{"categories":[{"id":"redox","name":"氧化还原与抗氧化防御","en_name":"Redox Homeostasis & Defense","color":"#10b981","icon":"shield-check","description":"调控细胞内活性氧（ROS/RNS）平衡，涵盖内源性抗氧化酶转录激活、直接自由基捕获猝灭以及内源还原剂（GSH）再生循环。"},{"id":"inflammation_immune","name":"免疫识别与炎症级联调控","en_name":"Immune & Inflammatory Signaling","color":"#ef4444","icon":"flame","description":"调控先天与适应性免疫，涵盖模式识别受体（PRRs）免疫应答训练、促炎转录因子（NF-κB）阻断、促炎酶抑制与促消退介质（SPMs）释放。"},{"id":"mitochondria_energy","name":"细胞生物能量与线粒体动力学","en_name":"Bioenergetics & Mitochondria","color":"#f59e0b","icon":"zap","description":"维持细胞 ATP 稳态与线粒体健康，涵盖呼吸链电子传递、NAD+ 补救合成、脂肪酸穿梭氧化与线粒体生物发生（PGC-1α）。"},{"id":"metabolism_longevity","name":"代谢感知、自噬与抗衰长寿","en_name":"Nutrient Sensing & Longevity","color":"#8b5cf6","icon":"hourglass","description":"干预细胞长寿与代谢感知网络，涵盖 AMPK 激活、mTORC1 变构调控、Sirtuins 去乙酰化、自噬激活与衰老细胞清除（Senolytics）。"},{"id":"neurotransmitters","name":"神经传递与突触可塑性","en_name":"Neurotransmission & Plasticity","color":"#06b6d4","icon":"brain","description":"影响中枢与周围神经系统，涵盖乙酰胆碱合成、单胺类递质平衡、GABA/谷氨酸抑制-兴奋稳态、以及 BDNF/NGF 神经营养因子诱导。"},{"id":"endocrine_hpa","name":"内分泌、激素轴与昼夜节律","en_name":"Endocrine, Hormones & HPA Axis","color":"#ec4899","icon":"activity","description":"平衡下丘脑-垂体-靶腺轴，涵盖皮质醇应激缓冲（HPA钝化）、游离类固醇激素解离、雌激素代谢分流与褪黑素授时节律。"},{"id":"epigenetics_methylation","name":"表观遗传与一碳甲基化","en_name":"Epigenetics & Methylation","color":"#6366f1","icon":"dna","description":"维持基因组表观稳定性与代谢去毒，涵盖甲基供体供应（SAMe循环）、同型半胱氨酸清除、以及组蛋白去乙酰化酶（HDAC）抑制。"},{"id":"vascular_endothelial","name":"血管内皮与血流动力学","en_name":"Vascular & Endothelial Function","color":"#14b8a6","icon":"heart-pulse","description":"改善微循环与组织氧供灌注，涵盖一氧化氮合酶（eNOS）偶联、无机硝酸盐还原、血小板活化缓冲与平滑肌舒张。"},{"id":"barrier_matrix","name":"生物屏障完整性与细胞外基质","en_name":"Barriers & Extracellular Matrix","color":"#84cc16","icon":"box","description":"保护上皮屏障（肠道屏障、血脑屏障）、紧密连接蛋白（ZO-1/Occludin）表达上调、胶原原纤维交联与基质金属蛋白酶（MMPs）抑制。"},{"id":"microbiome_host","name":"肠道微生态与菌群代谢互作","en_name":"Microbiome-Host Axis","color":"#d97706","icon":"trees","description":"以肠道菌群为生物代谢反应器，涵盖短链脂肪酸（SCFA/丁酸）发酵生成、胆汁酸-FXR/TGR5受体轴激活与竞争性生态排阻。"}],"mechanisms":[{"id":"mech_nrf2_are","category_id":"redox","name":"Nrf2/ARE 内源抗氧化酶转录激活","en_name":"Nrf2/ARE Transcriptional Activation","short_desc":"促使 Keap1 构象改变解离 Nrf2，入核结合 ARE，驱动 SOD、CAT、GSH-Px、HO-1 等数百种抗应激酶级联转录。","molecular_targets":["Keap1","Nrf2","ARE (Antioxidant Response Element)","HO-1","NQO1"],"functional_significance":"抗氧化酶能反复催化清除自由基，作用比一次性消耗的直接抗氧化剂更持久，是对抗慢性氧化应激的重要靶点。"},{"id":"mech_direct_ros","category_id":"redox","name":"直接自由基捕获与化学猝灭","en_name":"Direct ROS/RNS Quenching","short_desc":"凭借高共轭双键或活性酚羟基直接向自由基提供孤对电子，在微环境中化学终止脂质过氧化连锁反应。","molecular_targets":["Lipid Peroxides (LOOH)","Superoxide (O2•-)","Hydroxyl Radical (•OH)","Singlet Oxygen"],"functional_significance":"针对细胞膜脂质双分子层（如虾青素穿膜保护）或细胞外液微环境的急性自由基爆发提供即刻物理防御。"},{"id":"mech_gsh_synthesis","category_id":"redox","name":"谷胱甘肽（GSH）合成限速底物/辅因子供应","en_name":"GSH Biosynthesis & Regeneration","short_desc":"提供 GSH 生物合成的关键限速前体（L-半胱氨酸、甘氨酸）或辅酶辅基（NADPH、硒、核黄素），维持细胞内最强还原电位。","molecular_targets":["GCL (谷氨酸半胱氨酸连接酶)","GSH Synthase","Glutathione Reductase","GPx"],"functional_significance":"Phase II 结合解毒反应与肝细胞抗氧化的基础；若底物匮乏，单凭 Nrf2 激活也无法有效合成还原型 GSH。"},{"id":"mech_prr_immune","category_id":"inflammation_immune","name":"模式识别受体（PRRs）免疫监视与应答训练","en_name":"PRRs & Trained Immunity","short_desc":"模拟外源病原相关分子模式（PAMPs），与巨噬/树突细胞表面 Dectin-1 或 TLR2/4 结合，诱导免疫警戒与表观遗传重编程。","molecular_targets":["Dectin-1","TLR2/4","Syk 激酶","CARD9"],"functional_significance":"不直接引起剧烈促炎风暴，而是提升先天免疫细胞的病原监视敏锐度与吞噬效率，适合免疫低下或黏膜防御脆弱者。"},{"id":"mech_nfkb_inhibition","category_id":"inflammation_immune","name":"NF-κB / AP-1 促炎转录总控抑制","en_name":"NF-κB / AP-1 Transcriptional Blockade","short_desc":"阻抑 IKK 激酶磷酸化及 IκB 泛素化降解，阻止 p65/p50 异源二聚体入核，切断 TNF-α、IL-6、IL-1β 等前体表达。","molecular_targets":["IKK (IκB Kinase)","NF-κB p65/p50","IκBα","AP-1"],"functional_significance":"慢性系统性低度炎症（Inflammaging）的核心刹车靶点，几乎所有慢性退行性病变均伴有 NF-κB 的基础过度激活。"},{"id":"mech_cox_lox_inhibition","category_id":"inflammation_immune","name":"环氧合酶/脂氧酶（COX-2 / 5-LOX）直接酶活抑制","en_name":"COX-2 / 5-LOX Enzymatic Inhibition","short_desc":"竞争性或变构抑制 COX-2 及 5-LOX，阻断花生四烯酸转化为致痛致水肿的前列腺素 PGE2 及白三烯 LTB4。","molecular_targets":["COX-2 (环氧合酶-2)","5-LOX (5-脂氧酶)","FLAP"],"functional_significance":"天然抗炎镇痛与关节/组织肿胀平抑通道，且部分天然分子相比非甾体抗炎药（NSAIDs）对 COX-1 胃肠保护酶损伤显著较轻。"},{"id":"mech_spm_resolution","category_id":"inflammation_immune","name":"促消退介质前体与炎症主动消退（SPMs）","en_name":"Pro-Resolving Mediators (SPMs)","short_desc":"充当消退素（Resolvins RvE/RvD）、保护素（Protectins）、玛瑞新（Maresins）生物合成前体，主动诱导中性粒细胞凋亡与组织稳态重建。","molecular_targets":["Resolvins (RvE1, RvD1)","ChemR23 受体","BLT1 拮抗","巨噬细胞胞饮清除"],"functional_significance":"常规抗炎药主要是抑制炎症的启动；促消退介质（SPM）参与的是炎症的主动收尾，防止炎症迁延。补充鱼油能否明显增强这一通路、并带来临床获益，目前人体证据有限。"},{"id":"mech_mast_cell","category_id":"inflammation_immune","name":"肥大细胞膜稳定与脱颗粒阻滞","en_name":"Mast Cell Stabilization","short_desc":"调控肥大细胞膜流动性及膜电位，阻抑钙内流，阻止储存组胺、白三烯和类胰蛋白酶的分泌性颗粒破裂释放。","molecular_targets":["Ca2+ 通道内流阻断","FcεRI 受体交联抑制","组胺释放受阻"],"functional_significance":"针对过敏体质、季节性鼻炎、组织胺不耐受（HIT）及肥大细胞活化综合征（MCAS），作为不引起嗜睡的辅助手段（证据多来自小型研究）。"},{"id":"mech_mucosal_iron_binding","category_id":"inflammation_immune","name":"黏膜游离铁螯合与病原微环境剥夺","en_name":"Mucosal Iron Sequestration & Antimicrobial","short_desc":"高亲和力结合游离 Fe3+，剥夺革兰氏阴性菌与生物膜合成所需的必需铁，直接破坏细菌外膜脂多糖（LPS）结构。","molecular_targets":["Fe3+ 螯合口袋","细菌外膜 LPS","TLR4 信号钝化"],"functional_significance":"肠道、呼吸道黏膜抗感染第一道防线，既抗菌抗病毒，又避免滥用广谱抗生素破坏共生菌群平衡。"},{"id":"mech_etc_carrier","category_id":"mitochondria_energy","name":"线粒体电子传递链载体与氧化磷酸化偶联","en_name":"ETC Electron Carriers & OxPhos","short_desc":"在线粒体内膜 Complex I/II 与 Complex III 之间穿梭转运电子，维持质子跨膜电化学梯度，催生 ATP 合成。","molecular_targets":["Complex I (NADH脱氢酶)","Complex II (琥珀酸脱氢酶)","Complex III","ATP 合酶"],"functional_significance":"高代谢器官（心肌、大脑、骨骼肌）能量工厂的运转关键；他汀类药物可阻断其自身合成，需重点外源代偿。"},{"id":"mech_nad_salvage","category_id":"mitochondria_energy","name":"NAD+ 补救合成通路池充盈","en_name":"NAD+ Pool Repletion","short_desc":"通过 NMNAT / NRK 酶促反应生成烟酰胺腺嘌呤二核苷酸（NAD+），为三羧酸循环提供电子受体并供给 SIRT/PARP 酶消耗。","molecular_targets":["NAMPT","NMNAT","NRK","NAD+ 游离池"],"functional_significance":"随年龄增长体内 NAD+ 水平急剧断崖式下降，补充 NAD+ 前体可多维度唤醒线粒体功能并支撑基因组 DNA 修复。"},{"id":"mech_cpt_shuttle","category_id":"mitochondria_energy","name":"脂肪酰肉碱线粒体穿梭与 β-氧化","en_name":"Fatty Acid Mitochondrial Translocation","short_desc":"作为 CPT-1 / CPT-2 限速酶的关键辅底物，将胞浆中长链脂肪酰基穿梭送入线粒体基质裂解产生乙酰-CoA。","molecular_targets":["CPT-1 (肉碱脂酰转移酶-1)","CACT 转运体","β-氧化酶系"],"functional_significance":"改善心肌缺血代谢，提升耐力与骨骼肌脂肪供能效率，预防脂质在线粒体膜外异位堆积诱发胰岛素抵抗。"},{"id":"mech_phosphagen_buffer","category_id":"mitochondria_energy","name":"磷酸肌酸高能磷酸键瞬时缓冲系统","en_name":"Phosphagen / PCr-ATP Buffer","short_desc":"在肌酸激酶（CK）催化下转化为高能磷酸肌酸，在能量极度消耗时毫秒级回补 ADP 生成 ATP，平抑能量断崖。","molecular_targets":["Creatine Kinase (CK-MM / CK-BB)","Phosphocreatine Pool","ATP 再生"],"functional_significance":"除了运动爆发力支持外，大脑海马体与皮层在认知高负荷或缺氧缺血时依赖肌酸维持神经元能量突触稳定性。"},{"id":"mech_pgc1a_biogenesis","category_id":"mitochondria_energy","name":"PGC-1α 驱动线粒体生物发生与增殖","en_name":"PGC-1α Mitochondrial Biogenesis","short_desc":"激活 PGC-1α 辅激活因子，级联诱发 NRF-1/2 及线粒体转录因子 A（TFAM），促发线粒体 DNA 复制与数量新生增殖。","molecular_targets":["PGC-1α","NRF-1 / NRF-2","TFAM (线粒体转录因子 A)"],"functional_significance":"从根本上增加“细胞发电厂”的物理数量与体积，对抗慢性疲劳、代谢综合征及增龄引起的线粒体质量衰退。"},{"id":"mech_ampk_activation","category_id":"metabolism_longevity","name":"AMPK 细胞能量亏缺感知与代谢重编程","en_name":"AMPK Energy Sensor Activation","short_desc":"激活单磷酸腺苷活化蛋白激酶（AMPK），抑制 ACC/HMGCR 减少脂肪与胆固醇合成，刺激 GLUT4 易位增强胰岛素敏感性。","molecular_targets":["AMPK Thr172 磷酸化","ACC1/2","GLUT4 转运体","mTORC1 抑制"],"functional_significance":"模拟热量限制（Calorie Restriction）的代谢效应，是纠正代谢综合征、脂肪肝与胰岛素抵抗的核心中枢。"},{"id":"mech_sirtuin_activation","category_id":"metabolism_longevity","name":"Sirtuins 依赖型蛋白去乙酰化酶激活","en_name":"Sirtuin Activation (STACs)","short_desc":"通过变构构象或 NAD+ 底物供给激活 SIRT1-7 去乙酰化酶，调控组蛋白、FOXO、p53，促进 DNA 损伤修复与细胞存活。","molecular_targets":["SIRT1 (核去乙酰化)","SIRT3 (线粒体功能维持)","FOXO3a","PGC-1α 去乙酰化"],"functional_significance":"调控寿命表观遗传钟与代谢恢复力，协调氧化防御、自噬与线粒体功能。"},{"id":"mech_autophagy_mTOR","category_id":"metabolism_longevity","name":"mTORC1 变构阻滞与宏自噬（Autophagy）诱导","en_name":"mTORC1 Modulation & Autophagy","short_desc":"下调过度亢进的 mTORC1 信号，解除其对 ULK1 复合物的阻抑，启动自噬体吞噬消除错误折叠蛋白、β-淀粉样蛋白与老损线粒体。","molecular_targets":["mTORC1 (Raptor)","ULK1","Beclin-1","LC3-II 脂化"],"functional_significance":"维持细胞内蛋白质稳态（Proteostasis），清除神经退行性病变和老衰相关的“细胞分子垃圾”。"},{"id":"mech_senolytic","category_id":"metabolism_longevity","name":"衰老细胞促凋亡清除（Senolytic Activity）","en_name":"Senolytic Cell Clearance","short_desc":"短暂靶向抑制衰老细胞特征性促存活网络（SCAP 通路），促使释放 SASP 促炎毒素的“僵尸细胞”启动程序性凋亡。","molecular_targets":["BCL-2 / BCL-xL 家族","p21 (CDKN1A)","PI3K/AKT 促存活轴"],"functional_significance":"衰老干预前沿：阶段性间歇清除体内衰老细胞，显著改善组织纤维化，阻断促炎微环境（SASP）对邻近健康细胞的传染。"},{"id":"mech_cd38_inhibition","category_id":"metabolism_longevity","name":"CD38 外核苷酸酶抑制（NAD+ 消耗刹车）","en_name":"CD38 Ecto-Enzyme Inhibition","short_desc":"结合并抑制巨噬细胞与内皮细胞膜表面高表达的 CD38 糖水解酶，大幅切断其对细胞外及胞内 NAD+ 的病理性水解破坏。","molecular_targets":["CD38 催化结构域","NAD+ 降解水解酶","cADPR 合成抑制"],"functional_significance":"衰老过程中 CD38 表达暴增是导致组织 NAD+ 耗竭的关键元凶。抑制 CD38 相当于修补水桶破洞，与补充 NAD+ 前体形成完美协同。"},{"id":"mech_cholinergic","category_id":"neurotransmitters","name":"胆碱能神经传递（ACh 前体供给与 AChE 抑制）","en_name":"Cholinergic Transmission & Synthesis","short_desc":"透过血脑屏障为乙酰胆碱转移酶提供胆碱基质，或竞争性抑制乙酰胆碱酯酶，提高突触间隙乙酰胆碱浓度与受体占有率。","molecular_targets":["Choline Acetyltransferase (ChAT)","AChE (乙酰胆碱酯酶)","烟碱型/毒蕈碱型 ACh 受体"],"functional_significance":"大脑执行功能、注意力聚焦、记忆巩固与脑神经信号传递的核心基础。"},{"id":"mech_monoamine","category_id":"neurotransmitters","name":"单胺类神经递质平衡（多巴胺/去甲肾上腺素/5-HT）","en_name":"Monoamine Balance & Synthesis","short_desc":"提供芳香族氨基酸前体，或轻度调节 MAO 酶活性与转运体，支持多巴胺、去甲肾上腺素与血清素的稳态释放。","molecular_targets":["Tyrosine Hydroxylase (TH)","Aromatic L-amino Acid Decarboxylase","MAO-A/B","SERT/DAT"],"functional_significance":"调控动机、执行力、心境、奖赏通路与抗抑郁/抗焦虑神经心理韧性。"},{"id":"mech_gaba_glutamate","category_id":"neurotransmitters","name":"GABA-谷氨酸抑制/兴奋张力平衡","en_name":"GABA / Glutamate Balance","short_desc":"变构激动 GABA-A 抑制性氯离子通道，或生理性拮抗 NMDA 谷氨酸受体，平息皮层神经元过度放电与兴奋性毒性。","molecular_targets":["GABA-A 受体氯离子通道","NMDA 受体 GluN 亚基","GAD (谷氨酸脱羧酶)"],"functional_significance":"缓解焦虑症、大脑过度亢奋、睡前思维反刍与神经元兴奋性损伤（Excitotoxicity）。"},{"id":"mech_bdnf_ngf","category_id":"neurotransmitters","name":"神经营养因子合成与 TrkB/A 受体激活","en_name":"BDNF / NGF & Trk Signaling","short_desc":"刺激星形胶质细胞和神经元转录释放脑源性神经营养因子（BDNF）与神经生长因子（NGF），激活 TrkB/A，促进神经突触新生与存活。","molecular_targets":["BDNF","NGF","TrkB 受体激酶","CREB 转录因子"],"functional_significance":"神经可塑性（Synaptic Plasticity）与学习记忆长时程增强（LTP）的终极驱动力，对抗增龄性海马萎缩。"},{"id":"mech_hpa_cortisol","category_id":"endocrine_hpa","name":"下丘脑-垂体-肾上腺（HPA）轴钝化与皮质醇应激缓冲","en_name":"HPA Axis Regulation & Cortisol Buffering","short_desc":"下调 CRH 与 ACTH 应激级联，重置糖皮质激素受体敏感度，平抑持续高压状态下皮质醇的峰值飙升与夜间节律倒错。","molecular_targets":["CRH 受体","ACTH 肾上腺反应","GR (糖皮质激素受体)","11β-HSD1"],"functional_significance":"与长期慢性压力、应激性失眠以及压力相关的腹部脂肪堆积有关。"},{"id":"mech_circadian_clock","category_id":"endocrine_hpa","name":"昼夜节律时钟（SCN / MT1-MT2）相位重置","en_name":"Circadian Clock Entrainment (SCN / MT1-MT2)","short_desc":"作用于视交叉上核（SCN）主时钟的 MT1/MT2 褪黑素受体，抑制 SCN 神经元放电并前移/后移昼夜相位，同步外周 CLOCK/BMAL1 时钟基因振荡。","molecular_targets":["MT1 (MTNR1A)","MT2 (MTNR1B)","SCN 视交叉上核","CLOCK/BMAL1","PER/CRY"],"functional_significance":"纠正睡眠相位后移、时差与轮班节律紊乱，缩短入睡潜伏期；节律同步本身是代谢、免疫与激素分泌时序稳态的上游调控者。"},{"id":"mech_steroid_shbg","category_id":"endocrine_hpa","name":"性腺轴（HPG）与 SHBG / 游离性激素调节","en_name":"HPG Axis & SHBG / Free Sex Hormone Modulation","short_desc":"通过下丘脑 GnRH-垂体 LH 信号、Leydig/卵泡膜细胞类固醇合成，或改变肝脏 SHBG 合成与结合，双向调节循环游离睾酮/雌激素的生物可用水平。","molecular_targets":["SHBG (性激素结合球蛋白)","GnRH / LH","Leydig 细胞 StAR 蛋白","17β-HSD"],"functional_significance":"男性：在不外源补充雄激素、不抑制 HPG 轴的前提下改善游离睾酮；女性（如 PCOS）：反向升高 SHBG、降低过高的游离睾酮。方向取决于具体分子。"},{"id":"mech_estrogen_detox","category_id":"endocrine_hpa","name":"雌激素代谢分流与解毒途径调优","en_name":"Estrogen Metabolism & Clearance","short_desc":"诱导 CYP1A1 酶促使雌二醇向低活性的 2-OHE1（保护型）羟化，抑制高致突变的 4-OHE1 和 16α-OHE1 生成，配合葡萄糖醛酸排出。","molecular_targets":["CYP1A1","CYP1B1 竞争抑制","β-葡萄糖醛酸酶抑制","COMT 甲基化转移"],"functional_significance":"改善雌激素优势（Estrogen Dominance）、子宫内膜/乳腺增生风险及经前期综合征（PMS）。"},{"id":"mech_vdr_calcium","category_id":"endocrine_hpa","name":"维生素 D 受体（VDR）核转录与钙靶向沉积","en_name":"VDR Nuclear Signaling & Carboxylation","short_desc":"结合细胞核 VDR 受体调控超千个基因，协同依赖维生素 K2 的 γ-谷氨酰羧化酶激活骨钙素（Osteocalcin）与基质 Gla 蛋白（MGP），引钙入骨并防止血管钙化。","molecular_targets":["VDR (维生素 D 受体)","γ-谷氨酰羧化酶","Osteocalcin","MGP (基质 Gla 蛋白)"],"functional_significance":"全身基因免疫、骨密度与心血管钙化防范的核心生命轴心，D3 负责肠道吸收钙，K2 负责导航定向沉积。"},{"id":"mech_methylation_sam","category_id":"epigenetics_methylation","name":"一碳循环甲基供体（SAMe）再生与 Hcy 清除","en_name":"One-Carbon Cycle & Methyl Donors","short_desc":"在甲硫氨酸合成酶（MS）或甜菜碱转甲基酶（BHMT）催化下，将细胞毒性的同型半胱氨酸（Hcy）再甲基化，充填 SAMe 甲基池。","molecular_targets":["MTHFR","MS / MTR 酶","BHMT","SAMe / SAH 比值","DNMTs"],"functional_significance":"维持 DNA 全基因组甲基化稳定、神经递质合成消解，并预防高同型半胱氨酸血症所致的内皮损伤与心脑血管事件。"