有什么作用？

Aspirin's an anti-inflammatory.

阿司匹林是一种抗炎药。

It also has pronounced effects on the vasodilation and vasoconstriction system.

它还对血管舒张和血管收缩系统有显着的作用。

It actually allows more blood to flow through those arteries, vessels, and capillaries.

它实际上允许更多的血液流经这些动脉、血管和毛细血管。

A lot of people actually use baby aspirin or small amounts of aspirin as a way to offset cardiovascular disease.

许多人实际上使用婴儿阿司匹林或少量阿司匹林作为抵消心血管疾病的方法。

That's another discussion, but what do we know?

这是另一个讨论，但我们知道什么？

We know that In migraine, there's a hyper dilation of the blood vessels, a hyper dilation of the very little portals that exist in the brain and around the brain, and that are going to cause the pain.

我们知道，在偏头痛中，血管过度扩张，大脑和大脑周围存在的非常小的门户过度扩张，这会导致疼痛。

They're going to activate those sensory neurons, those nociceptors, that will then give us the experience of extreme headache and migraine.

它们会激活那些感觉神经元，那些伤害感受器，然后会给我们带来极度头痛和偏头痛的体验。

So taking an aspirin or something like it for migraine, in some cases, the worst possible choice.

因此，在某些情况下，服用阿司匹林或类似药物来治疗偏头痛是最糟糕的选择。

Again, so knowing what kind of headache you are experiencing is going to be essential here.

再次强调，了解您所经历的头痛类型至关重要。

The other thing that you'll sometimes hear is that drinking a cup of coffee or getting caffeine through tea is a great way to deal with headache.

您有时会听到的另一件事是，喝一杯咖啡或通过茶获取咖啡因是治疗头痛的好方法。

Why would that be?

为什么会这样呢？

Well, it turns out that coffee can cause either vasoconstriction or vasodilation depending on when you take it.

事实证明，咖啡会导致血管收缩或血管舒张，具体取决于您何时服用。

And we'll get into the use of caffeine as a treatment for headache, because indeed it can be a very potent treatment for headache, but you absolutely need to know what kind of headache you are experiencing because in some cases, drinking caffeine, whether it's in tea or coffee, can absolutely alleviate the pain of a headache, especially if you catch that onset of a migraine or a tension type headache early on.

我们将讨论使用咖啡因来治疗头痛，因为它确实是一种非常有效的头痛治疗方法，但你绝对需要知道你正在经历哪种头痛，因为在某些情况下，喝咖啡因，无论是茶还是咖啡，绝对可以减轻头痛的疼痛，特别是如果你很早就出现偏头痛或紧张型头痛。

But in some cases, it can make it far, far worse.

但在某些情况下，它可能会使情况变得更糟。

Again, knowing which type of headache you're experiencing and how the different treatments work is key.

同样，了解您正在经历哪种类型的头痛以及不同的治疗方法如何发挥作用是关键。

Okay, so we have tension type headaches, migraine type headaches.

好的，我们有紧张型头痛、偏头痛型头痛。

I think you're starting to get the picture.

我想你已经开始明白了。

They have different underlying biologies.

它们具有不同的基础生物学。

The next type of headache is cluster headaches.

下一种头痛是丛集性头痛。

Cluster headaches are the ones I mentioned earlier that arise from deep within the head.

丛集性头痛是我之前提到的从头部深处产生的头痛。

They feel as if they're coming from the inside out, and they tend to be on one side or the other, what scientists and clinicians call unilateral, and tends to originate behind the eye and sometimes the nose region, sometimes in the mouth region as well.

它们感觉好像是从内到外产生的，并且往往位于一侧或另一侧，科学家和临床医生称之为单侧，并且往往起源于眼睛后面，有时是鼻子区域，有时也在嘴部区域。

It feels kind of patchy, but as if it's coming from the inside out.

感觉有点不完整，但好像是从内到外的。

And again, that's because of that trigeminal nerve.

再说一次，那是因为三叉神经。

For those of you listening and not watching this on YouTube, I've got three fingers as if I'm putting up three fingers and I've got one pointed toward my eye, one pointed towards my nose region, and one towards my upper lip.

对于那些在 YouTube 上收听而不是观看此内容的人，我有三个手指，就好像我举起三个手指一样，其中一根指向我的眼睛，一根指向我的鼻子区域，一根指向我的上唇。

The trigeminal nerve is an easy one to remember, and it will completely explain cluster headaches and what to do about cluster headaches in a moment if you remember that the herpes 1 virus, so not herpes 2, not genital herpes, but herpes 1 virus is the one that gives cold sores on the mouth.

三叉神经是一个很容易记住的神经，如果您记得疱疹 1 病毒，而不是疱疹 2，不是生殖器疱疹，而是疱疹 1 病毒是导致口腔唇疱疹的病毒，那么它很快就会完全解释丛集性头痛以及如何处理丛集性头痛。

Herpes 1 virus, by the way, is exceedingly common up to 90% of people, many children, in fact, have these.

顺便说一下，1 型疱疹病毒在高达 90% 的人中非常常见，事实上，许多儿童都患有这种病毒。

Again, this is not a sexually transmitted herpes, although it can be, of course, transmitted through kissing and sexual contact, but that's not the only origin of it.

再次强调，这不是性传播的疱疹，尽管它当然可以通过接吻和性接触传播，但这并不是其唯一的起源。

Okay?

好的？

It can be passed by skin contact and mucosal contact.

可通过皮肤接触和粘膜接触传播。

So mucosal-mucosal, so that would be kissing mucosal lining or even skin to mucosal lining, so that's why it's so common.

所以粘膜-粘膜，所以会亲吻粘膜衬里，甚至皮肤与粘膜衬里，所以这就是为什么它如此常见。

And the reason why cold sores develop on the mouth for people that have herpes 1 is because the virus actually lives on the trigeminal nerve.

患有 1 型疱疹的人之所以会在口腔上出现唇疱疹，是因为该病毒实际上生活在三叉神经上。

And yes, it is true that sometimes the virus will inflame the nerve, and the inflammation will occur at the level of the eye, so people do unfortunately sometimes get herpes of the eye.

是的，确实有时病毒会使神经发炎，炎症会发生在眼睛的水平，所以不幸的是，人们有时会患上眼睛疱疹。

It actually can be quite dangerous if you have an infection of the eye, herpes infection of the eye, you should see an ophthalmologist.

如果您的眼睛受到疱疹感染，实际上可能非常危险，您应该去看眼科医生。

Or the nose region, they can experience pain in the mucosal tissue of the nose.

或者鼻子区域，他们会感到鼻子粘膜组织疼痛。

More often than not, the most inflammation is occurring on the branch that innervates the lip or the region close to the lip, and that's why a cold sore develops there, an immune response there, signaling that there's inflammation due to the herpes virus, which lives on that neuron for a very long time.

通常情况下，最严重的炎症发生在支配嘴唇的分支或靠近嘴唇的区域，这就是为什么那里会出现唇疱疹，这是那里的免疫反应，表明存在由疱疹病毒引起的炎症，疱疹病毒会在该神经元上存活很长时间。

Neurons don't turn over in the lifespan, so it can live on there for the extent of the person's life.

神经元在一生中不会更新，因此它可以在人的一生中一直存在。

However, most people hopefully treat their HSV-1, but if they don't, the sort of frequency and the severity of infections tends to taper off with time.

然而，大多数人都希望治疗他们的 HSV-1，但如果他们不这样做，感染的频率和严重程度往往会随着时间的推移而逐渐减少。

We'll have an entire discussion about viruses and herpes in particular in a future episode.

我们将在未来的剧集中对病毒和疱疹进行全面讨论。

But the thing to keep in mind here is that this very nerve is the one that gets inflamed in these cluster type headaches.

但这里要记住的是，正是这根神经在这些丛集型头痛中发炎。

Now, cluster type headaches are associated with a bunch of very uncomfortable symptoms.

现在，丛集性头痛与一系列非常不舒服的症状有关。

Again, they tend to be unilateral, they tend to begin very deep, and they tend to be excruciatingly painful.

同样，它们往往是单方面的，它们往往开始得很深，而且往往会带来极度的痛苦。

Excruciatingly painful.

极其痛苦。

They can last anywhere from 30 minutes to three hours.

它们可以持续 30 分钟到三个小时。

Some people experience these in sleep.

有些人在睡眠中会经历这些。

In fact, this is one of the cases where men experience a headache more than females.

事实上，这是男性比女性更容易头痛的情况之一。

Men experience cluster type headaches that have a sudden onset during sleep at five times the frequency than do females.

男性在睡眠期间出现丛集性头痛的频率是女性的五倍。

The origins of that aren't exactly clear.

其起源尚不清楚。

They do seem to have something to do with the biological clock mechanisms, the so-called circadian mechanisms.

它们似乎确实与生物钟机制，即所谓的昼夜节律机制有关。

So if you are a man or woman for that matter, and you're waking up in the middle of the night with a unilateral headache, and it seems like it's deep within your head, or it's starting there, and it's on one side and localized to the eye and maybe these other regions the trigeminal is involved in, you may be suffering from cluster type headache, and you should talk to your physician.

因此，如果您是男性或女性，并且您在半夜醒来时感到单侧头痛，并且似乎头痛在您的头部深处，或者从那里开始，并且位于一侧并局限于眼睛，也许还有三叉神经参与的其他区域，那么您可能患有丛集型头痛，您应该咨询您的医生。

The other symptom that's quite common in cluster type headache is a droopy eyelid, which should make sense because the trigeminal innervates the eye region, and there are other nerves that control the eyelid, but they're in that general region, and they can be impacted.

丛集型头痛中很常见的另一个症状是眼睑下垂，这应该是有道理的，因为三叉神经支配眼部区域，并且还有其他神经控制眼睑，但它们位于该一般区域，并且可能受到影响。

The other thing is something called meiosis, which is that you can't dilate the pupil.

另一件事是所谓的减数分裂，即你无法扩大瞳孔。

I mentioned this before, so as your pupils might get really, really small and they won't dilate.

我之前提到过这一点，所以你的瞳孔可能会变得非常非常小并且不会放大。

And the other thing is lacrimation, tearing, and then nasal discharge, all because of a neural inflammation problem.

还有就是流泪、流泪，然后流鼻涕，都是因为神经炎症问题。

Why do I tell you with such detail about cluster headaches?

为什么我要向您详细介绍丛集性头痛呢？

Well, if you are somebody that's experiencing the kind of pain that is consistent with cluster headache, taking a standard anti-inflammatory or doing something that is going to adjust the dilation or constriction of blood vessels may have an indirect impact on cluster headache, but is unlikely to relieve cluster headache either acutely, meaning right away, or in preventing cluster headaches.

好吧，如果你正在经历与丛集性头痛相符的疼痛，那么服用标准的抗炎药或做一些调整血管扩张或收缩的事情可能会对丛集性头痛产生间接影响，但不太可能立即缓解丛集性头痛，也不太可能预防丛集性头痛。

You have to deal with this as a neural issue, and we'll talk about some of the main causes of inflammation and activation of these cluster type headaches at the level of the trigeminal nerve in a little bit because fortunately, there are some excellent treatments.

您必须将其视为神经问题，我们将稍微讨论一下三叉神经水平的炎症和这些丛集型头痛激活的一些主要原因，因为幸运的是，有一些很好的治疗方法。

The next type of headache that is quite common are hormonal headaches.

下一种很常见的头痛是激素性头痛。

Now, the phrase hormonal headache should already cue you to the fact that it's far too general a term because there are so many different hormones, testosterone, estrogen, thyroid hormone, growth hormone, and on and on and on, and they all have many different functions in the brain and body Every single hormone, and in particular the so-called steroid hormones.

现在，“激素性头痛”这个词应该已经提醒您这样一个事实：它是一个太笼统的术语，因为有很多不同的激素，睾酮、雌激素、甲状腺激素、生长激素等等，它们在大脑和身体中都有许多不同的功能，尤其是所谓的类固醇激素。

Steroids, again, not just limited to things that people take for sports.

再次强调，类固醇不仅仅局限于人们运动时服用的东西。

In fact, the steroid hormones refers to estrogen, testosterone of the sort that we all make, that men and women make naturally.

事实上，类固醇激素是指我们所有人都会产生的雌激素和睾酮激素，是男性和女性自然产生的。

And those steroid hormones can impact gene expression.

这些类固醇激素会影响基因表达。

They are, of course, what turns on the growth of the breast tissue, of the testicular tissue, of hair growth, and on and on.

当然，它们可以促进乳腺组织、睾丸组织、毛发生长等等的生长。

And that's all because of gene expression.

这都是因为基因表达。

If you're really going to change the identity and function of a cell long term, you're going to literally change the breast tissue, or change the penile tissue, or change the ovarian tissue in some sort of consistent way across the lifespan, you can bet that there are changes in gene expression.

如果你真的要长期改变细胞的身份和功能，你会在整个生命周期中以某种一致的方式改变乳腺组织，或改变阴茎组织，或改变卵巢组织，你可以打赌基因表达会发生变化。

And those changes in gene expression occur because these steroid hormones have this incredible ability, sort of like the X-Men of hormones, to pass through the outer membrane of a cell, which we call the extracellular membrane, and into the so-called nuclear membrane.

基因表达发生这些变化是因为这些类固醇激素具有令人难以置信的能力，有点像激素中的 X 战警，可以穿过细胞的外膜（我们称为细胞外膜）并进入所谓的核膜。

They can go into the area where genes are made and turn on and off different genes.

他们可以进入基因制造的区域并打开和关闭不同的基因。

However, they multitask in their life.

然而，他们在生活中同时处理多项任务。

That is, these steroid hormones, like estrogen in particular and testosterone in particular, can also bind to the surface of cells and impact all sorts of things at the level of the cells that have nothing to do with changes in gene expression.

也就是说，这些类固醇激素，特别是雌激素和睾酮，也可以与细胞表面结合，并在细胞水平上影响与基因表达变化无关的各种事物。

And that second mechanism of binding to the surface of cells is one of the ways in which estrogen can control different aspects of headache.

与细胞表面结合的第二种机制是雌激素控制头痛不同方面的方式之一。

Now, that doesn't necessarily mean that estrogen gives you headaches.

现在，这并不一定意味着雌激素会让你头痛。

In fact, it's just the opposite.

事实上，恰恰相反。

It turns out that low estrogen and another hormone, low progesterone, combine to give rise to headache because of the ways that low estrogen and low progesterone impact vasodilation and vasoconstriction and the inflammatory response.

事实证明，低雌激素和另一种激素（低孕激素）结合起来会引起头痛，因为低雌激素和低孕激素会影响血管舒张和血管收缩以及炎症反应。

We'll talk about how to deal with hormone-based headaches, in particular hormone-based headaches that occur because of low estrogen and progesterone in a moment.

我们稍后会讨论如何处理激素性头痛，特别是由于雌激素和孕激素低而引起的激素性头痛。

But the key thing to know is something that we covered in the fertility episode.

但要知道的关键是我们在生育事件中讨论过的事情。

I did a very long, very detailed episode on fertility, so I'm not going to go into this in significant detail now.

我做了一个关于生育能力的非常长、非常详细的剧集，所以我现在不打算详细讨论这个问题。

You can refer to that episode for probably more detail than you ever wanted, but also a lot of tools as it relates to fertility in both males and females.

您可以参考该剧集，了解可能比您想要的更多细节，但也可以参考很多与男性和女性生育能力相关的工具。

But right now, I'm just going to give you a course overview of that in about 60 to 120 seconds so that you'll understand when hormonal headaches are most likely to take place.

但现在，我将在大约 60 到 120 秒内向您提供课程概述，以便您了解何时最有可能发生荷尔蒙头痛。

Keep in mind that hormonal headaches are most likely to take place when estrogen and progesterone are lowest.

请记住，当雌激素和孕激素最低时，最有可能发生荷尔蒙头痛。

So if you understand that during the follicular stage of the ovulatory/menstrual cycle, so menstrual cycle is about 28 days on average, not in everyone, but it's about 28 days on average, and the first half of that estrogen starts creeping up.

因此，如果您了解在排卵/月经周期的卵泡阶段，那么月经周期平均约为 28 天，并非每个人都如此，但平均约为 28 天，并且雌激素的前半部分开始缓慢上升。

And as we learn in endocrinology, estrogen primes progesterone.

正如我们在内分泌学中了解到的那样，雌激素启动孕激素。

So estrogen will then peak and then start to fall pretty quickly, right about the time that the egg ovulates.

因此，雌激素会在卵子排卵时达到峰值，然后很快开始下降。

An egg is released and will essentially be ready for fertilization.

卵子被释放，基本上准备好受精。

If the egg is fertilized, a whole bunch of other things happen as it relates to pregnancy.

如果卵子受精，就会发生一系列与怀孕有关的其他事情。

If not, what ends up happening is that during the luteal phase, which is the second half of the menstrual cycle, there's been a buildup of the lining of the uterus because of an increase in progesterone.

如果不是，最终会发生的情况是，在黄体期（月经周期的后半期），由于黄体酮的增加，子宫内膜会堆积。

So estrogen goes up during the follicular phase, then it goes down, and then progesterone goes up, which is important for generating that thick lining of the uterus to allow the fertilized egg, if it's fertilized, to implant, and if it's not fertilized, all of that gets released from the body in this bleeding process that we call menstruation.

因此，雌激素在卵泡期上升，然后下降，然后黄体酮上升，这对于生成厚厚的子宫内膜非常重要，以便受精卵（如果受精）植入，如果没有受精，所有这些都会在我们称为月经的出血过程中从体内释放出来。

If menstruation occurs, and day one of the menstrual cycle is considered the first day in which bleeding occurs, well, then what that means is that estrogen is already low, because remember, estrogen was low at the start of the follicular phase and went up.

如果月经发生，并且月经周期的第一天被认为是发生出血的第一天，那么这意味着雌激素已经很低，因为请记住，雌激素在卵泡期开始时很低，然后上升。

Then it comes down right at the time of ovulation, and progesterone goes up during the luteal phase.

然后，它在排卵时下降，而黄体酮在黄体期上升。

In fact, it's more than a thousandfold increase in progesterone.

事实上，黄体酮增加了千倍以上。

But if there's no fertilization of the egg, progesterone starts coming down.

但如果卵子没有受精，黄体酮就会开始下降。

What does that mean?

这意味着什么？

That means that on the first to about the fourth or fifth day of the menstrual cycle, first being the first day of bleeding, till about the fourth or fifth day of the menstrual cycle, both estrogen and progesterone are very low.

这意味着在月经周期的第一天到第四天或第五天，首先是出血的第一天，直到月经周期的第四天或第五天，雌激素和黄体酮都非常低。

And it is at that time, at the very beginning of the menstrual cycle, so about the first week of the menstrual cycle, that many women are very prone to hormonal headaches.

正是在那个时候，在月经周期的最初阶段，也就是月经周期的第一周，许多女性非常容易出现荷尔蒙头痛。

Hormonal headaches, not because estrogen's high, that's a common misconception, rather because estrogen and progesterone are both low.

荷尔蒙头痛，不是因为雌激素高（这是一种常见的误解），而是因为雌激素和黄体酮都低。

And now that you understand the contour or the underlying reasons for hormonal headache, you can start to ask, well, what happens when estrogen is low?

现在您了解了荷尔蒙头痛的轮廓或根本原因，您可以开始问，当雌激素低时会发生什么？

Well, estrogen has a strong impact on the vasodilation-vasoconstriction system, as does progesterone.

嗯，雌激素对血管舒张-血管收缩系统有很大的影响，黄体酮也是如此。

We'll talk about that a little bit later.

我们稍后会讨论这个问题。

But now that you know what hormonal headache is, at least this one particular type of hormonal headache, which is very common given the number of women that are menstruating, and the fact that low estrogen, low progesterone is the cause of the hormonal headache, and the fact that, of course, there are women who are no longer menstruating, so they're either in perimenopause and menstruation is becoming more infrequent, or they're in menopause and it has ceased entirely.

但现在你知道荷尔蒙头痛是什么了，至少这是一种特殊类型的荷尔蒙头痛，考虑到经期女性的数量，这种头痛很常见，而且低雌激素、低孕激素是荷尔蒙头痛的原因，而且事实上，当然，有些女性不再经期，所以她们要么处于更年期，月经变得越来越少，要么正处于更年期。更年期，它已经完全停止了。

Well, now you understand what the origin of the hormonal headache is, and so all we need to know is what do estrogen and progesterone normally do in order to prevent headache, and thereby you'll know exactly how to offset, that is prevent or treat hormonal headache in that first week of the menstrual period.

好了，现在您了解了荷尔蒙性头痛的根源是什么，所以我们需要知道的是雌激素和黄体酮通常如何预防头痛，从而您将确切地知道如何抵消，即预防或治疗经期第一周的荷尔蒙性头痛。

The last type of headache that I'd like to discuss is headache associated with head hits, that is traumatic brain injury.

我想讨论的最后一种头痛是与头部撞击相关的头痛，即创伤性脑损伤。

Although, I definitely want to underscore the fact that even people who do not have traumatic brain injury can experience headaches as the consequence of hitting their head.

尽管如此，我绝对想强调这样一个事实：即使没有遭受脑外伤的人也会因头部撞击而感到头痛。

So the line between traumatic brain injury and lower level brain injury is one that still seeks definition.

因此，创伤性脑损伤和低水平脑损伤之间的界限仍然需要定义。

And in fact, this is one of the major goals of the clinical field as it relates to concussion.

事实上，这是临床领域与脑震荡相关的主要目标之一。

It's also what comes up a lot during the discussion about football.

这也是在有关足球的讨论中经常出现的内容。

These days, you'll see players hit really hard, and depending on whether or not they're ...

