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利他林成为考场“兴奋剂”
利他林成为考场&兴奋剂&
利他林成为考场&兴奋剂&&
&兴奋剂事件&国际运动场上屡屡出现,好象与我们离得远远的。但是,我们在此首次披露的是,出现在我们身边,我们校园,我们考场上的&兴奋剂现象&。这并非是耸人听闻。
出于对青少年的强烈责任感,上海《大众医学》医学责任编辑姚毅华女士和上海教科所心理学专家谢诒范副教授联手对5所重点中学和三所大学进行专项调查。日前,姚女士将调查结果告知记者:&考试期间服用镇定类和兴奋类药物的学生在5%,当然这样的数据是并不完全的。事实上小学生服药的情况更严重。有一个事实不容回避,在重要考试前夕,医院里镇定类和兴奋类药物的销量总是骤然猛增。&
在竞争激烈、注重考试的今天,以利他林为代表的中枢神经兴奋剂正扮演着神秘的角色,悄然潜入校园考场。教育专家和儿童医学专家们再也不能保持沉默了,一致提出紧急呼吁:认识利他林的负效应,制止滥用兴奋剂利他林!
查阅利他林档案
1937年,美国儿科医学取得划时代突破,发现了儿童脑功能失调的秘密,开始研制一种极有针对性的兴奋剂,于是利他林诞生了。
1979年开始,中国儿科医学对儿童脑功能轻微失调的研究有了重大的推进。一些注意力不能集中,考试老是不及格的小学生以及坐立不安调皮捣蛋的孩子,一时似乎都有了疗治的好办法。这些孩子都有了个医学名字:&多动症&。于是,利他林开始大显身手。
1997年中国成功地研制和生产兴奋剂利他林。同时,对儿童多动症的认定和利他林功能进行了深入细致的研究。
现在必须把问题提出来了。上海精神卫生中心儿童行为研究室主任杜亚松博士指出,八十年代出现的&多动症热&,在医学犯了一个&一刀切&和&扩大化&的错误,孩子学习有了问题,父母就送到医院去看病,医生大笔一挥就在诊断书上来个诊断:此儿童系多动症。据医学档案所载,在当时就医的儿童中50%被诊断为多动症。而今天的医学研究则表明,只有5%的儿童可能患有多动症,有的孩子上课喜欢开小差,但是老师讲课倒是听得进,这些孩子其实很聪明,现代医学证明在特定条件下一心可以两用,就是说这些孩子在特定条件下大脑的两个兴奋点同时都在运作,把他们&打成多动症&,是一种&误判&。往往是多动症的儿童都被指定服用利他林,所以伴随着多动症的&扩大化&,利他林的服用范围也迅速&扩大化&,迷信利他林疗效的误传也在无形中蔓延记者专门请教了有关药物专家。专家对利他林的药物机理进行了透彻的分析,多动症是俗称,医学名称是儿童脑功能轻微失调,这些儿童大脑的兴奋点总在不停地交叉替换,自控能力较弱,因此注意力不能集中。根据巴浦洛夫兴奋与抑制原理,过去用的是安定类药物,抑制儿童的过度兴奋,让多动的孩子少点动作,变得安静些。这样的治疗显然是有些消极的。而利他林的临床应用有时出现了立竿见影的积极疗效。多动症的孩子不再吓胡闹了,而且顿时变聪明了。为什么?对于大脑交叉兴奋功能失调的孩子用兴奋剂治疗是非常大胆的医学创举。利他林不是导致抑制效应,而是让兴奋集中到一点上来,让认知和推理的思维高度集中。
然而,世界上任何药物都不是圣诞老人的礼物。利他林作为神经中枢兴奋剂肯定是具有负效应的。对一个脑功能轻微失调的患儿,一方面具有积极疗效,另一方面也会产生不利现象,过多服用会导致恶心、厌食、失眠。那么一个正常儿童或者是青少年及成年人,如果过量服用,则会有何负效应呢?