},{"id":"mech_hdac_inhibition","category_id":"epigenetics_methylation","name":"组蛋白去乙酰化酶（HDAC）表观遗传抑制","en_name":"HDAC Inhibition & Chromatin Remodeling","short_desc":"抑制 Class I/II HDACs 酶活性，保留组蛋白赖氨酸乙酰基，使紧缩的染色质空间构象舒展，重新唤醒被病理性沉默的保护基因。","molecular_targets":["HDAC 1/2/3/8","Histone H3/H4 乙酰化","p21 基因重激活"],"functional_significance":"天然表观重编程与抗肿瘤/抗衰老机制，使机体自愈与凋亡监视机制恢复表达。"},{"id":"mech_enos_no","category_id":"vascular_endothelial","name":"内皮型一氧化氮合酶（eNOS）偶联与 NO 扩血管","en_name":"eNOS Coupling & NO Vasodilation","short_desc":"提供 L-精氨酸底物并防止 eNOS 解偶联，催生血管活性气体一氧化氮（NO），经 sGC-cGMP 途径舒张血管平滑肌。","molecular_targets":["eNOS","BH4 (四氢生物蝶呤)","sGC (可溶性鸟苷酸环化酶)","cGMP"],"functional_significance":"动脉血压弹性调节、勃起功能支持、大脑与外周微循环血流灌注的核心靶点。"},{"id":"mech_fibrinolysis","category_id":"vascular_endothelial","name":"纤维蛋白特异水解与内源纤溶系统激活","en_name":"Fibrinolysis & Antithrombotic Enzymatic Activity","short_desc":"直接水解交联纤维蛋白网，并刺激血管内皮释放组织型纤溶酶原激活剂（t-PA），降低血小板聚集与血液黏稠度。","molecular_targets":["Fibrin (纤维蛋白)","t-PA","PAI-1 抑制","红细胞聚集度改善"],"functional_significance":"预防静脉血栓、改善深静脉曲张与心脑微血管阻力，维持微循环灌注通畅。"},{"id":"mech_tight_junction","category_id":"barrier_matrix","name":"上皮紧密连接（ZO-1 / Occludin）加固与屏障修复","en_name":"Epithelial Tight Junction Assembly","short_desc":"直接供能或通过蛋白激酶信号刺激紧密连接复合体装配，锚定肌动蛋白细胞骨架，封闭细胞旁路渗透，降低上皮通透性。","molecular_targets":["Zonula Occludens-1 (ZO-1)","Occludin","Claudin-1/4","肌球蛋白轻链激酶 MLCK 抑制"],"functional_significance":"切断未消化大分子蛋白质与细菌内毒素（LPS）渗漏入血的源头，从根源平息系统性自体免疫与低度炎症。"},{"id":"mech_collagen_synthesis","category_id":"barrier_matrix","name":"胶原蛋白三螺旋交联与原纤维合成","en_name":"Collagen Synthesis & Cross-linking","short_desc":"提供富含脯氨酸-羟脯氨酸寡肽趋化信号，并作为脯氨酰/赖氨酰羟化酶辅助电子还原剂，交联组装坚韧的胶原纤维网。","molecular_targets":["Prolyl 4-Hydroxylase (P4H)","Lysyl Oxidase (LOX)","成纤维细胞胶原转录"],"functional_significance":"支持关节软骨、真皮真皮层网状结构、血管壁结缔组织韧性与伤口愈合。"},{"id":"mech_er_stress_chaperone","category_id":"barrier_matrix","name":"内质网应激（ER Stress）分子伴侣与胆汁酸疏通","en_name":"Chemical Chaperone & ER Proteostasis","short_desc":"作为内源性化学分子伴侣，稳定未折叠蛋白构象，阻止内质网未折叠蛋白反应（UPR）诱导的细胞凋亡，并改善肝内胆汁微循环。","molecular_targets":["GRP78/BiP","PERK/CHOP 凋亡轴阻断","BSEP 胆盐输出泵"],"functional_significance":"针对肝细胞脂肪变性、神经变性以及细胞应激毒性的深层细胞器保护机制。"},{"id":"mech_mucus_layer","category_id":"barrier_matrix","name":"肠道黏蛋白（MUC2）与水凝胶保护层分泌","en_name":"MUC2 Mucin Layer Synthesis & Goblet Cell Renewal","short_desc":"刺激杯状细胞分化与黏蛋白 MUC2 基因转录，形成致密的黏液水凝胶物理隔离层，阻止细菌直接接触上皮细胞表面。","molecular_targets":["MUC2 黏蛋白","杯状细胞分化","黏液层厚度"],"functional_significance":"肠道的第一层物理防护盾，黏液层变薄是发生炎症性肠病与肠通透性异常的最初诱因。"},{"id":"mech_scfa_fermentation","category_id":"microbiome_host","name":"结肠短链脂肪酸（SCFA/丁酸）发酵底物与受体激活","en_name":"SCFA Production & GPR41/43 Axis","short_desc":"提供结肠共生菌发酵碳源，高产丁酸、丙酸和乙酸，不仅为结肠上皮细胞提供直接能量，还激动全身 GPR41/43/109A 受体。","molecular_targets":["GPR41 (FFAR3)","GPR43 (FFAR2)","GPR109A","结肠上皮线粒体供能"],"functional_significance":"连接肠道菌群与全身代谢免疫的枢纽：下调系统性炎症、刺激脑-肠肽（GLP-1）分泌、诱导结肠 Foxp3+ Treg 细胞生成。"},{"id":"mech_ages_glycation","category_id":"metabolism_longevity","name":"晚期糖基化终产物（AGEs）与蛋白质交联阻断","en_name":"Anti-Glycation & AGEs Cross-link Inhibition","short_desc":"激活转酮醇酶将三糖磷酸分流，或直接与高活性二羰基化合物（如甲基乙二醛）结合，阻止胶原蛋白与微血管基底膜发生不可逆糖化硬化。","molecular_targets":["Transketolase (转酮醇酶)","Methylglyoxal (甲基乙二醛)","RAGE 受体","AGEs 交联断裂"],"functional_significance":"对抗血管壁硬化、视网膜病变与胶原老化的核心生化盾牌，阻断高血糖引发的微血管组织退行性病变。"},{"id":"mech_5ar_dht","category_id":"endocrine_hpa","name":"5α-还原酶抑制与双氢睾酮（DHT）阻断","en_name":"5-Alpha Reductase Inhibition & DHT Suppression","short_desc":"竞争性结合 5α-还原酶（Type 1 / Type 2），阻断睾酮不可逆转化为超强活性双氢睾酮（DHT），保护毛囊及前列腺上皮。","molecular_targets":["5α-Reductase Type 1/2","DHT (双氢睾酮)","毛囊雄激素受体","前列腺上皮增殖"],"functional_significance":"雄激素性脱发（AGA）与良性前列腺增生（BPH）的天然调控靶点，保持游离睾酮的同时减少外周有害高活性 DHT 转化。"},{"id":"mech_alcohol_aldh","category_id":"redox","name":"乙醛脱氢酶（ALDH2）激活与乙醇线粒体毒性清除","en_name":"ALDH2 Activation & Acetaldehyde Clearance","short_desc":"变构激活线粒体醛脱氢酶-2（ALDH2）及乙醇脱氢酶（ADH），加速致癌高毒性中间代谢物乙醛转化为无害乙酸，并竞争结合 GABA-A 乙醇受点。","molecular_targets":["ALDH2","ADH","乙醛 (Acetaldehyde)","GABA-A 乙醇结合位点"],"functional_significance":"东亚人群因 ALDH2*2 突变普遍缺乏乙醛代谢酶，激活该酶系是消除宿醉、心肌线粒体水肿与酒精性肝损伤的核心对策。"},{"id":"mech_osmolyte_calcium","category_id":"vascular_endothelial","name":"细胞渗透压维持与心肌神经钙稳态调控","en_name":"Osmoregulation & Intracellular Calcium Homeostasis","short_desc":"作为细胞内必需有机两性离子渗透质（Osmolyte），维持水化体积，敏化心肌肌浆网钙泵（SERCA2a），防止心律不齐与心肌重构。","molecular_targets":["SERCA2a 钙泵","TauT 转运体","心肌细胞膜电位","胆汁酸结合"],"functional_significance":"心血管血流动力学与神经细胞膜电位的润滑油，维持细胞在高代谢负荷下的渗透压弹性与离子通道稳定性。"},{"id":"mech_paf_platelet","category_id":"vascular_endothelial","name":"血小板活化因子（PAF）拮抗与微循环流变优化","en_name":"PAF Antagonism & Microvascular Hemorheology","short_desc":"特异性占据血小板活化因子（PAF）受体，阻断血小板黏附聚集与微血栓形成，改善红细胞变形性并降低毛细血管异常通透性。","molecular_targets":["PAF 受体 (PTAFR)","红细胞变形能力","微血管痉挛解除","自由基微区清除"],"functional_significance":"改善大脑深层微血管灌注、内耳微循环（耳鸣/眩晕）及肢端微血流阻力障碍的核心药效靶点。"},{"id":"mech_mitophagy_pink1","category_id":"mitochondria_energy","name":"线粒体自噬（Mitophagy / PINK1-Parkin）特异诱导","en_name":"Selective Mitophagy & PINK1-Parkin Cascade","short_desc":"选择性标记受损、去极化或衰老的线粒体，激活 PINK1-Parkin 泛素化或 BNIP3L 途径，引导自噬溶酶体吞噬消化并驱动健康线粒体更新再生。","molecular_targets":["PINK1","Parkin E3 连接酶","BNIP3L/NIX","LC3-II 结合受体","溶酶体酸性水解酶"],"functional_significance":"解决衰老和代谢综合征中功能障碍线粒体堆积释放大量活性氧并诱发 NLRP3 炎症小体的核心质控靶点；只促生线粒体而不清除病态线粒体容易加剧细胞氧化损伤。"},{"id":"mech_telomerase_activation","category_id":"epigenetics_methylation","name":"端粒酶逆转录酶（TERT）轻度激活与端粒稳定","en_name":"Telomerase (TERT) Activation & Telomere Protection","short_desc":"适度促进 TERT 基因转录或激活端粒酶催化亚基，减缓造血干细胞、免疫 T/B 细胞和血管内皮细胞复制性衰老过程中的端粒缩短损耗。","molecular_targets":["hTERT (端粒酶逆转录酶)","TRF1/2 保护套复合体","Shelterin 复合体","Hayflick 极限调控"],"functional_significance":"维持免疫系统长期增殖能力与干细胞耗竭储备的关键分子杠杆，需严格平衡在生理激活区间，防止组织异常增生。"},{"id":"mech_joint_cartilage_ecm","category_id":"barrier_matrix","name":"关节软骨基质聚糖（GAGs/Aggrecan）修复与润滑","en_name":"Cartilage Proteoglycan Synthesis & Joint Lubrication","short_desc":"为软骨细胞提供氨基多糖与透明质酸合成原料，抑制基质金属蛋白酶（MMP-13 / ADAMTS-5）降解软骨细胞外基质，提升滑液黏弹度。","molecular_targets":["Aggrecan (聚集蛋白聚糖)","MMP-13","ADAMTS-5","CD44 受体","滑膜 B 细胞透明质酸合成酶"],"functional_significance":"与骨关节炎和运动造成的软骨磨损有关。补充剂对软骨结构的作用主要来自动物和细胞研究，人体中能否保护或修复软骨尚不明确。"},{"id":"mech_oral_immune_tolerance","category_id":"inflammation_immune","name":"黏膜口服免疫耐受（Peyer's 结 Treg 诱导）","en_name":"Mucosal Oral Tolerance & Treg Induction","short_desc":"小剂量完整三维构象抗原经小肠派氏结（Peyer's patches）与树突细胞接触，诱导抗原特异性调节性 T 细胞（Treg）分化，分泌 TGF-β 与 IL-10 抑制自身免疫攻击。","molecular_targets":["Peyer's Patches M 细胞","CD4+CD25+Foxp3+ Treg","TGF-β","IL-10","自身反应性 T 细胞克隆抑制"],"functional_significance":"不同于传统广谱免疫抑制剂，口服免疫耐受可在不降低全身抗感染能力的前提下，特异性给针对自身靶组织的自身免疫攻击踩刹车。"},{"id":"mech_glut4_insulin","category_id":"metabolism_longevity","name":"骨骼肌 GLUT4 转位与胰岛素敏感性","en_name":"Skeletal Muscle GLUT4 Translocation & Insulin Sensitivity","short_desc":"肌肉收缩可以不依赖胰岛素，把葡萄糖转运蛋白 GLUT4 送到细胞膜上摄取血糖；规律训练还会提高肌肉对胰岛素的反应。","molecular_targets":["GLUT4","AMPK / CaMKII","胰岛素受体信号（IRS-1 / Akt）"],"functional_significance":"肌肉是餐后血糖最大的去处。提高这条通路的效率，是改善胰岛素抵抗和餐后血糖波动最直接的办法。"},{"id":"mech_autonomic_vagal","category_id":"endocrine_hpa","name":"自主神经平衡与迷走神经张力","en_name":"Autonomic Balance & Vagal Tone","short_desc":"增强副交感（迷走）神经活动、降低交感神经兴奋，可从心率变异性（HRV）升高、静息心率和血压下降上观察到。","molecular_targets":["迷走神经 / 乙酰胆碱","压力感受器反射","交感神经-去甲肾上腺素"],"functional_significance":"自主神经长期偏向“战斗或逃跑”状态，与高血压、焦虑和睡眠变浅有关；把它拉回平衡，是许多身心练习起效的共同途径。"},{"id":"mech_sleep_homeostasis","category_id":"endocrine_hpa","name":"睡眠稳态压力与睡眠条件反射","en_name":"Sleep Homeostatic Drive & Sleep Conditioning","short_desc":"清醒时间越长，脑内腺苷等“睡眠压力”积累越多；同时大脑会把床和卧室与“睡着”或“清醒焦虑”建立条件联结。","molecular_targets":["腺苷 / A1–A2A 受体","睡眠-觉醒行为联结","过度觉醒（认知与生理）"],"functional_significance":"慢性失眠往往不是“缺某种物质”，而是睡眠压力不足、床与清醒形成了联结。调整卧床时间和睡前行为，是失眠认知行为疗法的核心。"},{"id":"mech_muscle_protein_synthesis","category_id":"metabolism_longevity","name":"机械负荷驱动的肌蛋白合成","en_name":"Load-Induced Muscle Protein Synthesis","short_desc":"肌肉承受足够的机械张力后，mTORC1 等信号被激活，肌纤维蛋白合成增加，长期表现为肌肉体积和力量增长。","molecular_targets":["mTORC1 / p70S6K","卫星细胞","肌原纤维蛋白"],"functional_significance":"肌肉量和力量是老年人行动能力、跌倒风险和代谢健康的重要决定因素，而机械负荷是维持它们最主要的信号。"},{"id":"mech_heat_shock","category_id":"metabolism_longevity","name":"热应激与热休克蛋白诱导","en_name":"Heat Stress & Heat Shock Protein Induction","short_desc":"短时间升高体温会诱导热休克蛋白（HSP）表达，并带来心率加快、血管扩张等类似中等强度运动的心血管反应。","molecular_targets":["HSF1","HSP70 / HSP90","血管内皮剪切力"],"functional_significance":"热休克蛋白帮助细胞修复和清理受损蛋白；反复的热暴露还可能改善血管功能，这是桑拿相关研究关注的主要机制。"},{"id":"mech_cold_thermogenesis","category_id":"metabolism_longevity","name":"冷暴露产热与冷适应","en_name":"Cold-Induced Thermogenesis & Cold Adaptation","short_desc":"寒冷刺激交感神经释放去甲肾上腺素，激活棕色脂肪中的 UCP1 产热，并在反复暴露后形成冷适应。","molecular_targets":["UCP1（棕色脂肪）","去甲肾上腺素 / β3 受体","寒战产热"],"functional_significance":"冷暴露会短时间提高能量消耗并带来强烈的应激反应；它对长期代谢和情绪的影响在人体上仍缺少可靠证据。"}],"supplements":[{"id":"supp_curcumin","name":"姜黄素 (Curcumin)","en_name":"Curcumin / Curcuminoids","aliases":["姜黄提取物","C3 Complex","Meriva 姜黄磷脂"],"summary":"姜黄素在细胞和动物实验中可影响 Nrf2、NF-κB 与 COX/5-LOX 等炎症通路，人体中常规口服剂量能否达到同样的分子效应尚未确证。","bioavailability_note":"纯姜黄素结晶的肠道吸收率很低，经肝脏首过后迅速葡萄糖醛酸化，口服后血浆中母体浓度通常很低。常用的改良方式包括胡椒碱复配、磷脂复合和纳米乳化剂型，但胡椒碱会影响多种药物的代谢和转运，不宜一概推荐联用。高吸收配方之间并不可互换，其暴露和肝损伤风险不能从普通姜黄素剂量直接推算。","typical_dose":"标准提取物 500-1500 mg/天（配合胡椒碱），或磷脂复合型 250-1000 mg/天","functional_synergies":["与萝卜硫素或 NAC 联用（理论推测）：理论上可在 Nrf2 转录激活与谷胱甘肽底物供应两方面形成互补，但姜黄素的 Nrf2 激活证据主要来自动物，人体结果不一致，常规口服剂量下的效应尚不确定。"],"contraindications":"活动性胆结石或胆道梗阻者禁用，姜黄素可促进胆囊收缩。服用华法林等抗凝药者需严密监测。已有姜黄或姜黄素补充剂相关肝损伤的病例报告，多见于高吸收配方，出现黄疸或转氨酶升高须立即停用。姜黄素可抑制非血红素铁的吸收，缺铁者需注意。胡椒碱复配产品可能改变多种药物的代谢和转运，服用处方药者应先咨询医生。","mechanisms":[{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"B","target_role":"primary","notes":"姜黄素在实验模型中可抑制 IKK 和 NF-κB 信号。晚期胰腺癌患者每日服用 8 g 后，外周血单核细胞 NF-κB 表达下降，但常规剂量下的直接靶点和细胞核内转录活性尚未证实。"},{"mechanism_id":"mech_nrf2_are","score":3,"evidence_grade":"C","target_role":"primary","notes":"姜黄素可在实验模型中修饰 Keap1 的关键半胱氨酸，促使 Nrf2 入核并上调 HO-1 等抗氧化酶。相关证据主要来自小鼠，人体结果不一致，游离母体暴露低，常规口服剂量下的通路激活尚不确定。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"姜黄素在体外可捕获部分自由基。口服后血浆中姜黄素及代谢物仅处于约纳摩尔量级，且内源抗氧化体系存在竞争，直接清除自由基在体内的贡献尚不明确。"},{"mechanism_id":"mech_cox_lox_inhibition","score":1,"evidence_grade":"D","target_role":"secondary","notes":"姜黄素在体外可抑制 COX 和 5-LOX，但所需浓度远高于口服后的血浆母体浓度。人体试验中 PGE2 生成下降，但这不能证明直接抑制了酶活性，人体中的直接酶抑制尚未确证。"},{"mechanism_id":"mech_hdac_inhibition","score":1,"evidence_grade":"D","target_role":"secondary","notes":"姜黄素在部分细胞模型中可抑制 HDAC 活性。现有机制证据主要来自细胞和小鼠实验，人体中检测到的是 HDAC 相关基因表达变化，并不等于酶活被抑制，常规口服后的体内直接抑制尚未确证。"}],"indications":[{"indication_id":"joint_pain","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"inflammation_markers","grade":"B","verdict":"benefit"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"},{"indication_id":"anxiety_stress","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"exercise_recovery","grade":"B","verdict":"mixed"}]},{"id":"supp_beta_glucan","name":"酵母/真菌 β-葡聚糖 (β-Glucan)","en_name":"Yeast Beta-(1,3/1,6)-D-Glucan","aliases":["酵母葡聚糖","真菌多糖","β-1,3/1,6-D-葡聚糖"],"summary":"酵母 β-葡聚糖可被 Dectin-1 受体识别，进而激活巨噬细胞和中性粒细胞。口服后人体内的信号激活与免疫训练仅有小样本的转录标志物证据，尚待验证。","bioavailability_note":"口服后不能假定完整多糖直接入血。动物研究提示部分颗粒可经肠道 M 细胞和淋巴组织递呈，这一转运途径依制剂和粒径而异，并非所有多糖都经由同一途径。","typical_dose":"100 - 500 mg/天（高纯度 β-1,3/1,6 支链酵母源）","functional_synergies":["与维生素 C、锌联用：理论上可增强中性粒细胞的趋化与吞噬，但 2014 年的一项人体随机先导研究未观察到明确的白细胞杀菌功能增强，属理论推测","与益生元复配：理论上可兼顾局部肠道屏障与全身免疫，缺乏直接人体数据（理论推测）"],"contraindications":"器官移植术后服用免疫抑制剂者慎用；急性严重自体免疫病爆发期需遵医嘱。","mechanisms":[{"mechanism_id":"mech_prr_immune","score":4,"evidence_grade":"B","target_role":"primary","notes":"酵母 β-葡聚糖可被 Dectin-1 识别，这是其核心机制。口服后人体内 Syk-CARD9 通路的激活和免疫训练尚待验证，一项 19 人的小型安慰剂对照试验仅测得部分相关转录本改变。"},{"mechanism_id":"mech_scfa_fermentation","score":2,"evidence_grade":"C","target_role":"substrate","notes":"部分酵母多糖在小鼠实验中可改变菌群及粪便短链脂肪酸，结果依制剂而异。一项人体探索性试验未观察到粪便短链脂肪酸显著变化，因此不宜将其视为稳定的产酸来源。"}],"indications":[{"indication_id":"colds","grade":"B","verdict":"benefit"},{"indication_id":"anxiety_stress","grade":"B","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"}]},{"id":"supp_sulforaphane","name":"萝卜硫素 (Sulforaphane)","en_name":"Sulforaphane (SFN)","aliases":["西兰花籽提取物","莱菔硫烷","Glucoraphanin + Myrosinase"],"summary":"萝卜硫素是经典的 Nrf2 通路诱导物，人体随机试验中可见靶酶 NQO1 增加。HDAC 和 NF-κB 方面的人体证据较弱，效应短暂且结果不一致。","bioavailability_note":"游离萝卜硫素不稳定，常温下易降解。萝卜硫苷需经活性黑芥子酶转化为萝卜硫素，转化程度取决于酶活性、剂型和个体菌群，因此标示的萝卜硫苷毫克数不能固定换算为实际暴露量。可选择含活性黑芥子酶的复合物，或微囊化的稳定游离萝卜硫素制剂。","typical_dose":"等效游离萝卜硫素 10–30 mg/天。若选用芥子苷制剂（需配合活性黑芥子酶），标示的 50–150 mg 芥子苷并不对应固定的萝卜硫素暴露量，应以产品说明和实际剂型为准。","functional_synergies":["与 NAC 联用（理论推测）：萝卜硫素可诱导 GCL 等 Nrf2 靶酶，NAC 提供 L-半胱氨酸原料，两者理论上可共同支持谷胱甘肽合成。"],"contraindications":"常规剂量下耐受性良好，高剂量可能引起胃肠不适；理论上十字花科硫代葡萄糖苷代谢产生的硫氰酸盐可竞争甲状腺碘摄取，但人体试验未见甲状腺功能改变，严重缺碘伴甲减者可留意。","mechanisms":[{"mechanism_id":"mech_nrf2_are","score":5,"evidence_grade":"A","target_role":"primary","notes":"萝卜硫素是经典的 Nrf2 通路诱导物，可上调 Nrf2 靶基因。一项人体随机双盲试验中，吸烟者鼻腔灌洗细胞的 NQO1 增加；应答幅度随组织、剂量和制剂变化，并不保证每个人都有同等反应。"},{"mechanism_id":"mech_hdac_inhibition","score":2,"evidence_grade":"B","target_role":"secondary","notes":"萝卜硫素的代谢产物在体外可抑制 HDAC。少量人体研究显示食用西兰花芽后单核细胞 HDAC 活性短时下降，但剂量反应不明确，效应持续时间和亚型选择性也不清楚。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"实验模型中，萝卜硫素可减少 NF-κB 与 DNA 的结合，这可能与 p65 的半胱氨酸修饰有关。人体中的具体修饰位点尚未确认，常规口服后也没有直接测得可靠的通路抑制。"