这些天，你会看到玩家受到很大的打击，这取决于他们是否......

laying there for five seconds, 30 seconds, or three minutes.

躺在那里五秒、三十秒或三分钟。

The crowd and the people watching on television and everywhere else are all speculating as to whether or not the person should be allowed to play.

人群、电视上以及其他地方的人们都在猜测是否应该允许这个人参加比赛。

And to be quite direct, there really is no way to assess the extent of brain damage after the consequence of hitting one's head or having one's head hit because first of all, almost all of the best ways to detect traumatic brain injury, except the most severe ones, tend to require a lot of very large equipment like MRI and functional MRI and CT scans, none of which are available on the side of the field or in the locker room.

坦白说，确实没有办法评估头部受到撞击或被头部撞击后的脑损伤程度，因为首先，除了最严重的脑损伤之外，几乎所有检测脑外伤的最佳方法都往往需要大量非常大的设备，如 MRI 和功能性 MRI 和 CT 扫描，而这些设备在球场一侧或更衣室中都没有。

But also because many, many, if not most of the effects of traumatic brain injury are going to occur not in the immediate minutes or even hours after the injury, but several hours, days or even weeks after that injury.

但也因为创伤性脑损伤的许多、许多（即使不是大部分）影响不会发生在受伤后的几分钟甚至几小时内，而是发生在受伤后的几小时、几天甚至几周内。

So this is a discussion that we should hold off for a longer, full episode on traumatic brain injury.

因此，我们应该推迟对创伤性脑损伤进行更长时间、更完整的讨论。

Keeping in mind, of course, that football is this very salient example of traumatic brain injury and concussion, as is boxing, as is even soccer with heading of the ball.

当然，请记住，足球是创伤性脑损伤和脑震荡的一个非常突出的例子，拳击也是如此，甚至头球足球也是如此。

Believe it or not, repeated low-level impact to the forehead and other parts of the head can give rise to, over time, traumatic brain injury without the need for any kind of full-blown concussion or being, quote-unquote, "knocked out." But sports-related concussion actually occupies just a tiny fraction of the majority of traumatic brain injury and concussion.

不管你相信与否，随着时间的推移，对前额和头部其他部位的反复轻微撞击可能会导致创伤性脑损伤，而不需要任何类型的全面脑震荡或“被击倒”。但与运动相关的脑震荡实际上只占大多数创伤性脑损伤和脑震荡的一小部分。

Most traumatic brain injury and concussion and low-level brain injury that can accumulate over time to become traumatic for sake of daily living, that is lowered cognition, disruption in mood, sleep, et cetera, is actually the consequence of things other than sports.

大多数创伤性脑损伤和脑震荡以及低度脑损伤会随着时间的推移而积累，从而成为日常生活的创伤，即认知能力下降、情绪、睡眠中断等，实际上是运动以外的原因造成的。

So for instance, bicycle accidents, playground accidents, construction accidents, and this is often forgotten.

例如，自行车事故、操场事故、建筑事故，而这一点经常被遗忘。

And for some reason, all the sports, and in particular football, tend to grab all the attention as it relates to concussion.

出于某种原因，所有运动，尤其是足球，往往会吸引所有与脑震荡相关的注意力。

Keep in mind that while for certain people is a path to a living, for most people, traumatic brain injury is going to occur in a car accident, construction work, or other types of work for which people generally don't have many options in terms of the type of work that they're doing.

请记住，虽然对于某些人来说这是一条谋生之路，但对于大多数人来说，创伤性脑损伤会发生在车祸、建筑工作或其他类型的工作中，而人们通常在所做的工作类型方面没有太多选择。

So they are prone to concussions and head injuries simply by virtue of their work, without any millions of dollars contracts or the opportunity to necessarily, in some cases they do, but necessarily to do other things.

因此，他们很容易因为工作而遭受脑震荡和头部受伤，没有任何数百万美元的合同，也没有机会去做其他事情，在某些情况下他们确实会做，但也不一定要做其他事情。

And certainly car accidents or bicycle accidents are not voluntary events.

当然，车祸或自行车事故也不是自愿事件。

So the point being, traumatic brain injury and headache-related traumatic brain injury extends far beyond the realm of sports.

因此，重点是，创伤性脑损伤和头痛相关的创伤性脑损伤远远超出了运动领域。

And in fact, if you were to look at the numbers, what you'll find is that more than 90% of traumatic brain injury, so people coming into the hospital or clinic, or people claiming that they've got consistent headaches, they're not sleeping well, their mood is off, they're feeling more irritable after having hit their head even once, is not the consequence of sports.

事实上，如果你看一下这些数字，你会发现，超过 90% 的脑外伤，也就是那些来医院或诊所的人，或者那些声称自己持续头痛、睡眠不好、情绪低落、甚至在一次撞击头部后就感觉更烦躁的人，都不是运动造成的。

It's going to be the consequence of accidents either at the workplace or in terms of a bicycle or other sorts of transportation-based accident, like a car accident.

这将是工作场所事故、自行车事故或其他类型的交通事故（如车祸）的后果。

With that in mind, any kind of head hit, certainly if it involves a concussion or traumatic brain injury, often leads to headaches.

考虑到这一点，任何类型的头部撞击，当然如果涉及脑震荡或脑外伤，通常都会导致头痛。

Either infrequent but severe headaches or chronic low-level headaches, or a feeling that there's kind of a stuffiness or a fullness to the head.

要么是罕见但严重的头痛，要么是慢性低度头痛，或者是头部有一种闷热或饱胀的感觉。

There can be a lot of different origins to that.

这可能有很多不同的起源。

A common origin is going to be actual swelling of the, not necessarily the brain tissue directly, but if you recall our discussion about the meninges, which include the dura and the other tissues that surround the brain.

一个共同的起源是实际的肿胀，不一定是直接的脑组织肿胀，但如果你还记得我们关于脑膜的讨论，脑膜包括硬脑膜和大脑周围的其他组织。

There are actually three layers that we call the meninges, the dura just being one of them.

实际上有三层，我们称之为脑膜，硬脑膜只是其中的一层。

And there's a very little space between the brain, the meninges that surround it, and the skull.

大脑、大脑周围的脑膜和头骨之间的空间很小。

It's called the subarachnoid space.

它被称为蛛网膜下腔。

Very cool, right?

很酷，对吧？

Arachnoid, like spider.

蛛网膜，像蜘蛛一样。

Well, if there's even a slight bit of swelling in the brain or even distant brain tissue, so for instance, even if there's whiplash, so there's swelling of the tissue, muscular tissue and neural tissue in the neck area, that can constrict the flow of things like cerebral spinal fluid, blood flow, and indeed mucus and other things that are essential.

嗯，如果大脑甚至远处的脑组织有一点点肿胀，比如说，即使有颈部扭伤，颈部的组织、肌肉组织和神经组织也会肿胀，这会限制脑脊液、血流、甚至粘液和其他重要物质的流动。

We all hear mucus and we think illness, but mucus is a vital, vital substance within the body for a lot of important reasons in health as well as in sickness.

我们一听到粘液就会想到疾病，但粘液是体内一种至关重要的物质，对于健康和疾病有很多重要的原因。

Well, if there's less of that liquid and other fluids and mucus being delivered to that space, well then it can clog up.

好吧，如果输送到该空间的液体和其他液体和粘液较少，那么它就会堵塞。

So sort of the plumbing is clogged up, or that it's caught at the level of the site of hit or injury because there's some local swelling and inflammation there.

管道被堵塞了，或者被击中或受伤的部位卡住了，因为那里有一些局部肿胀和炎症。

So there are many different mechanisms that can underlie headache associated with head hits or traumatic brain injury.

因此，与头部撞击或创伤性脑损伤相关的头痛有许多不同的机制。

Now fortunately, there's some recent data pointing to some, what I would call non-obvious treatments for headache in traumatic brain injury.

幸运的是，最近有一些数据指出了一些我所说的针对创伤性脑损伤头痛的非明显治疗方法。

Keeping in mind that any time we're talking about injury or disease, or health for that matter, mental health or physical health, we have to highlight a fact that's going to come up again and again in every single episode of this podcast.

请记住，每当我们谈论伤害或疾病或健康、心理健康或身体健康时，我们都必须强调一个事实，这个事实将在本播客的每一集中一次又一次地出现。

And I think it's not being overly redundant to do so, which is that regular sufficient amounts of deep sleep each night are going to be important for all aspects of mental health, physical health, and performance.

我认为这样做并不过分多余，每晚定期充足的深度睡眠对于心理健康、身体健康和表现的各个方面都很重要。

And have been shown over and over again to reduce the frequency of headache and to reduce the time to repair after traumatic brain injury and can improve cognition, and on and on and on.

并且已经被一再证明可以减少头痛的频率，减少创伤性脑损伤后的修复时间，并且可以提高认知能力，等等​​。

So sleep is essential for all the normal things that encourage healthy activity of the different tissues that are involved in brain and body to occur.

因此，睡眠对于促进大脑和身体不同组织的健康活动的所有正常活动至关重要。

So sleep deprivation, of course, is going to limit those.

因此，睡眠不足当然会限制这些。

But I do want to point out that sleep, sunlight, and I've talked about this almost ad nauseam on this podcast, but regular circadian cycles, getting sunlight in your eyes early in the day and in the evening as well, and as much as possible throughout the day without burning your skin and limiting your exposure to artificial lights at night and on and on, all of which is covered in the Light for Health episode of the Huberman Lab podcast, the Master Your Sleep episode of the Huberman Lab podcast, and in the Perfect Your Sleep episode of the Huberman Lab podcast.

但我确实想指出，睡眠、阳光，我在这个播客上谈到了这个几乎令人作呕的问题，但有规律的昼夜节律周期，在早上和晚上都让阳光照射到你的眼睛里，全天尽可能多地接受阳光，而不灼伤你的皮肤，并限制你在晚上和晚上接触人造光，所有这些都在胡伯曼实验室播客的“健康之光”一集、胡伯曼实验室播客的“掌握你的睡眠”一集和胡伯曼实验室播客的“完美你的睡眠”一集。

You can find all that at hubermanlab.com.

您可以在 hubermanlab.com 找到所有这些内容。

Getting light and avoiding light at the proper times of the 24-hour cycle is also going to favor all the pathways ranging from gut-brain access to the inflammatory, anti-inflammatory pathways, neural pathways, et cetera, that of course, if you do that, you're going to improve and offset any kind of detriment caused by traumatic brain injury.

在 24 小时周期的适当时间接受光照和避免光照也将有利于所有通路，从肠脑通路到炎症通路、抗炎通路、神经通路等等，当然，如果你这样做，你将改善和抵消由创伤性脑损伤引起的任何损害。

Is it treating traumatic brain injury directly?

是直接治疗脑外伤吗？

No. But is not getting sufficient sleep, not getting sunlight at the right times of day and getting too much artificial light at night going to make any impact of traumatic brain injury, including headache, far worse?

不会。但是，睡眠不足、在一天中的正确时间没有接受阳光照射以及夜间接受过多的人造光是否会使包括头痛在内的创伤性脑损伤的影响变得更严重？

Yes.

是的。

There are certainly a ton of data to support that statement as well.

当然也有大量数据支持这一说法。

And then of course, nutrition and exercise are also important.

当然，营养和运动也很重要。

So we can list out sleep, sun Proper nutrition, exercise, and I would put proper social connection, whatever that means to you.

所以我们可以列出睡眠、阳光、适当的营养、锻炼，我会列出适当的社会联系，无论这对你意味着什么。

Healthy social connections include romantic, friendship, familial, and relationship to self.

健康的社会关系包括浪漫、友谊、家庭和自我关系。

Those five things, sleep, exercise, sun, nutrition, and social connection are all critical for maintaining baselines of health and raising your baselines of health.

这五件事：睡眠、锻炼、阳光、营养和社交联系对于维持健康基线和提高健康基线都至关重要。

And I mention that, I kind of segment this out now because I think that any time we're about to start discussing pointed treatments, that is, things that you can take or do to reduce headache or things that you can take or do to improve anything within mental health, physical health, and performance, we have to remember that the foundation of mental health, physical health, and performance is only set at its highest level by tending to those other things, and that nothing really surpasses any of those things.

我提到，我现在将其分开，因为我认为任何时候我们要开始讨论针对性治疗，即你可以采取或做的事情来减少头痛，或者你可以采取或做的事情来改善心理健康、身体健康和表现方面的任何事情，我们必须记住，心理健康、身体健康和表现的基础只有通过关注其他事情才能达到最高水平，并且没有什么真正可以超越这些事情。

Or put differently, there's no replacement for any of those things in the form of a pill, a powder, even a behavioral practice.

换句话说，无论是药丸、粉末，还是行为练习，这些东西都无法替代。

There are things you can do to offset getting less than ideal sleep, the things that you can use, like bright artificial lights during the day to try and partially offset lack of sunlight.

您可以采取一些措施来抵消不理想的睡眠，您可以使用一些措施，例如白天明亮的人造灯，以尝试部分抵消阳光不足的影响。

But really there is no exercise pill.

但确实没有运动药。

There is no sunlight device, although some bright lights are very bright.

没有阳光装置，虽然有些强光很亮。

There's no replacement for actual sunlight.

没有什么可以替代真正的阳光。

There's no replacement for actual sleep.

真正的睡眠是无可替代的。

There's no replacement for actual nutrition.

实际营养是无可替代的。

And I do feel it's an important conversation to have as we head into the next segment, which is what can you take or do to reduce headache?

我确实认为，当我们进入下一个部分时，这是一次重要的对话，即您可以采取或采取哪些措施来减轻头痛？

And in order to address this, we're going to start first with the headaches associated with head hits and traumatic brain injury because it turns out there's a surprising and very useful approach to doing that.

为了解决这个问题，我们首先要从与头部撞击和创伤性脑损伤相关的头痛开始，因为事实证明有一种令人惊讶且非常有用的方法可以做到这一点。

But this same approach also can help offset and treat headache in other conditions as well.

但同样的方法也可以帮助抵消和治疗其他情况下的头痛。

Meaning not just for headaches caused by traumatic brain injury, but also headaches caused by sudden onset tension headache or migraine headache, or even perhaps, again perhaps, cluster type headaches.

这不仅适用于脑外伤引起的头痛，还适用于突然发作的紧张性头痛或偏头痛，甚至可能是丛集性头痛。

So the first substance that I'd like to highlight that has been shown to significantly reduce the intensity and/or frequency of headaches is creatine.

因此，我想强调的第一种已被证明可以显着降低头痛强度和/或频率的物质是肌酸。

Now creatine, as many of you know, is something that people supplement and take.

现在，正如你们许多人所知，肌酸是人们补充和服用的东西。

Most often creatine is discussed in the context of muscle performance, not just for people who weightlift, but for people who do endurance exercise.

大多数情况下，肌酸是在肌肉表现的背景下讨论的，不仅适用于举重的人，也适用于进行耐力运动的人。

And it's often been said that five to 10 grams per day of creatine monohydrate, depending on how much you weigh, five to 10 grams per day of creatine monohydrate can increase creatine phosphate stores in muscles, can bring more water into muscles, can make you stronger, get increased power output, and that is all true.

人们常说，每天 5 到 10 克一水肌酸，具体取决于你的体重，每天 5 到 10 克一水肌酸可以增加肌肉中磷酸肌酸的储存，可以给肌肉带来更多的水分，可以让你变得更强壮，获得更大的功率输出，这都是事实。

That is all completely true.

这完全是真的。

We discussed this in the Huberman Lab podcast with Dr. Andy Galpin when he was a guest on the Huberman Lab podcast sort of standard series.

我们在胡伯曼实验室播客中与安迪·加尔平博士讨论了这个问题，当时他是胡伯曼实验室播客标准系列的嘉宾。

And we discuss this extensively in an upcoming episode from Dr. Andy Galpin in his special six-part guest series where he is a guest on the Huberman Lab podcast, but where really he's the one doing the majority of the teaching.

我们将在安迪·加尔平 (Andy Galpin) 博士即将推出的六集特邀嘉宾系列节目中广泛讨论这一问题，他是 Huberman Lab 播客的嘉宾，但实际上他才是承担大部分教学的人。

That series covers everything from strength, hypertrophy, endurance, and there's an episode on supplementation where we go deep into the discussion about creatine.

该系列涵盖了从力量、肥大、耐力等各个方面，其中有一集是关于补充的，我们深入讨论了肌酸。

Now in that discussion, and again now, we highlight the fact that creatine, while most often discussed online and in the media as a supplement for sports performance for the reasons I just mentioned, actually has far more data behind it, that is laboratory studies exploring the role of creatine in the clinical setting.

现在，在这次讨论中，我们再次强调这样一个事实：虽然由于我刚才提到的原因，肌酸最常在网上和媒体中被讨论为运动表现的补充，但实际上它背后有更多的数据，即探索肌酸在临床环境中的作用的实验室研究。

So I'd like to highlight a paper from that literature now that will make very clear as to why creatine is interesting and in fact very effective for treating headache, in particular headache caused by head hits or traumatic brain injury.

因此，我现在想重点介绍该文献中的一篇论文，该论文将非常清楚地说明为什么肌酸很有趣，而且实际上对于治疗头痛非常有效，特别是由头部撞击或创伤性脑损伤引起的头痛。

The title of the paper is "Prevention of Traumatic Headache, Dizziness, and Fatigue with Creatine Administration." Now keep in mind this is a pilot study.

论文的标题是“用肌酸预防外伤性头痛、头晕和疲劳”。现在请记住，这是一项试点研究。

It was performed in humans, so when you hear the words preclinical, that is if you hear there was a preclinical study on blank, that means almost always that the study was performed on animal models, mice, rats, primates, et cetera.

它是在人类身上进行的，所以当你听到临床前这个词时，也就是说，如果你听到有一项针对空白的临床前研究，这几乎总是意味着该研究是在动物模型、小鼠、大鼠、灵长类动物等上进行的。

A clinical trial is something that's carried out on humans, and a pilot study means that the study was carried out on humans, but on a fairly small cohort, a fairly small group, or limited number of subjects.

临床试验是在人类身上进行的，而试点研究意味着该研究是在人类身上进行的，但是是在相当小的队列、相当小的群体或有限数量的受试者中进行的。

Nonetheless, if the data are robust as it is in this case of this paper, I think it's worth paying attention to.

尽管如此，如果数据像本文中的情况一样可靠，我认为值得关注。

So in this study, what they looked at was creatine administration.

因此，在这项研究中，他们关注的是肌酸给药。

So what they did is they had people ingest a certain amount of creatine, I'll tell you in a moment, in fluid, so it could be taken in water or milk, with or without food.

所以他们所做的是让人们摄入一定量的肌酸，我稍后会告诉你，在液体中，这样它就可以在水或牛奶中服用，无论是否与食物一起服用。

Doesn't really matter what time of day.

一天中的什么时间并不重要。

They had people take creatine.

他们让人们服用肌酸。

Why would they have people take creatine after a traumatic brain injury and in particular for people that are suffering from headache, dizziness, fatigue, et cetera?

为什么他们会让人们在脑外伤后服用肌酸，特别是那些患有头痛、头晕、疲劳等的人？

The reason is that neurons, nerve cells, rely very heavily on the regulation of calcium in order to generate those action potentials to communicate with one another.

原因是神经元、神经细胞非常依赖钙的调节来产生动作电位以相互交流。

So it doesn't matter if it's a motor neuron, a sensory neuron, or a modulatory neuron, they all generate action potentials or something similar to it, and calcium is important for that process.

因此，无论是运动神经元、感觉神经元还是调节神经元，它们都会产生动作电位或类似的东西，而钙对于这个过程很重要。

Calcium becomes dysregulated after traumatic brain injury in a number of different ways, in particular in ways that impact the energy production systems of cells that are related to ATP, adenosine triphosphate.

创伤性脑损伤后，钙会以多种不同的方式失调，特别是影响与 ATP（三磷酸腺苷）相关的细胞能量产生系统的方式。

For those aficionados out there that want to look it up, you can simply look up calcium, ATP, and neurons, and you can learn about that cycle.

对于那些想要查找它的爱好者来说，您只需查找钙、ATP 和神经元，就可以了解该循环。

Creatine can be stored in muscles, as we talked about before, but creatine and in particular the phosphorylated form of creatine, which is the readily available fuel source form of creatine, can also be stored in brain tissue, and is actually quite prominently stored in the forebrain, the area or the real estate of your brain just behind the forehead, which is involved in planning and action and understanding context.

正如我们之前讨论过的，肌酸可以储存在肌肉中，但肌酸，特别是磷酸化形式的肌酸（肌酸的现成燃料来源形式）也可以储存在脑组织中，并且实际上非常显着地储存在前脑中，即前额后面的大脑区域或房地产中，该区域参与计划、行动和理解上下文。

So it's very important for cognition.

所以这对于认知来说非常重要。

It's important for personality, too.

这对于个性也很重要。

But it's important for a number of different aspects of life that have to do with making plans, being able to focus very intensely on your work, et cetera, or on anything for that matter.

但这对于生活的许多不同方面都很重要，这些方面与制定计划、能够高度专注于你的工作等等或任何与此相关的事情有关。

All functions that become heavily disrupted in people who have traumatic brain injury and concussion.

患有脑外伤和脑震荡的人的所有功能都会受到严重破坏。

Creatine's ability to communicate with the calcium and the ATP system was the motivation behind this study.

肌酸与钙和 ATP 系统沟通的能力是这项研究背后的动机。

That is, the authors hypothesized on the basis of preclinical data in animals that by increasing creatine stores within the brain, not just in the muscle, but in particular within the brain, that The availability of creatine would allow for better cognitive function in general.

