功能性醫療 Functional Medicine
提升免疫力：功能性醫學在新冠肺炎疫情，對預防與最佳化免疫系統功能的建議
Some things don’t need prayer, they need discipline. （有些事情並不需要祈禱，需要的是紀律。）
行為
戴口罩：當在公共場所或是即便有人群聚的室內，正確戴好完整覆蓋口鼻的口罩。首先正確洗好手後，在確保能自然呼吸前提下，確實緊密蓋住口鼻直到完整覆蓋到下巴。
shu’s note：歐美社會對戴口罩視為不自由，許多國家故也把打完疫苗就能不用強制戴口罩做為政策，期盼吸引民眾新冠病毒疫苗注射的誘因。然而，各國都出現多個變種病毒傳播力更快，也讓脫口罩的政策備受挑戰。還有已經施打完疫苗的孩童，回學校跟未（或尚未完全）施打疫苗的孩童共學，也凸顯各國對於脫口罩政策的缺乏配套與紛擾。
勤洗手：勤奮並徹底地用肥皂與清水洗手，是公認最有效預防諸如流感與冠狀病毒等呼吸道感染。必須至少用肥皂與清水完整徹底地搓洗20秒。
乾洗手：用肥皂與清水徹底洗手是降低細菌最好的方法，然而若是無法執行時，含至少60%的酒精成分為主的乾洗手可以減少感染。附註：避免任何含如三氯沙(Triclosan)成分的環境荷爾蒙產品。
註：三氯沙（Triclosan）具有抑制微生物生長之效果，添加於人體清潔沐浴等化粧品及牙膏產品中，可達到抗菌及防腐等作用。然而，三氯沙(Triclosan)是一種「環境荷爾蒙」、「雌激素」。 … 環境荷爾蒙」又稱為「內分泌干擾素(Endocrine disrupter substance簡稱EDS)」。
遮住口鼻：咳嗽或是打噴嚏時，用紙巾遮住口鼻。假若空不出手或是沒有紙巾，對袖子咳嗽或是打噴嚏，不能空手接觸。
不碰臉：沒洗手時不碰觸眼睛,鼻子跟嘴，方能避免病菌進入身體。根據統計資料，每人平均每個小時碰觸臉15次，真的要保持警醒！
保持接觸表面乾淨：頻繁地清潔並消毒會接觸到的表面，特別是當有人生病時。包括門把,電話,電腦鍵盤,遙控器跟任何會頻繁碰觸到的房間，例如浴室跟廚房。
生活型態
壓力釋放：慢性壓力會抑制免疫系統反應，增加生病的機率。找出個人的壓力源與舒壓方法並定期練習釋放壓力。
睡眠：睡眠對免疫系統功能有巨大的影響，因此必須有充分的睡眠。練習好的睡眠習慣並且維持連續有節奏的睡眠時數，幫助睡眠的方法包括關掉螢幕,確認房間涼爽,安靜與昏暗，並且設提醒機制幫助自己定期上床睡覺。
運動：適度,規律的體能活動，能提升抗發炎的白血球數量與免疫細胞，提高身體循環與降低壓力荷爾蒙，如此能幫助提升免疫系統功能。
營養的食物/飲食：研究報告指出，比起大多數的人工補充品，鮮豔多彩的蔬菜與水果可以幫助提升免疫力。吃大量的蔬菜與水果意指儘可能一天吃到10份。
shu’s note：1份約莫75g，或是1/2杯），其中建議日常飲食要包括發酵蔬菜或是富含益生菌/益生原，膳食纖維的食物。
提升免疫系統的普遍意涵
大多市面上的醫藥只能針對病毒感染的症狀處理，大多數並無法幫助免疫系統對抗發炎。然而針對新冠病毒還沒有研究顯示任何具體有效的作法，以下是一些自然的實踐方針，作為生病時減緩症狀的最佳化與提升免疫系統。
自我照顧：當對抗上呼吸道感染時，最重要的是補充足夠的水分跟充分休息。喝大量液體，並且在家自己烹煮的蔬菜或大骨湯也是對健康非常有幫助的。各種花草茶/熱飲品都能幫助攝取水分，並且減輕不適症狀。許多種類花草茶都很好，包括胡椒薄荷,薑,尤加利,洋甘菊，與加黃檸檬的熱水，蜂蜜，與肉桂等。
喉嚨痛：鹽水漱口去除黏液粘膜，與抵擋微生物菌的喉嚨感染。熱茶與含有榆樹皮（Slippery elm）成分的喉片，是非常好的緩和止痛劑（舒緩輕微疼痛與口腔黏膜發炎），以舒緩令人感到難受的喉嚨痛。
作者註：榆樹皮（Slippery elm）是北美州普遍的一種草藥成分，有刺激消化系統末端神經的作用，支持黏膜分泌黏液，有效保護和改善消化系統，紓緩腸道炎、胃潰瘍和胃酸。榆樹皮對黏膜起到的保護作用，也有效紓緩口腔潰瘍和喉嚨發炎引起的不適。加2湯匙的蜂蜜到熱水裡，也是對舒緩與降低喉嚨發炎與疼痛有所幫助。洋甘菊與胡椒薄荷茶，也是對於舒緩有所幫助。藥蜀葵根(marshmallow root)與甘草(licorice root)，這兩種也是相當不錯的舒緩鎮定劑。
呼吸道有痰與鼻竇炎：針對呼吸道有痰，加濕器, 噴霧器或蒸氣吸入器，或是花些時間在泡充滿蒸氣的浴缸/或是淋浴。噴霧器與吸入器也能用來解除充血，或是精油，諸如尤加利,薄荷醇,胡椒薄荷,或是乳香。木糖醇洗鼻噴劑也是很有用，可作為鼻腔清洗器，洗鼻壺(neti pot)或是鼻塞清洗器(nasal irrigation bottle)。磷酸鹽緩衝生理食鹽水很容易調製或買到分裝好的，可以去除任何產生對纖細惱人的粘膜刺激。