}],"indications":[{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"C","verdict":"mixed"}]},{"id":"supp_berberine","name":"小檗碱 (Berberine / 黄连素)","en_name":"Berberine Hydrochloride","aliases":["黄连素","二氢小檗碱 (Dihydroberberine)"],"summary":"人体临床研究显示小檗碱可降低血糖和血脂，这一结局证据较为可靠。其分子机制多来自动物与细胞实验，例如 AMPK 激活，常规口服后靶组织内是否发生同样的激活尚未直接测得。","bioavailability_note":"小檗碱的肠道吸收有限，进入体循环的量很少，作用多集中在肠道局部和菌群。二氢小檗碱是另一种衍生物，并非小檗碱的同义词，其吸收和耐受性上的优势也不能推广到所有制剂。","typical_dose":"标准盐酸小檗碱 500 mg 每日 2-3 次（餐前或随餐）；二氢小檗碱 100-200 mg 每日 1-2 次","functional_synergies":["与水飞蓟宾联用：理论上可抑制 P-糖蛋白外排、提高小檗碱吸收，但吸收增加的幅度缺乏人体依据（理论推测）","与 α-硫辛酸联用：理论上可协同改善胰岛素敏感性，但缺乏人体协同证据（理论推测）"],"contraindications":"孕妇和哺乳期禁用，小檗碱可置换白蛋白结合的胆红素，有新生儿核黄疸风险。小檗碱可抑制 CYP3A4、CYP2D6、CYP2C9 及 P-糖蛋白，可能升高环孢素、他克莫司、部分他汀和地高辛等药物的血药浓度，相互作用程度因药物而异，服用处方药者须先咨询医生。与二甲双胍、胰岛素、磺脲类等降糖药合用有低血糖叠加风险。长期大剂量可能轻度改变肠道菌群平衡，目前缺乏充分的人体依据支持周期性循环使用。","mechanisms":[{"mechanism_id":"mech_ampk_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"小檗碱可轻度抑制线粒体呼吸链，使细胞内 AMP/ATP 比值升高，进而激活 AMPK。大鼠骨骼肌研究中观察到 AMPK 活化，但人体常规口服后靶组织内是否同样激活尚未直接测量，降糖结局本身也不能证明这一机制。"},{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"小檗碱在小鼠肠损伤模型和部分细胞模型中可改善上皮屏障，但屏障改善并不总伴随紧密连接蛋白总量的上调。人体效果及 MLCK 依赖性尚待验证，也缺乏肠活检的直接确认。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"小檗碱在动物和细胞炎症模型中可抑制 TLR4 与 NF-κB 信号，减少促炎因子释放。人体口服后的通路抑制尚未直接确证，体外加药的人体细胞实验也不等同于口服试验。"}],"indications":[{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"benefit"},{"indication_id":"triglycerides","grade":"B","verdict":"benefit"},{"indication_id":"ibs","grade":"B","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"benefit"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"pcos","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"}]},{"id":"supp_nac","name":"N-乙酰半胱氨酸 (NAC)","en_name":"N-Acetyl-L-Cysteine","aliases":["乙酰半胱氨酸","NAC"],"summary":"NAC 可提供半胱氨酸以支持谷胱甘肽合成，人体随机试验中可见细胞内 GSH 得到补充。对自由基的直接清除作用有限，溶解痰液的临床应用则较为成熟。","bioavailability_note":"NAC 口服生物利用度较低，约为 4–10%。它在小肠黏膜和肝脏中脱乙酰化为游离 L-半胱氨酸，再参与 GSH 合成。效果取决于组织和个体的基础状态，并不是每次服用都会等量提升细胞内 GSH。","typical_dose":"600 - 1800 mg/天，分次空腹或轻餐服用","functional_synergies":["与甘氨酸联用（GlyNAC）：两者都是 GSH 合成的底物，但半胱氨酸和甘氨酸并非在所有人中都同时限速，固定 1:1 比例及抗衰效果尚无确立标准（理论推测）","与硒联用：硒参与谷胱甘肽过氧化物酶（GPx）的活性中心，理论上可与 GSH 循环相配合，但缺乏直接的人体协同数据（理论推测）"],"contraindications":"活动性消化性溃疡慎用，NAC 的黏液溶解特性可能刺激胃壁。胃肠不适并非仅见于少数人，部分人服用后会有轻微不适。与硝酸甘油合用可增强其扩血管作用，导致低血压和剧烈头痛，合用须遵医嘱。","mechanisms":[{"mechanism_id":"mech_gsh_synthesis","score":5,"evidence_grade":"A","target_role":"substrate","notes":"NAC 脱乙酰化后提供半胱氨酸，在底物不足时支持 GSH 合成，这是其定义性作用。一项人体随机双盲试验中，HIV 感染者全血和 T 细胞的 GSH 得到补充，效果取决于组织和基础状态。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"A","target_role":"secondary","notes":"在特定的剧烈运动应激条件下，一项人体随机双盲交叉试验观察到骨骼肌 NF-κB 磷酸化减弱。这是特定应激下的次级作用，不代表 NAC 对炎症有普遍的抑制作用。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"NAC 的游离巯基在体外可与次氯酸等氧化剂直接反应，但对超氧阴离子的直接清除相对缓慢。常规口服后的浓度以及与内源抗氧化体系的竞争，使其直接清除自由基的体内贡献有限。"}],"indications":[{"indication_id":"male_fertility","grade":"B","verdict":"benefit"},{"indication_id":"pcos","grade":"B","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"}]},{"id":"supp_coq10","name":"辅酶 Q10 / 还原型泛醇 (CoQ10 / Ubiquinol)","en_name":"Coenzyme Q10 (Ubiquinol / Ubiquinone)","aliases":["泛醇","还原型辅酶Q10","Ubiquinol","Ubiquinone"],"summary":"CoQ10 是线粒体内膜呼吸链中连接复合体 I/II 与复合体 III 的关键脂溶性电子载体。CoQ10 缺乏的患者口服补充后有临床改善，但在组织本已充足的情况下，补充是否提升线粒体功能，目前尚无一致结论。","bioavailability_note":"泛醌（氧化型）吸收时不必先还原为泛醇。两种形式的相对吸收优势因制剂和研究设计而异，并不存在统一的倍数。","typical_dose":"泛醇 100 - 300 mg/天，随含油脂正餐服用","functional_synergies":["与 PQQ 联用（理论推测）：理论上 CoQ10 支持电子传递，PQQ 可能促进线粒体新生，二者作用于不同环节；但 PQQ 促进人体线粒体新生的证据不充分，两者的临床协同也未得到确证。","与 L-肉碱联用：理论上可协同支持心肌脂肪酸氧化，缺乏人体证据（理论推测）"],"contraindications":"化学结构与维生素 K 相似，可能减弱华法林抗凝效果（INR 下降），服用华法林者需监测 INR；可轻度降低血压与血糖，联用降压/降糖药者注意。","mechanisms":[{"mechanism_id":"mech_etc_carrier","score":4,"evidence_grade":"A","target_role":"substrate","notes":"CoQ10 是线粒体内膜中连接复合体 I/II 与复合体 III 的关键脂溶性电子载体，这一生化作用在人体中是确定的。外源补充并不必然提高已经充足的组织的线粒体含量或呼吸能力。"},{"mechanism_id":"mech_direct_ros","score":3,"evidence_grade":"B","target_role":"primary","notes":"还原型泛醇可在生物膜脂质相中直接截获脂质过氧自由基，化学基础明确，人体脂蛋白研究也支持这一作用。离体的氧化抵抗实验不能直接量化体内的自由基清除。"}],"indications":[{"indication_id":"migraine","grade":"B","verdict":"benefit"},{"indication_id":"fatigue","grade":"B","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"benefit"},{"indication_id":"male_fertility","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"mixed"}]},{"id":"supp_resveratrol","name":"白藜芦醇 (Trans-Resveratrol)","en_name":"Trans-Resveratrol","aliases":["反式白藜芦醇","虎杖提取物"],"summary":"白藜芦醇可在实验中影响 SIRT1、AMPK-PGC-1α 与 NF-κB 等通路。人体随机试验中 NF-κB 活性下降有一定证据，但 SIRT1 直接激活存在争议，线粒体新生和 Nrf2 相关作用的人体结果不一致。","bioavailability_note":"反式白藜芦醇是常见的活性构型，见光可异构化为顺式形式。顺式形式的活性和作用谱可能不同，不能简单视为失效。口服后可被吸收，但血液中主要是结合代谢物，未结合的母体药物全身暴露较低，组织间差异较大。","typical_dose":"微粉化反式白藜芦醇 250 - 500 mg/天（早晨随少许健康脂肪服用）","functional_synergies":["与 NMN 或 NR 联用：理论上 NAD+ 前体可为 SIRT1 提供底物，但两者联用能否增强人体 SIRT1 活性，缺乏充分的人体证据（理论推测）","与槲皮素联用：理论上可延长白藜芦醇的体内半衰期，但缺乏充分的人体证据（理论推测）"],"contraindications":"具有微弱植物雌激素性质，雌激素敏感型肿瘤患者需谨慎。可抑制 CYP3A4、CYP2C9 等肝药酶，人体探针研究还观察到 CYP2D6 抑制和 CYP1A2 诱导，药物相互作用应视为潜在风险，实际临床影响幅度尚不清楚。白藜芦醇具抗血小板聚集活性，与华法林、氯吡格雷等抗凝或抗血小板药合用可能增加出血风险，术前 1–2 周停用。高剂量（≥1 g/天）常见腹泻等胃肠反应。妊娠及哺乳期的安全性资料不足，相关人群应先咨询医生。较高剂量的人体试验（脂肪肝患者）中曾观察到转氨酶升高，不宜直接套用于常规剂量的安全判断。","mechanisms":[{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"A","target_role":"secondary","notes":"人体随机试验在常规剂量下观察到 NF-κB 活性下降，不同人群和指标的结果并不一致。这一作用的上游机制尚未确定，也不能据此证明 SIRT1 直接去乙酰化 NF-κB p65。"},{"mechanism_id":"mech_ampk_activation","score":2,"evidence_grade":"A","target_role":"secondary","notes":"一项人体随机交叉试验在 150 毫克/天后观察到肌肉 AMPK 活化，但另一项随机试验未能复现。这一作用可能是间接且依情境而定的弱效应。"},{"mechanism_id":"mech_sirtuin_activation","score":2,"evidence_grade":"B","target_role":"secondary","notes":"SIRT1 的直接变构激活因检测底物而异，结论仍有争议。人体中 SIRT1 蛋白可有增加，但蛋白增加不等于酶活增强。经磷酸二酯酶抑制等途径的间接作用，在人体常规剂量下证据也不足。"},{"mechanism_id":"mech_pgc1a_biogenesis","score":2,"evidence_grade":"B","target_role":"secondary","notes":"部分人体研究中 PGC-1α 蛋白有所升高，但线粒体含量未随之增加，呼吸功能的改变也不能单独证明线粒体新生。人体中由 SIRT1 介导的线粒体生物发生及其上游机制仍不确定。"},{"mechanism_id":"mech_nrf2_are","score":2,"evidence_grade":"B","target_role":"secondary","notes":"部分研究提示白藜芦醇有 Nrf2 相关反应，小型人体组织研究中 NQO1 有所改变，但作用路径和剂量依赖尚不明确。单用白藜芦醇的人体证据并不一致，SOD 或 Nrf2 基因表达变化也不足以单独证明 ARE 激活。"}],"indications":[{"indication_id":"joint_pain","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"}]},{"id":"supp_fisetin","name":"漆黄素 (Fisetin)","en_name":"Fisetin","aliases":["非瑟酮","黄栌提取物"],"summary":"漆黄素在细胞和部分高剂量小鼠模型中显示出清除衰老细胞的潜力，并可影响 mTOR、自噬与炎症相关指标。目前尚无可靠证据证明常规补充剂量能在人体中选择性清除衰老细胞。","bioavailability_note":"漆黄素脂溶性高、水溶性差，纯粉口服吸收通常较低。脂质体、纳米胶束或与葵花籽卵磷脂共溶的剂型可能改善吸收，但这一优势不能一概而论，应以具体产品的人体数据为准。","typical_dose":"常见补充剂量为 100–250 mg/天，但这一剂量并非已确立的有效或长期安全剂量。临床研究中使用的间歇性冲击方案（20 mg/kg 体重，连续 2–3 天，每月一次）属于研究方案，不宜作为日常用法。","functional_synergies":["与槲皮素联用（理论推测）：理论上两者可分别作用于衰老细胞的抗凋亡蛋白（BCL-2 / BCL-xL）相关通路，但漆黄素在人体中的选择性清除作用尚未确证。"],"contraindications":"服用华法林等抗凝药者需注意可能的代谢酶相互作用，但目前人体数据不足，应咨询医生并考虑监测。长期安全性资料同样不充分。","mechanisms":[{"mechanism_id":"mech_senolytic","score":3,"evidence_grade":"C","target_role":"primary","notes":"漆黄素在部分细胞模型和高剂量小鼠实验中显示出清除衰老细胞的潜力，部分脂肪组织的衰老标志有所减少。它在人体中的选择性清除作用尚未确证，动物实验剂量较高，不宜外推至常规补充剂量。"},{"mechanism_id":"mech_autophagy_mTOR","score":3,"evidence_grade":"C","target_role":"secondary","notes":"漆黄素在部分动物模型中改变了 mTOR 与自噬相关指标，作用方向依模型而异，个别细胞模型中自噬反而受抑。人体自噬通量以及 SIRT1 依赖性尚未确证。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"在部分动物炎症模型中，漆黄素可减少 p65 入核和 DNA 结合。SASP 中促炎因子的减少不能单独证明 NF-κB 被抑制，常规口服后人体靶通路的效应尚不明确。"}],"indications":[{"indication_id":"inflammation_markers","grade":"C","verdict":"mixed"},{"indication_id":"fatigue","grade":"C","verdict":"mixed"}]},{"id":"supp_spermidine","name":"亚精胺 (Spermidine)","en_name":"Spermidine","aliases":["小麦胚芽提取物","三盐酸亚精胺"],"summary":"亚精胺是天然存在的多胺，在细胞和动物实验中可促进自噬。人体随机试验中仅有特定淋巴细胞亚群的自噬通量增加，全身性自噬激活和抗衰老效果的人体证据尚不充分。","bioavailability_note":"小麦胚芽提取物是天然复合形态，合成的三盐酸盐纯度更高。小肠存在多胺转运系统，但口服后的利用程度随剂量、制剂和组织而异。一项人体药代试验中未见血浆亚精胺浓度显著升高，因此不宜笼统地认为口服吸收良好。","typical_dose":"等效纯亚精胺 1–6 mg/天。目前尚无统一的抗衰有效剂量。小麦胚芽提取物（约 500–1500 mg）的亚精胺含量差异较大，不能按固定比例换算。","functional_synergies":["与间歇性禁食（Intermittent Fasting）联用（理论推测）：两者理论上可通过不同途径促进细胞自噬，但亚精胺的全身性自噬激活证据有限，样本很小。"],"contraindications":"活动性恶性肿瘤确诊期患者建议暂停（部分恶性肿瘤细胞可能利用外源多胺快速分裂）。","mechanisms":[{"mechanism_id":"mech_autophagy_mTOR","score":3,"evidence_grade":"A","target_role":"primary","notes":"亚精胺可在模型中促进自噬。2026 年一项 40 人随机双盲先导试验中，6 mg/日使疫苗无应答者的特定淋巴细胞亚群自噬通量增加，T 细胞未见同样结果。样本很小，不能推定全身性的自噬激活，也不能证明直接抑制 mTORC1。"},{"mechanism_id":"mech_pgc1a_biogenesis","score":2,"evidence_grade":"C","target_role":"secondary","notes":"亚精胺可促进线粒体自噬，清除受损线粒体，动物和细胞模型中也可见 PGC-1α 相关变化。但线粒体自噬与生物发生是不同过程，人体中由此推导出的线粒体新生因果链尚未确证。"},{"mechanism_id":"mech_mitophagy_pink1","score":2,"evidence_grade":"C","target_role":"secondary","notes":"口服亚精胺的小鼠心脏线粒体自噬增强，说明这类作用在动物体内可以发生。PINK1/Parkin 通路的直接证据主要来自细胞实验，人体中尚未确证。"}],"indications":[{"indication_id":"hair_loss","grade":"C","verdict":"mixed"},{"indication_id":"memory","grade":"B","verdict":"no_benefit"}]},{"id":"supp_ashwagandha","name":"南非醉茄 (Ashwagandha)","en_name":"Ashwagandha (Withania somnifera)","aliases":["印度人参","KSM-66","Sensoril"],"summary":"南非醉茄是常用的适应原类草药，部分随机试验观察到受压人群血清皮质醇下降，幅度因制剂和人群而异。其对 CRH 和 GABA 相关通路的作用在人体中尚未确证。","bioavailability_note":"活性成分主要为醉茄内酯（Withanolides）。KSM-66（全根水提取物，含 5% 醉茄内酯）和 Sensoril（根叶复合，含 10% 醉茄糖苷）是两种常见的标准化产品。二者在抗压、促睾和镇静方面的差异缺少直接比较研究，不能仅凭产品名称判断其效果侧重。","typical_dose":"300 - 600 mg/天（标准化 5% 醉茄内酯）","functional_synergies":["与磷脂酰丝氨酸（PS）联用（理论推测）：两者理论上都可能减弱皮质醇应激反应，但对深睡眠结构的改善缺乏直接的人体证据。","与甘氨酸镁联用（理论推测）：理论上可能叠加与镇静相关的作用，但缺乏人体联用证据，活性成分在人体中的靶点尚未明确。"],"contraindications":"已有多例草药性肝损伤（DILI）报告，多在服用 2–12 周内出现胆汁淤积型黄疸和转氨酶升高。出现乏力、黄疸或尿色加深须立即停用，既往肝病者避免使用。孕妇禁用，哺乳期人群应避免使用或遵医嘱。甲状腺功能亢进或正在服用左甲状腺素者慎用，因其可升高 T4；自身免疫性甲状腺炎患者需注意。与苯二氮䓬类、巴比妥类等中枢镇静药或免疫抑制剂联用需谨慎。与降糖药、降压药及抗癫痫药合用也可能发生相互作用，需先咨询医生。","mechanisms":[{"mechanism_id":"mech_hpa_cortisol","score":4,"evidence_grade":"A","target_role":"primary","notes":"部分随机试验观察到慢性压力人群的血清皮质醇下降，但下降幅度依制剂和人群而异。这些试验直接测得了皮质醇变化，而下丘脑 CRH 被抑制的机制尚未确证。"},{"mechanism_id":"mech_steroid_shbg","score":3,"evidence_grade":"A","target_role":"secondary","notes":"部分男性随机试验测得睾酮升高，相关荟萃分析也提示这一趋势。但这些结果并不证明其直接作用于 SHBG 或 GnRH-LH 轴，SHBG 与性腺轴的因果机制仍不明确。"},{"mechanism_id":"mech_gaba_glutamate","score":3,"evidence_grade":"C","target_role":"secondary","notes":"提取物在部分动物模型中表现出与 GABA 相关的作用，人体中的活性成分与靶点尚未明确。人体中睡眠或压力的改善并不能证明 GABA-A 受体被占据，也不能等同于苯二氮䓬类的药理作用。"}],"indications":[{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"B","verdict":"benefit"},{"indication_id":"endurance","grade":"B","verdict":"benefit"},{"indication_id":"menopause","grade":"B","verdict":"benefit"},{"indication_id":"muscle_strength","grade":"B","verdict":"mixed"},{"indication_id":"testosterone","grade":"B","verdict":"mixed"}]},{"id":"supp_phosphatidylserine","name":"磷脂酰丝氨酸 (Phosphatidylserine / PS)","en_name":"Phosphatidylserine (PS)","aliases":["复合脑磷脂","PS 磷脂"],"summary":"磷脂酰丝氨酸是神经细胞膜的组成成分之一。小型试验显示，特定运动应激方案下皮质醇反应有所减弱，效果依方案而异；突触层面的人体证据尚不充分。","bioavailability_note":"常见来源为大豆或葵花籽卵磷脂提取物，脂溶性较好。口服后 PS 可在肠道被水解，完整分子能否穿过人体血脑屏障并整合进入突触膜，目前缺乏直接证据。","typical_dose":"用于认知支持的常见用量为 100–300 mg/天。文献中用于运动应激干预的剂量为 400–800 mg/天（晚间或训练前），但这并非已确立的通用降皮质醇方案，给药时间和不同制剂的效果尚不确定。","functional_synergies":["与 DHA / EPA 联用（理论推测）：PS 与 DHA、EPA 均为神经细胞膜的脂质成分，理论上可能共同影响膜的脂质环境，但 PS 能否整合进入突触膜尚缺乏直接的人体证据。","与 α-GPC 联用（理论推测）：两者理论上都可能与胆碱能神经传递相关，但人体突触层面的乙酰胆碱变化尚无可靠证据，认知层面的联合效果也缺乏直接验证。"],"contraindications":"极少数人在极高剂量下早晨服用可能会有困倦感，建议主要放傍晚服用。","mechanisms":[{"mechanism_id":"mech_hpa_cortisol","score":3,"evidence_grade":"A","target_role":"primary","notes":"部分随机试验直接测得运动应激后皮质醇反应有所下降，但样本较小，结果依运动方案而异。这些数据不足以推断其能防止海马水肿或退化，也不能推广到所有应激情境。"},{"mechanism_id":"mech_cholinergic","score":2,"evidence_grade":"C","target_role":"secondary","notes":"动物实验中，腹腔给予 PS 后老年大鼠皮层乙酰胆碱释放发生改变，但这一给药途径不同于常规口服。PS 本身也不是胆碱，人体突触层面的乙酰胆碱合成或释放是否增加，目前没有可靠证据。"}],"indications":[{"indication_id":"memory","grade":"B","verdict":"mixed"},{"indication_id":"attention","grade":"C","verdict":"mixed"}]},{"id":"supp_alpha_gpc","name":"α-GPC (甘油磷酰胆碱)","en_name":"L-Alpha Glycerylphosphorylcholine (Alpha-GPC)","aliases":["α-甘油磷酸胆碱","Alpha-GPC"],"summary":"α-GPC 是胆碱的前体化合物，可为乙酰胆碱合成提供胆碱。人体血浆游离胆碱增加有据，但突触层面的效应尚不明确，中枢作用的证据多来自动物研究。","bioavailability_note":"α-GPC 易吸潮水解，纯品需严格防潮。目前不能认定它是最高效穿越人体血脑屏障的胆碱来源，相对于酒石酸胆碱等其他胆碱来源的优势也缺乏充分证据，且无法保证不出现胃肠道不适或三甲胺异味。","typical_dose":"常见用量为 300–1200 mg/天，建议早晨或高强度脑力活动、训练前 30–45 分钟服用。欧洲食品安全局 2026 年评估的申报制剂最高为 203.7 mg/日，因此不能直接证明 300–1200 mg/日长期使用的安全性。","functional_synergies":["与石杉碱甲（Huperzine A）联用（理论推测）：α-GPC 可提供乙酰胆碱合成的胆碱原料，石杉碱甲理论上可抑制乙酰胆碱的水解，两者可能共同作用于胆碱能通路；但突触间隙乙酰胆碱是否因此增加，尚无直接的人体证据。"],"contraindications":"易失眠体质避免晚间服用。长期超大剂量需关注血浆 TMAO 水平。一项观察性队列研究发现 α-GPC 处方与中风风险相关，但存在混杂因素，不能据此认定因果关系。有心脑血管疾病病史者应先咨询医生。","mechanisms":[{"mechanism_id":"mech_cholinergic","score":4,"evidence_grade":"B","target_role":"substrate","notes":"α-GPC 水解后可提供胆碱，作为乙酰胆碱合成的原料。人体血浆游离胆碱增加支持其前体供应的作用，但尚不能由此直接推定突触间隙乙酰胆碱增加。中枢胆碱能作用的依据主要来自动物实验。"},{"mechanism_id":"mech_autonomic_vagal","score":2,"evidence_grade":"B","target_role":"secondary","notes":"12 名超重或肥胖女性的交叉随机试验：单次服用 1000 mg 后，静息时心率变异性的高频成分升高，冲刺运动后恢复更快。样本小，且只测了单次服用。"},{"mechanism_id":"mech_bdnf_ngf","score":2,"evidence_grade":"C","target_role":"secondary","notes":"高剂量动物实验中，口服 α-GPC 与海马 BDNF 表达增加相关。胆碱能兴奋与 BDNF 上调之间的因果路径尚未确证，人体中的作用也不清楚。"