也就是说，作者根据动物的临床前数据假设，通过增加大脑内的肌酸储存，不仅是在肌肉中，而且特别是在大脑内，肌酸的可用性将有助于改善一般的认知功能。

Now, they didn't look at cognition specifically in this paper, but they did look at the other aspects, that is, the bad stuff associated with TBI.

现在，他们在这篇论文中并没有专门研究认知，但他们确实研究了其他方面，即与 TBI 相关的坏东西。

And they had people supplement with creatine at a level that is much higher than the typical level that people supplement with creatine simply for sports performance.

他们让人们补充肌酸的水平远远高于人们仅仅为了运动表现而补充肌酸的典型水平。

So as I mentioned before, most people, if they supplement with creatine for sports performance, they take creatine monohydrate, typically five grams per day, sometimes 10 grams per day if they're about 100 kilograms or greater in body weight.

正如我之前提到的，大多数人如果为了运动表现而补充肌酸，他们会服用一水肌酸，通常每天 5 克，如果体重约为 100 公斤或以上，有时每天 10 克。

100 kilograms is approximately 220 pounds.

100 公斤约为 220 磅。

So the dosage that was used for supplementing creatine in this study to address the potential impact of creatine on headache, dizziness, and fatigue was quite a bit higher than the dosages used simply for muscle performance.

因此，本研究中用于补充肌酸以解决肌酸对头痛、头晕和疲劳的潜在影响的剂量比单纯用于肌肉表现的剂量要高得多。

In this study, they had people take a dose of 0.4 grams of creatine monohydrate per kilogram of body weight.

在这项研究中，他们让人们服用每公斤体重 0.4 克一水肌酸的剂量。

So for somebody that weighs 100 kilograms or 220 pounds, that would be 40 grams of creatine per day.

因此，对于体重 100 公斤或 220 磅的人来说，每天需要 40 克肌酸。

Okay?

好的？

If someone weighs half that much, they would take 20 grams of creatine per day.

如果某人的体重只有这个体重的一半，那么他们每天需要摄入 20 克肌酸。

And they did that over a period of six months.

他们花了六个月的时间做到了这一点。

And we know that when you take creatine over and over day to day, that there's a buildup of creatine stores both in the muscles and within the brain tissue.

我们知道，当您每天反复服用肌酸时，肌肉和脑组织中都会积累肌酸储存。

Now, what they found as a consequence of this creatine administration was really striking and I think quite exciting.

现在，他们发现肌酸给药的结果确实令人震惊，我认为非常令人兴奋。

They found a very significant decrease in the frequency of headache in people that were supplementing with creatine as opposed to the controls.

他们发现，与对照组相比，补充肌酸的人头痛频率显着降低。

Now, keep in mind that this is a pilot study, but the effects are very dramatic.

现在，请记住，这是一项试点研究，但效果非常显着。

They found a very statistically significant decrease in the frequency of headache in people that were taking creatine.

他们发现服用肌酸的人头痛频率显着降低，具有统计学意义。

In fact, if you look at the controls and you see that they're basically getting headache at a frequency of 90% or more after TBI, the reduction in headache frequency is down to about 10 or 12% in the people taking creatine.

事实上，如果你观察对照组，你会发现他们在 TBI 后头痛的频率基本上为 90% 或更高，而服用肌酸的人头痛频率减少了约 10% 或 12%。

So that's quite a dramatic effect.

所以这是一个非常戏剧性的效果。

And if you look at the other measures they took, keep in mind again, this is a pilot study, so a limited number of subjects, but again, the results are very impressive.

如果你看看他们采取的其他措施，请再次记住，这是一项试点研究，因此受试者数量有限，但结果再次令人印象深刻。

What they found is that the number of people experiencing dizziness was significantly reduced in people supplementing with creatine, as was the number of people experiencing fatigue, kind of acute fatigue and chronic fatigue.

他们发现，补充肌酸的人出现头晕的人数显着减少，出现疲劳、急性疲劳和慢性疲劳的人数也显着减少。

Again, not chronic fatigue syndrome per se, but chronic fatigue, which was in this study defined as a general sense of bodily weakness and even mental weakness.

再说一次，这不是慢性疲劳综合症本身，而是慢性疲劳，在这项研究中，慢性疲劳被定义为身体虚弱甚至精神虚弱的普遍感觉。

Mental weakness is a little bit hard to quantify, but they were very careful to distinguish between cognitive and mental fatigue versus physical and somatic fatigue.

精神弱点有点难以量化，但他们非常仔细地区分认知和精神疲劳与身体和躯体疲劳。

They acknowledge that both of those occur in TBI or post-TBI.

他们承认这两种情况都发生在 TBI 或 TBI 后。

The headache is quite frequent.

头痛的情况相当频繁。

Basically, the takeaway of this study is that for people experiencing headache, dizziness, and fatigue due to TBI, and perhaps, and I want to underline perhaps because it hasn't really been explored yet, but perhaps headache, dizziness, and fatigue due to other conditions, symptoms, or causes of headache, creatine monohydrate supplementation might be, again, might be an excellent candidate for people to try.

基本上，这项研究的结论是，对于因 TBI 导致头痛、头晕和疲劳的人来说，也许，我想强调，也许是因为它还没有真正被探索过，但也许由于其他情况、症状或头痛原因而导致头痛、头晕和疲劳，一水肌酸补充剂可能是人们尝试的绝佳选择。

Why do we say that?

为什么这么说呢？

Well, first of all, creatine monohydrate is relatively inexpensive.

首先，一水肌酸相对便宜。

It's considered safe at the dosages used in this study and certainly for sports performance as well.

在本研究中使用的剂量下它被认为是安全的，当然对于运动表现也是如此。

And there are very few other compounds that have been shown to have as significant an impact on headache over the long term as has creatine monohydrate in these studies of people with TBI.

在针对 TBI 患者的这些研究中，很少有其他化合物能够像一水肌酸那样对头痛产生如此显着的长期影响。

It's also important to highlight the fact that many, many people suffer from TBI, as I mentioned earlier, and as now, there are very few treatments for TBI.

同样重要的是要强调这样一个事实，即正如我之前提到的，许多人都患有 TBI，而目前 TBI 的治疗方法却很少。

You tend to get the basic advice coming back, and again, I think it's excellent advice.

你往往会得到基本的建议，而且我再次认为这是很好的建议。

Get proper amounts of sleep, get exercise, but don't get another traumatic brain injury.

保证充足的睡眠，进行锻炼，但不要再次遭受创伤性脑损伤。

That's obvious, but you'd be surprised how many people go right back to work because they have to, and we have to be sympathetic to the fact that many people just can't stop working or go on disability.

这是显而易见的，但你会惊讶地发现有多少人因为不得已而立即回去工作，我们必须同情这样一个事实，即许多人就是无法停止工作或继续残疾。

So many people have to go back to work.

这么多人必须回去工作。

That could be sport or it could be other kind of work where they are then subject to perhaps getting more TBI.

这可能是体育运动，也可能是其他类型的工作，他们可能会遭受更多的创伤性脑损伤。

Maybe they're getting less rest as a consequence, and stress.

也许他们因此得到的休息更少，压力也更大。

Obviously, stress is a confounding issue for TBI.

显然，压力对于 TBI 来说是一个令人困惑的问题。

But sleep, exercise, sun, nutrition, all of those things, proper social connection, are what people are encouraged to do when they have TBI, but there have been very few compounds, in particular, very few over-the-counter compounds that are known to be safe that have shown efficacy in dealing with TBI.

但是，睡眠、锻炼、阳光、营养、所有这些事情、适当的社会联系，都是人们在患有 TBI 时被鼓励做的事情，但很少有化合物，特别是已知安全的非处方化合物，能够有效治疗 TBI。

So I think that while this is a pilot study and we can consider it preliminary, I think it's important enough and the effects were dramatic enough that people with headache, and in particular, people with TBI, ought to consider supplementing with creatine in order to deal with their headaches.

因此，我认为，虽然这是一项试点研究，我们可以将其视为初步研究，但我认为它足够重要，而且效果足够显着，头痛患者，特别是患有 TBI 的人，应该考虑补充肌酸来治疗头痛。

And of course, I eagerly await other studies exploring the role of this high dosage of creatine, or I should say relatively high dosage of creatine monohydrate for offsetting headache.

当然，我热切地等待其他研究探索这种高剂量肌酸的作用，或者我应该说相对高剂量的一水肌酸可以缓解头痛。

Meanwhile, I think there are a number of people out there suffering from headache who might consider using creatine monohydrate in an exploratory fashion and seeing whether or not it helps offset their headaches.

与此同时，我认为有很多患有头痛的人可能会考虑以探索性的方式使用一水肌酸，看看它是否有助于缓解头痛。

Keep in mind, of course, anytime you're going to add or remove anything, supplement or otherwise from your treatment, your nutrition, et cetera, I do suggest that you consult with your physician, in particular if you have chronic headaches.

当然，请记住，每当您要在治疗、营养等中添加或删除任何东西、补充剂或其他内容时，我建议您咨询您的医生，特别是如果您患有慢性头痛。

I don't say that to protect me.

我这么说并不是为了保护我。

I say that, of course, to protect you.

我这么说，当然是为了保护你。

What I'd like to discuss next I find extremely exciting.

我觉得接下来要讨论的内容非常令人兴奋。

Why?

为什么？

Well, what I'm about to describe is a compound, or I should say a set of compounds, that are available over the counter that have been shown to be very effective in reducing the frequency and intensity of headaches.

好吧，我要描述的是一种化合物，或者我应该说是一组化合物，它们可以在柜台上买到，已被证明可以非常有效地减少头痛的频率和强度。

And not just one kind of headache, but multiple types of headaches.

而且不仅仅是一种头痛，而是多种类型的头痛。

So what I'll describe has been shown to have significant effects in reducing the intensity or frequency of tension-type headaches, migraine-type headaches, as well as hormone-type headaches that are related to the menstrual cycles that I described earlier.

因此，我将描述的内容已被证明对减少紧张型头痛、偏头痛型头痛以及与我之前描述的月经周期相关的激素型头痛的强度或频率有显着效果。

Now, there are a lot of data centered around this general topic, but I'm going to focus on three main papers What I haven't told you yet, of course, is what is the compound that I'm referring to?

现在，有很多数据围绕这个一般主题，但我将重点关注三篇主要论文，当然，我还没有告诉你的是我所指的化合物是什么？

What is this over-the-counter compound?

这种非处方药是什么？

Well, it turns out this over-the-counter compound is not just available over the counter, it's also available in food.

事实证明，这种非处方化合物不仅可以在柜台上购买，还可以在食品中使用。

So it turns out that nutrition can have a very strong impact on the frequency and intensity of headache, although supplementation with this particular compound can accomplish the same thing as well.

因此，事实证明，营养对头痛的频率和强度有很大的影响，尽管补充这种特殊的化合物也可以达到同样的效果。

What I'm referring to here are omega-3 fatty acids.

我这里指的是omega-3脂肪酸。

Many of you are probably familiar with omega-3 fatty acids.

你们中的许多人可能熟悉 omega-3 脂肪酸。

These are fatty acids that come in the form of so-called EPA and DHA, and omega-3 fatty acids are commonly distinguished from the so-called omega-6 fatty acids.

这些脂肪酸以所谓的 EPA 和 DHA 形式存在，而 omega-3 脂肪酸通常与所谓的 omega-6 脂肪酸不同。

Omega-6 fatty acids come in a bunch of different foods, and they of course can be supplemented as well.

Omega-6 脂肪酸存在于许多不同的食物中，当然也可以补充。

Omega-3 fatty acids come in a bunch of different foods and can be supplemented as well.

Omega-3 脂肪酸存在于许多不同的食物中，也可以补充。

Common forms of omega-3 fatty acids, or I should say common sources of omega-3 fatty acids in foods include fatty ocean fish, including salmon, salmon skins, sardines, anchovies, things of that sort.

omega-3 脂肪酸的常见形式，或者我应该说食物中 omega-3 脂肪酸的常见来源包括富含脂肪的海洋鱼类，包括鲑鱼、鲑鱼皮、沙丁鱼、凤尾鱼等。

Common sources in supplement form are so-called fish oil capsules or liquid fish oil.

补充剂形式的常见来源是所谓的鱼油胶囊或液体鱼油。

Again, omega-3 fatty acids, and almost always when we're talking about omega-3 fatty acids, we're talking about a combination of EPA and DHA, but really it is the quantity of EPA omega-3 fatty acids that seems to be the most impactful for the sorts of health metrics that we're going to talk about in a few minutes.

再说一遍 omega-3 脂肪酸，几乎总是当我们谈论 omega-3 脂肪酸时，我们谈论的是 EPA 和 DHA 的组合，但实际上，EPA omega-3 脂肪酸的数量似乎对我们几分钟后要讨论的各种健康指标影响最大。

Now, with respect to omega-6 fatty acids, the most typical food sources of omega-6 fatty acids are seed oils.

现在，就 omega-6 脂肪酸而言，omega-6 脂肪酸最典型的食物来源是种子油。

I know nowadays seed oils have become quite controversial.

我知道现在种子油已经变得相当有争议。

I've given my stance on this in a prior podcast, but I'll just repeat it for those of you that haven't heard it.

我已经在之前的播客中表达了我对此的立场，但我会为那些还没有听过的人重复一遍。

I am not of the belief that all seed oils are bad, that they're all inflammatory, that they are killing us or making us sick, that they are the major cause of metabolic dysfunction, et cetera.

我不相信所有种子油都是不好的，它们都会引起炎症，它们会杀死我们或让我们生病，它们是代谢功能障碍的主要原因，等等。

However, I think it is very clear, and I learned this from Dr. Layne Norton when he was a guest on this podcast and taught us all about nutrition in great depth, I highly recommend that episode if you're interested in nutrition, that people are consuming a lot more oil generally, and a lot of those oils that people are consuming more of nowadays include a lot of the so-called omega-6 fatty acids, and a lot of those oils are seed oils.

然而，我认为这是非常清楚的，我从 Layne Norton 博士那里了解到这一点，当时他是这个播客的嘉宾，并深入地教给我们大家有关营养的知识。如果你对营养感兴趣，我强烈推荐这一集，人们普遍消耗更多的油，而现在人们消耗更多的油中含有大量所谓的 omega-6 脂肪酸，其中很多油都是种子油。

The particular omega-6 fatty acid that's going to be relevant for today's discussion is linoleic acid, and that is common in a lot of seed oils.

与今天讨论相关的特定 omega-6 脂肪酸是亚油酸，它在许多种子油中很常见。

So again, I'm not going to tell you that seed oils are bad.

再说一次，我不会告诉你种子油不好。

However, it does seem to be the case that many people are consuming far too many seed oils, and in doing so, are consuming far too many calories and perhaps are consuming too much of the omega-6 fatty acids relative to the omega-3 fatty acids.

然而，情况似乎确实是这样，许多人摄入了太多的种子油，并且在这样做的过程中，消耗了太多的卡路里，并且相对于 omega-3 脂肪酸，可能消耗了太多的 omega-6 脂肪酸。

Now, with that said, I think there is general agreement among nutritionists and health professionals that we could all stand to get more omega-3 fatty acids, perhaps for cardiovascular health, although that's a little bit debated, but certainly for immune system function, for mood, and for functioning of the brain, and for the potent anti-inflammatory effects of omega-3.

话虽如此，我认为营养学家和健康专业人士普遍认为，我们都可以摄入更多的 omega-3 脂肪酸，也许是为了心血管健康，尽管这有点争议，但肯定是为了免疫系统功能、情绪和大脑功能，以及 omega-3 的强大抗炎作用。

So again, omega-3s can be sourced from food, both animal-based and plant-based.

同样，omega-3 可以从动物性和植物性食物中获取。

You can simply go online and look up the various food-based sources.

您只需上网查找各种食品来源即可。

But in thinking about headache and different treatments for headache, there are some recent studies exploring how supplementing with omega-3 fatty acids, and in one case, how supplementing with omega-3 fatty acids and deliberately reducing the amount of linoleic acid, the omega-6 fatty acids, how that can impact headache.

但在考虑头痛和头痛的不同治疗方法时，最近有一些研究探索如何补充 omega-3 脂肪酸，以及在一种情况下，补充 omega-3 脂肪酸并刻意减少亚油酸、omega-6 脂肪酸的量，这如何影响头痛。

So the first study I'd like to describe in reference to the role of omega-3 fatty acids in headache was published in 2018, and the title of the paper is "Long-Chain Omega-3 Fatty Acids and Headache in the US Population." There are a number of things that I really like about this study.

因此，我想描述的第一项关于 omega-3 脂肪酸在头痛中的作用的研究于 2018 年发表，论文的标题是“美国人口中的长链 Omega-3 脂肪酸与头痛”。我非常喜欢这项研究的很多方面。

A few of those include the fact that they looked at an enormous number of people.

其中一些事实包括他们观察了大量的人。

That is, they included 12,317 men and women, I like the fact that they included men and women in the study, aged 20 or older, and that they broke down the population into categories that included age.

也就是说，他们包括 12,317 名男性和女性，我喜欢这样一个事实：他们在研究中包括了 20 岁或以上的男性和女性，并且他们将人口分为包括年龄在内的类别。

They certainly looked at race and ethnicity.

他们当然关注种族和民族。

They looked at educational background.

他们考察了教育背景。

They looked at body mass, total energy intake, which is really important.

他们观察了体重、总能量摄入量，这非常重要。

If you think about it, people are going to be eating, and within the things that they eat, they're going to be consuming some omega-3s hopefully, as well as some omega-6s.

如果你想一想，人们会吃东西，在他们吃的东西中，他们可能会消耗一些 omega-3 脂肪酸，以及一些 omega-6 脂肪酸。

And if they're eating far more, then they're likely going to get far more of both of those things than they would ordinarily if they were eating smaller amounts.

如果他们吃得更多，那么他们摄入的这两种东西可能会比平时吃得少的时候多得多。

So they controlled for total caloric intake in a way that I find particularly useful for looking at these kind of data.

因此，他们控制总热量摄入的方式我发现对于查看此类数据特别有用。

So the reason they explored omega-3s is worth mentioning.

所以他们探索 omega-3 的原因值得一提。

Omega-3 fatty acids are known to have an anti-inflammatory effect.

众所周知，Omega-3 脂肪酸具有抗炎作用。

That anti-inflammatory effect is mediated through a couple of different pathways.

这种抗炎作用是通过几种不同的途径介导的。

We won't go into these in too much detail now, but the omega-3 fatty acids, keep in mind, actually make up various parts of cells in the brain and body.

我们现在不会详细讨论这些内容，但请记住，Omega-3 脂肪酸实际上构成了大脑和身体细胞的各个部分。

That's right.

这是正确的。

The membrane that-- Remember I talked before about how steroid hormones can go through the different membranes of the cells, the outer membrane and the inner membrane?

膜——还记得我之前谈到过类固醇激素如何穿过细胞的不同膜，外膜和内膜？

A lot of those actual membranes, the structural constituents of neurons and other cells, are actually made up of or include certain fatty acid, long-chain fatty acids.

许多实际的膜，即神经元和其他细胞的结构成分，实际上是由某些脂肪酸、长链脂肪酸组成或包含某些脂肪酸、长链脂肪酸。

And the omega-3 fatty acids are important for the actual construction of those tissues, as well as having anti-inflammatory effects through things like limiting prostaglandins and other things that can cause inflammation.

omega-3 脂肪酸对于这些组织的实际构建非常重要，并且通过限制前列腺素和其他可能引起炎症的物质来发挥抗炎作用。

Okay, so there are a bunch of different ways that omega-3 fatty acids can be useful.

好吧，omega-3 脂肪酸有很多不同的用途。

They refer in this study to an earlier study that looked at the so-called analgesic effect, the pain-relieving effect, analgesic means pain-relieving effect, of omega-3 fatty acids in what had been a randomized control trial.

他们在这项研究中提到了一项早期研究，该研究在一项随机对照试验中观察了 omega-3 脂肪酸的所谓镇痛作用，即镇痛作用，镇痛意味着镇痛作用。

And in that previous paper, what they found was that diets high in omega-3s and low in omega-6s, okay, so high three, low six, and as compared to diets that were just reduced omega-6s, they found a greater analgesic effect of increasing omega-3s while also reducing omega-6 fatty acids.

在之前的论文中，他们发现，饮食中 omega-3 含量高而 omega-6 含量低，好吧，那么高 3，低 6，与仅减少 omega-6 的饮食相比，他们发现增加 omega-3 的同时减少 omega-6 脂肪酸的镇痛效果更好。

So in the context of the seed oil discussion, although keeping in mind that omega-6s can come from other sources as well, if omega-6s were just reduced on their own, there wasn't As great an effect in terms of reducing pain and inflammation as there was when omega-3 fatty acids were deliberately increased and omega-6 fatty acids were reduced.

因此，在讨论种子油的背景下，尽管要记住 omega-6 也可以来自其他来源，但如果仅减少 omega-6 本身，在减轻疼痛和炎症方面并不会像故意增加 omega-3 脂肪酸和减少 omega-6 脂肪酸时那样有效。

Again, in all of these studies, because these are the ones in which they controlled things well, as we say, they are holding constant the caloric intake.

同样，在所有这些研究中，正如我们所说，因为这些研究中他们控制得很好，所以他们保持了恒定的热量摄入。

So it's not just that you're removing fat, eating less fat, there's actually a removal of certain fats and fatty acids and a replacement of those with omega-3 fatty acids.

所以，这不仅仅是去除脂肪、少吃脂肪，实际上是去除某些脂肪和脂肪酸，并用 omega-3 脂肪酸替代它们。

In one case, in the other case, it's just a reduction in omega-6s, and you're using other food types and macronutrients to offset that reduction in calories caused by reducing omega-6s.

