This is the 4870th article of Da Yi Xiao Nu
In recent years, I have seen some posts on the Internet in the name of popular science, claiming that blood purification treatment can prolong life and maintain good health, and promote it as a health care measure to healthy people. As a relatively new medical technology, double plasmapheresis (DFPP) is often claimed by unscrupulous businessmen as a health care technology enjoyed by the high-end population in Japan. In fact, DFPP does not have any health indications and may even cause damage to the body.
Bedside blood purification is a treatment technique often used by critically ill patients, which can partially replace the function of the kidneys and eliminate excess water, metabolic wastes, toxins, autoantibodies and immune complexes from the patient's body. It is mainly used for patients with renal dysfunction, and other diseases such as poisoning, liver failure, autoimmune diseases, etc., bedside blood purification technology is also often used.
In 1854, the Scottish chemist Thomas Graham first proposed the concept of "dialysis". In 1913, John Abel and his colleagues conducted the first experiments on live animals and built tubular dialyzers. In 1924, Georg Haas in Germany first applied dialysis technology to humans. In 1943, Willem Johan Kolff of the Netherlands designed a drum artificial kidney and successfully treated patients with acute kidney failure. With the advancement of technology, the first hollow fiber dialyzer appeared in the 1960s, which greatly improved the efficiency of dialysis. In terms of blood purification methods, in addition to traditional hemodialysis, hemofiltration, hemoperfusion and plasma exchange methods have also emerged. In the 21st century, blood purification devices are becoming more miniaturized and intelligent, making treatment easier and more accurate.
Plasmapheresis is a special blood purification technique that originated in the 60s of the 20th century and was originally developed as a treatment for myasthenia gravis. In the early stage, plasmapheresis was mainly used to treat some immune diseases, and it can rapidly remove autoantibodies and immune complexes from the body, thereby alleviating pathological damage. With the development of technology, the application field of plasmapheresis has gradually expanded to treat lipid metabolism disorders, liver failure and other diseases. The traditional plasmapheresis technique involves separating the plasma from the blood and discarding it entirely, while supplementing it with an equal amount of fresh frozen plasma and albumin solution. The disadvantage of this method is that the cost is high, and the discarded plasma not only contains pathogenic substances, but also contains many beneficial components such as coagulation factors, and a large amount of exogenous plasma needs to be replenished, and the current blood source is very tight.
On this basis, people have invented the technology of double plasmapheresis. Plasma isolated from the blood is no longer directly discarded, but further separated, discarding the disease-causing macromolecular proteins in the plasma, leaving the beneficial components back into the body. The obvious benefit is that plasma loss is reduced, which reduces or eliminates the need for exogenous plasma transfusion, making it safer. The disadvantage is that the cost of treatment is higher than that of single-weight plasmapheresis. Initially, this technique was mainly used to treat hyperacute rejection and autoimmune diseases after kidney transplantation. With the continuous development and improvement of technology, the clinical application scope of dual plasmapheresis technology has also been expanding, and it is also used to treat blood diseases, liver diseases, neurological diseases, etc., but its clinical effect still needs to be confirmed.
However, various bedside blood purification technologies, including plasmapheresis, are often used in patients with liver and kidney dysfunction and play an auxiliary role. At present, no matter how good the medical alternative technology is, it is far less powerful than the body's own organs. Moreover, the effectiveness of these techniques is controversial in the medical community, even in clinical patients, such as the use of blood purification techniques in patients with sepsis, which has not been proven to improve patient outcomes by evidence-based medical evidence. And using these technologies on healthy people, claiming to have health benefits and be able to prolong life, is an outright scam. There is no rigorous medical literature to confirm, or even mention that DFPP and other clinical technologies have health care effects, and coaxing healthy people to use DFPP and other clinical technologies for "health care" is not only deceptive and misleading, but also illegal.
The reason why scammers like to use DFPP to mislead the public may be because the technology is relatively new, and the general public and even some medical personnel do not know about it, and second, the technology does not require a large amount of rehydration and blood transfusion during use, and is relatively safe. The so-called "health care" institutions have a low level of medical technology and weak medical security capabilities, and the risk of using complex and dangerous technologies to defraud is too great.
There are still a lot of such pseudo-popular science posts on the Internet, which often talk about medical knowledge first, creating a very professional impression on readers, and then quietly package the private goods to be sold in medical terms and push them to readers. For example, DFPP is a health care technology used by high-end people in Japan, which should be carried out every six months, and can treat a variety of diseases that ordinary people cannot understand and do not understand, and the price of a treatment is 70,000 yuan. In fact, in a regular hospital in China, the cost of a DFPP is only a few thousand yuan.
Scammers take advantage of the public's concern for health, and under the cloak of pseudo-popular science, they wantonly carry out fraud and misleading behaviors in the field of health, and promote all kinds of ineffective and even harmful "health care products" and "health care technologies". In the face of a large amount of fake medical information on the Internet, how can ordinary people identify it? The most effective and easiest way is to consult doctors in regular hospitals. Even if you don't go to the hospital, it is not difficult to find a doctor among relatives and friends around you. However, many people, especially the elderly, would rather believe all kinds of advertisements disguised as popular science rather than listen to the advice of professional doctors, and popular science propaganda has a long way to go.
Author: Songjiang Hospital, Shanghai Jiao Tong University School of Medicine
Emergency Critical Care Unit
Han Dan, Wang Xuemin
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