}],"indications":[{"indication_id":"cognitive_decline","grade":"B","verdict":"benefit"},{"indication_id":"attention","grade":"C","verdict":"mixed"},{"indication_id":"muscle_strength","grade":"C","verdict":"mixed"}]},{"id":"supp_theanine","name":"L-茶氨酸 (L-Theanine)","en_name":"L-Theanine","aliases":["茶氨酸","γ-谷氨酰乙胺"],"summary":"L-茶氨酸常用于放松与专注类补充，人体研究中可见放松相关的脑电与主观结局。它对 GABA 和谷氨酸的作用主要来自动物实验，受体层面的人体作用尚未确证。","bioavailability_note":"茶氨酸结构上与谷氨酰胺相近，口服后可被肠道吸收。它穿过血脑屏障并起效的具体时间，目前缺乏直接的人体证据。","typical_dose":"100 - 400 mg/天","functional_synergies":["与咖啡因以 2:1 比例联用（100 mg 咖啡因 + 200 mg 茶氨酸）：理论上可减轻咖啡因引起的心悸、震颤和焦虑，同时保留专注感。但这一组合不能保证消除这些反应，个体差异较大（理论推测）"],"contraindications":"低血压患者极高剂量下偶见血压略微下降，常规剂量下耐受性良好。","mechanisms":[{"mechanism_id":"mech_gaba_glutamate","score":3,"evidence_grade":"C","target_role":"secondary","notes":"茶氨酸结构与谷氨酸相近，动物实验中能改变脑内 GABA 和谷氨酸相关指标，但不同模型的结果方向不一。人体研究看到的是脑电 α 波增加和主观放松感，这些结局本身无法说明它具体作用于 GABA-A 还是 NMDA 受体。"},{"mechanism_id":"mech_monoamine","score":2,"evidence_grade":"C","target_role":"secondary","notes":"茶氨酸在动物研究中可改变脑区单胺含量及纹状体多巴胺释放，方向依模型和神经递质而异。人体中未见常规口服后中枢单胺释放的直接验证，这一作用的人体意义尚不清楚。"}],"indications":[{"indication_id":"sleep_quality","grade":"B","verdict":"benefit"},{"indication_id":"attention","grade":"B","verdict":"benefit"},{"indication_id":"sleep_onset","grade":"B","verdict":"mixed"},{"indication_id":"anxiety_stress","grade":"B","verdict":"mixed"}]},{"id":"supp_citrulline","name":"L-瓜氨酸 (L-Citrulline)","en_name":"L-Citrulline / Citrulline Malate","aliases":["瓜氨酸","瓜氨酸苹果酸盐"],"summary":"L-瓜氨酸可在体内转化为精氨酸，为一氧化氮合成提供间接底物。人体试验测得血浆精氨酸和一氧化氮相关指标上升，但对 eNOS 功能的实际改善尚未直接证明。","bioavailability_note":"与直接口服 L-精氨酸相比，瓜氨酸带来的血浆精氨酸暴露优势取决于剂量和制剂，并不必然表现为峰值高出数倍。胃肠不良反应仍可能发生。","typical_dose":"纯 L-瓜氨酸 3–6 克/天。瓜氨酸苹果酸盐常见用量为 6–8 克/天，但标示比例（常为 2:1）和实际瓜氨酸含量因产品而异，不能将复合物的总重量直接等同于瓜氨酸剂量。","functional_synergies":["与葡萄籽提取物（原花青素 OPC）联用（理论推测）：理论上原花青素可激活 eNOS 磷酸化，瓜氨酸提供精氨酸原料，两者可能共同支持一氧化氮的生成，但联用效果缺乏人体证据。"],"contraindications":"正在服用处方磷酸二酯酶-5（PDE5）抑制剂（如他达拉非、西地那非）者注意协同降压。","mechanisms":[{"mechanism_id":"mech_enos_no","score":4,"evidence_grade":"A","target_role":"substrate","notes":"瓜氨酸经精氨酰琥珀酸合成酶（ASS）等步骤转化为精氨酸，为一氧化氮合酶提供间接底物。人体随机交叉试验测得血浆精氨酸、尿硝酸盐和 cGMP 升高，这支持 NO 相关信号增强，但不能单独证明 eNOS 解偶联得到纠正。"}],"indications":[{"indication_id":"blood_pressure","grade":"B","verdict":"benefit"},{"indication_id":"erectile_function","grade":"C","verdict":"benefit"},{"indication_id":"endurance","grade":"B","verdict":"mixed"},{"indication_id":"exercise_recovery","grade":"B","verdict":"mixed"},{"indication_id":"muscle_strength","grade":"B","verdict":"no_benefit"}]},{"id":"supp_astaxanthin","name":"天然虾青素 (Astaxanthin)","en_name":"Natural Astaxanthin","aliases":["雨生红球藻提取物","虾青素"],"summary":"虾青素是脂溶性类胡萝卜素，在体外可猝灭单线态氧，效力随实验体系而异。人体中氧化损伤指标的变化不能直接说明其清除自由基的作用，常规剂量下的相对贡献尚未确定。","bioavailability_note":"虾青素是脂溶性类胡萝卜素，随含脂肪的餐食服用通常有助于吸收。橄榄油、牛油果或 Omega-3 等脂肪来源均可，并非必须是某一种。空腹服用的吸收程度通常较低。","typical_dose":"4 - 12 mg/天，随餐服用","functional_synergies":["与叶黄素、玉米黄质联用（理论推测）：三者均为脂溶性类胡萝卜素，理论上可在视网膜黄斑区及脉络膜微血管中共同发挥抗氧化作用，但虾青素对体内自由基清除的相对贡献尚未确定，联用效果缺乏直接的人体证据。"],"contraindications":"常规剂量下短期耐受性较好。极高剂量长期服用时，皮肤可能出现轻微发红。长期安全性数据有限，孕期和哺乳期的资料也不足，相关人群应先咨询医生。","mechanisms":[{"mechanism_id":"mech_direct_ros","score":3,"evidence_grade":"D","target_role":"primary","notes":"虾青素在体外可猝灭单线态氧，其效力受实验体系影响。人体中氧化损伤指标的变化不是直接猝灭的特异性证据，常规剂量下它对体内自由基清除的相对贡献尚未确定。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"在糖尿病大鼠和巨噬细胞实验中，虾青素可降低 NF-κB 相关信号。常规口服剂量下能否在人体中直接抑制 NF-κB 活性，目前尚无可靠证据。"}],"indications":[{"indication_id":"male_fertility","grade":"C","verdict":"benefit"},{"indication_id":"skin_aging","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"no_benefit"}]},{"id":"supp_quercetin","name":"槲皮素 (Quercetin)","en_name":"Quercetin Dihydrate / Phytosome","aliases":["洋葱素","槲皮素磷脂复合物"],"summary":"槲皮素在实验模型中可抑制肥大细胞脱颗粒，并影响 NF-κB 与 SIRT1 相关信号。人体中的相关证据有限，单药清除衰老细胞的作用尚未确立。","bioavailability_note":"槲皮素二水合物的口服吸收率很低，具体数值依研究而异。磷脂复合物的吸收优势约为 20 倍，该数字来自特定比较并针对总槲皮素暴露，不等同于游离活性原形药增加 20 倍。","typical_dose":"磷脂型 250 - 500 mg/天，普通型 500 - 1000 mg/天（随餐配脂质）","functional_synergies":["与锌联用：槲皮素作为锌离子载体阻断病毒复制的说法主要是体外假设，常规口服与锌联用后在人体中是否产生该作用尚未证实（理论推测）","与维生素 C 联用：理论上可减少槲皮素的提前氧化，缺乏人体证据（理论推测）"],"contraindications":"严重肾损伤慎用。体外实验显示槲皮素可能抑制 CYP3A4，但这不能直接推断临床上的相互作用程度，合用处方药时应逐一核对具体药物。","mechanisms":[{"mechanism_id":"mech_mast_cell","score":3,"evidence_grade":"C","target_role":"primary","notes":"槲皮素可在实验模型中抑制肥大细胞脱颗粒，减少组胺释放。人体试验中部分过敏症状有所改善，但未能直接确证人体肥大细胞的稳定作用，症状变化也不能替代机制测量。"},{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"C","target_role":"secondary","notes":"槲皮素在部分动物和细胞模型中可抑制 NF-κB 信号，减弱 p65 核转位。常规口服后循环中主要为结合型代谢物，人体中 p65 核转位是否受阻尚无直接证据。"},{"mechanism_id":"mech_sirtuin_activation","score":1,"evidence_grade":"C","target_role":"secondary","notes":"动物模型提示槲皮素可能间接调节 SIRT1，但直接变构激活 SIRT1 的说法存在检测方法和底物依赖的争议。人体常规剂量下的作用尚未证实。"},{"mechanism_id":"mech_senolytic","score":1,"evidence_grade":"D","target_role":"secondary","notes":"与达沙替尼联用清除衰老细胞的研究仍处于探索阶段，结果不能归因于槲皮素单药。槲皮素单药的选择性清除作用主要来自细胞实验，尚未确立。"}],"indications":[{"indication_id":"allergic_rhinitis","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"endurance","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"},{"indication_id":"colds","grade":"B","verdict":"no_benefit"}]},{"id":"supp_5_mthf","name":"活性甲基叶酸 (L-5-MTHF)","en_name":"L-5-Methyltetrahydrofolate (5-MTHF)","aliases":["Quatrefolic","左旋甲基叶酸","活性叶酸"],"summary":"5-MTHF 是可直接利用的活性叶酸形式，参与同型半胱氨酸的再甲基化。人体随机试验显示其可降低血浆同型半胱氨酸，对 SAMe/SAH 比值和 DNA 甲基化的影响尚未得到直接证实。","bioavailability_note":"普通合成叶酸需经 DHFR 和 MTHFR 等酶多步还原后才能成为活性形式。MTHFR C677T 多态性并不意味着无法利用叶酸，循环中未代谢叶酸的增加也不能简单归因于这一变异。5-MTHF 是已还原的活性形式，可直接参与代谢。","typical_dose":"以 DFE 计 400–1000 mcg/天，可根据同型半胱氨酸水平调整。制剂标示的 5-MTHF 微克数与 DFE 换算值并不相同，不能不经换算直接互用。","functional_synergies":["与甲钴胺（甲基 B12）联用：甲硫氨酸合成酶（MS）必需依赖甲基 B12 才能完成 5-MTHF 的甲基接力","与 TMG（甜菜碱）联用（理论推测）：甜菜碱可提供另一条甲基供体途径，理论上可与 5-MTHF 的再甲基化途径互为补充，但二者联用的直接人体证据尚缺。"],"contraindications":"未确诊 B12 缺乏者单用大剂量叶酸，可能纠正贫血而掩盖恶性贫血的神经系统退行病变，延误神经损伤的识别。使用前应评估 B12 状态。并非所有使用者都需要同时补充 B12，但未确诊的 B12 缺乏者不应单用大剂量叶酸。","mechanisms":[{"mechanism_id":"mech_methylation_sam","score":5,"evidence_grade":"A","target_role":"substrate","notes":"5-MTHF 为甲硫氨酸合成酶提供甲基，该酶依赖维生素 B12，参与同型半胱氨酸的再甲基化，这是其定义性的底物作用。随机对照试验显示补充后血浆同型半胱氨酸下降，但实际反应仍受叶酸和 B12 状态及其他代谢途径的限制。"}],"indications":[{"indication_id":"b12_folate_deficiency","grade":"B","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"mixed"}]},{"id":"supp_magnesium_threonate","name":"苏糖酸镁 (Magnesium L-Threonate)","en_name":"Magnesium L-Threonate (Magtein)","aliases":["苏糖酸镁","Magtein","脑镁"],"summary":"苏糖酸镁是一种旨在提高脑内镁水平的镁盐制剂。镁对 NMDA 受体通道的生理性阻滞已确立，但该制剂在人脑中的增效作用及突触可塑性改善，目前主要来自动物研究。","bioavailability_note":"L-苏糖酸经葡萄糖转运蛋白携带镁跨越血脑屏障的说法缺乏可靠的人体证据，其脑脊液升镁效果是否优于等元素镁剂量的其他制剂，也尚无人体数据支持。","typical_dose":"1000–2000 mg/天（提供元素镁约 72–144 mg），常于午后或睡前 1 小时服用。","functional_synergies":["与 L-茶氨酸联用：两者都与神经兴奋性的调节有关，但联用能否改善深睡眠纺锤波，缺乏可靠的临床证据（理论推测）","与猴头菇联用：理论上可支持神经突触再生，缺乏直接的人体数据（理论推测）"],"contraindications":"肾功能不全者需遵医嘱限制高镁补充。初期个别人可能在入眠时出现多梦。镁可降低四环素类、氟喹诺酮类及口服双膦酸盐等药物的吸收，应按具体药品说明分开服用。","mechanisms":[{"mechanism_id":"mech_gaba_glutamate","score":3,"evidence_grade":"C","target_role":"primary","notes":"镁离子以电压依赖方式阻滞 NMDA 受体通道，这一生理现象是确立的。但该口服制剂能否在人脑中增强这种阻滞、从而防止兴奋毒性，直接证据不足，动物机制也不能直接外推至常规人体剂量。"},{"mechanism_id":"mech_bdnf_ngf","score":3,"evidence_grade":"C","target_role":"secondary","notes":"在部分大鼠模型中，苏糖酸镁可提高 BDNF 表达和突触标志物水平，人体中是否出现同样变化尚待验证。目前没有可靠证据证明常规剂量能在人脑中产生同等改变。"},{"mechanism_id":"mech_autonomic_vagal","score":2,"evidence_grade":"B","target_role":"secondary","notes":"100 名对睡眠不满意的成人随机试验：每天 2 g、6 周后，可穿戴设备测得的夜间 RMSSD 比安慰剂组略高。这是探索性指标，需要更多研究确认。"}],"indications":[{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"},{"indication_id":"memory","grade":"B","verdict":"mixed"}]},{"id":"supp_sodium_butyrate","name":"丁酸钠 / 丁酸甘油酯 (Sodium Butyrate / Tributyrin)","en_name":"Sodium Butyrate / Tributyrin","aliases":["丁酸盐","三丁酸甘油酯","Postbiotic Butyrate"],"summary":"丁酸是结肠上皮细胞的重要能量底物，在动物模型中可调节紧密连接蛋白，实验中也可抑制 HDAC 并促进部分调节性 T 细胞分化。常规口服制剂能否在人体结肠达到有效浓度，目前尚不确定。","bioavailability_note":"普通丁酸钠气味刺鼻，在上消化道即可被吸收，结肠中的递送量并不明确。肠溶微囊和三丁酸甘油酯是常见的改良形式，但三丁酸甘油酯可被胃和胰脂肪酶水解，不能保证直达远端结肠，各产品的释放位置也需逐一验证。不同盐类、包埋制剂和甘油酯的标示重量不能直接视为等量的丁酸。","typical_dose":"肠溶微囊丁酸钠常见用量为 500–1500 mg/天，三丁酸甘油酯常见用量为 500–1000 mg/天。各产品的标示重量并不等同于相同的丁酸量，这些数字仅供参考，应以产品说明的丁酸含量为准。","functional_synergies":["与谷氨酰胺（Glutamine）联用（理论推测）：谷氨酰胺可为小肠黏膜提供营养，丁酸可为结肠上皮提供燃料，理论上两者可共同支持肠道屏障，但丁酸在人体结肠的递送量尚不确定，联用效果缺乏人体证据。"],"contraindications":"肠易激综合征（IBS）严重发作期个别人需小剂量递增耐受。","mechanisms":[{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"丁酸是结肠上皮细胞的重要燃料，在烫伤小鼠等动物模型中可减轻肠通透性增加及紧密连接蛋白异常。常规口服制剂在人体结肠的递送量，以及 ZO-1、Occludin 的人体反应，尚未确立。"},{"mechanism_id":"mech_hdac_inhibition","score":3,"evidence_grade":"C","target_role":"primary","notes":"丁酸在部分实验模型中可抑制 HDAC，并促进部分调节性 T 细胞分化。HDAC 抑制及 Foxp3 相关乙酰化的依据来自动物和体外实验，常规口服制剂能否在人体靶组织达到有效浓度尚不确定。"},{"mechanism_id":"mech_scfa_fermentation","score":3,"evidence_grade":"C","target_role":"primary","notes":"外源丁酸可作为上皮燃料，动物实验提示其肠黏膜保护作用与 GPR109A 相关。常规口服制剂能否在人体结肠激活 GPR41 和 GPR43，目前没有直接证据，效应也取决于制剂。"}],"indications":[{"indication_id":"ibs","grade":"B","verdict":"benefit"},{"indication_id":"diarrhea","grade":"C","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"},{"indication_id":"body_weight","grade":"C","verdict":"mixed"}]},{"id":"supp_lions_mane","name":"猴头菇提取物 (Lion's Mane)","en_name":"Lion's Mane (Hericium erinaceus)","aliases":["猴头菌提取物","Hericenones / Erinacines"],"summary":"猴头菇提取物在部分动物和细胞实验中可调节 NGF 和 BDNF 水平，但成分与提取部位差异大。人体中的神经营养因子变化尚未确证，认知结局也不能据此推断脑内机制。","bioavailability_note":"水提取物富含 β-葡聚糖类多糖，醇提取物富含脂溶性成分。子实体与菌丝体的成分不同，双提取产品也不能保证含有足够剂量的有效成分，更不能据此断定其在人脑中有效穿透血脑屏障。选购时应查看产品标示的提取方式和有效成分含量。","typical_dose":"双提取物 500 - 1500 mg/天（标准化含猴头素或菌丝体提取物）","functional_synergies":["与胞磷胆碱（CDP-Choline）或 α-GPC 联用（理论推测）：猴头菇成分理论上可能通过神经营养因子促进突触新生，胆碱前体则为乙酰胆碱合成提供原料，但这一组合在人体中的作用尚未确证。"],"contraindications":"对真菌菌菇严重过敏者禁用，有菌菇过敏史者应避免使用。长期使用、孕期及哺乳期的安全性数据不足，相关人群应避免使用或先咨询医生。","mechanisms":[{"mechanism_id":"mech_bdnf_ngf","score":3,"evidence_grade":"C","target_role":"primary","notes":"猴头菇成分在部分动物和细胞模型中可调节 NGF 与 BDNF 表达。高效穿透人体血脑屏障及明确激活 TrkA 的说法尚未确证；神经营养因子的变化主要来自动物和细胞数据，人体中的作用尚不清楚。"},{"mechanism_id":"mech_prr_immune","score":2,"evidence_grade":"D","target_role":"secondary","notes":"猴头菇多糖在细胞实验中可调节 PRR 相关信号，作用依多糖结构而异。该补充剂口服后是否激活特定受体，尚无人体或明确动物机制的验证。"}],"indications":[{"indication_id":"cognitive_decline","grade":"C","verdict":"mixed"},{"indication_id":"attention","grade":"C","verdict":"mixed"},{"indication_id":"anxiety_stress","grade":"C","verdict":"mixed"}]},{"id":"supp_omega3_spm","name":"高浓缩 Omega-3 (EPA/DHA / SPM 前体)","en_name":"High-Concentrate Omega-3 (EPA / DHA)","aliases":["深海鱼油","rTG 鱼油","促消退介质前体"],"summary":"EPA 和 DHA 每天 2–4 g 可使甘油三酯下降约 20–30%，这一点有大量随机试验支持。它们也是炎症消退介质（SPMs）的前体，但人体内各类促消退介质的变化并不一致，对炎症消退功能的实际影响仍不明确。","bioavailability_note":"重酯化甘油三酯型（rTG）相比乙酯型（EE）的吸收优势受餐食、剂量和研究设计影响，不宜概括为固定的百分比，鱼腥反流的程度也因人而异。鱼油易氧化哈败，购买和保存时可参考产品的 TOTOX 氧化值。","typical_dose":"每日提供纯 EPA + DHA 1500 - 3000 mg，随高脂正餐服用","functional_synergies":["与天然虾青素联用（理论推测）：虾青素的抗氧化特性理论上可能减缓鱼油中多不饱和脂肪酸的氧化，但其在体内清除自由基的相对贡献尚未确定。"],"contraindications":"大剂量（每天超过 4 g）具有轻度抗血小板聚集活性。重大手术前是否需要暂停，应结合出血风险和具体手术由医生评估，并非所有手术前都需一律停用。正在服用抗凝药者需监测，高剂量纯 EPA 使用者手术前同样需要评估。高剂量 Omega-3 的随机试验中观察到房颤风险增加，服用者应评估剂量和自身心血管风险。","mechanisms":[{"mechanism_id":"mech_spm_resolution","score":4,"evidence_grade":"A","target_role":"substrate","notes":"EPA 是 E 系列消退素的前体，DHA 是 D 系列消退素、保护素等介质的前体，二者为炎症消退介质的代谢原料。人体随机研究可测得部分促消退脂质介质的变化，但不同介质的变化及其对炎症消退功能的影响并不一致。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"B","target_role":"secondary","notes":"Omega-3 可调节 FFAR4 受体及下游炎症信号。小型人体研究中测得了上游受体和相关基因的变化，但完整的 GPR120 到 NF-κB 抑制链条尚未在人体中得到证明，NF-κB 核转位是否受抑也未直接确证。"},{"mechanism_id":"mech_autonomic_vagal","score":2,"evidence_grade":"B","target_role":"secondary","notes":"随机试验的荟萃分析显示，鱼油可小幅提高心率变异性中反映迷走神经的高频成分，但 RMSSD 没有变化；超重成人每天约 2 g EPA+DHA 的试验结果为阳性，透析患者的试验则为阴性。整体作用较小。"}],"indications":[{"indication_id":"triglycerides","grade":"A","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"A","verdict":"benefit"},{"indication_id":"cardiovascular_events","grade":"A","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"},{"indication_id":"falls","grade":"B","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"A","verdict":"no_benefit"},{"indication_id":"blood_glucose","grade":"A","verdict":"no_benefit"},{"indication_id":"all_cause_mortality","grade":"A","verdict":"no_benefit"},{"indication_id":"eye_health","grade":"B","verdict":"no_benefit"}]},{"id":"supp_dim","name":"二吲哚基甲烷 (DIM)","en_name":"Diindolylmethane (DIM)","aliases":["DIM","十字花科植物提取物"],"summary":"DIM 可改变尿液中雌激素代谢物的比值，人体随机试验中可测得 2/16α-羟基雌酮比值上升。这一比值变化的临床意义尚不明确，能否代表特定酶途径的诱导或健康获益，目前也无法确定。","bioavailability_note":"纯 DIM 单体难溶于水，口服暴露通常较低。生物强化型复合制剂（如 BioResponse DIM，以维生素 E、磷脂和聚乙二醇微囊化）可能改善暴露，但不同产品之间不可互换，也不能概括为所有普通制剂的吸收率都极低。","typical_dose":"强化生物利用度型 DIM 100 - 200 mg/天，随餐服用","functional_synergies":["与 D-葡萄糖二酸钙（CDG）联用（理论推测）：DIM 可使尿液中 2-羟基雌酮与 16α-羟基雌酮的比值上升，CDG 理论上可能抑制肠道葡萄糖醛酸酶；但二者联用的人体证据尚缺，代谢物比值变化的临床意义也不明确。"],"contraindications":"雌二醇过低者不宜大剂量使用。备孕女性及孕期、哺乳期应在医生指导下使用。正在使用他莫昔芬者需注意：一项随机试验中 DIM 降低了部分他莫昔芬活性代谢物的浓度，临床后果尚不确定，应先咨询医生。","mechanisms":[{"mechanism_id":"mech_estrogen_detox","score":3,"evidence_grade":"A","target_role":"primary","notes":"DIM 可提高尿液中 2-羟基雌酮与 16α-羟基雌酮的比值。