在一种情况下，在另一种情况下，这只是 omega-6 的减少，而您正在使用其他食物类型和常量营养素来抵消因减少 omega-6 而导致的卡路里减少。

The basic takeaway that they're relying on marching into the study is that increasing omega-3s and reducing omega-6s seems to be beneficial for reducing pain.

他们参与这项研究的基本结论是，增加 omega-3 摄入量和减少 omega-6 摄入量似乎有利于减轻疼痛。

And indeed, in this study, they find something quite similar, which is that when you hold caloric intake constant and when you look at omega-6s, whether or not you decrease omega-6 fatty acids or not, you find is that increasing omega-3 fatty acids in the diet, so either consumed through food sources or by supplementation, was associated with a lower prevalence of severe headache or migraine.

事实上，在这项研究中，他们发现了一些非常相似的东西，那就是当你保持热量摄入不变时，当你观察 omega-6 脂肪酸时，无论你是否减少 omega-6 脂肪酸，你都会发现饮食中增加 omega-3 脂肪酸，因此无论是通过食物来源还是通过补充剂摄入，与严重头痛或偏头痛的患病率较低有关。

So severe tension-type headache or migraine.

所以出现严重的紧张型头痛或偏头痛。

So this is promising and points to the fact that long-chain omega-3 fatty acids are likely to have either a pain-reducing, and there's evidence for that, and/or an inflammation-reducing effect that can significantly reduce the severity of headache in both tension-type headache and in migraine.

因此，这是有希望的，并指出了这样一个事实：长链 omega-3 脂肪酸可能具有减轻疼痛的作用，并且有证据表明这一点，和/或具有减轻炎症的作用，可以显着减轻紧张型头痛和偏头痛的头痛严重程度。

So that's the first study.

这是第一项研究。

The second study is a more recent study, it was published in 2021, that used, I would say, a more or less similar type of overall design as the one I referred to earlier.

第二项研究是一项更新的研究，它于 2021 年发表，我想说，它使用了与我之前提到的或多或少相似的总体设计类型。

The title of this paper is Dietary Alteration of what they call n-3, but those are omega-3, and n-6, omega-6.

这篇论文的标题是他们所谓的 n-3 的饮食改变，但那些是 omega-3、n-6、omega-6。

Sorry for the shift in nomenclature.

对于术语的改变，我们深表歉意。

I didn't write the paper.

论文不是我写的。

Dietary alteration of omega-3 and omega-6 fatty acids for headache reductions in adults with migraine, and this was a randomized control trial.

改变 omega-3 和 omega-6 脂肪酸的饮食可减少成人偏头痛患者的头痛，这是一项随机对照试验。

Randomized control trials involve having people be in one condition where they do one thing, and then they get swapped randomly into another condition.

随机对照试验涉及让人们在一种条件下做一件事，然后将他们随机交换到另一种条件下。

So they serve as their own internal control, and that controls for all sorts of things like differences in sex, differences in age, differences in health background, and any number of other variables as best as one can.

因此，它们作为自己的内部控制，并尽可能控制各种因素，例如性别差异、年龄差异、健康背景差异以及任何数量的其他变量。

In this study, they had people either ingest a diet that had increased omega-3s, so increased EPA and DHA, or increased EPA and DHA and reduced amounts of linoleic acid.

在这项研究中，他们让人们摄入增加 omega-3 的饮食，从而增加 EPA 和 DHA，或者增加 EPA 和 DHA 并减少亚油酸的含量。

Okay, so that's going to reduce omega-6s.

好的，这会减少 omega-6 的摄入量。

Or a control diet in which they had people taking what's essentially the average intake of omega-3s and omega-6s.

或者是控制饮食，让人们摄入基本上相当于平均摄入量的 omega-3 和 omega-6。

And you can probably already guess what the general results of this study are going to be.

您可能已经猜到这项研究的总体结果是什么。

The general results were that there were reductions in headaches.

总的结果是头痛减少了。

Okay?

好的？

The really cool thing is, is it was a massive reduction in headache.

真正酷的是，头痛的情况大大减少了。

Okay.

好的。

They refer to it as a robust reduction in headache, in particular for the subjects that increased their omega-3s and reduced the amount of linoleic acid that they took.

他们将其称为头痛的显着减轻，特别是对于那些增加了 omega-3 摄入量并减少了亚油酸摄入量的受试者。

The other thing that I really like about this study is that while they don't know the exact underlying mechanism for the effect, they did spend some time delineating what it is that the omega-3 and omega-6 fatty acids are likely doing to either offset or exacerbate headache.

我真正喜欢这项研究的另一件事是，虽然他们不知道这种作用的确切潜在机制，但他们确实花了一些时间来描述 omega-3 和 omega-6 脂肪酸可能会抵消或加剧头痛。

Now, I didn't say that omega-6 fatty acids exacerbate headache, but it does seem that people who ingest more linoleic acid and omega-6 are experiencing more inflammation, and that is evident in a bunch of different conditions.

现在，我并不是说 omega-6 脂肪酸会加剧头痛，但摄入更多亚油酸和 omega-6 的人似乎会经历更多的炎症，这在许多不同的情况下都很明显。

One, for instance, is increases in things like CGRP.

例如，其中之一是 CGRP 等物质的增加。

CGRP is a molecule that's associated with a calcium signaling pathway.

CGRP 是一种与钙信号通路相关的分子。

It's involved in vasodilation, the expansion of the blood vessels and capillaries, and that's known, as I mentioned earlier, to exacerbate certain forms of headache.

它与血管舒张、血管和毛细血管扩张有关，正如我之前提到的，它会加剧某些形式的头痛。

Okay?

好的？

There are also forms of headache that can be caused by vasoconstriction.

还有一些形式的头痛可能是由血管收缩引起的。

We'll talk about one very dramatic example, perhaps as we get toward the end.

也许当我们接近尾声时，我们将讨论一个非常戏剧性的例子。

It's a very uncommon example, but it's called thunderclap headache, and trust me, you do not want thunderclap headache.

这是一个非常罕见的例子，但它被称为雷击头痛，相信我，你不会想要雷击头痛。

And so we'll talk about thunderclap headache a little bit later.

稍后我们将讨论雷击性头痛。

That involves constriction of the blood vessels.

这涉及血管收缩。

In any case, in this paper, they didn't study mechanism directly, but they're resting on this known analgesic, anti-pain, as well as known anti-inflammatory pathways related to increasing omega-3 intake and simultaneously resting on the idea, or I think we now can say conclusion, that omega-6 fatty acids, in particular linoleic acid, can increase inflammation by way of increasing things like CGRP, vasodilation, and some other pathways related to the so-called inflammatory cytokine pathways.

无论如何，在这篇论文中，他们没有直接研究机制，但他们依赖于这种已知的镇痛、抗痛以及已知的与增加 omega-3 摄入量相关的抗炎途径，同时依赖于这个想法，或者我认为我们现在可以得出结论，omega-6 脂肪酸，特别是亚油酸，可以通过增加 CGRP、血管舒张和其他一些与所谓炎症相关的途径来增加炎症。细胞因子途径。

And there's a whole discussion nowadays of what's called the inflammatome.

现在有一个关于所谓的炎症组的完整讨论。

So the basic takeaway is that if you are interested in reducing headache, it may be beneficial, at least according to these two studies, and another one I'll talk about in a moment, to increase amounts of omega-3 fatty acids, and that can be done again through the ingestion of foods.

因此，基本的结论是，如果您有兴趣减少头痛，至少根据这两项研究以及我稍后将讨论的另一项研究，增加 omega-3 脂肪酸的含量可能是有益的，而这可以通过摄入食物来实现。

Although based on the dosages that we'll talk about in a moment, increasing omega-3 fatty acids by taking liquid form fish oil, which is perhaps the most cost-effective way to supplement omega-3s, or capsules, which is perhaps the most efficient way to supplement omega-3s, really to a level of one gram or more of EPA per day.

虽然基于我们稍后将讨论的剂量，但通过服用液体鱼油来增加 omega-3 脂肪酸，这可能是补充 omega-3 的最具成本效益的方法，或者胶囊，这可能是补充 omega-3 的最有效的方法，实际上达到每天一克或更多 EPA 的水平。

Again, that's the EPA form in particular.

再说一遍，特别是 EPA 表格。

So if you're, for instance, taking supplemental fish oil or you're getting your omega-3s from food and you're getting what you determine to be 2,000 milligrams or two grams per day of omega-3s, keep in mind that's going to include EPA and DHA, and it does seem that getting above one gram per day of EPA omega-3 fatty acids, either through food or supplements or both, is going to be the critical threshold for reductions in the frequency and intensity of headaches that include both tension headaches and migraine headaches.

因此，例如，如果您正在服用鱼油补充剂，或者您从食物中获取 omega-3，并且您确定每天摄入 2,000 毫克或两克 omega-3，请记住，其中将包括 EPA 和 DHA，并且通过食物或补充剂或两者兼而有之，每天获得超过 1 克的 EPA omega-3 脂肪酸似乎将成为减少摄入量的关键阈值。头痛的频率和强度，包括紧张性头痛和偏头痛。

Now, some people will find actually that ingesting Far more omega-3 fatty acids, generally through supplementation, but again, can be accomplished through foods as well, can also be beneficial for other things, such as mood, and indeed, there's a whole literature related to effects of ingesting one to three grams, again, three grams per day of EPA.

现在，有些人实际上会发现，摄入更多的 omega-3 脂肪酸（通常通过补充剂，但同样也可以通过食物来实现）也对其他方面有益，例如情绪，事实上，有大量文献涉及每天摄入 1 到 3 克（同样是 3 克）EPA 的效果。

So that's going to require quite a high intake of omega-3s in whatever form or supplement you decide to take those into your body.

因此，无论您决定以何种形式或补充剂摄入体内，都需要摄入大量 omega-3。

But that can improve mood and so forth.

但这可以改善情绪等等。

The basic range that I was able to find in the meta-analysis, so meta-analyses are where a researcher will look at the results of a bunch of different studies focused on the same thing, look at the different strength of those studies.

我能够在荟萃分析中找到的基本范围，因此荟萃分析是研究人员查看针对同一事物的一系列不同研究的结果，看看这些研究的不同强度。

They'll do all sorts of cool statistical gymnastics, like remove the most potent study, the one that had the greatest effect, and see whether or not there's still an effect of some treatment.

他们会做各种很酷的统计体操，比如删除最有力的研究，即效果最大的研究，然后看看某些治疗是否仍然有效。

Or for instance, they will swap in and out different studies and different combinations to see whether or not any one study is really leading to the conclusion that a given treatment does something.

或者例如，他们会交换不同的研究和不同的组合，看看任何一项研究是否真的得出了特定治疗有作用的结论。

In any case, in the meta-analyses of omega-3 fatty acids for the treatment of headache, and that includes all the different kinds of headache, they found in exploring a huge range of omega-3 supplementation, ranging from 200 milligrams all the way up to 2,000 milligrams per day, it really was at the one gram or higher dosage per day where the significant impact in reducing headache frequency and intensity was found.

无论如何，在 omega-3 脂肪酸治疗头痛（包括所有不同类型的头痛）的荟萃分析中，他们在探索各种 omega-3 补充剂（从每天 200 毫克一直到 2,000 毫克）时发现，确实是每天 1 克或更高的剂量对降低头痛频率和强度有显着影响。

And just very briefly, earlier I mentioned that not only has omega-3 fatty acid supplementation been shown to be effective in reducing the frequency and intensity of headache in tension type and migraine type headache, but it's also been shown to improve outcomes for premenstrual syndrome-related headaches.

我之前提到过，补充 omega-3 脂肪酸不仅可以有效降低紧张型和偏头痛型头痛的频率和强度，而且还可以改善经前综合症相关头痛的结果。

These are what we referred to earlier as hormone-based headaches.

这些就是我们之前所说的激素性头痛。

Again, the low estrogen, low progesterone associated with certain phases of the menstrual cycle, as well as other phases of the menstrual cycle, are often associated with headache.

同样，与月经周期的某些阶段以及月经周期的其他阶段相关的低雌激素、低孕激素通常与头痛有关。

In a study entitled "Effect of omega-3 fatty acids on premenstrual syndrome: A systematic review and," again, "meta-analysis," what they found, and here I'm paraphrasing the conclusion, was that omega-3 fatty acids could, yes, effectively reduce the severity of PMS symptoms.

在一项题为“Omega-3 脂肪酸对经前综合症的影响：系统回顾和荟萃分析”的研究中，他们发现（我在这里解释一下结论）是，Omega-3 脂肪酸可以有效减轻经前综合症症状的严重程度。

And one of the symptoms in particular that they found that was reduced was the pain-related symptoms associated with headache.

他们发现减少的症状之一是与头痛相关的疼痛相关症状。

And they actually had some very nice hypotheses as to why that likely would be, and in fact, point out that in earlier studies, omega-3 fatty acids have actually been considered as nonsteroidal anti-inflammatory drugs in some cases.

他们实际上有一些非常好的假设来解释为什么会出现这种情况，事实上，他们指出，在早期的研究中，Omega-3 脂肪酸在某些情况下实际上被认为是非甾体抗炎药。

And indeed, there are prescription forms of omega-3 fatty acids.

事实上，Omega-3 脂肪酸有处方形式。

And I highlight that not because I think people need to run out and get the prescription form of omega-3 fatty acids.

我强调这一点并不是因为我认为人们需要用完并获得处方形式的 omega-3 脂肪酸。

They're actually quite hard to obtain and quite expensive.

它们实际上很难获得并且非常昂贵。

But because I think oftentimes when we're talking about something like omega-3 fatty acids, the fact that they are available over the counter in a supplement or by liquid or available in food for that matter, leads many people to conclude that, oh, this is supplementation.

但因为我认为，当我们经常谈论像 omega-3 脂肪酸这样的东西时，事实上它们可以在柜台上以补充剂、液体或食物的形式购买，这一事实导致很多人得出结论，哦，这是补充剂。

This is something that it's going to have relatively weak or minor impact on things like headache or other health metrics.

这对头痛或其他健康指标的影响相对较弱或较小。

But let's just say that the fact that it exists as a prescription drug in its highest potency form, at least in my opinion, points to the potency of omega-3 fatty acids in dealing with analgesic effects, that is reducing pain and anti-inflammation, as well as some of the known cardiovascular improvements that are associated with increasing omega-3 fatty acid intake.

但我们只能说，它以最高效力形式存在的事实，至少在我看来，表明了 omega-3 脂肪酸在镇痛作用方面的效力，即减轻疼痛和抗炎，以及与增加 omega-3 脂肪酸摄入量相关的一些已知的心血管改善作用。

Put simply, omega-3s are not just something that comes from food or supplements, they are also being marketed as prescription drugs.

简而言之，Omega-3 不仅仅来自食品或补充剂，它们还作为处方药销售。

So I do think they need to be considered as quite potent, and at least as far as these papers, that again include meta-analyses of many other papers and data sets, indicate that supplementing with omega-3 fatty acids to a point where you're getting above one gram per day of EPA is not just going to be beneficial for treating and reducing the frequency and intensity of one particular type of headache, but many types of headaches.

因此，我确实认为它们需要被认为是非常有效的，至少就这些论文而言，其中再次包括许多其他论文和数据集的荟萃分析，表明补充 omega-3 脂肪酸达到每天 EPA 超过 1 克的程度，不仅有利于治疗和减少一种特定类型头痛的频率和强度，而且有利于许多类型的头痛。

And when you combine hormonal headaches, tension headaches, and migraine headaches, you account for more than 70% of the total types of headaches that are out there.

如果将荷尔蒙性头痛、紧张性头痛和偏头痛综合起来，则占所有头痛类型的 70% 以上。

The effects of omega-3s on cluster headaches and some of the other types of headaches, at least to my knowledge, have not been evaluated.

至少据我所知，omega-3 对丛集性头痛和其他一些类型头痛的影响尚未得到评估。

There's no reason to think that omega-3s would not be beneficial for those types of headaches.

没有理由认为 omega-3 对这些类型的头痛没有帮助。

But at least as far as the data sets we talked about here are concerned, it is clear omega-3 fatty acids are going to be a very potent way to reduce pain and to reduce inflammation in ways that can reduce the frequency and the intensity of different kinds of headache.

但至少就我们在这里讨论的数据集而言，很明显 omega-3 脂肪酸将成为一种非常有效的减轻疼痛和炎症的方法，从而减少不同类型头痛的频率和强度。

Before we continue our discussion about many not commonly known and yet very potent treatments for different forms of headache, I want to touch on a topic we mentioned a little bit earlier and also provide a treatment, that is, a way to alleviate something, and that's photophobia and aura.

在我们继续讨论许多不为人所知但非常有效的不同形式头痛的治疗方法之前，我想谈谈我们之前提到的一个话题，并提供一种治疗方法，即缓解某些症状的方法，那就是畏光和光环。

Now keep in mind that earlier I referred to aura as this sense that something's about to happen.

现在请记住，之前我提到的光环是指某种事情即将发生的感觉。

That is true, meaning that is an accurate description of aura, but oftentimes people also come to understand aura as the feeling that something surrounds a given object visually, or even that people have a sense that something's around them.

确实如此，这意味着这是对光环的准确描述，但人们通常也将光环理解为在视觉上有东西围绕着给定物体的感觉，甚至人们有一种感觉，有东西在他们周围。

So again, this can be a little bit vague, but this idea that aura is a sense of something about to happen, or that visually or in an auditory way and maybe even in kind of a sense that something is about to happen in a certain environment.

再说一遍，这可能有点模糊，但光环是一种对即将发生的事情的感觉，或者是视觉上或听觉上的感觉，甚至可能是某种在特定环境中即将发生某事的感觉。

And the reason I'm making kind of arc shapes with my hands, for those of you that are just listening, I'm making arc shapes with my hands, is that aura is often described as kind of a halo or emanating out from one's body or from something that they're looking at.

我用手做出弧形的原因，对于那些只是在听的人来说，我用手做出弧形，是因为光环通常被描述为一种光环，或者从一个人的身体或他们正在看的东西散发出来。

Again, nothing spiritual about this in the context of the discussion about migraine and headache, but rather many people experience photophobia, sometimes with aura, sometimes no. And I just want to touch on a couple of the mechanisms by which aura and photophobia occur and mention just briefly a Pretty well-established way that people can start to offset photophobia.

再说一次，在讨论偏头痛和头痛的背景下，这并没有什么精神上的意义，而是很多人都经历过畏光，有时有先兆，有时没有。我只想谈谈光环和畏光发生的几种机制，并简要提及人们可以开始抵消畏光的一种相当成熟的方法。

And again, I mention that because many people experience photophobia in headache, but there are also a number of people that experience photophobia even if they don't have intense headaches.

我再次提到这一点，因为很多人在头痛时都会出现畏光症状，但也有一些人即使没有剧烈头痛，也会出现畏光症状。

So photophobia is pretty common, pretty debilitating.

所以畏光症很常见，而且让人非常虚弱。

It actually, it's one of the reasons why people feel not well and need to leave work or not go to school or leave school, these kinds of things, or lay in bed all day or dim the lights, not go outside.

事实上，这就是人们感觉不舒服、需要下班、不上学、离开学校之类的原因之一，或者整天躺在床上，或者调暗灯光，不出门。

Again, sunlight being so congruent with health, you can imagine how photophobia can lead to all sorts of negative downstream consequences.

同样，阳光与健康如此一致，你可以想象畏光会如何导致各种负面的下游后果。

Okay, so what is aura and what is photophobia?

好的，那么什么是光环，什么是畏光？

The exact origins of aura aren't exactly clear, but it is generally thought that what aura represents is what's called spreading depression, and this is not depression of one's mood, although it can be associated with that.

气场的确切起源尚不清楚，但一般认为气场代表的是所谓的蔓延性抑郁，这并不是一个人情绪的抑郁，尽管它可能与此有关。

This is depression of neuronal activity.

这是神经元活动的抑制。

Again, neurons communicate with one another by generating electrical impulses that travel down the length of their so-called axons, which are like little wires, and then they dump neurotransmitter out at the so-called synapse and impact the electrical activity of other neurons.

同样，神经元通过产生电脉冲来相互通信，电脉冲沿着所谓的轴突（就像小电线）的长度传播，然后它们在所谓的突触处倾倒神经递质并影响其他神经元的电活动。

Depression is a electrical, or I should say a chemoelectrical, chemoelectrical is the proper term, phenomenon in which the excitability of neurons is reduced.

抑郁症是一种电现象，或者我应该说是一种化学电现象，化学电现象是正确的术语，即神经元兴奋性降低的现象。

So again, doesn't have anything to do with depression as a mood state per se.

再说一次，作为一种情绪状态本身与抑郁症没有任何关系。

Rather, it is a reduced excitability of neurons.

相反，它是神经元兴奋性降低。

And it's been shown in some imaging studies that aura is associated with a back to front, so from the back of the brain to front, spreading depression like a wave of lowering levels of electrical excitability.

一些影像学研究表明，先兆与从后到前（即从大脑后部到前部）相关，抑郁症会像电兴奋性水平降低的波浪一样传播。

And because this originates in the visual cortex, which is in the back, so that's the part of your brain that is making sense of visual images coming in through the eyes and relayed through other stations in the brain, that people will start to see a kind of halo of light, or that they'll start to feel that the light around them is literally surrounding their body or some other object or body that they're looking at.

因为它起源于位于后面的视觉皮层，所以大脑的这一部分负责理解通过眼睛进入并通过大脑中其他站点传递的视觉图像，人们会开始看到一种光晕，或者他们会开始感觉到周围的光确实围绕着他们的身体或他们正在看的其他物体或身体。

And then it spreads forward in the brain, and that's when it tends to stretch over into other so-called sensory modalities.

