赖氨酸能治猫鼻支吗 猫咪补充赖氨酸的意义何在？ 谁说的要用赖氨酸治猫鼻支

猫鼻支用赖氨酸一事早该在2年前尘埃落定，毕竟所有活体研究都没发现任何益处。 2018年的 还是有许多“我觉得有效，所以赖氨酸有效”的观点（随机控制实验了解下？）

诚然，个人观察结果当然不能彻底无视，真理的雏形有时就诞生自其中。谬误更是常常存在。我们常说“相信科学”，但真正面临科学结论与个人观察产生的轶事证据（anecdotal evidence）冲突时，不少人忽然失去了审视与分析的能力，无视科学的结果，忘记亲眼所见往往掺有假象。

只敬罗衣不敬人的心理对我们所有人都有影响。厨子只是一个小透明，甚至被个知乎大v骂作“一个翻译成天装大神”，一些观点，即便我加再多引用源也不如医生当面的几句话。这没有什么不正常，咱们大家都会这样，俺自己也会。所以，我这次特别选择了毒舌麦肯锡医生的文章进行逐句翻译，对赖氨酸一事做个梳理。

动物医学界的剧本与人医别无二致，只不过多了些滞后性。举例来说，给猫使用赖氨酸的理论基础在后续研究中就站不住脚。根据理论，赖氨酸应该拮抗精氨酸，降低后者的浓度，进而抑制猫疱疹病毒（FHV-1）的复制，达成临床症状减轻与病毒散播减少的目的。可是，这一理论中的任何一环都没能成功证实。给猫口服赖氨酸无法减少细胞内精氨酸浓度，而且在正常生理环境下无法抑制猫疱疹病毒的复制。

类似的命运同样降临在了猫疱疹临床试验身上。起初表明赖氨酸有效的研究病患数量不足，实验方法存在局限，即便产生了一些正面结果却无法在后续大规模研究中再现。

最新的两篇相关回顾也没有为赖氨酸带来曙光。（引用7，11）其中较乐观的一篇是这么说的：研究结果中存在“显著差异” “这些研究中的数据表明给猫口服赖氨酸并无危险，吞服喂食后可能减少猫感染后期的病毒散播..在收容所环境中口服给药产生的压力，可能会抵消其作用，数据亦不支持使用赖氨酸作为膳食补充。

1.There is no evidence for lysine-arginine antagonism in the cat.

赖氨酸对精氨酸的拮抗作用没有证据

2.Lysine supplementation does not have an inhibitory effect on FHV-1 replication in the cat.

赖氨酸补充无法遏制猫疱疹病毒在猫体内的复制

3.The claim that lysine supplementation is effective for the prevention or treatment of herpetic lesions in humans cannot be supported by scientific evidence.

科学证据不支持赖氨酸治疗、预防人疱疹的的说法

4.Lysine supplementation is not effective to prevent cats from becoming infected with FHV-1, it does not decrease the chance of developing clinical signs related to active FHV-1 infection, and it does not have a positive effect on the clinical course of its disease manifestations.

赖氨酸无法预防猫感染猫疱疹，猫疱疹活毒疫苗导致的临床症状也无法使用赖氨酸预防，对疾病的临床演变无正面效果。

5.Based on the complete lack of scientific evidence for the efficacy of lysine supplementation, we recommend an immediate stop of lysine supplementation for cats.

因为相关科学证据的彻底缺失，我们建议立刻停止为猫使用赖氨酸。

The accumulation of evidence against the use of lysine for FHV-1 cases has had an impact. Some shelter medicine specialists, for example, now recommend against this practice.12-13However, there has also been resistance to abandoning this treatment despite the evidence. Unfortunately, such resistance has not been based so much on any substantive dispute about the science but instead on the seductive power of anecdotal evidence.

反对赖氨酸使用的证据不断增多，影响因此产生。部分流浪动物中心的医学专家开始反对赖氨酸的使用。即便如此，赖氨酸疗法的摈弃依然存在许多阻力。悲哀的是，不愿放弃赖氨酸使用的理由并非基于科学上的分歧，而单纯来源自“个人经验”。

When the review by Bol and Bannik (2015) was reported in VeterinaryV Practice News, for example, objections from some respected veterinarians explicitly cited anecdotal experience as a reason for continuing the use of lysine:14

这里就有个现成的例子。兽医执业新闻网（Veterinary Practice News）报道Bol等人关于赖氨酸的研究时，一些广受赞誉的兽医却表示抗拒，引用个人经验来进行反驳

Anecdotal evidence should not be discarded…I have clients who tell me that every time they take the cat off lysine the problem returns…Maybe it’s just as well to leave those cats on lysine if the clients genuinely feel that it’s making a difference.

个人经验不能完全不作数，我的一个客户和我说他家猫一天不吃赖氨酸就犯病...要是客户觉得赖氨酸有效，不如让那些猫吃着算了

[Lysine] is used frequently by many of my clients at the recommendation of Dr. Google…Some cats have a very convincing response in spite of what the science says…Its use should be based on response, whether scientific or not.

我的不少客户经常根据网络信息给猫吃赖氨酸...且不管科学咋说，一些猫反响很好...用不用赖氨酸要看疗效，别管科学不科学

结论

Science is, by nature, a competitive community process. Disagreement between individuals is healthy and an integral part of this process, spurring replication of research that helps compensate for the inevitable blind spots and biases we all suffer from. However, the explicit preference for anecdote over controlled research evidence is counterproductive and lends itself to the retention of treatments that do not truly help our patients and which deserve to be abandoned.

There is some limited evidence suggesting lysine could actually exacerbate FHV-1 symptoms, which would certainly make abandoning it the right choice.7 Even if it is completely harmless, however, wasting resources on treatment that has been through the scientific vetting process over 50 years and has still failed to show convincing evidence of benefits is not justified.

科学，论其本质，是个带有竞争性的团体进程。个人层面的观点冲突不仅有益，还是科学进程的组成部份，能够刺激复制性研究的产生，从而弥补人人皆有的偏见与盲点。 直接置个人经验于临床对照研究之上则完全相反，反而会导致早该被放弃、对病患无助益的疗法继续存在。有限证据显示赖氨酸还会恶化猫疱疹的症状，这进一步正当化了弃用赖氨酸。（引用7） 即便赖氨酸真的无害，在一个科学界论证50余年依旧无法证明有效的疗法上投入额外资源实在谈不上明智。

As I argued last month, evidence-based medicine is a necessary pillar of effective and ethical clinical practice. This means we must be willing to acknowledge our limitations and set aside anecdotal evidence, even our own, when appropriate research evidence indicates we are mistaken.

正如我（作者）上个月所提到的，循证医学是高效、道德的临床执业所必须的。这意味着，当出现明确科学证据表明我们认知错误时，（作为医师）我们必须愿意接受自身存在的局限，置“轶事证据”甚至“个人经验”于一旁。