这一代谢物比值的改变不能单独证明具体的酶途径、癌症风险下降或临床解毒获益，其意义尚不明确。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"DIM 在细胞和小鼠实验中可抑制 NF-κB 活化并减轻脑部炎症，动物肺组织中也见到相关通路变化。常规口服 DIM 后人体 NF-κB 活性是否改变，目前没有可靠的试验直接证明。"}],"indications":[]},{"id":"supp_nmn","name":"NMN (烟酰胺单核苷酸)","en_name":"β-Nicotinamide Mononucleotide (NMN)","aliases":["NMN","β-NMN","NAD+ 前体"],"summary":"NMN 是 NAD+ 的直接前体，人体随机试验证实口服后血液 NAD+ 水平升高。它能否在靶组织中带动 Sirtuin 与 PGC-1α 通路，人体中尚未确证，长期获益的数据也很有限。","bioavailability_note":"人体 RCT 证实口服 250-1000 mg/天可升高血液 NAD+ 水平，但骨骼肌 NAD+ 是否随之升高结果不一。口服后相当部分在肠道被 CD73 去磷酸化为 NR、或经菌群转化为烟酰胺后再吸收；小鼠研究提出 Slc12a8 为 NMN 特异转运体，但该结论存在争议、人体中未证实。舌下含服可“绕过 CD38”优于胶囊的说法缺乏可靠证据。","typical_dose":"250 - 1000 mg/天，早晨服用（与白藜芦醇同服的协同作用尚未确立）。","functional_synergies":["与白藜芦醇联用（理论推测）：白藜芦醇直接激活 SIRT1 的说法存在争议，两者联用的人体协同效果尚未确立。","与芹菜素联用（理论推测）：芹菜素能否在人体内抑制 CD38、减少 NAD+ 分解，尚未确立。","与 TMG 联用（理论推测）：常规补充 NMN 时联用 TMG 以防止甲基耗竭，缺乏可靠的临床证据支持。"],"contraindications":"恶性肿瘤活动期建议暂停，因为活跃的肿瘤细胞也可能利用 NAD+，但这一风险目前仍不明确。孕妇和哺乳期人群不建议使用。长期安全性尚无充分的人体数据。","mechanisms":[{"mechanism_id":"mech_nad_salvage","score":5,"evidence_grade":"A","target_role":"substrate","notes":"NMN 经 NMNAT1-3 催化直接生成 NAD+，是 NAD+ 合成的关键前体。人体随机试验显示口服后血液 NAD+ 升高，但不同组织和细胞区室的反应并不一致，骨骼肌中的结果也不统一。"},{"mechanism_id":"mech_glut4_insulin","score":3,"evidence_grade":"B","target_role":"secondary","notes":"一项随机对照试验（25 名超重、糖尿病前期的绝经后女性）：每天 250 mg、10 周后，钳夹试验测得的肌肉胰岛素敏感性提高，肌肉 AKT 磷酸化增加。目前只有这一项研究，其他人群尚待验证。"},{"mechanism_id":"mech_sirtuin_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"NAD+ 是 Sirtuin 去乙酰化反应的必需辅底物，NAD+ 增加在理论上有利于 SIRT 活性。但补充前体并不必然提高酶活性，小鼠实验中观察到了 SIRT3 依赖的蛋白去乙酰化，人体口服 NMN 后的直接证据尚缺。"},{"mechanism_id":"mech_pgc1a_biogenesis","score":2,"evidence_grade":"C","target_role":"secondary","notes":"NMN 理论上可经 SIRT1 去乙酰化激活 PGC-1α。SIRT3 缺失小鼠的心肌中，NMN 使 PGC-1α、TFAM 等蛋白增加，但人体血液 NAD+ 升高并不能说明线粒体数量增加，人体线粒体新生尚未确证。"}],"indications":[{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"endurance","grade":"C","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"C","verdict":"mixed"},{"indication_id":"fatigue","grade":"C","verdict":"mixed"}]},{"id":"supp_nr","name":"NR (烟酰胺核糖)","en_name":"Nicotinamide Riboside (NR / Niagen)","aliases":["Niagen","氯化烟酰胺核糖","NR"],"summary":"NR 经 NRK1/2 磷酸化生成 NMN，再转化为 NAD+。人体随机试验显示口服后全血 NAD+ 明显升高，但 SIRT3 相关机制主要来自动物实验，长期安全性和抗衰获益也缺乏人体证据。","bioavailability_note":"NR 水溶性良好，口服后可经小肠吸收，并通过 NRK1/2 磷酸化生成 NMN；部分 NR 在循环中转化为烟酰胺（NAM），再进入 NAD 代谢。水溶性并不等同于小肠吸收率极高，但人体试验已显示口服后血液 NAD+ 明显升高。","typical_dose":"300 - 1000 mg/天，早晨服用","functional_synergies":["与紫檀芪联用（理论推测）：两者在去乙酰化酶与线粒体相关通路上的协同效果，在人体中尚未确立。"],"contraindications":"极少数个体有轻微头痛或兴奋感，建议避免睡前服用。短期试验中耐受性尚可，但长期服用的安全性尚无充分的人体数据。","mechanisms":[{"mechanism_id":"mech_nad_salvage","score":5,"evidence_grade":"A","target_role":"substrate","notes":"NR 经 NRK1/NRK2 磷酸化生成 NMN，再转化为 NAD+。人体随机试验中，每天 100、300、1000 mg 分别使全血 NAD+ 平均增加约 22%、51%、142%。这一结果来自血液，不同组织中的增幅有所差异。"},{"mechanism_id":"mech_sirtuin_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"NR 提供的 NAD+ 是 Sirtuin 反应的必需底物，理论上可驱动 SIRT3 去乙酰化，进而激活线粒体抗氧化酶 SOD2。这一链条主要来自动物和细胞实验。人体血液 NAD+ 升高并不能证明组织中的 SIRT3 活性同步提高。"}],"indications":[{"indication_id":"cognitive_decline","grade":"C","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"},{"indication_id":"body_weight","grade":"C","verdict":"mixed"}]},{"id":"supp_pqq","name":"PQQ (吡咯喹啉醌)","en_name":"Pyrroloquinoline Quinone (PQQ / BioPQQ)","aliases":["吡咯喹啉醌二钠盐","BioPQQ","PQQ"],"summary":"PQQ 在细胞和小鼠实验中可激活 CREB 与 PGC-1α，使线粒体相关指标上升。常规口服后血清浓度仅为纳摩尔级，人体中的线粒体新生和直接清除自由基作用均未确证。","bioavailability_note":"PQQ 纯品为二钠盐形态，水溶性良好，但这并不能说明 BioPQQ 等发酵来源的构象更稳定。约 0.2 mg/kg 口服后，人体血清峰浓度约为纳摩尔级（FDA 数据摘要报告约 9 nM），尚不能证明微量口服即可产生显著的人体线粒体效应。","typical_dose":"10 - 20 mg/天，晨起随水或轻食服用","functional_synergies":["与辅酶 Q10 联用（理论推测）：两者分别作用于线粒体数量与线粒体内的电子传递，但联用能否增加人体线粒体数量，尚未确证。","与猴头菇联用（理论推测）：两者联用能否增强 BDNF 释放，目前缺乏人体协同证据。"],"contraindications":"长期安全性仍需研究。过高剂量（超过 40 mg）可能造成短暂的神经兴奋感，但目前缺乏可靠的剂量阈值证据，不能确定 40 mg 即为界限。","mechanisms":[{"mechanism_id":"mech_pgc1a_biogenesis","score":3,"evidence_grade":"C","target_role":"secondary","notes":"PQQ 可激活 CREB 磷酸化，上调 PGC-1α 与 TFAM，推动线粒体生成。细胞实验浓度（10–30 μM）和小鼠腹腔注射的给药方式都远高于常规口服，人体组织中是否出现同样效应尚无直接证据。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"PQQ 具有氧化还原循环能力，但这一性质主要在体外无细胞体系中得到观察。人体血清中的 PQQ 仅为纳摩尔级，而且氧化还原循环也可能造成蛋白氧化，因此不能据此认为它在体内能强效清除自由基。"},{"mechanism_id":"mech_bdnf_ngf","score":1,"evidence_grade":"D","target_role":"secondary","notes":"在培养的星形胶质细胞中，PQQ 可促进 NGF 的合成或分泌。大鼠脑内 NGF 增加的研究使用的是 PQQ 衍生物，无法直接套用到口服的 PQQ。人体脑内是否出现同样变化，目前没有证据。"}],"indications":[{"indication_id":"memory","grade":"B","verdict":"benefit"},{"indication_id":"attention","grade":"B","verdict":"mixed"}]},{"id":"supp_alcar","name":"乙酰-L-肉碱 (ALCAR)","en_name":"Acetyl-L-Carnitine (ALCAR)","aliases":["ALCAR","乙酰肉碱"],"summary":"ALCAR 既参与长链脂肪酸进入线粒体的转运，又能提供乙酰基用于乙酰胆碱合成。这些作用主要见于动物和体外研究，常规口服后在人体线粒体和脑内的效应尚未确证。","bioavailability_note":"ALCAR 口服后可进入血液循环，8 名健康人的药代研究显示口服 500 mg 后血浆 ALCAR 升高。ALCAR 脑通透性优于普通 L-肉碱、空腹服用吸收更充分、以及避免与富含支链氨基酸的蛋白餐竞争吸收等说法，目前缺少充分的人体证据；人体口服后的脑组织暴露资料也有限。","typical_dose":"500 - 1500 mg/天，早晨或脑力高负荷前空腹服用","functional_synergies":["与 α-硫辛酸（ALA）联用（理论推测）：两者分别与线粒体脂肪酸代谢和过氧化物清除有关，联用后线粒体功能改善的人体证据尚缺。","与 α-GPC 联用（理论推测）：α-GPC 提供胆碱，ALCAR 本身不提供胆碱，两者联用对脑内胆碱能传递的协同作用尚未在人体中确证。"],"contraindications":"甲状腺功能减退未控制者谨慎使用（肉碱可能抑制外周甲状腺素摄取）；晚间服用可能影响睡眠入眠速度。肉碱与肠道菌群代谢物 TMAO 可能有关，其长期临床意义仍不确定，不宜视为已证实的心血管风险。","mechanisms":[{"mechanism_id":"mech_cpt_shuttle","score":3,"evidence_grade":"C","target_role":"substrate","notes":"ALCAR 进入体内后可转化为游离肉碱，后者是长链脂酰基进入线粒体的穿梭底物。大鼠实验显示高剂量 ALCAR 可改善老年大鼠心肌的 CPT1 活性，但常规口服后人体肌肉的肉碱池和脂肪酸氧化是否随之改变，仍不确定。"},{"mechanism_id":"mech_cholinergic","score":3,"evidence_grade":"C","target_role":"substrate","notes":"ALCAR 携带的乙酰基先转移至辅酶 A，再用于乙酰胆碱合成，ALCAR 本身不提供胆碱。离体神经组织和大鼠脑微透析研究显示，它能增加部分脑区的乙酰胆碱释放，但常规口服剂量对人体突触乙酰胆碱的影响尚不清楚。"},{"mechanism_id":"mech_pgc1a_biogenesis","score":2,"evidence_grade":"C","target_role":"secondary","notes":"ALCAR 喂养后，大鼠失用肌中 PGC-1α、NRF-1 和 TFAM 的转录水平升高，提示它可能参与线粒体生物发生。这一结果来自动物模型，尚无可靠的人体研究证明常规剂量能通过 PGC-1α 增加线粒体数量。"}],"indications":[{"indication_id":"low_mood","grade":"B","verdict":"benefit"},{"indication_id":"cognitive_decline","grade":"B","verdict":"mixed"},{"indication_id":"neuropathy","grade":"B","verdict":"mixed"},{"indication_id":"fatigue","grade":"C","verdict":"mixed"},{"indication_id":"male_fertility","grade":"C","verdict":"mixed"}]},{"id":"supp_r_ala","name":"R-α-硫辛酸 (R-ALA)","en_name":"R-Alpha Lipoic Acid (R-ALA / Na-R-ALA)","aliases":["天然硫辛酸","稳定态R-硫辛酸钠","Na-R-ALA"],"summary":"R-ALA 是抗氧化剂，外源游离形式并不等同于结合在线粒体酶上的辅基。直接清除自由基和激活 AMPK 的作用主要见于体外和动物研究；人体中可测到总谷胱甘肽升高，但具体路径尚未确证。","bioavailability_note":"R 构型与混旋体的药代特征不同，但目前不能笼统地断言其所有临床作用都显著优于混旋体。游离 R-ALA 遇热、遇酸容易聚合失活，因此稳定态的 R-硫辛酸钠盐（Na-R-ALA）在制剂上更有优势。另外，外源游离硫辛酸并不等同于已结合在线粒体酶上的辅基。","typical_dose":"稳定型 R-ALA 100 - 300 mg/天，餐前 30 分钟空腹服用","functional_synergies":["与小檗碱联用（理论推测）：两者联用对胰岛素抵抗和糖化终产物（AGEs）堆积的协同作用，目前缺乏人体证据。","与 NAC 联用（理论推测）：两者都与谷胱甘肽相关，但联用对细胞内还原型谷胱甘肽水平的协同作用尚未在人体中确证。"],"contraindications":"可能轻度降低血糖，低血糖倾向者需随备含糖轻食。长期大剂量服用时，因螯合作用而需要常规补充锌、铁的说法缺乏充分证据。东亚人群（尤其携带 HLA-DRB1*04:06 者）有诱发胰岛素自身免疫综合征（Hirata 病，反复严重低血糖）的报告，出现反复低血糖须立即停用就医。","mechanisms":[{"mechanism_id":"mech_nrf2_are","score":3,"evidence_grade":"A","target_role":"secondary","notes":"一项人体随机对照试验显示，R-ALA 600 mg/天可使外周单核细胞中的 HO-1 表达升高。这一剂量高于该补充剂常用的 100–300 mg/天，低剂量能否产生同样效果，目前不能保证。"},{"mechanism_id":"mech_gsh_synthesis","score":3,"evidence_grade":"B","target_role":"secondary","notes":"较高剂量的混旋硫辛酸在人体试验中使血液总谷胱甘肽升高，但研究未区分合成、再生和转运。细胞实验显示其可改善胱氨酸利用。具体路径在人体中尚未确证，结果也不宜直接套用到常规剂量的 R-ALA。"},{"mechanism_id":"mech_ampk_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物与细胞研究显示，硫辛酸可增加骨骼肌 AMPK 活性和葡萄糖摄取，GLUT4 转位的研究也主要来自动物和细胞。人体降糖或胰岛素敏感性的结果，不能代替组织内 AMPK 磷酸化的直接测量，常规剂量的作用幅度也不清楚。"},{"mechanism_id":"mech_direct_ros","score":2,"evidence_grade":"D","target_role":"secondary","notes":"硫辛酸及其还原产物二氢硫辛酸在体外具有氧化还原活性，能与自由基反应。但人体内游离硫辛酸的暴露时间较短，还需与其他抗氧化体系竞争，直接清除自由基的贡献在人体中难以确定。"}],"indications":[{"indication_id":"neuropathy","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"}]},{"id":"supp_creatine","name":"一水肌酸 (Creatine Monohydrate)","en_name":"Creatine Monohydrate (Creapure)","aliases":["肌酸","Creapure","微粉化肌酸"],"summary":"肌酸是磷酸原能量缓冲系统的关键分子。人体研究显示补充后肌肉磷酸肌酸和总肌酸升高，并有增加力量的临床证据。脑内的能量与谷氨酸相关作用主要来自动物和体外研究，人体中尚未确证。","bioavailability_note":"一水肌酸本身吸收良好。微粉化（200 目）主要改善分散和溶出速度，不能据此认定人体吸收明显提高。每天 3 克持续 28 天，肌肉总肌酸逐渐升高约 20%；负荷 5 天后，静息肌肉磷酸肌酸较安慰剂升高约 16%（常见负荷方案为 20 g/天，连续 5–7 天）。脑内肌酸的升高幅度存在剂量、脑区和个体差异，不能保证都达到 5%–10%，部分研究未见明显变化。","typical_dose":"3 - 5 克/天，随温水、碳水或餐后服用","functional_synergies":["与碳水化合物同服：碳水化合物可能促进肌酸摄取，但同服并非补充肌酸的必要条件。","与苏糖酸镁联用（理论推测）：两者在脑细胞电位与能量稳态方面的协同作用，尚无人体证据。"],"contraindications":"已有肾脏疾病者，无论病变轻重，都应考虑评估肾功能，并监测肾小球滤过率。肌酸补充可使血肌酐轻微升高，这一变化不一定代表肾损伤，但会干扰肌酐估算肾小球滤过率的解释，必要时可结合胱抑素 C 或实测滤过率评估。补充期间注意充足饮水。","mechanisms":[{"mechanism_id":"mech_phosphagen_buffer","score":5,"evidence_grade":"A","target_role":"substrate","notes":"肌酸经肌酸激酶催化形成磷酸肌酸（PCr）。PCr 在肌酸激酶催化下把磷酸基转给 ADP，快速再生 ATP，起到能量缓冲作用。人体随机交叉试验中，负荷 5 天后静息肌肉磷酸肌酸较安慰剂升高约 16%，这一结果直接来自人体。"},{"mechanism_id":"mech_gaba_glutamate","score":2,"evidence_grade":"B","target_role":"secondary","notes":"动物和体外研究提示，肌酸可能通过能量缓冲减轻谷氨酸相关的兴奋性损伤。一项无安慰剂对照的小型人体研究中，脑磁共振测得的谷氨酸相关信号下降，但这是组织总信号，不能代表突触外谷氨酸。转运体反转受阻的机制尚未证实。"},{"mechanism_id":"mech_glut4_insulin","score":2,"evidence_grade":"B","target_role":"secondary","notes":"2 型糖尿病患者在规律运动的同时每天服 5 g、12 周，肌肉 GLUT4 转位比安慰剂组多（25 人随机试验）。不运动时是否有同样作用尚未证实，更适合看作运动的辅助。"}],"indications":[{"indication_id":"muscle_strength","grade":"A","verdict":"benefit"},{"indication_id":"exercise_recovery","grade":"B","verdict":"mixed"},{"indication_id":"memory","grade":"B","verdict":"mixed"},{"indication_id":"attention","grade":"B","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"},{"indication_id":"bone_density","grade":"B","verdict":"mixed"},{"indication_id":"falls","grade":"B","verdict":"mixed"},{"indication_id":"endurance","grade":"B","verdict":"no_benefit"},{"indication_id":"testosterone","grade":"B","verdict":"no_benefit"}]},{"id":"supp_pterostilbene","name":"紫檀芪 (Pterostilbene)","en_name":"Pterostilbene","aliases":["二甲氧基白藜芦醇","紫檀素"],"summary":"紫檀芪是白藜芦醇的二甲氧基衍生物，脂溶性较高，其口服生物利用度高于白藜芦醇的说法主要来自动物数据。它对 SIRT1 的直接激活仍有争议，人体随机试验中，单用紫檀芪组的 LDL-C 反而升高。","bioavailability_note":"紫檀芪的半衰期（约 105 分钟，白藜芦醇约 14 分钟）和口服生物利用度数据主要来自动物条件，不宜作为固定的人体药代参数使用。肝脏首过代谢较少、组织蓄积更深等比较结论，同样缺少可靠的人体数据支持。","typical_dose":"50 - 150 mg/天，随含油脂早餐服用","functional_synergies":["与烟酰胺核糖（NR）联用（理论推测）：两者分别与 NAD+ 供给和 SIRT1 相关通路有关，但联用形成确定的抗衰老效果尚无可靠人体证据。","与小檗碱联用（理论推测）：两者在代谢调节方面的联合效果，目前缺乏人体证据。"],"contraindications":"在一项随机对照试验中，紫檀芪单用组的 LDL-C 升高（Riche 等，2014），这一效应不宜视为仅见于极少数大剂量使用者的短暂变化。添加柑橘黄酮或小檗碱能否抵消这一效应，尚未获得证实。","mechanisms":[{"mechanism_id":"mech_sirtuin_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物模型中可见紫檀芪恢复 SIRT1 去乙酰化活性及相关节律。但它能否直接变构结合并激活 SIRT1 仍有争议，抗衰基因上调也尚未在人体中证实。"},{"mechanism_id":"mech_ampk_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物模型中，紫檀芪可引起 AMPK 通路的变化，但 LKB1 激活和与 PPAR-α 的协同作用尚未确证。人体代谢指标的变化不能证明 AMPK 被激活，动物使用的剂量和疾病模型也不能直接代表常规补充剂量。"},{"mechanism_id":"mech_nrf2_are","score":2,"evidence_grade":"C","target_role":"secondary","notes":"口服紫檀芪后，小鼠肺组织中的 Nrf2/HO-1 相关指标上调，提示该通路被激活，但证据来自动物模型。SOD 和 CAT 活性的变化本身不能证明 Keap1 解离，紫檀芪与 Keap1 的直接结合及人体效应目前尚不明确。"}],"indications":[{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"no_benefit"}]},{"id":"supp_egcg","name":"绿茶提取物 (EGCG)","en_name":"Epigallocatechin Gallate (EGCG)","aliases":["茶多酚","表儿茶素没食子酸酯","EGCG"],"summary":"EGCG 是绿茶中的主要儿茶素，动物和细胞研究显示它可影响 AMPK、mTOR 和基质金属蛋白酶通路。这些结果多来自高剂量或体外实验，人体证据有限，随机试验也未显示其对胶原指标有明确保护作用。","bioavailability_note":"空腹口服吸收较好，但可能对胃黏膜有一定收敛刺激，因此建议餐后服用，或选用脱咖啡因磷脂微囊型（GreenSelect Phytosome）。浓缩提取物的肝损伤风险见禁忌说明。","typical_dose":"标准 EGCG 200 - 400 mg/天。800 mg/天并非已确立的安全阈值，低于该剂量也有个体肝损伤病例（见禁忌说明）。","functional_synergies":["与槲皮素联用（理论推测）：两者联用能否显著延长 EGCG 血浆半衰期，缺乏可靠的临床药代证据。","与维生素 C 联用（理论推测）：维生素 C 可能减少 EGCG 在肠腔内被氧化，但联用的人体获益尚未确证。"],"contraindications":"重度肝功能不全者禁用大剂量浓缩纯品；避免空腹一次性超大剂量饮用；孕妇限制使用。浓缩绿茶提取物可发生肝损伤，800 mg/天并非已确立的安全阈值，低于该剂量也有个体病例报告。","mechanisms":[{"mechanism_id":"mech_ampk_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"小鼠口服 EGCG 200 mg/kg 后，肝脏 AMPK 和 ACC 磷酸化增加，细胞研究也有类似结果。但体重或血脂变化并非 AMPK 的特异性指标，动物所用剂量较高，常规口服剂量下的人体组织效应尚未确立。"},{"mechanism_id":"mech_autophagy_mTOR","score":3,"evidence_grade":"C","target_role":"secondary","notes":"EGCG 在无细胞酶实验中可竞争 ATP 抑制 mTOR，小鼠注射后肝脏中也出现 LC3-II 增加、p62 下降等自噬相关变化。但这些结果来自体外或注射给药的动物，不能证明常规口服后人体组织中能达到持续抑制 mTOR 的游离浓度。"},{"mechanism_id":"mech_collagen_synthesis","score":1,"evidence_grade":"D","target_role":"secondary","notes":"动物实验中，口服绿茶多酚可降低紫外线照射后皮肤的 MMP 表达，细胞研究也有 MMP 调节证据。MMP 抑制属于胶原降解的调节，不能据此认为口服 EGCG 能促进胶原合成，人体随机试验也未显示其对胶原指标有明确保护作用。"}],"indications":[{"indication_id":"ldl_cholesterol","grade":"B","verdict":"benefit"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"}]},{"id":"supp_apigenin","name":"芹菜素 (Apigenin)","en_name":"Apigenin (Chamomile Extract)","aliases":["洋甘菊提取物","芹黄素","Apigenin"],"summary":"芹菜素在体外和小鼠实验中可抑制 CD38 并使肝脏 NAD+ 升高，但人体靶点占有尚不清楚。镇静作用可能涉及 GABA 能通路，受体层面的证据并不一致，人体镇静效应也未确立。","bioavailability_note":"纯单体脂溶性较高，建议随含脂正餐或睡前 1 小时配合少许健康脂肪（如坚果、甘油三酯）同服以促进淋巴吸收。","typical_dose":"50 - 200 mg/天，晚间或睡前 30-60 分钟服用。