然后它在大脑中向前传播，那时它往往会延伸到其他所谓的感觉方式。

Sensory modalities being things like touch or hearing.

感觉方式是触觉或听觉等。

So people will get the sense that they're kind of seeing something in their periphery of their vision.

所以人们会感觉到他们在视野的边缘看到了一些东西。

Then they'll start feeling something around them.

然后他们会开始感觉到周围有什么东西。

There's a sense that something's about to happen.

有一种预感，有什么事情即将发生。

So as this spreading wave of depression goes from back to front, people experience a number of these different semi-abstract sensory phenomena that we call aura.

因此，当抑郁症从后到前蔓延时，人们会体验到许多不同的半抽象感觉现象，我们称之为光环。

Okay?

好的？

So that's how aura originates.

气场就是这样产生的。

Now, photophobia is a little bit different.

现在，畏光症有点不同了。

Photophobia, we now understand because of some beautiful work that was done at Cliff Saper's lab at Harvard Medical School and some other laboratories, showing that photophobia originates from a specific set of neurons in the eye.

我们现在了解了畏光症，因为哈佛医学院 Cliff Saper 实验室和其他一些实验室所做的一些出色的工作表明，畏光症源于眼睛中的一组特定神经元。

We call these the intrinsically photosensitive melanopsin ganglion cells, which is really just a mouthful of nerd speak for neurons in the eye that connect to the brain, the so-called ganglion cells, that respond most robustly to bright blue light or other short wavelength light.

我们将这些细胞称为本质光敏黑视蛋白神经节细胞，这实际上只是一个书呆子们对眼睛中连接到大脑的神经元的说法，即所谓的神经节细胞，对明亮的蓝光或其他短波长光的反应最强烈。

So you've got short wavelength light that is blue and greens are short wavelengths, and then long wavelength light, which is red or it can even be out past red would be infrared.

所以你有短波长的光，即蓝色和绿色的短波长光，然后是长波长的光，即红色的光，甚至可以超过红色的光，即红外线。

We don't detect infrared consciously.

我们不会有意识地探测红外线。

Other species do, like pit vipers can see in the infrared.

其他物种也能看到，比如毒蛇可以看到红外线。

They can even heat sense.

它们甚至可以感知热。

So short wavelength light is going to be light that's bright blue, green.

所以短波长的光将是亮蓝色、绿色的光。

It's what's very common in fluorescent bulbs that are commonly used in household lighting and workplace lighting and other forms of artificial lighting.

这在荧光灯泡中很常见，常用于家庭照明、工作场所照明和其他形式的人工照明。

It's also, of course, present in sunlight.

当然，它也存在于阳光下。

Sunlight includes a huge range of wavelengths, including long wavelength light, of course.

阳光包含多种波长，当然也包括长波长光。

You've seen that as the reds and oranges in the sunset and so on.

您已经看到了日落中的红色和橙色等等。

Those intrinsically photosensitive retinal ganglion cells in the eye respond best to bright green or blue light, and they send connections to a bunch of different places in the brain, including the so-called central circadian clock, suprachiasmatic nucleus, that sets your day, night, sleep, wake rhythms.

眼睛中那些本质上感光的视网膜神经节细胞对明亮的绿色或蓝色光反应最好，它们向大脑中的许多不同位置发送连接，包括所谓的中央生物钟、视交叉上核，它设定你的白天、夜晚、睡眠和醒来节律。

This is why I encourage people to view sunlight in the morning to set this system in motion, to avoid bright light exposure at night from artificial sources in order to not send wake-up signals from the eye to the brain and then on to the rest of the body.

这就是为什么我鼓励人们在早上观看阳光来启动这个系统，避免在夜间暴露于人造光源的强光下，以免将唤醒信号从眼睛发送到大脑，然后再发送到身体的其他部位。

But these intrinsically photosensitive retinal ganglion cells are also known to connect with other areas of the brain, many other areas of the brain, in fact.

但众所周知，这些本质上感光的视网膜神经节细胞也与大脑的其他区域（实际上是大脑的许多其他区域）连接。

And one of the important areas of the brain they connect to as it relates to photophobia is an area of a structure called the thalamus.

它们所连接的大脑中与畏光相关的重要区域之一是称为丘脑的结构区域。

The thalamus is an egg-like structure that sits in the center of the brain, and it serves as a kind of a switchboard and like a sensory relay by which information coming from the eyes, from the ears, from the touch system, et cetera, are funneled into different compartments in the thalamus and then sent to different other areas of the brain.

丘脑是一个位于大脑中心的鸡蛋状结构，它充当一种总机和感觉中继器，来自眼睛、耳朵、触觉系统等的信息被汇集到丘脑的不同隔室中，然后发送到大脑的不同其他区域。

So think of it kind of like an old-fashioned switchboard, or you could think of it sort of like in an airport, you go to a particular wing of the airport, then you go to a particular gate and so on.

因此，可以将其想象为老式总机，或者您可以将其想象为在机场中，您前往机场的特定侧翼，然后前往特定的登机口，依此类推。

You're getting funneled progressively through narrower and narrower channels until you arrive at your particular plane.

你将逐渐通过越来越窄的通道，直到到达你的特定飞机。

Much in the same way, the thalamus has a bunch of different entry points, so it's sensory information coming in from a bunch of different sources, and those sources get routed into progressively narrower and narrower funnels to eventually arrive at the accurate place for their function.

同样，丘脑有许多不同的入口点，因此感觉信息来自许多不同的来源，这些来源被引导到越来越窄的漏斗中，最终到达其功能的准确位置。

So these intrinsically photosensitive ganglion cells send connections to a small but important area of the thalamus called LP.

因此，这些本质上感光的神经节细胞将连接发送到丘脑中一个小而重要的区域，称为 LP。

It's denoted L, the letter, and P, with lateral posterior thalamus.

它用 L（字母）和 P（丘脑外侧后部）表示。

Or I should say it's the lateral posterior nucleus of the thalamus for you aficionados out there.

或者我应该说，对于你们这些爱好者来说，它是丘脑的外侧后核。

And then the neurons in that location are going to respond.

然后那个位置的神经元就会做出反应。

That is, they're going to be activated by bright blue light, green light, or any kind of bright light originating from artificial sources or from sunlight.

也就是说，它们将被明亮的蓝光、绿光或任何来自人造光源或阳光的明亮光激活。

And the neurons there that respond to that have a very interesting pattern of connections.

对此做出反应的神经元具有非常有趣的连接模式。

They send connections up to the so-called sensory cortex, so a bunch of different layers throughout the cortex that are not associated with visual perception.

它们将连接发送到所谓的感觉皮层，即整个皮层中与视觉感知无关的一堆不同层。

That is, they're not associated with understanding that there are shapes and contours in the environment, but rather to neurons that are involved in the detection of pressure, pain, and other forms of sensory information at the level of what?

也就是说，它们与理解环境中的形状和轮廓无关，而是与参与检测压力、疼痛和其他形式的感觉信息的神经元有关，在什么水平上？

The meninges, and we talked about the meninges earlier.

脑膜，我们之前讨论过脑膜。

So again, while the brain itself does not have a sensory system to detect pain, the tissues around it do, and the tissues around those tissues, that is the stuff around the meninges, themselves can respond to pain, and intracranial pressure is also relayed through the meninges to our conscious awareness that there's pain.

再说一次，虽然大脑本身没有感觉系统来检测疼痛，但它周围的组织有，而这些组织周围的组织，即脑膜周围的东西，它们本身可以对疼痛做出反应，颅内压也通过脑膜传递给我们对疼痛的意识。

So what does this mean for photophobia?

那么这对于畏光症来说意味着什么呢？

It means that bright blue light and green light, and of course light from sunlight, will activate these neurons in the eye, these intrinsically photosensitive ganglion cells, which then activate the lateral posterior neurons, LP neurons, and those LP neurons communicate with areas of the brain that are specifically tuned to different sensory phenomenon, and in particular pain at the level of the meninges and intracranial pressure.

这意味着明亮的蓝光和绿光，当然还有阳光，将激活眼睛中的这些神经元，这些本质上感光的神经节细胞，然后激活外侧后神经元、LP神经元，而这些LP神经元与专门针对不同感觉现象的大脑区域进行通信，特别是脑膜水平的疼痛和颅内压。

What this means is that when we have headache, or if we simply have photophobia on its own, that bright light is actually the trigger for pain sensing and even the creation of pain at the level of the meninges and intracranial pressure.

这意味着，当我们头痛时，或者如果我们本身有畏光症，那么明亮的光线实际上会触发疼痛感知，甚至在脑膜和颅内压水平产生疼痛。

What does this mean in terms of dealing with or treating photophobia?

这对于应对或治疗畏光症意味着什么？

Well, most people deal with photophobia by deciding to turn off or dim all the lights and simply getting under the covers or wearing a very low-brimmed hat and putting on sunglasses, and they want to lie down, and sometimes because a migraine can be associated with nausea or even vomiting in its severe instances, rather.

好吧，大多数人通过决定关闭或调暗所有灯光，简单地躲在被子下或戴上低边帽子并戴上太阳镜来应对畏光，他们想躺下，有时是因为偏头痛在严重的情况下可能会导致恶心甚至呕吐。

But one very simple way to avoid activation of these retinal ganglion cells that would trigger photophobia is that if you are starting to feel like you have a migraine coming on or you have photophobia coming on, to shift to using patterns of light that are in the longer wavelength domain.

但是，避免这些视网膜神经节细胞激活而引发畏光的一种非常简单的方法是，如果您开始感觉自己患有偏头痛或畏光，请转向使用较长波长范围内的光模式。

What that means practically is shifting to using very orange, ideally dim, but very orange and red light.

这实际上意味着转向使用非常橙色、理想情况下昏暗但非常橙色和红色的光。

Now, this is not a call for people to go out and invest in expensive red light therapies.

现在，这并不是呼吁人们出去投资昂贵的红光疗法。

Admittedly, there are some excellent case uses for red light therapy, particularly for acne, wound healing, even for improving vision, especially in people beyond the age of 40, for some hormone augmentation.

诚然，红光疗法有一些极好的案例用途，特别是用于痤疮、伤口愈合，甚至用于改善视力，特别是对于 40 岁以上的人，用于某些激素增强。

We talked all about that in the episode that I did on light and health.

我们在我关于光与健康的那一集中讨论了所有这些。

Again, you can find that at hubermanlab.com, everything timestamped.

同样，您可以在 hubermanlab.com 上找到所有内容都带有时间戳。

What I'm talking about here would be simply having some red light bulbs on hand for any time that you need to remain awake, but you're starting to experience photophobia.

我在这里所说的只是在你需要保持清醒的任何时候手头准备一些红灯泡，但你已经开始畏光了。

These red light bulbs can be purchased very inexpensively as party lights.

这些红色灯泡可以作为派对灯以非常便宜的价格购买。

You can buy these online.

您可以在线购买这些。

So there is no specific need to get any, I would say, red light that's designed specifically for photophobia or anything of that sort.

因此，我想说，没有特别需要任何专为畏光或类似情况设计的红光。

You can find the cheapest red light available out there, and those will simply work.

您可以找到最便宜的红灯，它们就可以了。

The idea being that for many people who are experiencing photophobia, they want to reduce that feeling of pain and pressure in their head experienced through photophobia.

这个想法是，对于许多患有畏光的人来说，他们希望减少因畏光而产生的头部疼痛和压力感。

They also might want to stay awake, get some work done, and do things.

他们可能还想保持清醒，完成一些工作，做一些事情。

So operating under red light, or I should say living, working, et cetera, under red light would allow you to stay awake and not have to hide under the covers if you're experiencing photophobia.

因此，在红光下工作，或者我应该说在红光下生活、工作等，可以让你保持清醒，如果你有畏光症状，就不必躲在被子里。

In addition, and I mentioned this at the beginning of the episode, but many people find photophobia to be an entry point or a trigger to headache.

此外，我在本集开头提到过这一点，但很多人认为畏光是头痛的切入点或触发点。

So what happens is they start to experience some aura, some onset of photophobia, and then the photophobia itself leads to this feeling of malaise that then converts into headache.

所以发生的事情是他们开始经历一些光环，一些畏光的发作，然后畏光本身导致这种不适的感觉，然后转化为头痛。

And so while there are not a lot of clinical data on this just yet, an emerging idea in the realm of headache treatment is the idea that if you can offset some of the early signs, you can offset some of that photophobia and aura, perhaps through the use of dim red lights or red lights as I've described a moment ago, then you might be able to reduce the probability that you're going to have a migraine or other type of headache entirely.

因此，虽然目前还没有很多这方面的临床数据，但头痛治疗领域的一个新兴想法是，如果你可以抵消一些早期症状，你可以抵消一些畏光和光环，也许通过使用昏暗的红灯或红灯，就像我刚才描述的那样，那么你可能能够完全降低你患偏头痛或其他类型头痛的可能性。

So again, no need for expensive red lights, but you can find red lights very easily online and simply have them on hand or replace the current lights that you have on your nightstand or in whatever room you happen to be in with these red lights.

再说一遍，不需要昂贵的红灯，但您可以在网上轻松找到红灯，只需将它们放在手边，或者用这些红灯替换床头柜上或您恰好所在的任何房间中现有的灯。

These red lights are also, I should mention, very useful in limiting the amount of cortisol, a stress hormone that is very healthy for us to release at high levels early in the day.

我应该提到，这些红灯对于限制皮质醇的含量也非常有用，皮质醇是一种压力荷尔蒙，对我们来说非常健康，在一天中早些时候释放高水平的皮质醇。

In fact, viewing sunlight will increase cortisol levels.

事实上，观看阳光会增加皮质醇水平。

This is another reason why what I'm about to say is relevant to photophobia.

这也是我接下来要说的内容与畏光相关的另一个原因。

But if you want to keep cortisol levels low in the evening and at night, and indeed you do, and improve the transition to sleep and indeed your sleep overall, reducing cortisol at evening time and at nighttime is extremely beneficial, and red lights will help you accomplish that.

但是，如果您想在晚上和夜间保持较低的皮质醇水平（事实上您确实这样做了），并改善了向睡眠的过渡以及整体睡眠，那么在晚上和夜间减少皮质醇是非常有益的，红灯将帮助您实现这一目标。

I talked about that in the episode on light and health.

我在关于光与健康的节目中谈到了这一点。

So the point here is that if you suffer from photophobia with or without aura, using red lights and not simply dimming ordinary artificial lights or feeling that you have to turn off all lights entirely is going to be one relatively inexpensive, or I should say very inexpensive in some cases, because these red lights can be found very inexpensively online, way to be able to continue with your daily activities, at least in an indoor environment, if you are suffering from photophobia.

所以这里的要点是，如果你患有有或没有光环的畏光症，使用红灯而不是简单地调暗普通人造灯或感觉你必须完全关闭所有灯将是一种相对便宜的方法，或者我应该说在某些情况下非常便宜，因为这些红灯可以在网上非常便宜地找到，如果你患有畏光症，至少在室内环境中能够继续你的日常活动。

So shifting back to ways to reduce the intensity and frequency of different kinds of headaches, we haven't talked so much about tension headaches specifically, so that's what I'd like to do now.

因此，回到减少不同类型头痛的强度和频率的方法，我们还没有具体讨论紧张性头痛，所以这就是我现在想做的。

As you recall, tension headaches are going to be muscular in origin.

正如您所记得的，紧张性头痛起源于肌肉。

Again, keeping in mind that everything's neural when it comes to pain.

再次强调，当涉及到疼痛时，一切都是神经性的。

Everything's neural when it comes to everything, frankly, because every organ and tissue system in our body is ultimately controlled by our nervous system.

坦率地说，一切都是神经性的，因为我们体内的每个器官和组织系统最终都是由我们的神经系统控制的。

But tension headaches are often associated with tension of the muscles that are on the skull, of the jaw, of the neck, and can be quite painful for many people and debilitating.

但紧张性头痛通常与头骨、下巴和颈部肌肉紧张有关，对许多人来说可能会非常痛苦，并使人衰弱。

And the most common treatment for this, that most people rely on, that is, is to take Non-steroid anti-inflammatories, so things like acetaminophen, ibuprofen, sometimes aspirin and things of that sort.

大多数人依赖的最常见的治疗方法是服用非类固醇抗炎药，例如对乙酰氨基酚、布洛芬，有时还有阿司匹林之类的药物。

And oftentimes those can be helpful.

通常这些都是有帮助的。

There are a couple of things to keep in mind, however.

然而，有几件事需要记住。

The NSAIDs, non-steroid anti-inflammatory drugs, oftentimes will work very well at first, but people quickly develop a tolerance to them, meaning they're going to have to take more and more in order to get the same effect.

非甾体抗炎药（非类固醇抗炎药）通常一开始效果很好，但人们很快就会对它们产生耐受性，这意味着他们必须服用越来越多的药物才能获得相同的效果。

And oftentimes they can't take more and more because some of them are very hard on the liver, and in addition to that, some of them can offset some other things that you really want.

通常他们不能服用越来越多的药物，因为其中一些药物对肝脏非常不利，除此之外，其中一些药物可能会抵消您真正想要的其他一些东西。

So for instance, it's now known that non-steroid anti-inflammatory drugs can offset some of the benefits of exercise, and that makes sense because a lot of the adaptive benefits of exercise actually come from experiencing a lot of inflammation acutely.

例如，现在已知非类固醇抗炎药可以抵消运动的一些好处，这是有道理的，因为运动的许多适应性好处实际上来自于剧烈的炎症经历。

That means you actually want inflammation during your resistance training workout or even your endurance workout, but then that inflammation triggers an adaptation event or series of adaptation events that leads to greater strength, greater speed, more muscle, more endurance, whatever it is that you happen to be training for.

这意味着你实际上希望在阻力训练甚至耐力训练期间出现炎症，但随后炎症会触发适应事件或一系列适应事件，从而导致更大的力量、更快的速度、更多的肌肉、更多的耐力，无论你正在训练什么。

So reducing pain can be good, of course, but not if you have to take more and more of a given drug that it has side effects on the liver and can offset the effects of exercise and so forth.

因此，减轻疼痛当然是件好事，但如果你必须服用越来越多的药物，这种药物会对肝脏产生副作用，并且会抵消运动等的影响，那就不好了。

The other issue with non-steroid anti-inflammatory drugs is that many of them simply do not work for many people.

非类固醇抗炎药的另一个问题是，其中许多药物对很多人来说根本不起作用。

Or again, they'll work the first time and the second time, but then they stop working.

或者，它们第一次和第二次会工作，但随后就会停止工作。

They also tend to lower body temperature.

他们还倾向于降低体温。

I think most people are aware of this because many of these same drugs are used in order to reduce fever.

我想大多数人都知道这一点，因为许多相同的药物都是用来退烧的。

But if you are taking non-steroid anti-inflammatory drugs simply to reduce your headache and you're lowering core body temperature, that can have all sorts of downstream issues related to sleep-wake cycles, to metabolism, to immune system function more generally and on and on.

但是，如果您服用非类固醇抗炎药只是为了减轻头痛并降低核心体温，那么可能会产生与睡眠-觉醒周期、新陈代谢、更广泛的免疫系统功能等相关的各种下游问题。

For that reason, there's been quite a lot of exploration of alternatives to non-steroid anti-inflammatory drugs for the treatment of headache and indeed pain generally, but today we're talking about headache.

出于这个原因，人们对非类固醇抗炎药的替代品进行了大量的探索，以治疗头痛和一般疼痛，但今天我们讨论的是头痛。

Now as it relates to tension headache, one of the more advanced kind of modern treatments that you sometimes hear about is Botox, right?

现在，由于它与紧张性头痛有关，您有时听到的更先进的现代治疗方法之一是肉毒杆菌，对吧？

Botox, I think most people are familiar with as the thing that people get injected into their face around the eyes or around the lips or elsewhere in order to, quote-unquote, "reduce wrinkles." It was discovered some years ago when Botox treatments were being done for cosmetic reasons that it could often be very effective for relieving headache if injected into the muscles.

我想大多数人都熟悉肉毒杆菌，人们将其注射到脸上的眼睛周围、嘴唇周围或其他地方，以“减少皱纹”。几年前，当出于美容原因进行肉毒杆菌治疗时，人们发现，如果注射到肌肉中，通常可以非常有效地缓解头痛。

And the way that it works is that, of course, tension headache involves a tension of the muscles, kind of a, we'll call it clenching or cinching up of the muscles.

当然，它的作用方式是，紧张性头痛涉及肌肉紧张，我们称之为肌肉紧绷或收紧。

But what we're really talking about is contraction of the muscles, and that's controlled by neurons.

但我们真正讨论的是肌肉的收缩，这是由神经元控制的。

Neurons, which are neuromuscular, so neuromuscular neurons don't form synapses with or connections with other neurons, they form synapses with muscle.

神经元是神经肌肉神经元，因此神经肌肉神经元不会与其他神经元形成突触或连接，而是与肌肉形成突触。

They release acetylcholine onto the muscle, and that makes the muscle contract.

它们将乙酰胆碱释放到肌肉上，从而使肌肉收缩。

This is the way you move the limbs of your body.

这就是你移动身体四肢的方式。

This is also a way the muscles of your head contract and can give you tension-type headaches.

这也是头部肌肉收缩的一种方式，可能会导致紧张型头痛。

Botox arises from or is rather botulinum neurotoxin.

肉毒杆菌源自或者更确切地说是肉毒杆菌神经毒素。

Botulinum neurotoxin is a toxin that's found in canned goods, not all canned goods, of course, and what it does is it prevents a certain step in the release of so-called neurotransmitter in the little packets that they live in, which are called vesicles.