支撐免疫功能的保健品, 營養,與食物
有些營養素,藥草(botanicals)與保健品可以提升免疫功能，並且提供舒緩生病時的不適症狀與縮短生病的時間。針對預防與治療上呼吸道感染的有：
維生素C：維他命C可以對預防包括細菌與病毒的感染有所幫助。定期攝取為他命C可以縮短感冒的時程，在生病時攝取高劑量單位的維他命C，也能形同天然抗組織胺與抗發炎功用而發揮幫助。
shu’s note: 富含維生素C的食物包括但不限於：芭樂, 奇異果, 木瓜, 草莓, 彩椒, 花椰菜, 苦瓜 , 羽衣甘藍（kale）。
維生素D：維生素D是被廣為人知的太陽維他命，是對免疫系統最重要與強大的重要營養素之一。許多研究顯示維生素D可以降低得到感冒與風寒。然而，高比例的人口都是維生素D不足，所以每日攝取（最佳型態是維他命D3）將能提高較佳的保護力。
shu’s note: 富含維生素D的食物包括但不限於：[動物性食物] 海魚類的鮭魚、鮪魚、鯖魚、魚肝油、沙丁魚等。 [植物性食物] 蕈菇類 — 蘑菇、黑木耳、香菇。 [其他] 蛋黃、牛奶、麥片、酵母。
維生素A：短時間使用，特別是針對缺乏的族群，維他命A可以幫助身體提高對抗發炎，特別是呼吸道發炎的能力。
shu’s note: 富含維生素A的食物包括但不限於：地瓜, 胡蘿蔔, 南瓜, 黑豆, 菠菜,青花菜等。
鋅：鋅對提升免疫力扮演著重要角色。市場上大部分是以錠狀最為普遍，對於一般的感冒若在24小時內補充，鋅在幫助降低發炎的頻率與縮短時程非常有效。
shu’s note: 富含鋅的食物包括但不限於：牡蠣 ,肉(牛羊雞肉等), 燕麥 , 種子 , 蘆筍 , 菠菜 , 蘑菇 , 腰果。
硒：硒是免疫功能的關鍵營養素，並且是幫助身體對抗微生物,細菌與癌細胞重要的抗氧化劑。硒有可能可以幫助特定的流感病毒，硒容易自食物取得，例如巴西堅果(Brazil nuts)。
shu’s note: 富含硒的食物包括但不限於：大蒜, 洋蔥, 蘑菇, 菠菜, 鮪魚, 鮭魚, 蝦, 火雞肉, 堅果, 動物內臟等。
蜂蜜：若是可以取得可靠的，生蜂蜜更好，蜂蜜是很好的天然鎮定劑（可以舒緩輕微疼痛與粘膜發炎），有抗氧化劑成分並且有些抗菌作用。蜂蜜對於舒緩咳嗽與喉嚨痛有所幫助。蜂蜜也可以加在熱茶裡。
shu’s note: 要取得可靠的天然蜂蜜並不簡單，蜂蜜要非常注意除草劑的殘留，越來越多研究顯示除草劑不只對蜜蜂造成不可逆的傷害，間接食用蜂蜜的人類也會造成包括但不限於腦神經損傷。
大蒜：大蒜含有影響免疫力的多重元素。有些報告顯示新鮮大蒜, 發酵的大蒜萃取(aged garlic extract）與一些大蒜保健品，可能可以降低上呼吸道感染的嚴重性，同時發揮提供預防感染感冒病毒的功能。
益生菌：益生菌（對人體有益的）不只是對腸道健康扮演要角，並且對免疫系統的功能與運作也很重要。研究顯示益生菌對於減少上呼吸道感染，特別是小孩有顯著的幫助。
shu’s note: 富含益生菌的食物包括但不限於：優格, Kombucha (红茶菌), 泡菜, 客家福菜, 德國泡菜, 熟成乳酪等。但是關鍵不只是攝取益生菌食物，並且必須攝取足夠給益生菌好好在我們人體定居的食物：膳食纖維！
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以下為此篇的英文原文：
Boosting Immunity: Functional Medicine Tips on Prevention & Optimizing Immune Function During the COVID-19 Outbreak
BEHAVIOR
Wear a Mask: When in public settings or when around people outside of your household, wear a properly-fitting cloth face covering. Wash your hands before putting on your face covering, put it over your nose and mouth and secure it under your chin, and try to fit it snugly against the sides of your face. Make sure you can still breathe easily.