该剂量作为纯芹菜素改善睡眠或抑制人体 CD38 的有效剂量尚未确立，洋甘菊提取物也不能视为与等量纯芹菜素等同。","functional_synergies":["与 NMN 或 NR 联用（理论推测）：芹菜素抑制 CD38 减少 NAD+ 分解的作用在人体中尚未确定，联用的抗衰协同作用也缺少可靠的人体验证。","与苏糖酸镁联用（理论推测）：对深睡眠的协同作用缺少可靠的人体验证。"],"contraindications":"与中枢镇静药物（如地西泮）联用需注意中枢抑制叠加，但这一相互作用尚未得到充分研究；大剂量可能竞争结合雌激素受体。","mechanisms":[{"mechanism_id":"mech_gaba_glutamate","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物研究提示芹菜素的镇静作用可能涉及 GABA 能通路，但苯二氮䓬位点拮抗剂只阻断了部分镇静表现，受体层面的结果也不一致，对该位点的特异性尚不能确定。人体镇静效应尚未确立，也不能据此认为不会出现共济失调。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"动物研究支持芹菜素抑制 NF-κB 相关的 SASP 促炎信号。口服后人体组织中的通路效应尚不明确，这一机制目前主要停留在细胞和动物层面。"},{"mechanism_id":"mech_cd38_inhibition","score":1,"evidence_grade":"D","target_role":"primary","notes":"芹菜素在酶实验中抑制 CD38 的 IC50 约为 10.3 μmol/L，处理小鼠后肝脏 NAD+ 升高。但这一体外抑制浓度远高于人体膳食研究测得的血浆水平，50–200 mg 纯单体能否在人体内达到有效游离暴露，目前尚未确证。"},{"mechanism_id":"mech_senolytic","score":1,"evidence_grade":"D","target_role":"secondary","notes":"细胞与小鼠研究中，芹菜素可降低衰老相关分泌表型（SASP），减少促炎细胞因子的输出。但抑制分泌表型不等于清除衰老细胞，目前没有可靠证据证明芹菜素能选择性清除衰老细胞。"}],"indications":[{"indication_id":"anxiety_stress","grade":"C","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"C","verdict":"mixed"}]},{"id":"supp_liposomal_gsh","name":"脂质体谷胱甘肽 (Liposomal GSH)","en_name":"Liposomal Reduced Glutathione (GSH)","aliases":["还原型谷胱甘肽","脂质体 GSH"],"summary":"脂质体谷胱甘肽口服后，小型人体试验显示血液及部分细胞的 GSH 上升。但普通口服 GSH 也能提高部分指标，完整吸收与细胞摄取的确切贡献，以及相对普通制剂的优势，尚未确定。","bioavailability_note":"口服谷胱甘肽在胃肠道会被 γ-谷氨酰转移酶（γ-GT）等酶部分分解。但普通口服 GSH 也能提高部分人体 GSH 指标（Richie 等，2015），因此既不能断言普通制剂被完全降解，也不能断言脂质体必然以完整三肽形式吸收。S-乙酰谷胱甘肽是另一种化合物，其人体药代和疗效不能与脂质体还原型 GSH 互相替代。","typical_dose":"等效还原型 GSH 250 - 500 mg/天，早晨空腹服用","functional_synergies":["与维生素 C 联用（理论推测）：维生素 C 与 GSH 在抗氧化网络中可能相互配合，但能否帮助维持 GSH 的还原态，人体中尚未确证。","与水飞蓟宾联用（理论推测）：两者对肝脏的联合作用，目前缺乏人体证据。"],"contraindications":"对亚硫酸盐敏感个体可能偶有不适。","mechanisms":[{"mechanism_id":"mech_gsh_synthesis","score":3,"evidence_grade":"B","target_role":"substrate","notes":"口服脂质体 GSH 后，小型人体研究测得血液及部分细胞的 GSH 上升，证据来自人体。但研究未证明完整的外源 GSH 直接进入细胞，也未直接测定合成途径的贡献，细胞内 GSH 的补充机制仍不确定。"},{"mechanism_id":"mech_direct_ros","score":2,"evidence_grade":"D","target_role":"secondary","notes":"GSH 的巯基可在谷胱甘肽过氧化物酶（GPx）催化下还原过氧化氢和脂质过氧化物，这属于酶促反应，不同于直接的化学清除。血液 GSH 升高并不能证明补充剂通过直接捕获活性氧发挥作用。"}],"indications":[{"indication_id":"skin_aging","grade":"C","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"C","verdict":"mixed"}]},{"id":"supp_silybin_phytosome","name":"水飞蓟宾磷脂复合物 (Silybin Phytosome)","en_name":"Silybin Phytosome (Siliphos)","aliases":["水飞蓟宾","Siliphos","水飞蓟素磷脂"],"summary":"水飞蓟宾是水飞蓟中的主要活性成分之一，属于黄酮木脂素类。动物研究显示它可上调 Nrf2 靶基因，体外有抗氧化活性；人体中的 Nrf2 靶点、直接清除自由基及促进组织修复的机制均尚未确证。","bioavailability_note":"普通水飞蓟素水溶性和脂溶性都较差，口服生物利用度有报道不足 2%。与大豆卵磷脂以 1:2 形成的磷脂复合物（Siliphos）可提高血浆暴露，据报道约提高近 10 倍，但提升幅度取决于制剂、剂量以及是否测量结合代谢物，不宜视为固定数值。","typical_dose":"磷脂型水飞蓟宾 120 - 360 mg/天，随餐服用","functional_synergies":["与小檗碱联用（理论推测）：有观点认为水飞蓟宾可抑制小肠 P-糖蛋白外排、提高小檗碱血药浓度，但缺少可靠的临床药代证据。","与 NAC 联用（理论推测）：两者的联合护肝作用，目前缺乏人体证据。"],"contraindications":"胆道完全机械性梗阻者慎用（具轻度利胆作用）；常规剂量下耐受性较好。","mechanisms":[{"mechanism_id":"mech_nrf2_are","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物脂肪性肝炎模型中，口服水飞蓟宾后 Nrf2 靶基因表达上调，支持该通路受到调节。但直接改变 Keap1 构象，以及人体肝脏中 GST、HO-1 的诱导，目前均未得到证实。"},{"mechanism_id":"mech_tight_junction","score":2,"evidence_grade":"C","target_role":"secondary","notes":"小鼠肠屏障研究中，水飞蓟宾相关的肠道菌群变化伴随紧密连接蛋白上调，但这一结果不等同于肝脏微循环或胆管上皮屏障的改善。口服磷脂复合物后人体的紧密连接修复，尚未得到直接证明。"},{"mechanism_id":"mech_direct_ros","score":2,"evidence_grade":"D","target_role":"secondary","notes":"水飞蓟宾在体外有抗氧化活性，动物脂肪性肝炎模型中氧化应激指标有所改善，但这些变化同时伴随多条信号通路的改变。它在膜内直接截获脂质过氧化链式反应的作用，以及人体口服后的直接清除贡献，目前均未明确。"}],"indications":[{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"mixed"}]},{"id":"supp_glycine","name":"甘氨酸 (Glycine)","en_name":"Glycine (Free Form Amino Acid)","aliases":["氨基乙酸","Glycine"],"summary":"甘氨酸是 GSH 合成的底物，也是胶原三螺旋中每三个残基出现一次的结构残基。人体示踪证据支持其参与 GSH 合成，但常规补充能否突破限速、能否增加胶原合成，以及促睡效应，人体证据都不充分。","bioavailability_note":"游离甘氨酸水溶性好，味道温和带甜，对中高温较稳定，口服后可直接吸收入血。","typical_dose":"日常补充 3 - 5 克/天。人体睡眠研究中常用睡前约 3 克；5–10 克/天的深睡眠剂量缺少充分证据。","functional_synergies":["与 NAC 联用（GlyNAC 组合）：一项 24 名老年人的随机对照试验中 GSH 指标改善，另一项随机试验的总体主要终点未见显著改善，无法证明甘氨酸单独补足 GSH 原料或逆转线粒体衰老。","与水解胶原蛋白联用（理论推测）：两者联用对胶原合成的协同作用，目前缺乏人体证据。"],"contraindications":"常规剂量下耐受性良好，极高剂量（超过 15 克）偶可引起轻微肠蠕动加快。","mechanisms":[{"mechanism_id":"mech_gsh_synthesis","score":4,"evidence_grade":"B","target_role":"substrate","notes":"甘氨酸是谷胱甘肽合成的底物之一，人体示踪研究显示它可进入红细胞的 GSH 池。但补充试验多与 NAC 联用，无法把效果单独归因于甘氨酸，常规补充也不必然突破限速，是否限速取决于营养状态和其他底物。"},{"mechanism_id":"mech_collagen_synthesis","score":4,"evidence_grade":"B","target_role":"substrate","notes":"胶原多肽链中每三个残基就有一个甘氨酸，这是三股螺旋结构的必要条件。口服甘氨酸可进入血液循环，但营养充足者额外补充是否增加胶原合成尚无定论。"}],"indications":[{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"C","verdict":"benefit"},{"indication_id":"sleep_onset","grade":"C","verdict":"benefit"},{"indication_id":"fatigue","grade":"C","verdict":"benefit"}]},{"id":"supp_selenomethionine","name":"硒代甲硫氨酸 (L-Selenomethionine)","en_name":"L-Selenomethionine","aliases":["有机硒","硒代蛋氨酸","Selenium"],"summary":"硒代甲硫氨酸是天然的有机硒形式，经代谢提供硒，用于合成谷胱甘肽过氧化物酶（GPx）中的硒代半胱氨酸残基。补硒能提高缺硒人群的 GPx 活性，硒充足时继续补充通常不再提高 GPx。","bioavailability_note":"硒代甲硫氨酸口服后可被吸收。一部分经代谢生成共同的硒中间体，再用于合成含硒代半胱氨酸的硒蛋白；另一部分可非特异性掺入普通蛋白，形成体内的硒储存。“吸收率比亚硒酸钠高出约 80%”的幅度，以及经小肽通道转运的说法并不准确，不能作为通用药代参数。","typical_dose":"元素硒 100 - 200 mcg/天，应计入食物和其他制剂的总摄入，长期总摄入需低于成人可耐受上限（见禁忌说明）。","functional_synergies":["与 NAC 联用（理论推测）：NAC 可为 GSH 合成提供原料，硒则用于 GPx 的催化残基，两者联用对 GSH 利用的协同作用尚缺乏人体证据。","与维生素 E 联用（理论推测）：两者分别在水相和脂相中发挥抗氧化作用，联用的人体协同效果尚未确证。"],"contraindications":"治疗窗较窄：美国成人可耐受最高摄入量为 400 mcg/天（适用于全部来源），欧洲食品安全局 2023 年给出的成人上限为 255 mcg/天；长期超量可致硒中毒（呼气大蒜味、脱发、指甲变脆）；大型 RCT（如 SELECT、NPC）提示硒状态充足人群长期补充 200 mcg/天可能增加 2 型糖尿病风险，硒水平正常者不宜长期补充。","mechanisms":[{"mechanism_id":"mech_gsh_synthesis","score":4,"evidence_grade":"A","target_role":"substrate","notes":"硒代甲硫氨酸经代谢提供硒，用于合成谷胱甘肽过氧化物酶（GPx）的硒代半胱氨酸（Sec）催化残基。Sec 是 GPx 蛋白中的氨基酸残基，而非游离辅基。补硒可提高缺硒人群的 GPx 活性，但这属于 GSH 的利用，而非直接合成 GSH。"},{"mechanism_id":"mech_nrf2_are","score":2,"evidence_grade":"C","target_role":"secondary","notes":"硒状态可影响细胞的氧化还原信号，但维持 TrxR 功能与激活 Nrf2 不是同一回事。硒缺乏本身可在小鼠肝脏中激活 Nrf2-ARE 应激反应，而补充硒代甲硫氨酸能否直接激活人体 Nrf2，目前缺乏可靠证据。"}],"indications":[{"indication_id":"male_fertility","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"A","verdict":"no_benefit"},{"indication_id":"cardiovascular_events","grade":"A","verdict":"no_benefit"}]},{"id":"supp_boswellia_akba","name":"乳香提取物 (AKBA / 乙酰基-11-酮基-β-乳香酸)","en_name":"Boswellia Serrata Extract (AKBA / ApresFlex)","aliases":["乳香酸","AKBA","ApresFlex","5-Loxin"],"summary":"AKBA 在体外可抑制 5-脂氧酶（5-LOX）。人体随机试验显示 5-Loxin 可降低关节液 MMP-3，但口服乳香提取物后血浆 LTB4 未见下降。它在人体中的抗炎机制和软骨结构修复作用均尚未确证。","bioavailability_note":"普通乳香提取物中 AKBA 含量不足 3%，吸收也较弱。ApresFlex、5-Loxin 等专利提取物的组成、标准化含量（部分标准化为 20–30% AKBA）和药代各不相同，不能一概视为使用同一种脂质载体，也不能认定它们都有相同的吸收倍数。","typical_dose":"浓缩标准化 AKBA 提取物 100 - 250 mg/天，随餐服用","functional_synergies":["与姜黄素联用（理论推测）：两者的抗炎靶点不同（5-LOX 与 COX-2、NF-κB 等），但联用能否在花生四烯酸通路的多个环节同时发挥作用，缺少人体机制证据。","与未变性 II 型胶原蛋白联用（理论推测）：两者联用对关节的协同作用，目前缺乏人体证据。"],"contraindications":"对树脂乳香过敏者慎用；偶见极轻微胃肠反酸，随餐同服可避免。","mechanisms":[{"mechanism_id":"mech_joint_cartilage_ecm","score":3,"evidence_grade":"A","target_role":"secondary","notes":"一项随机对照试验中，5-Loxin 使关节液 MMP-3 下降，支持其对软骨基质降解相关通路的调节。但这一结果尚不能断言软骨结构再生，也不能单独归因于 AKBA。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"D","target_role":"secondary","notes":"直接抑制 IκB 激酶（IKK）及阻断 NF-κB 入核的结果，主要见于微摩尔级的体外实验，以及细胞和动物模型。常规剂量下游离 AKBA 能否达到有效浓度尚不明确，人体炎症结局也不能证明这一靶点。"},{"mechanism_id":"mech_cox_lox_inhibition","score":1,"evidence_grade":"D","target_role":"primary","notes":"AKBA 在体外可抑制 5-LOX，从而减少白三烯合成。但血浆蛋白结合和人体暴露偏低，限制了向常规口服的外推，口服乳香提取物后血浆 LTB4 也未见下降。人体内 5-LOX 的抑制程度尚不确定，也不能断言对 COX-1 或胃黏膜没有影响。"},{"mechanism_id":"mech_collagen_synthesis","score":1,"evidence_grade":"D","target_role":"secondary","notes":"关节液 MMP-3 下降说明软骨基质降解相关通路可能受到调节，但这一结果不能证明胶原合成或交联增加。该机制所指的胶原新生，在人体中尚无证据。"}],"indications":[{"indication_id":"joint_pain","grade":"B","verdict":"benefit"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"},{"indication_id":"diarrhea","grade":"C","verdict":"mixed"}]},{"id":"supp_elderberry","name":"黑接骨木莓提取物 (Elderberry)","en_name":"Black Elderberry (Sambucus nigra)","aliases":["接骨木莓","Sambucus nigra","Elderberry"],"summary":"黑接骨木莓提取物在体外可阻断流感病毒进入细胞，并使免疫细胞释放细胞因子。但口服后原形花青素暴露较低，2020 年流感随机对照试验未发现其缩短症状持续时间，体外结果不能等同于人体抗病毒疗效。","bioavailability_note":"黑接骨木莓富含矢车菊素-3-葡萄糖苷（C3G）。口服后原形花青素的暴露较低（一项 6 人药代研究），花青素经膜受体微泡迅速吸收的说法缺少可靠证据。不同提取物的成分和剂量不可直接互换。生的接骨木果实和植物其他部位含有生氰苷，应选用经过标准化脱毒热水提浓工艺的纯净提取物。","typical_dose":"标准化提取物 300 - 900 mg/天。感冒初期每 4–6 小时追加一次的用法不是公认的标准用法，缺乏充分的人体依据。","functional_synergies":["与维生素 C、锌联用（理论推测）：三者联合的抗病毒机制和疗效在人体中均未确立。","与酵母 β-葡聚糖联用（理论推测）：两者联用的免疫协同作用，目前缺乏人体证据。"],"contraindications":"未经煮沸加工的生接骨木植物各部位有毒；自身免疫病急性严重发作期注意监测免疫激活。","mechanisms":[{"mechanism_id":"mech_prr_immune","score":1,"evidence_grade":"D","target_role":"secondary","notes":"在体外，部分接骨木莓提取物可改变单核细胞的细胞因子释放，部分多糖组分可促进树突细胞成熟。但细胞因子的变化不能说明它通过哪种模式识别受体（如 Dectin-1、TLR2/4）起作用，也不能证明人体呼吸道形成了抗病毒警戒状态或免疫训练。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"花青素在体外具有清除自由基的活性。但口服后原形花青素的暴露较低，未见直接证据显示它在呼吸道黏膜达到足以发挥化学清除作用的浓度。这一机制目前只能在体外层面成立。"}],"indications":[{"indication_id":"colds","grade":"B","verdict":"mixed"}]},{"id":"supp_lactoferrin","name":"乳铁蛋白 (Lactoferrin)","en_name":"Lactoferrin (Apo-Lactoferrin / 脱铁型)","aliases":["脱铁乳铁蛋白","Apo-Lactoferrin","LF"],"summary":"乳铁蛋白是牛奶来源的铁结合糖蛋白。它在体外可结合铁并抑制部分细菌的生物膜形成，但口服后人体黏膜中的铁剥夺是否导致抑菌，尚未直接证实。","bioavailability_note":"乳铁蛋白易受胃酸和胃蛋白酶影响，胃内消化程度还受铁饱和度、食物及制剂的影响。常见做法是选用脱铁型（Apo-LF）并包埋于耐酸肠溶胶囊，但这并不能保证完整蛋白到达回肠和结肠。消化产生的片段也可能具有生物活性。","typical_dose":"100 - 300 mg/天，空腹服用。感染期增至 500–1000 mg/天的做法缺少足够证据。","functional_synergies":["与益生菌（双歧杆菌）联用（理论推测）：两者联用对肠道菌群的协同作用，目前缺少足够的人体证据。","与锌联用（理论推测）：两者联用的人体协同作用尚无可靠证据。"],"contraindications":"乳铁蛋白本身是牛奶蛋白，牛奶蛋白过敏者可能发生过敏反应，风险不只来自原料中残留的其他乳清蛋白，也不应仅限于极重度过敏者。对乳清蛋白过敏者需确认原料是否残留致敏原。乳糖不耐受者通常可耐受（高纯品基本不含乳糖）。","mechanisms":[{"mechanism_id":"mech_mucosal_iron_binding","score":3,"evidence_grade":"D","target_role":"primary","notes":"乳铁蛋白结合 Fe3+ 的能力是分子的明确性质，并可在体外抑制部分病原菌的生物膜形成。但口服后人体黏膜中的铁剥夺是否导致抑菌尚未直接证实，胃肠消化、铁饱和度及病原菌种类都会影响作用。"},{"mechanism_id":"mech_tight_junction","score":2,"evidence_grade":"C","target_role":"secondary","notes":"乳铁蛋白在动物和细胞模型中可改善受损肠屏障，并提高 ZO-1、occludin 等紧密连接蛋白的表达。但它促进小肠隐窝干细胞增殖的作用，以及人体口服后的紧密连接修复，目前均未确立。"},{"mechanism_id":"mech_prr_immune","score":2,"evidence_grade":"D","target_role":"secondary","notes":"体外实验中，重组人乳铁蛋白可通过 TLR2/4 相关途径诱导树突细胞成熟，免疫调节结果依实验条件而异。这些结果不能直接代表口服牛乳铁蛋白在人体中的模式识别受体占有或训练免疫，TLR4 反应也并非一律受到抑制。"}],"indications":[{"indication_id":"iron_deficiency","grade":"B","verdict":"mixed"},{"indication_id":"colds","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"}]},{"id":"supp_cdp_choline","name":"胞磷胆碱 (CDP-Choline / Citicoline)","en_name":"Citicoline (CDP-Choline / Cognizin)","aliases":["胞二磷胆碱","Cognizin","Citicoline"],"summary":"胞磷胆碱口服后可提供胆碱，人体研究中血浆胆碱和尿苷升高。动物研究提示它可影响脑内磷脂合成和多巴胺相关指标，但人体中这些作用尚未确证。","bioavailability_note":"口服肠道生物利用度据报道超过 90%。口服后循环中主要增加的是胆碱和尿苷，胞苷直接作为主要入脑形式的说法并不准确。胆碱可跨越血脑屏障，参与脑内乙酰胆碱及磷脂的合成。","typical_dose":"250 - 1000 mg/天，早晨或脑力专注前服用","functional_synergies":["与 DHA 联用（理论推测）：磷脂酰胆碱与 DHA 都与神经膜结构相关，但联用能否增加突触发生或改善认知，缺乏充分人体证据。","与石杉碱甲联用（理论推测）：两者都作用于胆碱能通路，但联用对认知的增益缺乏充分人体证据。"],"contraindications":"易神经亢奋或失眠体质者避免傍晚及睡前服用；偶见极轻微胃肠不适。","mechanisms":[{"mechanism_id":"mech_cholinergic","score":3,"evidence_grade":"B","target_role":"substrate","notes":"胞磷胆碱提供胆碱，可作为乙酰胆碱及磷脂合成的原料，但实际利用受生理状态调节，不一定是限速步骤。人体研究测得血浆胆碱升高，脑内含胆碱化合物的信号也有变化，但这不足以确认常规剂量下脑内乙酰胆碱合成或释放明显增加。"},{"mechanism_id":"mech_monoamine","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物研究中，大鼠腹腔注射 300 mg/kg 后纹状体多巴胺含量升高，纹状体酪氨酸羟化酶活性也有变化，提示多巴胺代谢可能改变。这些结果来自动物，且剂量和给药途径与常规口服不同，人体中尚无可靠的靶点验证。"},{"mechanism_id":"mech_bdnf_ngf","score":2,"evidence_grade":"C","target_role":"secondary","notes":"大鼠神经损伤后腹腔注射较高剂量的胞磷胆碱，第 3 天三叉神经节的 BDNF 基因表达升高。这是动物层面的结果，给药剂量较高，不能推定常规口服在人脑中产生同样效应。突触素的变化也不能代表 BDNF 或 NGF 通路。"}],"indications":[{"indication_id":"memory","grade":"B","verdict":"benefit"},{"indication_id":"attention","grade":"B","verdict":"benefit"},{"indication_id":"cognitive_decline","grade":"B","verdict":"mixed"},{"indication_id":"eye_health","grade":"C","verdict":"mixed"}]},{"id":"supp_huperzine_a","name":"石杉碱甲 (Huperzine A)","en_name":"Huperzine A (蛇足石杉提取物)","aliases":["Huperzine A","石杉碱A"],"summary":"石杉碱甲是可逆的乙酰胆碱酯酶（AChE）抑制剂，人体口服后可观察到红细胞 AChE 活性受抑。它在体外可拮抗 NMDA 通道，但所需浓度远高于人体血浆水平，常规剂量下的 NMDA 作用尚未证实。","bioavailability_note":"口服后吸收较快。人体半衰期随研究和制剂而异，约为 5–12 小时，并非普遍为 12–24 小时。剂量以微克（mcg）计量，需精确称量。用 5 天服用、2 天停用的周期方案缺乏可靠依据。","typical_dose":"50 - 200 mcg/天（注意单位为微克！避免超量），早晨服用","functional_synergies":["与 α-GPC 或 CDP-胆碱联用（理论推测）：胆碱供体与 AChE 抑制剂作用于同一通路的不同环节，但联用对记忆的增益缺乏可靠的人体证据。"],"contraindications":"癫痫、严重心动过缓（窦性心律迟缓）、机械性肠梗阻或支气管哮喘活动期禁用；与其他胆碱酯酶抑制剂或胆碱能药物合用可能增加不良反应；严禁私自加倍超量服用。","mechanisms":[{"mechanism_id":"mech_cholinergic","score":5,"evidence_grade":"A","target_role":"primary","notes":"石杉碱甲是可逆、选择性的 AChE 抑制剂，可减少乙酰胆碱水解。健康老年人递增口服给药后，红细胞 AChE 活性受抑，末次 200 μg 剂量后抑制超过 50%。但外周酶活变化不等于脑内突触乙酰胆碱的定量变化，后者尚无直接人体测定。"},{"mechanism_id":"mech_gaba_glutamate","score":1,"evidence_grade":"D","target_role":"secondary","notes":"体外实验中石杉碱甲可拮抗 NMDA 通道，表观 Ki 约 6 μM。人体单次口服 400 μg 后血浆峰浓度仅约 2.59 ng/mL，即约 11 nM，脑内浓度未直接测定，常规剂量下的 NMDA 拮抗作用尚未证实。"