肉毒杆菌神经毒素是一种存在于罐头食品中的毒素，当然，并非所有罐头食品，它的作用是阻止它们所居住的小包装（称为囊泡）释放所谓神经递质的某个步骤。

Little spheres of neurotransmitter live at the end of neuron nerve terminals and are released onto the muscle and make the muscle contract.

神经递质的小球体存在于神经元神经末梢的末端，并被释放到肌肉上并使肌肉收缩。

Botulinum neurotoxin cleaves a particular protein in there.

肉毒杆菌神经毒素会裂解其中的一种特定蛋白质。

For you aficionados who want to look this up, it's a really cool mechanism.

对于想要查找此内容的爱好者来说，这是一个非常酷的机制。

It cleaves something called SNAP 25.

它能裂解一种叫做 SNAP 25 的东西。

SNAP 25 is involved in the fusion of those little spheres with the membrane of the neuron and releasing of the neurotransmitter.

SNAP 25 参与这些小球体与神经元膜的融合以及神经递质的释放。

So when botulinum neurotoxin is present at the nerve muscle interface, those nerves cannot communicate with the muscle, and as a consequence, the muscles undergo kind of flaccid tone.

因此，当肉毒杆菌神经毒素存在于神经肌肉界面时，这些神经无法与肌肉沟通，因此，肌肉会出现某种松弛的张力。

They just kind of relax there underneath the skin.

它们只是在皮肤下面放松。

Sure, wrinkles are relieved, but if Botox is injected into the muscles themselves, it can provide long-lasting relief of certain types of headaches, in particular tension-type headaches.

当然，皱纹会得到缓解，但如果将肉毒杆菌注射到肌肉本身，它可以长期缓解某些类型的头痛，特别是紧张型头痛。

So while it seems like a bit of an extreme treatment, people who suffer very badly from tension-type headaches due to hypercontraction of the muscles of the forehead or around the temples or around the jaws or certain parts of the neck and the muscles of the neck that encroach on the back of the skull or that actually connect to the back of the skull can achieve tremendous long-lasting relief from these Botox injections.

因此，虽然这看起来有点极端的治疗方法，但由于前额、太阳穴周围、下颌周围或颈部某些部位的肌肉过度收缩而患有严重紧张型头痛的人，以及侵入颅骨后部或实际上连接到颅骨后部的颈部肌肉，可以通过肉毒杆菌注射获得巨大的持久缓解。

Sometimes for weeks or months or even longer, people go in for periodic re-ups of Botox.

有时，人们会定期补充肉毒杆菌，持续数周、数月甚至更长时间。

It actually is quite safe despite the fact that botulinum neurotoxin is quite dangerous.

尽管肉毒杆菌神经毒素非常危险，但它实际上非常安全。

It's given in very low doses and given locally, so those are the only muscles affected.

它的剂量非常低，并且是局部给药，因此这些肌肉是唯一受影响的肌肉。

So that's how Botox is used to treat headaches, and it's a very effective treatment at that.

这就是肉毒杆菌用于治疗头痛的方法，而且这是一种非常有效的治疗方法。

Of course, many people I imagine are interested in not just drug-based treatments and not Botox-type treatments for treating headache, but other types of treatments for headache that are of the more sort of let's call them natural or non-drug treatments.

当然，我想很多人不仅对基于药物的治疗方法感兴趣，也对治疗头痛的肉毒杆菌类治疗方法感兴趣，还对其他类型的头痛治疗方法感兴趣，我们称之为自然或非药物治疗。

And here we're starting to get into the realm of the kind of herbal and oil-based treatments for headache.

在这里，我们开始进入草药和油基头痛治疗领域。

Now, I confess when I first started researching this area of headache and treatment for headaches, that is, I found myself approaching it with a bit of trepidation because when I started to hear about essential oils and about herbal medications and things of that sort, I thought, "Okay, well, there'll probably be some effects."

现在，我承认，当我第一次开始研究头痛和头痛治疗这一领域时，我发现自己有点忐​​忑不安，因为当我开始听说精油和草药以及类似的东西时，我想，“好吧，好吧，可能会有一些效果。”

I mean, admittedly, we've talked before on this podcast about things like apigenin.

我的意思是，诚然，我们之前在这个播客上讨论过芹菜素之类的东西。

Apigenin is one of the core components of chamomile, and chamomile is known to make people feel a little bit sleepy and can enhance sleep.

芹菜素是洋甘菊的核心成分之一，众所周知，洋甘菊会让人感到有点困，可以增强睡眠。

Well, apigenin in high concentration can indeed augment sleep.

嗯，高浓度的芹菜素确实可以增强睡眠。

We talk about this in our sleep toolkit.

我们在睡眠工具包中讨论了这一点。

By the way, we don't just have episodes about sleep, master your sleep, perfect your sleep, et cetera.

顺便说一句，我们不仅仅有关于睡眠、掌握你的睡眠、完善你的睡眠等等的剧集。

But if you go to the hubermanlab.com website and you go to the menu and you click on Newsletter, you can scroll down and you'll see that we have a toolkit for sleep.

但是，如果您访问 hubermanlab.com 网站，进入菜单并单击新闻通讯，您可以向下滚动，您会看到我们有一个用于睡眠的工具包。

There's completely zero cost to access.

访问成本完全为零。

You don't even have to sign up, although if you'd like to sign up for future newsletters, you can get those.

您甚至不必注册，但如果您想注册未来的时事通讯，您可以获取这些。

One of the key components of the toolkit for sleep In addition to behavioral tools and things that are not supplement-based is apigenin, which is this component from chamomile.

除了行为工具和非补充剂之外，睡眠工具包的关键成分之一是芹菜素，它是来自洋甘菊的成分。

So the idea that certain herbal derivatives or herbs or oils could be very useful for improving symptoms of whatever, in this case, improving sleep with apigenin, is not unheard of.

因此，某些草药衍生物或草药或油对于改善任何症状非常有用，在这种情况下，用芹菜素改善睡眠，这种想法并非闻所未闻。

And in fact, the data continue to be released all the time that many of the things that we think of as herbal, et cetera, can actually have quite potent effects.

事实上，不断发布的数据表明，许多我们认为是草药等的东西实际上可以产生相当有效的效果。

And so, while I myself was approaching the discussion about essential oils and, or I should say oils, right?

因此，当我自己正在讨论精油时，或者我应该说油，对吗？

Who's to say if they're essential or not, oils and herbs in the treatment of headache, I finished out my research on this literature feeling quite, I should say, surprised and as if I need to really check myself a bit.

谁说它们是否是治疗头痛的必需品，油和草药，我完成了对这些文献的研究，我应该说，感觉很惊讶，好像我需要真正检查一下自己。

Because what I found is that there are certain herbs and oils, for instance, that far outperform non-steroid and anti-inflammatory drugs for the treatment of headache.

因为我发现，例如，某些草药和油在治疗头痛方面远远优于非类固醇和抗炎药物。

That's right.

这是正确的。

There are certain oils that are available over the counter that when looked at in many studies, meta-analyses, and I'll tell you about one particular study and a meta-analysis in a moment, they show that they can reduce the frequency and intensity of headache in a manner that far outpaces what you observe with non-steroid anti-inflammatory drugs, with apparently none of the same issues associated with non-steroid anti-inflammatory drugs.

有一些非处方药可以在柜台上买到，经过许多研究和荟萃分析（我稍后会告诉你一项特定的研究和荟萃分析），它们表明它们可以减少头痛的频率和强度，其程度远远超过您使用非类固醇抗炎药观察到的情况，而且显然没有与非类固醇抗炎药相关的相同问题。

So, I think it's really worth paying attention to.

所以，我认为这确实值得关注。

The first of those studies I'd like to describe to you is one that has now become kind of a classic in the literature, I should say, at least for those that are interested in the atypical treatments for headache.

我想向您描述的第一项研究现在已经成为文献中的经典，我应该说，至少对于那些对头痛的非典型治疗感兴趣的人来说是这样。

And the title of this paper is "Effect of Peppermint and Eucalyptus Oil Preparations on Neurophysiological and Experimental Algometric Headache Parameters." Okay, what does that mean?

这篇论文的标题是“薄荷和桉树油制剂对神经生理学和实验性痛觉头痛参数的影响”。好吧，那是什么意思？

Well, this is an interesting study because rather than look at the effectiveness of peppermint and eucalyptus oil and other oils on headache, what they did is because they want to look at the mechanisms underlying headache, which I confess I love the fact that they want to understand the neurophysiology and not just get subjective ratings of headache, although they did that too, but they really want to understand how these oils can impact things like muscular tension or perception of pain.

嗯，这是一项有趣的研究，因为他们所做的不是研究薄荷油、桉树油和其他油对头痛的有效性，而是因为他们想了解头痛的潜在机制，我承认我喜欢这样一个事实，即他们想要了解神经生理学，而不仅仅是获得头痛的主观评级，尽管他们也这样做了，但他们真正想了解这些油如何影响肌肉紧张或疼痛感知等事物。

What they did is they recreated headache in human subjects by using tightening cuffs of the head.

他们所做的是通过收紧头部的袖带在人类受试者中重现头痛。

They cut off blood supply to certain areas of the head.

他们切断头部某些区域的血液供应。

They basically induced headache, and then they measured things like the EMG, the muscle response at the level of electrophysiology in the muscle.

他们基本上会引发头痛，然后测量肌电图（EMG）等肌肉电生理水平的肌肉反应。

And of course, subjective measures of how much people perceive to be in pain or not in pain.

当然，还有对人们感知疼痛或不疼痛程度的主观测量。

I'll give you the broad contour of the study because I want to make sure that it's the conclusions that come through most clearly, and we will provide a link to the study in our show note captions.

我将向您介绍这项研究的大致轮廓，因为我想确保得出的结论是最清楚的，并且我们将在我们的节目注释标题中提供该研究的链接。

So what they did is they had people use one of four different preparations.

所以他们所做的是让人们使用四种不同制剂中的一种。

Say preparation one, which includes some peppermint oil and some eucalyptus oil.

说准备一，其中包括一些薄荷油和一些桉树油。

And all the details about the amount and the relative percentages are in the paper for you to peruse online through the link I mentioned before.

有关金额和相对百分比的所有详细信息都在论文中，供您通过我之前提到的链接在线阅读。

So they had four different groups.

所以他们有四个不同的组。

They had one group apply peppermint oil, but that peppermint oil also contained eucalyptus oil.

他们让一组使用薄荷油，但薄荷油还含有桉树油。

They had another group use just peppermint oil.

他们让另一组只使用薄荷油。

They had another group use just tiny traces of peppermint oil and smaller doses of eucalyptus oil.

他们让另一组只使用微量的薄荷油和较小剂量的桉树油。

And then they had a fourth group which was just using placebo.

然后他们有第四组只使用安慰剂。

When I say using, what they were doing is they were sponge applying the oil to the temples and forehead of people.

当我说使用时，他们所做的就是用海绵将油涂抹在人们的太阳穴和额头上。

And then what they did is they used these different approaches to measure the activation of muscles, to measure pain, and they then induced head pain.

然后他们所做的是使用这些不同的方法来测量肌肉的激活，测量疼痛，然后诱发头部疼痛。

They induced headache.

它们引起头痛。

So, and they looked at the temporal muscles on the side, they looked at forehead muscles, things of that sort.

因此，他们观察了侧面的颞肌，观察了前额肌肉，诸如此类的东西。

So they used three different types of pain stimuli.

因此他们使用了三种不同类型的疼痛刺激。

They looked at people's sensitivity to experimentally induced pain by either providing pressure, so this was kind of a cuff around the forehead, or thermal pain, so they actually had them basically heat it up at the level of the skin.

他们通过提供压力来观察人们对实验引起的疼痛的敏感性，所以这是一种在前额周围的袖带，或者热痛，所以他们实际上让他们基本上在皮肤的水平上加热它。

And actually, they brought the heat up pretty high to the point where people were rating the pain almost to the point of excessive pain and pain limits.

事实上，他们把热量提高到了人们对疼痛的评级几乎达到了过度疼痛和疼痛极限的程度。

So they obviously couldn't take them to the point of extreme pain.

所以他们显然不能让他们达到极度痛苦的地步。

And they had a constriction-type condition in which they cut off blood circulation to the pericranial muscles using an inflatable collar around the cranium, and they inflated that to pretty high pressure.

他们患有一种收缩型疾病，在这种情况下，他们使用颅骨周围的充气项圈来切断颅骨周围肌肉的血液循环，并将其充气到相当高的压力。

So kind of a brutal experiment to be involved in, but look, they're trying to mimic headache, and I think by using these different approaches, they're able to mimic the different aspects of headache and make sure, and here's the key point, that every person in the study is not just getting the same treatment for headache but is getting the same headache.

这是一项残酷的实验，但是看，他们试图模仿头痛，我认为通过使用这些不同的方法，他们能够模仿头痛的不同方面，并确保研究中的每个人不仅接受相同的头痛治疗，而且得到相同的头痛，这就是关键点。

And that's something that I think gives this study power.

我认为这赋予了这项研究力量。

It's not the only way to do a study like this, but it gives it a lot of power in trying to understand which types of interventions are going to assist in headache and maybe even specific dimensions of the pain in headache.

这不是进行此类研究的唯一方法，但它赋予了研究很大的力量，试图了解哪些类型的干预措施将有助于缓解头痛，甚至可能有助于了解头痛疼痛的具体程度。

And basically what they found in the study is that of all the treatments they used, the essential plant oil preparations that contained peppermint, and I'll just mention as an aside, and in other studies, menthol, so these minty type what we think of as flavors but are really aromas as well, and as I'll point out the mechanism in a moment, they had the effect of significantly reducing the intensity of the pain.

基本上他们在研究中发现的是他们使用的所有治疗方法，含有薄荷的精油制剂，我只是顺便提一下，在其他研究中，薄荷醇，所以这些薄荷类型我们认为是味道，但实际上也是香气，正如我稍后会指出的机制，它们具有显着减轻疼痛强度的效果。

That is, subjects could tolerate the pain far better and experienced less pain subjectively.

也就是说，受试者可以更好地忍受疼痛，并且主观上感受到的疼痛更少。

And the magnitude of the effects were really pretty impressive.

其影响的严重程度确实令人印象深刻。

Again, I went into all this thinking essential oils, okay, that's like some really woo stuff.

我再次思考精油，好吧，这就像一些真正吸引人的东西。

I don't know about that.

我对此一无所知。

But it turns out that these essential oils, at least the ones that contain peppermint oil, with or without eucalyptus oil, performed very well in reducing pain.

但事实证明，这些精油，至少是含有薄荷油的精油，无论是否含有桉树油，在减轻疼痛方面都表现得非常好。

The key takeaway from the study is, and here I'm paraphrasing from the study, that the combination of peppermint oil, eucalyptus oil, and these are basically in a ethanol suspension.

这项研究的关键要点是，我在这里解释一下这项研究，即薄荷油、桉树油的组合，这些基本上都在乙醇悬浮液中。

Again, people are not drinking these essential oils.

再次强调，人们并没有饮用这些精油。

I want to be very clear.

我想说得很清楚。

They are applying these to the skin Around the area that's in pain, in particular the temple and the foreheads.

他们将这些药物涂抹在疼痛区域周围的皮肤上，特别是太阳穴和前额。

Increased cognitive performance, I didn't talk about that, but this is the ability to maintain cognitive functioning while in pain.

认知能力的提高，我没有谈论这个，但这是在疼痛时维持认知功能的能力。

Here we're talking about headache up until now just as kind of pain, but that pain can be very debilitating for your ability to work and perform and do other things.

到目前为止，我们在这里谈论的头痛只是一种疼痛，但这种疼痛可能会严重削弱您的工作、表现和做其他事情的能力。

So this combination of peppermint oil and eucalyptus oil applied to the skin allow people to increase their cognitive performance while under pain, and it had a very muscle relaxing and mentally relaxing effect.

因此，这种将薄荷油和桉树油涂在皮肤上的组合可以让人们在疼痛时提高认知能力，并且具有非常好的肌肉放松和精神放松的效果。

Mental relaxation was of course measured subjectively.

精神放松当然是主观测量的。

But remember, one of the things that led me to feature this study in this episode in particular is that they didn't just say, "Oh, my muscles feel more relaxed."

但请记住，促使我在这一集特别介绍这项研究的原因之一是他们不只是说，“哦，我的肌肉感觉更放松了。”

They actually saw that the muscles of the forehead and temples, and some surrounding muscles, were more relaxed when people had these oils applied to their forehead and the temples.

他们实际上发现，当人们将这些油涂抹在额头和太阳穴上时，前额和太阳穴的肌肉以及周围的一些肌肉会更加放松。

Not perhaps to the same degree that one would observe with Botox, or for the same extent or duration as one would experience with Botox, but much in the same way.

也许与使用肉毒杆菌观察到的程度不同，或者与使用肉毒杆菌所体验到的程度或持续时间不同，但方式大致相同。

Which then raises the question of, well, what's going on here?

这就提出了一个问题：这里发生了什么？

I mean, is this all placebo effect?

我的意思是，这都是安慰剂效应吗？

Well, no, because they compared to placebo, and they controlled for the odor, of course, of the oil that was applied so that everyone thought that they were getting essentially the same thing, pun intended.

嗯，不，因为他们与安慰剂进行比较，当然，他们控制了所使用的油的气味，这样每个人都认为他们得到的基本上是相同的东西，双关语。

But in this case, what they found is that if they applied the essential oil to the forehead and temples, that people experience more or less a cooling sensation, or they could feel as if something was happening in the underlying muscle.

但在这种情况下，他们发现，如果将精油涂抹在额头和太阳穴上，人们会或多或少地感受到一种清凉的感觉，或者他们会感觉下面的肌肉好像发生了一些事情。

Well, what was happening?

嗯，发生了什么事？

We now know that menthol, peppermint, and other things that smell that way and taste that way actually have an impact on the sensory neurons at the level of the skin, and can actually inhibit certain sensory neurons and can activate other sensory neurons.

我们现在知道，薄荷醇、薄荷和其他具有这种气味和味道的物质实际上会对皮肤水平的感觉神经元产生影响，并且实际上可以抑制某些感觉神经元并可以激活其他感觉神经元。

Okay, so in order to understand this, we have to go back to what I said at the beginning of the episode, which is that you have motor neurons.

好吧，为了理解这一点，我们必须回到我在本集开头所说的，那就是你有运动神经元。

These are neurons that constrict muscles or, excuse me, that cause contraction of muscles.

这些神经元可以收缩肌肉，或者，对不起，可以引起肌肉收缩。

They don't constrict them.

他们不限制他们。

They cause contraction of muscles.

它们会引起肌肉收缩。

You have sensory neurons which sense different things, light, sound, or touch.

你有感觉神经元，可以感知不同的事物，比如光、声音或触觉。

And you have modulatory neurons.

而且你有调节神经元。

Menthol and eucalyptus are actually known to activate certain channels in the sensory neurons that respond not just to touch, but also the sensation of cooling.

事实上，薄荷醇和桉树可以激活感觉神经元中的某些通道，这些通道不仅对触摸做出反应，还对清凉感做出反应。

Okay?

好的？

So when we think of menthol and peppermint, we think of kind of cool scents and flavors.

因此，当我们想到薄荷醇和薄荷时，我们会想到一些凉爽的气味和口味。

Cool meaning cold.

酷的意思是寒冷。

And when we think of things like hot peppers, capsaicin, we think of anything that has a hot temperature, we tend to think of spicy.

当我们想到辣椒、辣椒素之类的东西时，我们想到任何具有高温的东西，我们往往会想到辣。

So spicy and hot go together, and peppermint and menthol and cool go together, much in the way that the gum commercials or the mint commercials would lead you to believe.

因此，辛辣和辣味是相辅相成的，薄荷和薄荷醇和凉感是相辅相成的，就像口香糖广告或薄荷广告会让你相信的那样。

And in fact, they're right.

事实上，他们是对的。

So what's happening here is that the application of these oils is very likely activating channels in these sensory neurons, including the TRP channels, but others as well, that are leading to the analgesic effect by shutting down the heat and pain pathways.

所以这里发生的情况是，这些油的应用很可能激活这些感觉神经元中的通道，包括 TRP 通道，但也包括其他通道，通过关闭热和疼痛通路来产生镇痛效果。

Because heat and pain, while they're not exactly the same in our nervous system, they are funneled through common pathways.

因为热和痛虽然在我们的神经系统中并不完全相同，但它们通过共同的途径传递。

Whereas cooling and pain relief are funneled through alternate, what we call parallel pathways.

而降温和止痛是通过交替的（我们称之为平行途径）传递的。

So the study on peppermint and eucalyptus oil preparations in reducing pain of headache and different aspects of pain due to headache, I think are really important because they don't just illustrate the fact that, yes, indeed, and here I'll go on record saying it because that's what the data say and there are other papers to support this statement as well.

因此，关于薄荷和桉树油制剂在减轻头痛疼痛和头痛引起的疼痛的不同方面的研究，我认为非常重要，因为它们不仅仅说明了这样一个事实，是的，确实如此，在这里我将记录下来说这一点，因为这就是数据所说的，而且还有其他论文支持这一说法。

Essential oils applied to the skin can reduce the symptoms of tension headache in a significant way and actually can lead to some offset of some of the cognitive defects seen with headaches.

涂抹在皮肤上的精油可以显着减轻紧张性头痛的症状，实际上可以在一定程度上抵消头痛引起的一些认知缺陷。

So that's itself very impressive, I must say.

我必须说，这本身就令人印象深刻。

Surprising for me, kind of put me in my place as somebody who thought, "Oh, essential oils." It was going to be like, "Okay." But it actually seemed to really hold some merit.