Hand washing: The most well-established way to prevent respiratory infections such as influenza and coronavirus is frequent and thorough hand washing with soap and water. Scrub your hands thoroughly with soap and water for at least 20 seconds.
Hand sanitizer: Handwashing with soap and water is the best way to reduce germs, but if they are not available, alcohol-based hand sanitizers that contain at least 60% alcohol can help to reduce the spread of infection. Note: avoid any products containing triclosan, a known hormone-disrupting chemical.
Covering your mouth and nose: Cover your mouth and nose with a tissue when coughing or sneezing; if your hands are not free or you don’t have a tissue, cough or sneeze into your sleeve, not your bare hands.
Not touching your face: Avoid touching your eyes, nose, and mouth with unwashed hands, which can help provide the virus with a route of entry into the body. Since the average individual touches their face an average of 15 times per hour, remain vigilant!
Keeping surfaces clean: Clean and disinfect frequently touched surfaces, especially when someone is ill. Surfaces to consider include doorknobs, phones, computer keyboards, remotes, and other surfaces that are frequently touched in rooms such as the bathroom and kitchen.
LIFESTYLE
Stress reduction: Chronic stress can negatively alter immune system responses, making you more likely to get sick. Identify your personal stress reduction strategies and practice them regularly.
Sleep: Sleep has a big influence on immune function, so it is essential to get plenty of sleep. Practice good sleep hygiene and maintain consistent sleep hours — turn off screens, ensure the room is cool, quiet, and dark, and set a reminder to help yourself go to bed on time.
Exercise: Moderate, regular physical activity helps to boost immune system function by raising levels of infection-fighting white blood cells and antibodies, increasing circulation, and decreasing stress hormones. Establish and follow an exercise program to not only help prevent respiratory infections but also to improve cognitive and physical resilience.