}],"indications":[{"indication_id":"cognitive_decline","grade":"B","verdict":"mixed"},{"indication_id":"memory","grade":"C","verdict":"mixed"}]},{"id":"supp_l_tyrosine","name":"L-酪氨酸 (L-Tyrosine)","en_name":"L-Tyrosine","aliases":["酪氨酸","L-Tyrosine"],"summary":"L-酪氨酸是儿茶酚胺类神经递质合成的前体，人体代谢标志物支持这一作用。但酪氨酸羟化才是主要限速步骤，常规剂量能否增加脑内递质释放尚无保证，应激下的认知改善证据也不足。","bioavailability_note":"游离态 L-酪氨酸水溶性一般，肠道吸收较好。N-乙酰-L-酪氨酸（NALT）是另一种化合物，两者的有效剂量和转化率不能直接互换。高蛋白餐可影响大型中性氨基酸的竞争转运，但与蛋白餐间隔 30 分钟的做法，其优势尚未确立。","typical_dose":"500 - 2000 mg/天，早晨或高负荷脑力工作前服用。空腹服用及与蛋白餐间隔 30–45 分钟的做法，优势尚未确立。","functional_synergies":["与 B 族维生素（尤其活性 B6，即 P-5-P）联用（理论推测）：活性 B6 是芳香族氨基酸脱羧酶的辅酶，但联用能否增加多巴胺合成，人体中尚未确证。","与咖啡因联用（理论推测）：咖啡因导致递质耗竭并可由酪氨酸逆转的说法，缺少可靠依据。"],"contraindications":"服用单胺氧化酶抑制剂（MAOI）抗抑郁药者严禁使用（可能诱发高血压危象）。正在使用左旋多巴或甲状腺激素治疗者，也应由医师核查相互作用。黑色素瘤患者或甲状腺机能亢进者慎用。","mechanisms":[{"mechanism_id":"mech_monoamine","score":4,"evidence_grade":"B","target_role":"substrate","notes":"酪氨酸是多巴胺和去甲肾上腺素合成的前体，人体代谢标志物支持这一作用。但酪氨酸羟化才是主要限速步骤，上述研究剂量通常高于 0.5–2 g/天，常规剂量能否增加中枢递质释放尚无保证，应激下的认知改善证据也不足。"}],"indications":[{"indication_id":"memory","grade":"B","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"}]},{"id":"supp_5_htp","name":"5-羟色氨酸 (5-HTP)","en_name":"5-Hydroxytryptophan (5-HTP / 加纳籽提取物)","aliases":["5-HTP","加纳籽提取物","5-羟色胺前体"],"summary":"5-HTP 是血清素的直接前体，经芳香族氨基酸脱羧酶转化为 5-羟色胺。人体随机试验显示 100 mg/天可使尿 5-HIAA 明显升高，但这主要反映外周代谢，不能证明脑内血清素增加或临床疗效。","bioavailability_note":"口服后吸收入血的比例较高（有报道超过 70%）。“能自由跨越血脑屏障且不与支链氨基酸竞争”的说法并不准确，5-HTP 可与 LAT1 转运系统相互作用，人体中的竞争程度仍需研究。","typical_dose":"50 - 200 mg/天，傍晚或睡前 1 小时服用","functional_synergies":["与活性 B6（P-5-P）联用（理论推测）：活性 B6 是芳香族氨基酸脱羧酶的辅酶，但联用能否提高 5-HTP 的转化效率，人体中尚未确证。","与绿茶提取物 EGCG 联用（理论推测）：EGCG 能否可靠抑制人体外周脱羧酶并增加中枢摄取，缺乏临床证据。"],"contraindications":"严禁与 SSRI、SNRI 等处方抗抑郁药物同服（有引发致命性“5-羟色胺综合征”风险）。MAOI、曲马多及利奈唑胺等促血清素药物也可能发生相互作用，需由医师评估。5-HTP 会干扰尿 5-HIAA 检测结果。孕妇禁用。","mechanisms":[{"mechanism_id":"mech_monoamine","score":5,"evidence_grade":"A","target_role":"substrate","notes":"5-HTP 经芳香族氨基酸脱羧酶直接生成 5-羟色胺，绕过色氨酸羟化酶这一限速步骤，前体作用在人体中有证据。但血清素储存于细胞囊泡中，不能据此认为突触间隙被直接充填。尿 5-HIAA 升高主要反映外周代谢，不能证明脑内血清素增加。"}],"indications":[{"indication_id":"migraine","grade":"B","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"C","verdict":"mixed"},{"indication_id":"low_mood","grade":"C","verdict":"mixed"},{"indication_id":"body_weight","grade":"C","verdict":"mixed"}]},{"id":"supp_rhodiola","name":"红景天提取物 (Rhodiola rosea)","en_name":"Rhodiola Rosea (红景天苷 / 络塞维)","aliases":["红景天","红景天苷","Rosavins","Salidroside"],"summary":"红景天提取物属于适应原类草药。一项 60 人随机试验显示，特定提取物可降低觉醒后的皮质醇反应。它在体外可抑制单胺氧化酶（MAO），但常规口服后脑内 MAO 抑制的人体证据不足。","bioavailability_note":"部分产品将红景天标准化为 3% 络塞维（Rosavins）与 1% 红景天苷（Salidroside），但这只是部分产品的规格，并非所有有效或正品制剂的统一比例。空腹服用吸收最佳的说法，目前缺乏充分的比较证据。避免晚间服用，以免引起兴奋。","typical_dose":"200 - 500 mg/天，早晨服用。部分产品标准化为 3% Rosavins 与 1% Salidroside，不同产品的规格不能直接互换。","functional_synergies":["与南非醉茄联用（理论推测）：两者分别与抗疲劳和皮质醇调节有关，但联用能否改善昼夜节律适应，缺乏人体证据。","与辅酶 Q10 联用（理论推测）：两者联用对疲劳或耐力的协同作用，目前缺乏人体证据。"],"contraindications":"双相情感障碍（躁郁症）患者禁用（可能诱发轻躁狂发作）；失眠体质者切勿傍晚或睡前使用。与抗抑郁药及其他精神活性药物合用的安全性和相互作用尚不明确，需由医师核查。不同产品的成分差异较大。","mechanisms":[{"mechanism_id":"mech_hpa_cortisol","score":3,"evidence_grade":"A","target_role":"secondary","notes":"一项 60 人随机对照试验中，576 mg/天特定提取物持续 28 天后，觉醒后唾液皮质醇反应出现组间差异，证据直接来自人体。但这不能证明 ACTH、受体敏感性或 Hsp70 也被调节，试验剂量略高于常规，结果不宜推广到所有提取物。"},{"mechanism_id":"mech_monoamine","score":1,"evidence_grade":"D","target_role":"secondary","notes":"红景天提取物及其组分在重组人 MAO 体系中显示抑制活性，这是体外结果。提取物成分和药代差异较大，体外抑制不能证明脑内达到有效浓度，目前也未见常规口服后人体脑内 MAO 抑制或单胺周转改变的可靠证据。"}],"indications":[{"indication_id":"fatigue","grade":"B","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"},{"indication_id":"endurance","grade":"B","verdict":"mixed"},{"indication_id":"anxiety_stress","grade":"C","verdict":"mixed"}]},{"id":"supp_tongkat_ali","name":"东革阿里提取物 (Tongkat Ali)","en_name":"Tongkat Ali (Eurycoma longifolia / LJ100)","aliases":["马来西亚人参","宽叶二氢阔兰酮","LJ100","Eurycomanone"],"summary":"东革阿里提取物在部分人体随机试验中可升高睾酮，但结果并不一致：200 mg/天使老年男性总睾酮升高，游离睾酮组间差异不显著。它是否通过竞争结合 SHBG 发挥作用，尚未确证。","bioavailability_note":"纯根水提浓缩物（如 LJ100）经冷水多步萃取富集活性糖肽与阔兰酮；苦味强烈，建议随餐服用减轻胃肠黏膜刺激。","typical_dose":"200 - 400 mg/天，早晨随早餐服用。标准化为 1%–2% 阔兰酮的规格并非统一标准，不同产品之间不能直接互换。","functional_synergies":["与硼联用（理论推测）：两者联用降低 SHBG 结合力的协同作用，缺乏人体证据。","与南非醉茄联用（理论推测）：两者对皮质醇的联合作用，目前缺乏人体证据。"],"contraindications":"激素依赖性恶性肿瘤（如前列腺癌）患者禁用；严重心脏病或未经控制的严重高血压患者慎用。欧洲食品安全局（EFSA）2021 年对一种根提取物的评估提示潜在遗传毒性，其安全性尚未确立；该结论不能直接等同于所有产品已证有害。","mechanisms":[{"mechanism_id":"mech_steroid_shbg","score":3,"evidence_grade":"A","target_role":"secondary","notes":"人体试验中，东革阿里提取物对睾酮的影响并不一致：200 mg/天使老年男性总睾酮升高，游离睾酮组间差异不显著。目前未证明阔兰酮竞争结合 SHBG，游离睾酮的升幅也不能确定。"},{"mechanism_id":"mech_hpa_cortisol","score":2,"evidence_grade":"A","target_role":"secondary","notes":"一项约 63 名受试者的安慰剂对照随机试验显示，200 mg/天提取物服用 4 周后，唾液皮质醇低于安慰剂组，证据直接来自人体。但这一结果仍需重复验证，效应大小及对其他制剂的适用性尚不确定。"}],"indications":[{"indication_id":"testosterone","grade":"B","verdict":"benefit"},{"indication_id":"fatigue","grade":"B","verdict":"benefit"},{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"},{"indication_id":"erectile_function","grade":"B","verdict":"mixed"},{"indication_id":"muscle_strength","grade":"B","verdict":"mixed"},{"indication_id":"menopause","grade":"B","verdict":"mixed"},{"indication_id":"male_fertility","grade":"C","verdict":"mixed"}]},{"id":"supp_calcium_d_glucarate","name":"D-葡萄糖二酸钙 (Calcium D-Glucarate / CDG)","en_name":"Calcium D-Glucarate (CDG)","aliases":["CDG","D-葡萄糖二酸钙","葡萄糖二酸"],"summary":"D-葡萄糖二酸钙在肠道内生成内酯，可抑制部分细菌来源的 β-葡萄糖醛酸酶。该作用主要来自大鼠研究，人体能否因此减少雌激素再吸收，目前没有可靠证据。","bioavailability_note":"口服后可在肠道内释放 D-葡萄糖二酸-1,4-内酯。随餐服用是否优于空腹，目前尚无人体数据确认；长期安全性也未确立。","typical_dose":"产品常用量为 500–1500 mg/天，分次随餐服用。这一剂量的人体有效性、随餐优势和长期安全性均未确立。","functional_synergies":["与 DIM 联用（理论推测）：DIM 可使尿液中 2-羟基雌酮的比值上升（具体的代谢分流途径尚未证实），CDG 理论上可减少结合态代谢物在肠道被再次水解。两者联用的效果尚无人体研究证实，DIM 的代谢物也并非都无害。","与水飞蓟宾联用（理论推测）：缺少直接的人体研究，联用的获益和风险均未确认。"],"contraindications":"可能影响部分经葡萄糖醛酸代谢的处方药（如他汀类、对乙酰氨基酚）的肠肝循环，存在相互作用的可能。错开服药时间不能保证避免，应结合具体药物由医师或药师评估。","mechanisms":[{"mechanism_id":"mech_estrogen_detox","score":3,"evidence_grade":"C","target_role":"secondary","notes":"CDG 在肠道内转化为内酯，可抑制部分细菌来源的 β-葡萄糖醛酸酶。大鼠实验中可见该作用；人体是否改变雌激素排出尚无可靠证据，标签所述的 CYP1A1 分流也未得到证实。"}],"indications":[]},{"id":"supp_methyl_b12","name":"甲钴胺 (活性甲基 B12)","en_name":"Methylcobalamin (Active Vitamin B12)","aliases":["甲基维生素B12","甲钴胺","Methyl-B12"],"summary":"甲钴胺是甲硫氨酸合成酶的辅酶，参与把 5-MTHF 的甲基转给同型半胱氨酸。人体研究显示补充维生素 B12 可降低同型半胱氨酸，但所引用的研究使用的是氰钴胺；神经修复作用目前仅见动物数据。","bioavailability_note":"舌下含服并未证明优于普通口服，因此不能认为其主要经口腔黏膜吸收、从而绕过内因子。大剂量口服时，少量被动吸收即可起效。","typical_dose":"常用量为 1000–5000 微克/天，早晨服用，口服或舌下含服均可。并非所有人都需要这一剂量，应以血液指标和医嘱为准。","functional_synergies":["与活性甲基叶酸（5-MTHF）联用：两者在一碳代谢中需要协同，甲钴胺负责把 5-MTHF 提供的甲基转交给同型半胱氨酸。","与 P-5-P 联用：同型半胱氨酸有两条清除途径，甲钴胺负责再甲基化，P-5-P 是转硫途径中胱硫醚 β-合酶的辅酶。B 族维生素联合补充降低同型半胱氨酸已有人体试验支持。"],"contraindications":"常规剂量下耐受性良好（水溶性多余随尿排出）；红细胞增多症未确诊者应先排查原因。","mechanisms":[{"mechanism_id":"mech_methylation_sam","score":5,"evidence_grade":"A","target_role":"substrate","notes":"甲钴胺是甲硫氨酸合成酶的辅酶，B12 缺乏时再甲基化受阻，补充可恢复这一步反应。人体研究中补充维生素 B12 可降低同型半胱氨酸，但所引用的试验使用的是氰钴胺，尚不能证明甲钴胺更有效。"},{"mechanism_id":"mech_bdnf_ngf","score":2,"evidence_grade":"C","target_role":"secondary","notes":"在腹腔注射甲钴胺的损伤小鼠中，背根神经节的 BDNF 和 NGF 表达上升；许旺细胞与髓鞘再生的数据多来自细胞和大鼠。人体中这一机制尚未确证，常规口服后的效应也不明。"}],"indications":[{"indication_id":"b12_folate_deficiency","grade":"B","verdict":"benefit"},{"indication_id":"neuropathy","grade":"B","verdict":"benefit"}]},{"id":"supp_tmg","name":"甜菜碱 (无水甜菜碱 / TMG)","en_name":"Trimethylglycine (TMG / Betaine Anhydrous)","aliases":["TMG","无水三甲基甘氨酸","甜菜碱"],"summary":"甜菜碱经肝脏 BHMT 酶提供甲基，把同型半胱氨酸转化为甲硫氨酸。人体随机试验中，1.5 g 以上剂量可降低同型半胱氨酸；较大剂量（6 g/天）会升高 LDL 胆固醇。","bioavailability_note":"高纯无水甜菜碱吸湿性强，水溶性好，肠道吸收较快；注意防潮密封保存。","typical_dose":"500 - 2000 mg/天，随晨餐服用","functional_synergies":["与 NMN 联用（理论推测）：NMN 代谢后的烟酰胺需经甲基化排出，理论上会消耗甲基池。但常规剂量下是否形成临床意义上的甲基耗竭尚无证据，不必然需要联用。","与 5-MTHF 联用（理论推测）：两者分别通过不同途径参与同型半胱氨酸代谢，联用的人体效果未经专门验证。"],"contraindications":"极少数个体大剂量初次服用可能出现轻度腹泻或体味轻微改变，建议从小剂量递增。高胆固醇血症者应关注血脂：人体试验显示 6 g/天会升高 LDL 胆固醇，较低剂量的血脂影响尚不确定，不宜简单以 4 g 为界。","mechanisms":[{"mechanism_id":"mech_methylation_sam","score":5,"evidence_grade":"A","target_role":"substrate","notes":"甜菜碱经肝脏 BHMT 酶把甲基直接交给同型半胱氨酸，生成甲硫氨酸。人体随机试验中，1.5 g/天持续 6 周或单次 3–6 g 可使同型半胱氨酸下降，单次 1 g 未见明显下降。"}],"indications":[{"indication_id":"muscle_strength","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"}]},{"id":"supp_same","name":"S-腺苷甲硫氨酸 (SAMe)","en_name":"S-Adenosyl-L-Methionine (SAMe)","aliases":["SAMe","腺苷蛋氨酸","Ademetionine"],"summary":"SAMe 是多种甲基转移酶的重要甲基供体。口服后血液中的 SAM 水平可以升高，但组织层面的甲基化效应因人而异；肝脏谷胱甘肽升高的证据也不一致。","bioavailability_note":"SAMe 分子不稳定，遇胃酸易分解。肠溶包衣制剂可减少这一损失，不同盐型的稳定性和吸收率也各不相同，应选择质量可靠的产品。","typical_dose":"常用量为 200–800 mg/天，多在早晨或午饭前服用。肠溶片应整片吞服，不宜嚼碎。","functional_synergies":["与维生素 B6、B12、甲基叶酸联用（理论推测）：三者参与 SAH 的代谢清除，理论上有助于减少 SAMe 代谢产物的积累，但这一组合的人体效果缺乏直接证据。"],"contraindications":"躁郁症（双相情感障碍）绝对禁用（会诱发极其严重的躁狂转相）；与处方抗抑郁药（抗 5-HT 药物）联用需医师严密监测。","mechanisms":[{"mechanism_id":"mech_methylation_sam","score":4,"evidence_grade":"A","target_role":"substrate","notes":"SAMe 是多种甲基转移酶的重要供体。肝病患者和健康人的研究均显示口服后血清或血浆 SAM 升高，但这不等于每种组织的甲基化通量都明显增加，也不等于直接促进同型半胱氨酸再甲基化。"},{"mechanism_id":"mech_gsh_synthesis","score":3,"evidence_grade":"B","target_role":"secondary","notes":"SAMe 脱去甲基后，经同型半胱氨酸的转硫途径生成半胱氨酸，间接为谷胱甘肽合成提供原料。一项小型对照研究中肝活检谷胱甘肽增加，但另一项随机试验未观察到血清谷胱甘肽的显著变化。"}],"indications":[{"indication_id":"low_mood","grade":"B","verdict":"mixed"},{"indication_id":"joint_pain","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"mixed"}]},{"id":"supp_p5p","name":"磷酸吡哆醛 (活性维生素 B6 / P-5-P)","en_name":"Pyridoxal-5-Phosphate (P-5-P)","aliases":["P-5-P","活性B6","磷酸吡哆醇"],"summary":"磷酸吡哆醛是维生素 B6 的活性形式，为多种氨基酸脱羧酶的辅酶，参与多巴胺、血清素和 GABA 等递质的合成。补充后脑内递质是否上升，在营养充足者中尚未确证。","bioavailability_note":"盐酸吡哆醇需在肝脏经两步反应转化为 P-5-P 才具有辅酶活性。口服的磷酸化形式在吸收时也可能先脱去磷酸基。目前没有证据表明 P-5-P 比普通 B6 更安全。","typical_dose":"常用量为 20–50 mg/天，随晨餐服用。长期使用时应计入饮食和其他补充剂中的 B6 总量。","functional_synergies":["与甘氨酸镁联用（理论推测）：有观点认为 P-5-P 协助镁离子进入细胞，但这一说法缺乏充分依据，联用后的镇静效果也未经验证。","与 5-HTP 或 L-酪氨酸联用（理论推测）：二者在体内生成多巴胺或血清素的后续步骤都依赖 PLP 参与的脱羧反应，但联用的人体效果和安全性缺乏专门研究。"],"contraindications":"长期使用需注意感觉神经病变，超过 200 mg/天的长期高剂量尤应监测下肢感觉。20–50 mg/天也并非绝对安全：按 B6 当量折算，可能超过欧洲食品安全局（EFSA）成人总摄入上限 12 mg/天。","mechanisms":[{"mechanism_id":"mech_monoamine","score":4,"evidence_grade":"B","target_role":"substrate","notes":"PLP 是芳香族氨基酸脱羧酶的辅酶，参与左旋多巴和 5-HTP 的脱羧，进而生成多巴胺和血清素。该酶作用机制明确，人体遗传缺陷研究提供支持；常规补充能否增加营养充足者的中枢单胺释放，尚未证实。"},{"mechanism_id":"mech_gaba_glutamate","score":4,"evidence_grade":"B","target_role":"substrate","notes":"PLP 是谷氨酸脱羧酶的必需辅酶，催化谷氨酸生成抑制性递质 GABA。人体小样本研究有相关生化证据，但不能据此保证营养充足者补充后脑内 GABA 上升。"},{"mechanism_id":"mech_gsh_synthesis","score":3,"evidence_grade":"B","target_role":"substrate","notes":"PLP 是转硫途径酶的辅因子，间接支持半胱氨酸供应。人体研究中有相关代谢指标的证据，但补充后谷胱甘肽不一定升高，因此不能据此认为它直接提升抗氧化储备。"},{"mechanism_id":"mech_methylation_sam","score":2,"evidence_grade":"B","target_role":"substrate","notes":"PLP 是胱硫醚 β-合成酶的辅酶，将同型半胱氨酸导入转硫途径。B6 状态低下者补充后，蛋氨酸负荷后的同型半胱氨酸升幅下降；但同位素研究未显示再甲基化通量明显改变，不能说明它直接增强 SAM 再生。"}],"indications":[{"indication_id":"pms","grade":"C","verdict":"mixed"},{"indication_id":"neuropathy","grade":"C","verdict":"mixed"}]},{"id":"supp_grape_seed_opc","name":"葡萄籽提取物 (原花青素低聚体 / OPC)","en_name":"Grape Seed Extract (GSPE / 95% OPC)","aliases":["葡萄籽提取物","OPC","原花青素","GSPE"],"summary":"葡萄籽原花青素的血管作用多数来自动物和体外研究。人体小型试验中血浆亚硝酸盐等指标有变化，但荟萃分析未发现血流介导扩张的总体改善。","bioavailability_note":"单体、二聚体和三聚体的吸收程度各不相同，三聚体及更大的聚合物完整吸收有限，不能笼统称为吸收良好。选购时应查看标示的检测方法和聚合度定义，不能只凭“95% OPC”判断体内活性。","typical_dose":"100 - 300 mg/天，早晨随餐服用","functional_synergies":["与 L-瓜氨酸联用（理论推测）：瓜氨酸可提供精氨酸的前体，理论上有助于 NO 合成，但原花青素与瓜氨酸联用的人体效果尚无直接研究。","与维生素 C 联用（理论推测）：维生素 C 参与胶原羟化，原花青素对胶原基质的作用来自动物研究，两者的联合效果未经验证。"],"contraindications":"具有轻度抗血小板聚集活性，手术前 1-2 周需暂停；正在服用抗凝药者应注意监测。","mechanisms":[{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"B","target_role":"secondary","notes":"小型人体研究观察到 NO 相关标志物的变化，但这些指标无法确定来自内皮 eNOS，结果也不一致。内皮 eNOS 磷酸化和动脉硬化改善在人体中尚无直接证据。"},{"mechanism_id":"mech_collagen_synthesis","score":3,"evidence_grade":"C","target_role":"secondary","notes":"大鼠骨关节炎模型中，较高剂量口服葡萄籽提取物影响了关节损伤和 MMP-13 等指标。人体中是否形成新胶原或增加交联，目前没有证据；体外的抑酶数据也不能直接外推到口服后的效果。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"多酚在体外能捕获自由基，相关的强弱比较多来自试管实验。口服后进入体循环的完整低聚体量有限，人体血管内直接清除过氧亚硝酸根的作用尚未得到证实。"}],"indications":[{"indication_id":"fatty_liver","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"},{"indication_id":"venous_insufficiency","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"no_benefit"}]},{"id":"supp_beetroot_nitrate","name":"甜菜根提取物 (无机硝酸盐供体)","en_name":"Beetroot Extract (Standardized Dietary Nitrate)","aliases":["甜菜根红素","膳食硝酸盐","Beet Nitrate"],"summary":"膳食硝酸盐经口腔细菌还原为亚硝酸盐，再生成 NO，这一途径不依赖内皮 eNOS。人体试验中可检测到血浆亚硝酸盐和 cGMP 升高，但效应在不同条件下并不一致。","bioavailability_note":"口服硝酸盐约 25% 会浓缩进入唾液，并依赖舌背细菌还原为亚硝酸盐。抗菌漱口水可能削弱这一还原过程，补充期间宜尽量避免使用。","typical_dose":"常用量以等效膳食硝酸盐计为 300–600 mg，运动或脑力活动前 2–3 小时服用。产品中硝酸盐含量差异很大，应按标示的硝酸盐含量折算，不宜按粉剂克数直接换算。","functional_synergies":["与 L-瓜氨酸联用（理论推测）：瓜氨酸经 eNOS 通路生成一氧化氮，硝酸盐途径则不依赖内皮 eNOS，经口腔细菌还原为亚硝酸盐后再生成 NO，理论上两条途径可互为补充，但二者联用的人体效果缺乏直接研究。","与辅酶 Q10 联用（理论推测）：膳食硝酸盐可降低运动时的氧耗，辅酶 Q10 参与呼吸链电子传递，两者都与线粒体能量效率有关，但联用效果未见人体研究。"],"contraindications":"与 PDE-5 抑制剂（如西地那非、他达拉非）合用可能叠加降压作用，应避免超大剂量同用，并结合血压和用药情况评估。