让我感到惊讶的是，这让我陷入了一个想法“哦，精油”的人的境地。它会像，“好吧”。但它实际上似乎确实有一些优点。

And when you compare the magnitude of the effect, even though this wasn't an enormous number of subjects, you compare the magnitude of the effect in a paper like this or similar papers on these essential oils to the impact of non-steroid anti-inflammatory drugs, and they really hold their own and in some cases exceed the positive impact of anti-inflammatory drugs.

当你比较效果的大小时，即使这不是一个巨大的受试者数量，你将像这样的论文或类似的关于这些精油的论文中的效果大小与非类固醇抗炎药的影响进行比较，它们确实有自己的作用，在某些情况下超过了抗炎药的积极影响。

So for that reason, I think we can look at peppermint oils and peppermint and eucalyptus-containing oils, menthol-containing oils applied to the skin for the treatment of tension-type headache as among the more potent treatments available out there.

因此，出于这个原因，我认为我们可以将薄荷油、含有薄荷和桉树的油、含有薄荷醇的油涂抹在皮肤上治疗紧张型头痛，作为现有的更有效的治疗方法之一。

Now, another way to approach treatment of tension headache is something that many of you have probably heard about before, and that I've talked a little bit about on this podcast in previous episodes, and that's acupuncture.

现在，治疗紧张性头痛的另一种方法可能是你们中的许多人之前听说过的，我在之前的播客中已经谈过一些，那就是针灸。

We will do an entire episode all about acupuncture, but much in the same way that essential oils, I think for many people, not all, but for many people, are considered kind of a woo biology, or people think of it as very alternative medicine.

我们将做一整集关于针灸的内容，但我认为对于很多人来说，不是所有人，但对于很多人来说，精油被认为是一种求爱生物学，或者人们认为它是一种非常另类的医学。

Keep in mind that as the underlying mechanisms of things like these peppermint oils are starting to be discovered, or omega-3s are starting to be discovered, mechanistically, they hold up very well.

请记住，随着这些薄荷油等物质的潜在机制开始被发现，或者 omega-3 开始被发现，从机制上讲，它们的作用非常好。

There's a logic there.

这是有逻辑的。

There's an underlying understanding of not just why they should work, but in many cases, how they work.

人们不仅对它们为什么应该起作用，而且在许多情况下它们如何工作都有一个基本的理解。

In the same way, acupuncture, which of course has existed for thousands of years, has been used very successfully to treat headache and other forms of pain.

同样，针灸当然已经存在了数千年，已经非常成功地用于治疗头痛和其他形式的疼痛。

So much so that many insurance companies will now pay for acupuncture as an insured practice.

如此之多以至于许多保险公司现在将针灸作为一种受保的做法进行支付。

Not all, but many will.

不是全部，但很多人会。

And in addition to that, the scientific community is starting to understand mechanistically how acupuncture works.

除此之外，科学界开始从机械上理解针灸的作用原理。

So I don't want to make this the major focus for now, but very briefly, there's a laboratory at Harvard Medical School run by Qiufu Ma.

所以我现在不想把这个作为主要焦点，但简单地说，哈佛医学院有一个由马求夫管理的实验室。

Qiufu is well-known in the neuroscience community for doing excellent work in parsing the mechanisms of touch sensation and pain in particular.

求夫在神经科学界享有盛誉，因为他在解析触觉和疼痛机制方面做出了出色的工作。

So not just touch at the level of skin, but pain and pain pathways.

因此，不仅仅是皮肤层面的触摸，还有疼痛和疼痛路径。

And in recent years, his laboratory has started to do studies on how acupuncture works, because indeed, acupuncture has been known to work to alleviate pain for a long time, but the underlying mechanisms haven't been clear.

近年来，他的实验室开始研究针灸如何发挥作用，因为事实上，针灸长期以来一直被认为可以缓解疼痛，但其潜在机制尚不清楚。

What Qiufu's lab has published now in excellent journals like Nature, Science, and other journals, is that the Precise insertion sites of different needles lead to activation of sensory neurons and their downstream pathways in ways that can potently reduce inflammation and that can be used to potently reduce the activity of certain muscles, for instance, muscles in the forehead and temples.

求福实验室现已在《自然》、《科学》等优秀期刊上发表文章称，不同针的精确插入部位会激活感觉神经元及其下游通路，从而有效减少炎症，并可有效减少某些肌肉的活动，例如前额和太阳穴的肌肉。

So when you hear acupuncture can reduce pain, I think some people think, "Oh, well, if there's needles sticking out of your face, first of all, that must hurt." And actually, the needles are very fine needles, and skilled acupuncturists can insert them without any pain, or actually, the person receiving it doesn't even usually recognize that the needles are in.

因此，当你听到针灸可以减轻疼痛时，我想有些人会想，“哦，好吧，如果有针从你的脸上伸出，首先，那一定很痛。”事实上，这些针都是非常细的针，熟练的针灸师可以毫无疼痛地插入它们，或者实际上，接受针的人通常甚至没有意识到针已经插入了。

That's how quickly and efficiently they can put them in, and people don't detect any pain.

这就是他们可以如此快速有效地放置它们，而且人们不会察觉到任何疼痛。

But that has been shown to greatly reduce pain, in particular headache-related pain and back-related pain and some other forms of pain.

但事实证明，这可以大大减轻疼痛，特别是与头痛相关的疼痛、与背部相关的疼痛以及其他一些形式的疼痛。

Qiufu's lab has shown that the specific needle insertion sites can activate the sensory pathways and can deactivate the sensory motor pathways, and now you're familiar with sensory neurons, motor neurons, and modulatory neurons, and can modulate the activity of the pain pathways by way of impacting the activity of all sorts of different organs, including organs that give rise to some of the inflammatory cytokines.

求福的实验室已经证明，特定的针插入部位可以激活感觉通路，也可以停用感觉运动通路，现在您已经熟悉了感觉神经元、运动神经元和调节神经元，并且可以通过影响各种不同器官的活动来调节疼痛通路的活动，包括产生一些炎症细胞因子的器官。

So basically what I'm saying here is that thanks to thousands of years of acupuncture and the maps of different insertion sites, we now know, or I should say people have long known and people in the West are starting to adopt the understanding that acupuncture, yes, indeed, it really does work for relieving pain.

所以基本上我在这里要说的是，由于数千年的针灸和不同插入部位的地图，我们现在知道了，或者我应该说人们早就知道了，西方人开始接受针灸的理解，是的，确实，它确实可以缓解疼痛。

And laboratories both in the United States, which is Qiufu's, and elsewhere are starting to find the underlying mechanisms, and those mechanisms include deactivation of the pain pathways, activation of some of the parallel pathways that assist in shutting down pain or in relaxing the muscles that are causing tension-type headache, as well as activation of neural pathways that impinge on organs that then cause or reduce the release of molecules into the body that give us the experience of pain.

美国和其他地方的实验室正开始寻找潜在的机制，这些机制包括疼痛通路的失活，激活一些平行通路，帮助停止疼痛或放松引起紧张型头痛的肌肉，以及激活影响器官的神经通路，从而导致或减少分子释放到体内，从而给我们带来疼痛的体验。

So reduced inflammation and, in many cases, increasing anti-inflammatory pathways.

因此减少了炎症，并且在许多情况下增加了抗炎途径。

So I just want to be sure to mention acupuncture and a little bit of mechanistic understanding of why acupuncture works because indeed, acupuncture is shown to be quite effective for the treatment of tension-type headache and, to some extent, migraine headache as well.

所以我只想提一下针灸以及对针灸为何有效的一点机械理解，因为事实上，针灸被证明对于治疗紧张型头痛非常有效，在某种程度上也可以治疗偏头痛。

So we talked about omega-3 fatty acids, we talked about essential oils, we talked about acupuncture, so this episode is starting to sound like alternative treatments to headache, including migraine.

所以我们谈论了 omega-3 脂肪酸，我们谈论了精油，我们谈论了针灸，所以这一集开始听起来像是头痛（包括偏头痛）的替代疗法。

But I want to be very clear, this is not about alternative treatments.

但我想非常明确的是，这与替代疗法无关。

Everything that I'm talking about here has a mechanistic basis, and what we're talking about today are approaches to dealing with headache that, yes, are typically over-the-counter compounds or are grounded in nutrition or, in the case of acupuncture, behavioral practices, but that are not necessarily meant as replacements for things like non-steroid anti-inflammatory drugs or prescription drugs.

我在这里谈论的一切都有其机制基础，我们今天谈论的是治疗头痛的方法，是的，这些方法通常是非处方化合物或基于营养，或者针灸的情况下，基于行为实践，但并不一定意味着可以替代非类固醇抗炎药或处方药等药物。

Of course, those things can still be taken.

当然，那些东西还是可以拿走的。

Many people derive benefit from them.

许多人从中受益。

But the goal is always, I believe, or I should hope, for people to find ways that they can control their health outcomes and reduce things like headache using a minimum number of things that have other side effects.

但我相信，或者我应该希望，我们的目标始终是，让人们找到控制健康结果的方法，并使用最少数量的具有其他副作用的药物来减少头痛等疾病。

And that, of course, can also include the use of essential oils in conjunction with things like non-steroid anti-inflammatory drugs or the use of red light to offset photophobia in conjunction with any number of different treatments, either prescription or otherwise.

当然，这还可以包括将精油与非类固醇抗炎药等药物结合使用，或使用红光来抵消畏光，并结合多种不同的治疗方法（无论是处方药还是其他方法）。

So I do want to make that clear, and I especially want to make that clear as I transition to the next segment where I'm going to tell you about herbal treatments for migraine.

所以我确实想澄清这一点，当我过渡到下一个部分时，我特别想澄清这一点，我将向您介绍偏头痛的草药治疗。

And this is based on what I consider a very comprehensive review of many randomized control studies.

这是基于我认为对许多随机对照研究的非常全面的回顾。

Indeed, the title of the paper is "Herbal Treatments for Migraine: A Systematic Review of Randomised Controlled Studies." And this was published in 2020, and this contains an immense amount of information, so we will provide a link to it for those of you that really want to dive deep on this.

事实上，这篇论文的标题是“偏头痛的草药治疗：随机对照研究的系统回顾”。该文章于 2020 年发布，包含大量信息，因此我们将为那些真正想深入了解这一点的人提供一个链接。

In this paper, they focus on a number of different reviews and analyses of data focused on compounds for the treatment of migraine, ranging from and including things like menthol and peppermint oil.

在本文中，他们重点关注了针对治疗偏头痛的化合物的许多不同的数据评论和分析，范围包括薄荷醇和薄荷油等。

So we already covered that, so I won't cover that again in detail.

我们已经介绍过这一点，所以我不会再详细介绍这一点。

But in this review, they highlight the results I referred to before, plus other results that show that menthol and peppermint oil can be quite effective in the treatment of tension-type headache and, in this case, migraine headache as well.

但在这篇评论中，他们强调了我之前提到的结果，以及其他结果，表明薄荷醇和薄荷油可以非常有效地治疗紧张型头痛，在这种情况下，也可以治疗偏头痛。

So that's interesting that menthol and peppermint oils can be used not just to treat tension-type headaches but migraine headaches as well.

有趣的是，薄荷醇和薄荷油不仅可以用于治疗紧张型头痛，还可以用于治疗偏头痛。

And they look at an enormous number of other types of herbal and essential oil-type treatments, everything from coriander to citron to damask rose, chamomile, lavender, a bunch of things.

他们还研究了大量其他类型的草药和精油类治疗方法，从香菜到香橼到大马士革玫瑰、洋甘菊、薰衣草等等。

So I'm not going to go through each and every one of these in a lot of detail.

因此，我不会详细介绍每一项内容。

What I've tended to do today and I'm going to do now is to highlight the most potent of these different treatments.

我今天想做的和现在要做的就是强调这些不同治疗方法中最有效的。

Again, menthol peppermint oil being among the most potent.

再次强调，薄荷油是最有效的。

In addition to that, there's a particular pathway that's associated with headache, and when I say that, I mean the different types of headache, which includes the activation of this thing that we call CGRP.

除此之外，还有一个与头痛相关的特定途径，当我这么说时，我指的是不同类型的头痛，其中包括我们称为 CGRP 的物质的激活。

CGRP, again, is involved in this calcium regulation pathway and leads to vasodilation of the vessels and arteries and capillaries in a way that can create pain and this feeling of pressure inside the head, which can be very uncomfortable, of course.

CGRP 再次参与这种钙调节途径，并导致血管、动脉和毛细血管舒张，从而产生疼痛和头部内部的压力感，当然，这可能会非常不舒服。

Now, earlier in the episode, I mentioned that I was going to touch on caffeine, and so I'm going to do that now.

现在，在本集的早些时候，我提到我要接触咖啡因，所以我现在就这样做。

Now, the reason I mention caffeine is that there's a sort of lore out there that if you have a headache, drinking a cup of coffee can eliminate that headache.

现在，我提到咖啡因的原因是，有一种传说认为，如果您头痛，喝一杯咖啡可以消除头痛。

A few things about that point.

关于这一点的一些事情。

First of all, if you are somebody who ingests caffeine every day and you do not ingest caffeine, you will indeed get a headache, and drinking caffeine will relieve that particular headache.

首先，如果你是每天摄入咖啡因的人，而你不摄入咖啡因，你确实会头痛，而喝咖啡因可以缓解这种头痛。

So it's absolutely true that caffeine can relieve the lack of caffeine-induced headache.

因此，咖啡因确实可以缓解缺乏咖啡因引起的头痛。

That's sort of a duh.

这有点废话。

But that leads actually to a very important question, which is why would that be the case?

但这实际上引出了一个非常重要的问题，那就是为什么会出现这种情况？

Well, it turns out that caffeine is both a vasodilator and a vasoconstrictor.

事实证明，咖啡因既是血管扩张剂，又是血管收缩剂。

How does it do that?

它是如何做到的？

Well, one of the main ways in which caffeine makes us more alert is that it occupies the receptors for something called adenosine.

咖啡因让我们更加警觉的主要方式之一是它占据了腺苷的受体。

Adenosine is a molecule that builds up in the brain and body more and more the longer we've been awake.

腺苷是一种分子，我们清醒的时间越长，它在大脑和身体中积累的就越多。

It's one of the things that makes us feel sleepy.

这是让我们感到困倦的原因之一。

So when we drink caffeine, that caffeine occupies the adenosine receptor, and the adenosine cannot have its normal effect of making us sleepy.

因此，当我们喝咖啡因时，咖啡因会占据腺苷受体，腺苷就无法发挥其正常的使我们昏昏欲睡的作用。

When that caffeine wears off, the adenosine can bind, and we feel sleepy.

当咖啡因消失时，腺苷就会结合，我们就会感到困倦。

Adenosine is a vasodilator.

腺苷是一种血管扩张剂。

So when we drink caffeine, because it blocks the effects of adenosine, there is a vasoconstriction associated with drinking caffeine.

因此，当我们喝咖啡因时，因为它会阻止腺苷的作用，所以会出现与喝咖啡因相关的血管收缩。

So if you have a headache that is associated with excessive vasodilation and pressure in the head, indeed, drinking some caffeine can cause some vasoconstriction by preventing that adenosine pathway that would normally lead to vasoconstriction, and you can get some relief from that headache.

因此，如果您的头痛与血管过度舒张和头部压力有关，那么喝一些咖啡因确实可以通过阻止通常会导致血管收缩的腺苷途径来引起一定程度的血管收缩，这样您就可以在一定程度上缓解头痛。

However, caffeine is also a vasodilator.

然而，咖啡因也是一种血管扩张剂。

Caffeine has the ability to impinge on the so-called NO pathway, the nitric oxide pathway, which is a nerve to blood pathway that involves a few different enzymes that we won't get into right now, but maybe in a future episode, that causes dilation of the blood vessels, and as a consequence, drinking caffeine can also increase vasodilation.

咖啡因能够影响所谓的一氧化氮途径，即一氧化氮途径，这是一种神经到血液的途径，涉及几种不同的酶，我们现在不会了解这些酶，但也许在未来的事件中，这会导致血管扩张，因此，喝咖啡因也可以增加血管舒张。

So it's sort of a two-pronged effect.

所以这是一种双管齐下的效果。

Now, one of the ways in which you might think about this and perhaps utilize this, is that if you are well rested, or if it's early in the day and you've had some sleep the previous night, adenosine levels are very likely to be low, especially if you slept very well the night before.

现在，您可能会思考并利用这一点的方法之一是，如果您休息得很好，或者如果是在一天的早些时候并且您前一天晚上睡了一些觉，那么腺苷水平很可能会很低，尤其是如果您前一天晚上睡得很好的话。

Under those conditions, when you ingest caffeine, you are not going to experience the vasoconstriction effects of caffeine that would ordinarily be there by inhibiting adenosine.

在这种情况下，当您摄入咖啡因时，您不会体验到咖啡因通常通过抑制腺苷而产生的血管收缩作用。

Why?

为什么？

Because adenosine is not present at all, and under those conditions, drinking coffee ought to lead to some vasodilation.

因为根本不存在腺苷，在这种情况下，喝咖啡应该会导致一定程度的血管舒张。

Not a lot, but nonetheless, vasodilation.

虽然不是很多，但仍然有血管舒张。

If, however, you haven't slept well or it's late in the day and you've been up for a long time, drinking caffeine is likely to have more of a vasoconstriction effect.

然而，如果你睡得不好，或者已经很晚了，而且你已经起床很长时间了，那么喝咖啡因可能会产生更大的血管收缩作用。

And this is important because some of the treatments that you hear about that involve using caffeine to treat headache are as extreme as, okay, if you have a headache at night, drink a cup of coffee and then go to sleep.

这很重要，因为您听说的一些涉及使用咖啡因治疗头痛的治疗方法非常极端，就像，好吧，如果您晚上头痛，喝一杯咖啡，然后睡觉。

I actually saw that in the literature, which I couldn't quite believe because, yes, indeed, some people can fall asleep after drinking caffeine, but we know very well, thanks to the beautiful work and science communications of people like Dr.

我实际上在文献中看到了这一点，我不太相信，因为，是的，确实，有些人在喝咖啡因后可以入睡，但我们非常清楚，这要归功于像博士这样的人的出色工作和科学交流。

Matthew Walker from University of California, Berkeley, and who's been a guest on this and many other podcasts, that even if you can fall asleep after drinking caffeine, ingesting caffeine within the 10 to 12 hours prior to bedtime is simply not a good idea because of the ways it disrupts the architecture of sleep.

加州大学伯克利分校的马修·沃克（Matthew Walker）是这个播客和许多其他播客的嘉宾，他表示，即使你可以在喝咖啡后入睡，但在睡前 10 到 12 小时内摄入咖啡因也不是一个好主意，因为它会破坏睡眠结构。

So what's the takeaway about caffeine and headache and vasodilation?

那么咖啡因与头痛和血管舒张有什么关系呢？

You need to be very clear on whether or not caffeine tends to remove your headache or exacerbate it.

您需要非常清楚咖啡因是否会消除或加剧头痛。

Now, this is going to depend on time of day and the amount of adenosine in your system, as I mentioned before, but also there seems to be a kind of bimodal distribution whereby some people, when they drink caffeine, it really improves their headache.

现在，这将取决于一天中的时间和系统中腺苷的量，正如我之前提到的，但似乎也存在一种双峰分布，即有些人在喝咖啡因时，确实改善了他们的头痛。

In some cases, very significant effects.

在某些情况下，效果非常显着。

Whereas other people, when they drink caffeine, it really exacerbates their headache.

而其他人，当他们喝咖啡因时，确实会加剧他们的头痛。

And at least as far as I could tell from the literature, it's not easy to predict who those people are going to be.

至少据我从文献中可以看出，预测这些人是谁并不容易。

What is reassuring, however, is it does not seem to be the case that if you're somebody who experiences relief from headaches by drinking caffeine, that suddenly one day to the next, you're going to experience a worsening of your headache, and vice versa is also true.

然而，令人放心的是，如果您是一个通过喝咖啡因缓解头痛的人，那么您的头痛似乎不会突然一天又一天地恶化，反之亦然。

So if you're somebody that drinks caffeine and your headaches get worse, I don't think there's any reason to think that caffeine one day or from one day to the next rather, is going to somehow alleviate your headache.

因此，如果你是一个喝咖啡因的人并且你的头痛变得更严重，我认为没有任何理由认为咖啡因有一天或一天​​到下一天会以某种方式缓解你的头痛。

So you have to determine for yourself whether or not headaches are relieved or exacerbated by drinking caffeine, and if you're wondering why it's so confusing, it's because caffeine hits both the vasodilation and the vasoconstriction pathways, and there's nothing you or I or anyone else can do about it.

因此，你必须自己确定饮用咖啡因是否会缓解或加剧头痛，如果你想知道为什么它如此令人困惑，那是因为咖啡因会影响血管舒张和血管收缩途径，而你、我或其他任何人对此无能为力。

Now, the last thing I'd like to talk about in terms of relief for headaches is something that I'm guessing about probably 25% of you are familiar with and 75% of you are not, which is curcumin.

现在，关于缓解头痛，我想谈论的最后一件事是姜黄素，我猜你们中可能有 25% 的人熟悉而 75% 的人不熟悉。

Curcumin is often also referred to as turmeric, and turmeric is a root, and curcumin is one of the key components of that root.

姜黄素通常也被称为姜黄，姜黄是一种根，姜黄素是该根的关键成分之一。

Curcumin is known to have very potent anti-inflammatory properties.

众所周知，姜黄素具有非常有效的抗炎特性。

I don't think that's debated at all.