专家的调查和医生的忠告
问题是许多家长把利他林当作了圣诞老人的礼物,还有一些家长则把利他林当作考场的&秘密武器。&
上海教科所教育心理学家谢诒范副教授在专题调查中听到了这样的对话:
&利他林真个是灵,我送儿子到考场,精确地算了时间,提前30分中吃一粒利他林,然后操场里兜一圈,等到拿到考卷,唰唰唰,脑子发光,下笔如有神。一场考试多拿了10分。&一位家长在炫耀。
&侬迭个是不公平竞争。&另一位家长愤愤不平。但在私底下又是默认了利他林的&功劳&。
医学编辑姚毅华女士则在调查中获悉,除了一度怀疑孩子患有多动症的家长外,在教师和医务界圈子里有一些家长也在盲目滥用利他林。
上海精神卫生中心的儿童医学博士杜亚松指出:&在医学上一知半解比无知更加危险。一些家长以为自己懂点医学概念了,可是知其一,不知其二。尤其是把医嘱和药品的负作用给忘却了。应当提醒的是,利他林,英文缩写为MHP,其化学结构与药物机理均与'摇头丸(苯丙胺)相类似,而苯丙胺'摇头丸'已被列为禁药。&
上海精神卫生中心儿童心理专家、上海徐汇区优特色学校校长忻仁娥教授长期研究包括多动症在内的儿童各类心理疾病,积累丰富的临床经验。她的观点是:&利他林适用于多动症患儿。可以提高脑功能,集中注意力。当然疗效也是因人而异。但是利他林毕竟是中枢神经兴奋剂,容易提高脑兴奋性,也容易促发癫痫。除重症患儿以外,一般不能长期服用。其实,多动症本身会伴随儿童大脑的最终发育成熟自然消失。然而,在校园里考场上的兴奋剂现象值得关注。我们知道在国际竞技场上的兴奋剂丑闻,是刺激人的肌肉,超常地爆发人的体能,从医学上讲比较简单容易操作,但这是以伤害运动员的健康为惨痛前提的,这本身就违背了奥林匹克精神。而在考场上盲目使用利他林之类的兴奋剂,这是家长对孩子的一种身心伤害。再者,从医学上来讲,比起刺激肌肉的兴奋剂,要远为复杂,利他林是刺激神经中枢的兴奋药,来应付考试这是一种冒险。由于个体的差异,每个人的反应都会出现差异。有的由于过度兴奋,反而造成考试失误;有的由于极度兴奋之后,大脑皮层迅速出现抑制,考生突然变得疲惫不堪。总之,一些似懂非懂的家长把利他林看作'聪明药'、'考试灵'肯定是一项误操作。&
社会学家的紧急提示
&现在压力最大是谁?是我们的孩子。&这是青少年问题专家杨雄副研究员的一个深深的感叹。如果说服用利他林是为了搏个好成绩,那么服用安定类药物则是为了逃避考试的的巨大压力。杨雄副研究员手头有着全国范围的此类情况调查,其中以武汉的多例安定事件最为典型:今年3月武汉中德医院心理门诊就诊的92名学生,就有82位学生承认长期服用安定来麻痹自己,来回避考试带来的精神压力。武汉第六医院则先后救治了服用安定中毒的学生,病例高达300余件。杨雄告诉记者:&在美国出现学生大面积服药的趋势,以安定类和兴奋类为主的服药率在学生中要占70%左右。据资料获悉美国有三千万学生和成人为了应付考试和其他压力在服用利他林。这是科学进步的年代出现的非科学反科学的现象。这是科学的悲剧和悖论。&
&依赖药物,说明了什么?说明我们的孩子我们的家长丧失了自信力,丧失了自我控制能力。一个正常人冒险地服用利他林,无疑使自己走进了一个精神怪圈,直接进入了亚健康状态。&上海科教所谢诒范副教授对此现象提出了一针见血的观点。他认为,过去是讲大道理,思想工作不能落到实处,如今呢?有的家长索性简简单单,实际到顶,来个物质主义手段:吃药!这怎么行得通呢!在已有的巨大的学习压力之下,我们的教师、我们的家长对孩子不要再加压了,我们的教师我们的家长还要学点心理疏导,真正关心孩子的身心健康。而千万不能把考分看得高于健康啊!
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