Nutritious foods/diet: Research indicates that brightly colored vegetables and fruits boost immunity better than most supplements. Eat plenty of fruits and vegetables — aim for 10 servings per day. Include fermented vegetables or other probiotic-containing foods.
Natural Means of Boosting Immunity
Most over-the-counter medications only treat the symptoms of viral infections; most don’t actually help the immune system fight the infection. Although there is no research to determine what is effective specifically for coronavirus, the following are some natural modalities you can utilize to both address symptoms as well as boost your immune system if you do come down with an illness:
Self-care: When battling upper respiratory infections, top priorities are plentiful hydration and rest. Drink plenty of fluids; homemade vegetable or bone broths are also extremely beneficial. Various herbal teas/hot drinks can help with hydration and reducing symptoms; good choices include peppermint, ginger, eucalyptus, chamomile, and hot water with lemon, honey, and cinnamon.
Sore throats: Salt water gargles are excellent for loosening mucus and helping fend off bacterial throat infections. Hot teas and lozenges containing slippery elm are excellent demulcents (to relieve minor pain and inflammation of mucous membranes) for soothing irritated sore throats. Two tablespoons of honey in hot water can also help to soothe and decrease throat inflammation and pain. Chamomile and peppermint teas are also helpful for soothing irritated sore throats, as are teas or infusions made from marshmallow root and licorice root, both of which can act as soothing demulcents.
Respiratory congestion & sinuses: For respiratory congestion, use a humidifier, vaporizers, or steam inhalers, or spend time in steamy baths or showers. Vaporizers and inhalers can also be used with decongestants or essential oils such as eucalyptus, menthol, peppermint, or frankincense. Nasal xylitol sprays are very beneficial, as is nasal irrigation using a neti pot or nasal irrigation bottle. Buffered saline is easy to make or can be purchased in packets and eliminates any irritation to delicate, irritated mucous membranes.
SUPPLEMENTS, NUTRIENTS, AND FOODS TO SUPPORT IMMUNE FUNCTION
There are several nutrients, plant-based botanicals, and supplements that can boost immune function and provide symptom relief during illness and may help to shorten the duration of illness. For preventing and treating viral upper respiratory infections, consider some of the following:
Vitamin C: Vitamin C may help to prevent infections, including those caused by bacteria and viruses. Regularly administered vitamin C has been shown to shorten the duration of colds, and higher doses of vitamin C during an illness can also act as a natural antihistamine and anti-inflammatory.
Vitamin D: Vitamin D, known as the “sunshine vitamin,” is one of the most important and powerful nutrients for supporting the immune system. Numerous studies have shown that it helps reduce the risk of colds and flu. Unfortunately, a high percentage of the population is deficient, so daily supplementation (ideally in the form of vitamin D3) offers the best protection.
Vitamin A: For short-term use and particularly for those with moderate vitamin A deficiency, supplementation can be extremely helpful in supporting the body’s ability to fight infections, particularly with regard to respiratory infections.
Zinc: Zinc plays a significant role in boosting immunity. Often available as lozenges, zinc can help to reduce the frequency of infections as well as the duration and severity of the common cold when taken within 24 hours of onset.
Selenium: Selenium, a key nutrient for immune function, is also an antioxidant that helps boosts the body’s defenses against bacteria, viruses, and cancer cells. It may particularly help to protect against certain strains of flu virus. Selenium is easily obtained from foods, with the richest source being Brazil nuts.
Honey: Honey, preferably raw, is a good demulcent (it relieves minor pain and inflammation of mucous membranes), has antioxidant properties, and has some antimicrobial effects. It is helpful for coughs and sore throats and can be added to hot tea.
Garlic: Garlic contains a variety of compounds that can influence immunity. Some studies have shown that both fresh garlic as well as aged garlic extract and some other garlic supplements may reduce viral upper respiratory infection severity as well as function in the prevention of infection with viruses that can cause colds.
Probiotics: Probiotics contain “good bacteria” that not only support the health of the gut but also influence immune system functioning and regulation. Studies have shown that probiotic use can decrease the number of respiratory infections, particularly in children.