我认为这根本没有争议。

In fact, it's so potent as an anti-inflammatory that some people have cautioned against taking high levels of curcumin prior to, for instance, resistance training workouts or even cardiovascular workouts because it so prevents inflammation that it also can prevent the adaptation response.

事实上，它的抗炎作用非常有效，以至于有些人警告不要在进行阻力训练甚至心血管锻炼之前服用高浓度的姜黄素，因为它可以防止炎症，也可以防止适应反应。

Because remember, the inflammation that occurs during exercise, both resistance and cardiovascular exercise, is, at least in part, the trigger for the adaptation that it's going to lead to enhanced endurance, enhanced strength, hypertrophy, et cetera.

因为请记住，运动期间发生的炎症，无论是阻力运动还是心血管运动，至少在一定程度上是适应的触发因素，它将导致耐力增强、力量增强、肥大等。

Nonetheless, curcumin has been explored in the context of treatment of migraine, and it's one of the compounds that was analyzed in extensive detail in this wonderful review that I mentioned a little bit earlier.

尽管如此，姜黄素已经在治疗偏头痛的背景下进行了探索，它是我之前提到的这篇精彩评论中进行了广泛详细分析的化合物之一。

What I like about this study is that they were able to explore the effects of curcumin as explored in previous research studies and compare those across a large range of different dosages and a large range of combinations with other things like coenzyme Q10, which we've talked about on this podcast before.

我喜欢这项研究的地方在于，他们能够探索姜黄素在之前的研究中探索的效果，并将各种不同剂量和各种组合与其他物质（例如我们之前在这个播客中讨论过的辅酶 Q10）的组合进行比较。

But I think for sake of this discussion, just really focusing on what curcumin does alone or in conjunction with the omega-3 fatty acids is what turns out to be the most interesting.

但我认为，就本次讨论而言，真正关注姜黄素单独或与 omega-3 脂肪酸结合的作用才是最有趣的。

First of all, curcumin has been shown to be generally safe for most people at dosages as high as 8,000 milligrams per day or eight grams per day.

首先，姜黄素已被证明对大多数人来说通常是安全的，剂量高达每天 8,000 毫克或每天 8 克。

Now, I want to be very clear, I do not recommend that anyone take dosages of curcumin, AKA turmeric, that are that high.

现在，我想澄清的是，我不建议任何人服用那么高剂量的姜黄素（又名姜黄）。

Why?

为什么？

Well, curcumin and turmeric not only are anti-inflammatory, but they also can impinge on other pathways, in particular hormonal pathways.

姜黄素和姜黄不仅具有抗炎作用，而且还可以影响其他途径，特别是激素途径。

And in fact, curcumin, AKA turmeric, can alter the synthesis of something called dihydrotestosterone.

事实上，姜黄素（又名姜黄）可以改变二氢睾酮的合成。

Dihydrotestosterone is involved in an enormous range of different bodily functions.

二氢睾酮参与多种不同的身体功能。

It's involved in libido, it's involved in men in beard growth, and in the regulation of a number of different tissues, both in the reproductive axis and outside the reproductive axis.

它与性欲有关，与男性胡须的生长有关，并且与生殖轴内和生殖轴外的许多不同组织的调节有关。

And curcumin is a potent inhibitor of DHT.

姜黄素是 DHT 的有效抑制剂。

So I do want to caution that people who take high doses of curcumin, and some people who are very sensitive to curcumin, will, even at low doses, experience reductions in DHT that lead to things that they would not like, such as sufficient reductions in libido.

因此，我确实想提醒一下，服用高剂量姜黄素的人，以及一些对姜黄素非常敏感的人，即使在低剂量下，也会经历 DHT 的减少，从而导致他们不喜欢的事情，例如性欲的充分降低。

However, curcumin has been shown to be effective as an anti-inflammatory and has been shown to be very effective in treating different types of headache, in particular migraine headache.

然而，姜黄素已被证明具有有效的抗炎作用，并且在治疗不同类型的头痛（特别是偏头痛）方面非常有效。

One of the ways in which curcumin does that is to inhibit this thing that I talked about a few minutes ago, which is nitric oxide or NO, which causes vasodilation.

姜黄素的作用之一是抑制我几分钟前谈到的一氧化氮或一氧化氮，它会导致血管舒张。

And in doing that, can reduce the feeling that one has a lot of intracranial pressure.

而且这样做，可以减轻颅内压很大的感觉。

Okay, so curcumin dosages come in enormous range, as I mentioned before.

好的，正如我之前提到的，姜黄素的剂量范围很大。

Dosages that range anywhere from 80 milligrams per day, taken for eight weeks' time.

剂量范围从每天 80 毫克不等，服用八周。

That's been examined.

这已经被检查过了。

It's been explored at 80 milligram dosages taken alongside two and a half grams of omega-3 fatty acids or omega-3 fatty acids alone and against placebo.

已对 80 毫克剂量与两克半 omega-3 脂肪酸一起服用或单独服用 omega-3 脂肪酸以及对照安慰剂进行了探索。

And the general conclusion of these studies is that curcumin, when taken at dosages of about 80 milligrams, although for those of you very sensitive to curcumin, probably as low as 25 or even 50 milligrams per day in conjunction with, although not necessarily at the same time, but taken daily alongside omega-3 fatty acids at two and a half grams per day, led to significant improvements in migraine and other forms of headache.

这些研究的总体结论是，虽然对于那些对姜黄素非常敏感的人来说，每天服用姜黄素的剂量可能低至 25 甚至 50 毫克，但每天服用 2 克半的 omega-3 脂肪酸（虽然不一定同时服用），但服用剂量约为 80 毫克时，可以显着改善偏头痛和其他形式的头痛。

Meaning both the frequency and the intensity of the headaches that occurred was greatly reduced.

这意味着头痛发生的频率和强度都大大降低了。

One important point about curcumin to keep in mind, is that curcumin is known to inhibit something called cytochrome P450.

关于姜黄素需要记住的重要一点是，姜黄素已知会抑制一种叫做细胞色素 P450 的物质。

That's associated with an enzymatic pathway and some other things that relate to blood coagulation.

这与酶途径和其他一些与凝血有关的东西有关。

So for people that are taking medications that are anticoagulants to prevent clotting, you do need to be very cautious about using curcumin.

因此，对于正在服用抗凝药物来防止凝血的人来说，使用姜黄素确实需要非常谨慎。

And of course, with curcumin or any other supplement, you should always talk to your doctor prior to including it or removing it from your supplement regimen.

当然，对于姜黄素或任何其他补充剂，在将其纳入或从补充剂方案中删除之前，您应该始终咨询您的医生。

So as you can see, there are a number of different things that in addition to prescription drugs and over-the-counter pain medications, things like non-steroid anti-inflammatory drugs, can really impact the different aspects of headache and different types of headache, in some cases differentially.

正如您所看到的，除了处方药和非处方止痛药之外，还有许多不同的药物，例如非类固醇抗炎药，可以真正影响头痛的不同方面和不同类型的头痛，在某些情况下影响不同。

Now, today, we talked mainly about tension type and migraine type headaches because those are the most common forms of headache.

今天，我们主要讨论紧张型和偏头痛型头痛，因为这些是最常见的头痛形式。

There are, of course, the cluster type headaches that are of neural origin.

当然，也有神经源性的丛集性头痛。

We talked about hormonal headaches and indeed some treatments such as omega-3s, which have been shown to be beneficial for offsetting the menstrual-related headaches.

我们讨论了荷尔蒙性头痛，以及一些治疗方法，例如 omega-3，它已被证明有助于抵消与月经相关的头痛。

Now, in the context of the discussion about omega-3s, keep in mind that omega-3s can be obtained from supplementation or from nutrition.

现在，在讨论 omega-3 时，请记住 omega-3 可以从补充剂或营养中获取。

So you don't necessarily have to take omega-3 capsules or liquid form omega-3s if you want to use omega-3s to target different symptoms of headache.

因此，如果您想使用 omega-3 来治疗不同的头痛症状，则不一定要服用 omega-3 胶囊或液体 omega-3。

But that probably is going to be the most efficient way to do it, given that many foods do contain omega-3s, but it's hard to get above that one-gram dosage.

但这可能是最有效的方法，因为许多食物确实含有 omega-3，但很难超过一克剂量。

And in fact, most of the studies that we talked about today involved getting two or even two and a half, or in some cases on this podcast with previous guests such as Dr. Rhonda Patrick, she talked about the advantages of getting as high as three grams of omega-3s per day, which almost with certainty is going to require some external form of supplementation, even for those of you that are making a point to eat fatty ocean fish with the skin on.

事实上，我们今天讨论的大多数研究都涉及摄入两克甚至两克半，或者在某些情况下，在这个播客中与朗达·帕特里克博士等之前的嘉宾一起，她谈到了每天摄入高达三克 omega-3 的好处，几乎可以肯定，这将需要某种外部形式的补充，即使对于那些特意吃带皮多脂海洋鱼的人来说也是如此。

So I just want to make sure that I highlight that.

所以我只想确保我强调了这一点。

Before we wrap up, I can't help myself but to talk about something that I heard about on the news several years ago, and it sounded too outrageous to be true, but then was confirmed as accurate by one of my neurologist colleagues.

在结束之前，我忍不住要谈谈几年前我在新闻中听到的一件事，这听起来太离谱了，难以置信，但后来被我的一位神经科医生同事证实是准确的。

And that's the fact that eating certain very spicy peppers can induce headache, and in some cases, can induce brain damage.

事实上，吃某些非常辣的辣椒会引起头痛，在某些情况下，还会引起脑损伤。

And bear with me here, I'm not talking about your traditional jalapeno, and I'm acknowledging the fact that certain people can tolerate far more spicy tastes than do others.

请耐心听我说，我不是在谈论传统的墨西哥辣椒，我承认某些人比其他人更能忍受辛辣的味道。

Some people are very sensitive to spicy, some people can tolerate very spicy food, and that one can build up a tolerance to spicy food by ingesting progressively spicier and spicier foods over time.

有些人对辣非常敏感，有些人可以忍受非常辣的食物，并且随着时间的推移，人们可以通过摄入越来越辣的食物来增强对辛辣食物的耐受性。

Nonetheless, there are these pepper eating contests out there that, while not very common, do exist, and people challenge each other to eat peppers of extreme spiciness.

尽管如此，吃辣椒比赛虽然并不常见，但确实存在，人们互相挑战吃极辣的辣椒。

And there's one in particular that's referred to as the Carolina Reaper.

其中有一个特别被称为卡罗莱纳死神。

By the way, that's not a person, as far as I know.

顺便说一句，据我所知，那不是一个人。

That's a pepper.

那是一个辣椒。

The Carolina Reaper, which is known to have the most potent spice of any pepper.

卡罗莱纳死神辣椒被认为是所有辣椒中最有效的香料。

And here's why you would not want to eat the Carolina Reaper.

这就是为什么你不想吃卡罗莱纳死神的原因。

A few years ago at one of these pepper eating contests, a man ate a Carolina Reaper as part of the competition and suddenly experienced what's called thunderclap headache.

几年前，在一次吃辣椒比赛中，一名男子在比赛中吃了一颗卡罗莱纳死神辣椒，然后突然出现了所谓的“霹雳性头痛”。

Thunderclap headache is a unique type of headache, very different from all the other types of headaches.

霹雳性头痛是一种独特的头痛类型，与所有其他类型的头痛非常不同。

It is not from the surface in, so it's not tension headache.

它不是从表面进来的，所以不是紧张性头痛。

It's not even the cluster type headache of the nerve activation of the trigeminal.

甚至还不是三叉神经激活的丛集型头痛。

It's actually a hyperconstriction of the vasculature in the brain caused by the ingestion of the pepper and inflammatory response.

这实际上是由于摄入辣椒和炎症反应引起的大脑血管过度收缩。

And remember that heat and spicy go together in these neural pathways.

请记住，热量和辛辣在这些神经通路中是相辅相成的。

And a bunch of different heat-related and spice-related pathways get activated simultaneously when one ingests something of extreme spice.

当一个人摄入极度香料时，一系列不同的与热相关和与香料相关的通路会同时激活。

And the blood vessels, and indeed some of the smaller arteries feeding neural tissue, shut down, and he experienced this thunderclap headache, which is a brutal headache and, sadly in his case, permanent brain damage.

血管，甚至是一些供给神经组织的小动脉都停止了运作，他经历了剧烈的头痛，令人遗憾的是，对他来说，这是永久性的脑损伤。

So loss of neuronal tissue because neuronal tissue is very metabolically active.

神经元组织的损失是因为神经元组织的代谢非常活跃。

You cut off the blood supply to that tissue, not only would you feel miserable, maybe even pass out, but lose vision, and certain brain areas will actually die off in the absence of of blood flow to those areas.

如果切断了该组织的血液供应，您不仅会感到痛苦，甚至可能昏倒，还会失去视力，并且某些大脑区域在没有血液流向这些区域的情况下实际上会死亡。

We know this more commonly as stroke.

我们通常将其称为中风。

So I don't want to strike fear in anybody about eating a jalapeño or even a very spicy meal from time to time, but if you're not somebody who's familiar with eating very spicy foods, you certainly don't want to enter one of these competitions.

因此，我不想让任何人对时不时吃墨西哥辣椒甚至非常辛辣的食物感到恐惧，但如果您不熟悉吃非常辛辣的食物，那么您当然不想参加其中一项比赛。

And just realize that the pathways from menthol and cool or spicy and hot, those aren't just subjective pathways.

只要意识到从薄荷醇到凉或辣到热的途径，这些不仅仅是主观途径。

These are actually neural pathways that, again, originate in our so-called, nerds call it the sensory epithelium, so our skin, our hearing, our eyes, and that feed that information into the body to make use of that information.

这些实际上是神经通路，再次起源于我们所谓的，书呆子称之为感觉上皮，我们的皮肤，我们的听力，我们的眼睛，并将这些信息输入身体以利用这些信息。

In some case, motor movements, so sensory motor.

在某些情况下，运动运动，即感觉运动。

In other cases, the information can be fed through nerve pathways that goes to the vasculature and causes the vasculature to either dilate or constrict these very spicy peppers causing, as I just mentioned, extreme cerebro, of the head, vasoconstriction and brain damage.

在其他情况下，信息可以通过神经通路输送到脉管系统，导致脉管系统扩张或收缩这些非常辣的辣椒，正如我刚才提到的，导致头部极端脑部血管收缩和脑损伤。

Again, that's not going to be a common thing out there, but nonetheless, I encourage people to be very cautious about the Carolina Reaper.

再说一遍，这不会是常见的事情，但尽管如此，我鼓励人们对卡罗莱纳死神保持非常谨慎的态度。

So today we talked about headaches.

那么今天我们就来聊聊头痛的事。

And first we highlighted the different types of headache, making it clear that understanding which headache you might be experiencing can be very beneficial for understanding which sorts of treatments ought to be best, and perhaps also best avoided, in trying to alleviate those headaches or prevent them from happening at all.

首先，我们强调了不同类型的头痛，明确指出，了解您可能正在经历哪种头痛，对于了解哪种治疗方法应该是最好的，也许也是最好避免的，以减轻这些头痛或根本预防它们的发生。

We talked about tension headaches, migraine headaches, hormone-based headaches, cluster headaches, and traumatic brain injury related headaches.

我们讨论了紧张性头痛、偏头痛、激素性头痛、丛集性头痛和创伤性脑损伤相关头痛。

We talked about different types of treatments ranging from creatine to omega-3 fatty acid supplementation, some herbal and indeed some essential oil treatments, as well as acupuncture, all of which have been shown to have significant impact in reducing the frequency and intensity of headaches.

我们讨论了不同类型的治疗方法，从肌酸到 omega-3 脂肪酸补充剂、一些草药治疗和一些精油治疗，以及针灸，所有这些都已被证明对减少头痛的频率和强度有显着的影响。

And in many cases, reductions in the frequency and intensity of headaches that are at least as great as the results that are seen with non-steroid anti-inflammatory drugs.

在许多情况下，头痛频率和强度的降低至少与非类固醇抗炎药的效果一样好。

Again, I want to highlight that none of these approaches are necessarily designed to be done on their own or in replacement of prescription drugs from your physician.

我想再次强调的是，这些方法都不一定可以单独完成或替代医生的处方药。

There are excellent prescription drugs out there that your physician can prescribe for you for the treatment of headache.

您的医生可以为您开出一些很好的处方药来治疗头痛。

Nonetheless, I think many people who are listeners of this podcast are interested in the things that they can do in order to inoculate themselves or at least reduce the likelihood of experiencing headache, especially for people who are experiencing chronic recurring headaches such as migraine or the other forms of headache which can be so debilitating.

尽管如此，我认为这个播客的许多听​​众都对他们可以做的事情感兴趣，以便为自己接种疫苗或至少减少头痛的可能性，特别是对于那些正在经历慢性复发性头痛（例如偏头痛或其他形式的头痛）的人来说，这些头痛可能会让人衰弱。

Thank you for joining me for today's discussion.

感谢您参加今天的讨论。

If you're learning from and/or enjoying this podcast, please subscribe to our YouTube channel.

如果您正在学习和/或喜欢此播客，请订阅我们的 YouTube 频道。

That's the best zero-cost way to support us.

这是支持我们的最佳零成本方式。

In addition, please subscribe to the podcast on Spotify and Apple.

此外，请订阅 Spotify 和 Apple 上的播客。

And on both Spotify and Apple, you can leave us up to a five-star review.

在 Spotify 和 Apple 上，您都可以给我们五星级的评价。

If you have questions for me or comments about the podcast or guests that you'd like me to include on the Huberman Lab podcast, please put all of that in the comments section on YouTube.

如果您对我有疑问，或者对您希望我在 Huberman Lab 播客中加入的播客或嘉宾有意见，请将所有内容放入 YouTube 的评论部分。

I do read all the comments.

我确实阅读了所有评论。

In addition, please check out the sponsors mentioned at the beginning and throughout today's episode.

此外，请查看今天节目开头和整个节目中提到的赞助商。

That's the best way to support this podcast.

这是支持这个播客的最佳方式。

If you're not already following us on social media, we are Huberman Lab on Instagram, Twitter, Facebook, and LinkedIn.

如果您还没有在社交媒体上关注我们，我们是 Instagram、Twitter、Facebook 和 LinkedIn 上的 Huberman Lab。

And on both Instagram and Twitter, I cover science and science-related tools, some of which overlap with the content of the Huberman Lab podcast, but much of which is distinct from the content of the Huberman Lab podcast.

在 Instagram 和 Twitter 上，我介绍了科学和科学相关工具，其中一些与 Huberman Lab 播客的内容重叠，但其中大部分与 Huberman Lab 播客的内容不同。

So again, it's Huberman Lab on Instagram, Twitter, Facebook, and LinkedIn.

再说一次，它是 Instagram、Twitter、Facebook 和 LinkedIn 上的 Huberman Lab。

During today's episode and on many previous episodes of the Huberman Lab podcast, we discuss supplements.

在今天的节目以及 Huberman 实验室播客的许多以前的节目中，我们讨论了补充剂。

While supplements aren't necessary for everybody, many people derive tremendous benefit from them for things like improving sleep, hormone support, and focus.

虽然补充剂并不是每个人都需要的，但许多人从它们中获得了巨大的益处，例如改善睡眠、激素支持和注意力集中。

Huberman Lab podcast has partnered with Momentous supplements because Momentous supplements are of the very highest quality and they include single ingredient formulations.

Huberman Lab 播客与 Momentous 补充剂合作，因为 Momentous 补充剂具有最高品质，并且包含单一成分配方。

This is very important.

这非常重要。

As I pointed out in the episode about a rational approach to supplementation, single ingredient formulations allow you to develop the most biologically effective and cost-effective approach to supplementation.

正如我在有关合理补充方法的一集中指出的那样，单一成分配方可让您开发出最具生物有效性和成本效益的补充方法。

In addition, Momentous ships internationally, which is important because I realize that many of you reside outside of the United States.

此外，Momentous 还面向全球发货，这一点很重要，因为我意识到你们中的许多人居住在美国境外。

If you'd like to see the supplements described on this and other episodes of the Huberman Lab podcast, you can go to Live Momentous, spelled O-U-S, livemomentous.com/huberman.

如果您想查看 Huberman Lab 播客的本集和其他剧集中描述的补充内容，您可以访问 Live Momentous，拼写为 O-U-S，livemomentous.com/huberman。

If you haven't already subscribed to the Huberman Lab podcast Neural Network Newsletter, it's a monthly newsletter that's completely zero cost.

如果您还没有订阅 Huberman Lab 播客《神经网络通讯》，这是一份完全零成本的每月通讯。

It includes summaries of podcast episodes and includes toolkits for everything from improving your sleep to deliberate cold exposure and heat exposure for health and performance, focus, dopamine regulation, and much more.

它包括播客剧集的摘要，并包括从改善睡眠到刻意冷暴露和热暴露以促进健康和表现、注意力、多巴胺调节等各个方面的工具包。

In order to sign up for the Huberman Lab podcast Neural Network Newsletter, you simply go to hubermanlab.com, go to the menu, scroll down to newsletter, and you provide your email.

要注册 Huberman Lab 播客神经网络新闻通讯，您只需访问 hubermanlab.com，进入菜单，向下滚动到新闻通讯，然后提供您的电子邮件。

We do not share your email with anybody, and again, it is completely zero cost.

我们不会与任何人分享您的电子邮件，而且这完全是零成本。

Thank you once again for joining me for today's discussion all about the science and treatment of headaches.

再次感谢您参加今天有关头痛的科学和治疗的讨论。

And last but certainly not least, thank you for your interest in science.

最后但并非最不重要的一点是，感谢您对科学的兴趣。