尿液和粪便可能呈现无害的微红色（甜菜尿，Beeturia）。","mechanisms":[{"mechanism_id":"mech_enos_no","score":5,"evidence_grade":"A","target_role":"substrate","notes":"硝酸盐经口腔细菌还原为亚硝酸盐，再转化为 NO，作用于 sGC–cGMP 通路，不依赖内皮 eNOS。人体随机试验中，硝酸盐或甜菜根汁可提高血浆亚硝酸盐和 cGMP，部分研究还观察到血压下降。"},{"mechanism_id":"mech_etc_carrier","score":3,"evidence_grade":"A","target_role":"secondary","notes":"硝酸盐并非电子传递链的载体，其作用在于改变线粒体的氧化磷酸化效率。人体研究中，膳食硝酸盐后分离出的骨骼肌线粒体 P/O 比有所提高，但这一效应并非在所有条件下都一致。"},{"mechanism_id":"mech_autonomic_vagal","score":2,"evidence_grade":"B","target_role":"secondary","notes":"14 名健康成人的交叉随机试验：单次服用含约 400 mg 硝酸盐的甜菜根汁后，肌肉交感神经活动比安慰剂低，压力感受器反射敏感性没有变化。只是单次服用的结果。"}],"indications":[{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"endurance","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"}]},{"id":"supp_nattokinase","name":"纳豆激酶 (Nattokinase)","en_name":"Nattokinase (枯草芽孢杆菌纤溶酶)","aliases":["纳豆激酶","NK","Nattokinase (FU)"],"summary":"纳豆激酶具有直接的体外纤溶活性。单次口服 2000 FU 后，小型人体试验可见 D-二聚体等纤溶指标短暂变化；长期服用的临床获益尚未得到确认。","bioavailability_note":"以纤溶活性单位（FU）标定。作为约 28 kDa 的蛋白酶，其口服后能否以活性形式大量入血仍有争议；小样本人体研究在单次 2000 FU 后观察到 D-二聚体、FDP 等纤溶指标短暂变化。通常晚间服用。","typical_dose":"2000 - 4000 FU/天，晚间随水吞服","functional_synergies":["与原花青素联用（理论推测）：两者分别针对血管壁和纤维蛋白，但联用的人体效果尚无研究，不能视为已证实的组合。"],"contraindications":"活动性内出血者禁用。正在服用抗凝药（如华法林、利伐沙班）或抗血小板药（如阿司匹林）者应避免自行使用，合用前需由医师评估出血风险。重大手术前需停用，但停用的时间间隔并无统一的验证标准，应由手术团队结合出血风险和全部用药决定。对大豆严重过敏者需确认发酵酶源。","mechanisms":[{"mechanism_id":"mech_fibrinolysis","score":3,"evidence_grade":"A","target_role":"primary","notes":"纳豆激酶在体外有直接的纤溶活性。单次 2000 FU 可使人体纤维蛋白降解指标短暂升高，但活性酶能否稳定入血尚不确定；直接裂解纤维蛋白或失活 PAI-1 在人体中也未被证实。"}],"indications":[{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"no_benefit"}]},{"id":"supp_glutamine","name":"L-谷氨酰胺 (L-Glutamine)","en_name":"L-Glutamine","aliases":["谷氨酰胺","L-Glutamine"],"summary":"谷氨酰胺是肠上皮细胞的重要代谢底物，动物模型中有助于维持紧密连接蛋白表达。人体试验主要见于感染后腹泻型肠易激综合征，屏障通透性指标有所改善，但并不适用于所有“肠漏”人群。","bioavailability_note":"谷氨酰胺是游离氨基酸，不存在蛋白质那样的变性问题，温水或凉水冲服均可。服用时间不必一概要求空腹。","typical_dose":"常用量为 5–15 克/天，可分 2–3 次用温水冲服。该剂量在人体试验中主要用于感染后腹泻型肠易激综合征，并非所有“肠漏”人群均已证实有效。","functional_synergies":["与肌肽锌联用（理论推测）：谷氨酰胺可为肠上皮细胞提供代谢燃料，肌肽锌在小型人体试验中可减轻肠道通透性升高，但二者联用的人体效果尚无直接研究，其直接附着创面的机制也未在人体中证实。","与丁酸钠联用（理论推测）：小肠上皮主要以谷氨酰胺供能，结肠上皮主要以丁酸供能，两者分别照顾肠道的不同部位，联用效果尚无人体研究。"],"contraindications":"重度肝性脑病患者慎用。严重肝病或肾功能不全者使用较大剂量时应结合病情评估。晚期肿瘤患者的谷氨酰胺需求因人而异，并非一律需要限制，但过量的单氨基酸冲剂应遵医嘱使用。","mechanisms":[{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"B","target_role":"substrate","notes":"谷氨酰胺是肠上皮细胞的重要代谢燃料。动物实验中它可增加闭合蛋白（occludin）表达并降低通透性；人体随机试验中，感染后腹泻型肠易激综合征患者的通透性比值下降，但这不能直接证明紧密连接蛋白的装配。"},{"mechanism_id":"mech_prr_immune","score":3,"evidence_grade":"C","target_role":"secondary","notes":"谷氨酰胺为免疫细胞提供代谢底物，动物研究中可改变回肠 TLR4 表达及相关先天免疫信号。它并不直接结合模式识别受体，也未见人体研究证明常规口服能促进分泌型 IgA 转运。"},{"mechanism_id":"mech_heat_shock","score":2,"evidence_grade":"B","target_role":"secondary","notes":"8 名受训者在高温环境运动的交叉随机试验：每天约 11 g，第一天运动后血液单核细胞的 HSP70 比安慰剂组高。样本很小，只是初步证据。"}],"indications":[{"indication_id":"ibs","grade":"B","verdict":"benefit"},{"indication_id":"exercise_recovery","grade":"C","verdict":"mixed"},{"indication_id":"muscle_strength","grade":"C","verdict":"mixed"}]},{"id":"supp_zinc_carnosine","name":"肌肽锌 (Zinc Carnosine / PepZin GI)","en_name":"Zinc L-Carnosine (PepZin GI)","aliases":["肌肽锌","PepZin GI","Polaprezinc"],"summary":"肌肽锌是锌与 L-肌肽形成的螯合物。小型人体试验显示它可减轻吲哚美辛引起的肠道通透性升高，但它直接附着创面、诱导 Hsp70 等机制尚未在人体得到证实。","bioavailability_note":"与普通无机锌相比，肌肽锌在胃酸中解离较慢，可在胃和小肠中缓慢释放。人体对其耐受性总体良好，但仍可能出现胃肠不适。","typical_dose":"标准复合物 75 - 150 mg/天（含元素锌约 16-32mg，L-肌肽 58-116mg），早晚餐前或餐后服用","functional_synergies":["与脱甘草酸甘草（DGL）联用（理论推测）：DGL 在动物研究中可增加胃黏液分泌细胞，但人体中黏液增加的可靠证据尚缺；两者理论上可共同保护胃黏膜，但缺少联用的人体研究。","与 L-谷氨酰胺联用（理论推测）：两者都与肠黏膜修复相关，联用的人体效果尚未研究。"],"contraindications":"复合物本身已含足量元素锌，应计入所有补充剂的锌总量，避免过量导致缺铜。锌还会减少四环素类、喹诺酮类及青霉胺等药物的吸收，服药应按具体药物错开。","mechanisms":[{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"B","target_role":"secondary","notes":"小型人体随机试验显示，肌肽锌可减轻吲哚美辛引起的肠道通透性升高。它是否通过 EGF、Hsp70 或 occludin 起作用，人体中尚未直接证实，相关分子证据主要来自实验研究。"},{"mechanism_id":"mech_direct_ros","score":2,"evidence_grade":"D","target_role":"secondary","notes":"肌肽在试管中可与羟自由基反应，并有金属结合活性，但这些是体外结果。人体中，口服肌肽锌能否在黏膜局部直接清除自由基，目前没有可靠证据。"}],"indications":[{"indication_id":"gastric_mucosa","grade":"B","verdict":"mixed"}]},{"id":"supp_collagen_tripeptide","name":"水解胶原蛋白三肽 (Collagen Tripeptide / CTP)","en_name":"Collagen Tripeptide (Gly-Pro-Hyp / CTP)","aliases":["胶原三肽","CTP","Gly-Pro-Hyp","小分子胶原多肽"],"summary":"胶原三肽（Gly-Pro-Hyp 等）是胶原水解后的小分子肽，口服后可在血中检出。动物研究显示其可增加皮肤羟脯氨酸，但人体中直接刺激成纤维细胞合成胶原的作用尚未证实。","bioavailability_note":"胶原水解物中的 Gly-Pro-Hyp（分子量约 285 Da）进入血液后可被检出，其中一部分还会继续水解。“微囊化渗透吸收率”没有明确的人体药代指标，不宜作为比较依据。","typical_dose":"常用量为 1–3 克/天，早晨或睡前温水服用。普通胶原水解物同样会产生二肽和三肽，目前不能认为 1–3 克三肽等同于 10–15 克普通胶原粉。","functional_synergies":["与维生素 C、铜联用（理论推测）：维生素 C 参与胶原羟化，铜参与赖氨酰氧化酶介导的交联，两者都是胶原合成所需的营养素，但与三肽联用的效果尚无直接研究。"],"contraindications":"对鱼类或牛源性胶原严重过敏者需仔细查验提取来源；常规剂量下耐受性总体良好。","mechanisms":[{"mechanism_id":"mech_collagen_synthesis","score":3,"evidence_grade":"C","target_role":"substrate","notes":"口服后三肽可在血中检出，但人体中整合素结合及直接促进 I 型和 III 型原胶原转录的证据尚缺。动物实验中皮肤羟脯氨酸和部分基质金属蛋白酶指标有所改变，这不能直接说明人体胶原新生或交联增加。"}],"indications":[{"indication_id":"skin_aging","grade":"B","verdict":"benefit"}]},{"id":"supp_tudca","name":"牛磺熊去氧胆酸 (TUDCA)","en_name":"Tauroursodeoxycholic Acid (TUDCA)","aliases":["TUDCA","牛磺熊去氧胆酸"],"summary":"牛磺熊去氧胆酸是内源亲水性胆汁酸，动物实验显示其可减轻内质网应激。人体试验（1750 毫克/天）仅见部分胰岛素敏感性指标改善，组织中的内质网应激标志物未见变化。","bioavailability_note":"口服后可进入肝肠循环，并在胆汁中富集。随含脂餐服用并非必需，目前尚无证据表明餐中服用效果更好。","typical_dose":"常用量为 250–500 毫克/天，可随餐服用。1750 毫克/天的人体试验结果不能直接套用于这一剂量。","functional_synergies":["与 NAC 联用（理论推测）：两者分别作用于内质网应激和氧化应激，理论上可能互补，但联用的人体研究尚缺。"],"contraindications":"完全性机械性胆总管结石完全梗阻者禁用；孕妇慎用。","mechanisms":[{"mechanism_id":"mech_er_stress_chaperone","score":3,"evidence_grade":"C","target_role":"primary","notes":"TUDCA 在糖尿病小鼠和细胞实验中可减轻内质网应激指标。20 人随机试验中，1750 毫克/天改善了部分胰岛素敏感性，但肌肉和脂肪组织的应激标志物未变，人体分子伴侣作用尚未证实。"},{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"肠道紧密连接的改善证据主要来自高脂饮食小鼠和结肠炎模型，TUDCA 能恢复部分紧密连接相关基因表达，并减轻 ZO-1 和 occludin 的下调。人体中尚无常规口服剂量下直接测量紧密连接蛋白的可靠研究。"}],"indications":[{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"C","verdict":"mixed"}]},{"id":"supp_resistant_starch","name":"抗性淀粉 (Resistant Starch / RS2/RS3)","en_name":"Resistant Starch (RS2 / Green Banana / Potato)","aliases":["抗性淀粉","生土豆淀粉","青香蕉粉","RS2"],"summary":"抗性淀粉不被小肠消化，到达结肠后可被菌群发酵产生丁酸等短链脂肪酸。人体研究中可测得粪便丁酸增加，但个体差异明显；对紧密连接和胰岛素敏感性的改善尚无一致的人体证据。","bioavailability_note":"加热会改变抗性淀粉的结构，但冷却后可形成回生型 RS3，不宜简单认为超过 40°C 就全部失去发酵价值。宜从小剂量（如 5–10 克）开始，逐渐增加。","typical_dose":"产品用量常为 10–30 克/天，混入温凉水、酸奶或代餐中饮用。标签上的抗性淀粉含量并不等于产品总重量；产酸和菌群反应也因淀粉类型、剂量及个人菌群而异。","functional_synergies":["与双歧杆菌类益生菌联用（理论推测）：抗性淀粉可为结肠菌群提供可发酵底物，但它并非双歧杆菌的专属食物，联用效果尚无直接的人体研究。","与丁酸钠联用（理论推测）：丁酸钠可直接提供丁酸，抗性淀粉则在结肠中持续产生丁酸，两者的联合效果尚未在人体中验证。"],"contraindications":"重度小肠细菌过度生长（SIBO）患者在未经抗菌调理前大量服用可能出现腹胀排气增多，建议从微量开始测试。","mechanisms":[{"mechanism_id":"mech_scfa_fermentation","score":5,"evidence_grade":"A","target_role":"substrate","notes":"抗性淀粉不被小肠消化，在结肠被菌群发酵，是产生丁酸等短链脂肪酸的底物。人体研究中，高抗性淀粉饮食可增加粪便丁酸浓度，但个体差异明显，受体激活程度也无法由粪便浓度直接推断。"},{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"紧密连接的改善证据主要来自糖尿病小鼠研究。丁酸可为结肠上皮供能，但代谢综合征患者的随机交叉试验未显示明确的通透性改善，人体中的连接蛋白变化尚未证实。"}],"indications":[{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"constipation","grade":"B","verdict":"mixed"}]},{"id":"supp_akkermansia","name":"阿克曼氏菌 (AKK 菌巴氏灭活后生元)","en_name":"Pasteurized Akkermansia muciniphila","aliases":["AKK菌","嗜粘蛋白阿克曼氏菌","巴氏灭活 AKK"],"summary":"巴氏灭活的阿克曼氏菌（后生元）在小鼠研究中可改善黏液屏障和紧密连接相关指标。人体直接证据仍然有限，尚不能确认其对糖脂代谢或肠道屏障的改善。","bioavailability_note":"活菌在常温下难以保存，培养条件也较苛刻，因此多采用巴氏灭活制剂。灭活的效应取决于菌株、制备工艺和观察终点，不能断言灭活后蛋白必然更易暴露，效力也不会因此倍增。","typical_dose":"每日约 10^9 至 10^10 等效灭活细胞数，随餐服用","functional_synergies":["与绿茶多酚（EGCG）或原花青素联用（理论推测）：多酚或能促进肠道内阿克曼氏菌的定植，但这一作用在人体中并不稳定，联用效果尚未验证。","与 L-谷氨酰胺联用（理论推测）：两者都与肠道屏障相关，联用的人体研究尚无。"],"contraindications":"巴氏灭活制剂不含存活菌，不具备活菌定植失控的风险，但这不能保证对所有人绝对无风险。长期使用及特殊人群的安全数据仍有限。","mechanisms":[{"mechanism_id":"mech_mucus_layer","score":3,"evidence_grade":"C","target_role":"secondary","notes":"巴氏灭活菌在小鼠抗生素相关腹泻模型中可改善 Muc2 等屏障指标。细胞实验显示 Amuc_1100 可激活 TLR2，但从 TLR2 到 MUC2 分泌、再到人体黏液层增厚的完整链条尚未确证。"},{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物研究中，灭活菌可上调 ZO-1、occludin 等紧密连接蛋白，并减轻其下调。人体中，血液内毒素或代谢指标的变化不能证明紧密连接蛋白上调，也不能说明细菌产物入血被完全阻断。"},{"mechanism_id":"mech_ampk_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"AMPK 相关变化来自小鼠和细胞实验，例如特定灭活菌株研究中 GLP-1 与 AMPK 相关指标有变化。但人体中尚无口服灭活菌后测得组织 AMPK 激活的可靠研究，GLP-1 驱动肝脏 AMPK 的因果关系也未确立。"},{"mechanism_id":"mech_prr_immune","score":3,"evidence_grade":"C","target_role":"primary","notes":"Amuc_1100 在细胞中可激活 TLR2。小鼠研究中，TLR2 缺失会部分抵消纯化 Amuc_1100 的作用，但这一证据来自纯化蛋白，不能直接说明整株灭活菌在人体中有相同的免疫效应。"}],"indications":[{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"muscle_strength","grade":"B","verdict":"mixed"},{"indication_id":"pcos","grade":"C","verdict":"mixed"}]},{"id":"supp_d3_k2","name":"维生素 D3 + 维生素 K2 (MK-7)","en_name":"Vitamin D3 + K2 (MK-7 / Menaquinone-7)","aliases":["维D3+K2","胆钙化醇","MK-7","引钙入骨搭档"],"summary":"维生素 D3 在体内转化为活性形式，结合细胞核内的 VDR 受体，调控钙吸收及部分免疫基因。K2 是维生素 K 依赖蛋白羧化的辅因子，但其预防血管钙化的作用尚未确立。","bioavailability_note":"维生素 D3 为脂溶性，随含脂肪的餐食服用有助于吸收。K2 建议选择天然发酵来源（如鹰嘴豆来源）的全反式 MK-7，其半衰期达 72 小时，远长于普通 MK-4。","typical_dose":"维生素 D3 常用 2000–5000 IU/天，K2（MK-7）常用 100–200 微克/天，随含脂肪的餐食服用。5000 IU/天已超过美国成人通常的可耐受摄入上限（4000 IU/天），长期使用应按缺乏程度在医师指导下评估并定期监测。","functional_synergies":["与甘氨酸镁联用：镁参与维生素 D 的代谢活化过程，但补充 D3 并不必须同步补镁。"],"contraindications":"原发性甲状旁腺功能亢进伴严重高钙血症者禁用。服用华法林等抗凝药者需严密监测：即使低剂量的 K2 也可能影响华法林的抗凝作用，开始、停用或调整剂量前应与抗凝管理者协调并监测 INR。","mechanisms":[{"mechanism_id":"mech_vdr_calcium","score":5,"evidence_grade":"A","target_role":"substrate","notes":"活性维生素 D 结合细胞核 VDR，调控钙转运等基因的表达。K2（MK-7）是骨钙素和基质 Gla 蛋白羧化的辅因子，人体随机试验已测得羧化指标改善。但这不代表该组合能定向把钙锁入骨骼或防止血管钙化。"},{"mechanism_id":"mech_prr_immune","score":2,"evidence_grade":"B","target_role":"secondary","notes":"活性维生素 D 可调节部分先天免疫基因。人体研究中，D3 补充后 TLR 相关血清指标有变化，但在部分研究中 LL-37 转录未显著高于对照，D3 本身也并非已证实的 TLR 病原模拟配体。"}],"indications":[{"indication_id":"vitamin_d_deficiency","grade":"B","verdict":"benefit"},{"indication_id":"bone_density","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"mixed"},{"indication_id":"falls","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"no_benefit"}]},{"id":"supp_magnesium_bisglycinate","name":"双甘氨酸螯合镁 (Magnesium Bisglycinate)","en_name":"Magnesium Bisglycinate Chelate","aliases":["甘氨酸镁","双甘氨酸镁","Chelated Magnesium"],"summary":"双甘氨酸镁是有机螯合镁，口服耐受性通常较好。镁阻滞 NMDA 通道是明确的细胞现象，但常规补镁能否在人体中达到相应的作用强度，尚无直接证据。","bioavailability_note":"双甘氨酸镁的稳定性较好。一项 1994 年针对肠切除患者的研究中，两种镁制剂的平均吸收率相近，因此不能断言它比氧化镁吸收高数倍，也不能认为它完全不引起腹泻。","typical_dose":"常用量以元素镁计为 200–400 mg/天，多在晚餐后或睡前服用。补充剂及药物来源的镁，美国成人通常上限为 350 mg/天，400 mg/天已超过该水平。","functional_synergies":["与 L-茶氨酸或 P-5-P 联用（理论推测）：有观点认为三者联用可舒缓交感神经紧张，但这一组合的睡眠或镇静效果缺乏人体研究证实。","与维生素 D3 联用（理论推测）：镁参与维生素 D 的代谢活化过程，联用的人体效果尚无专门研究。"],"contraindications":"严重晚期肾衰竭（肌酐清除率极低）患者需限制外源镁摄入，防止高镁血症；常规人群耐受度较好。镁可减少四环素类、喹诺酮类等药物的吸收，服药应按具体药物错开。","mechanisms":[{"mechanism_id":"mech_gaba_glutamate","score":2,"evidence_grade":"D","target_role":"primary","notes":"镁能以电压依赖的方式阻滞 NMDA 通道，这一细胞现象是明确的。但口服双甘氨酸镁能否提高脑内游离镁并增强该阻滞，目前无人体证据。甘氨酸并不直接激动 GABA 受体，且是 NMDA 受体的共同激动剂。"}],"indications":[{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"migraine","grade":"C","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"},{"indication_id":"muscle_cramps","grade":"B","verdict":"no_benefit"}]},{"id":"supp_zinc_picolinate","name":"吡啶甲酸锌 (Zinc Picolinate)","en_name":"Zinc Picolinate","aliases":["吡啶羧酸锌","有机锌","Zinc Picolinate"],"summary":"吡啶甲酸锌是锌与吡啶甲酸的螯合物。锌是胸腺素活性所必需的营养素；在特定患者中补锌可改变 TLR2 表达，但尚无证据表明吡啶甲酸锌直接激活模式识别受体或激活 Nrf2。","bioavailability_note":"有对比研究报告其在红细胞和毛发中的蓄积率高于葡萄糖酸锌和柠檬酸锌，但证据有限，不能据此断言其始终具有最高吸收率。服用时可随轻食同服，减少空腹时的恶心等不适。","typical_dose":"元素锌 15 - 30 mg/天，随餐服用","functional_synergies":["与槲皮素联用（理论推测）：有观点认为槲皮素可作为锌离子载体，促进锌进入细胞并抑制病毒复制，但这一说法未经临床确证。","长期补锌时可考虑同时关注铜状态，但没有证据要求固定按锌铜 15:1 的比例补充。"],"contraindications":"应避免长期持续大剂量补充。美国成人锌的通常可耐受上限为每日总摄入 40 毫克（需计入饮食），超过时可竞争性抑制铜吸收，导致缺铜性贫血。锌还会减少四环素类、喹诺酮类及青霉胺等药物的吸收，服药应按具体药物错开。","mechanisms":[{"mechanism_id":"mech_prr_immune","score":2,"evidence_grade":"A","target_role":"secondary","notes":"锌是胸腺素活性的必需辅因子，与 T 淋巴细胞成熟相关。人体研究中，葡萄糖酸锌曾使白塞病患者的白细胞 TLR2 表达下降，但这不能证明吡啶甲酸锌直接激动模式识别受体或诱导免疫训练。"},{"mechanism_id":"mech_nrf2_are","score":2,"evidence_grade":"B","target_role":"secondary","notes":"锌是 Cu/Zn-SOD1 的结构金属，但这不等于激活 Nrf2。人体随机试验中，移植后骨髓瘤患者补锌时 NRF2 及 SOD 相关基因表达升高；mRNA 变化不足以证明 Nrf2 入核，另一项中老年人研究也未见抗氧化指标的普遍获益。"}],"indications":[{"indication_id":"diarrhea","grade":"B","verdict":"benefit"},{"indication_id":"pcos","grade":"C","verdict":"mixed"},{"indication_id":"low_mood","grade":"C","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"},{"indication_id":"male_fertility","grade":"B","verdict":"no_benefit"}]},{"id":"supp_pea","name":"棕榈酰乙醇酰胺 (微粉化 PEA)","en_name":"Palmitoylethanolamide (PEA / Micronized PEA)","aliases":["PEA","棕榈酰乙醇胺","微粉化PEA"],"summary":"棕榈酰乙醇胺（PEA）是人体内源性脂质，可激活 PPAR-α 受体。动物模型中它能减轻炎症并调节肥大细胞浸润，但人体中肥大细胞和 NF-κB 相关机制尚未确证。","bioavailability_note":"PEA 亲脂性强，粗晶颗粒的溶出和吸收较差，微粉化可能改善这一点。但并非所有有效制剂都必须微粉化，也没有证据表明必须随脂肪餐服用。","typical_dose":"微粉化 PEA 300 - 1200 mg/天，随早晚餐服用","functional_synergies":["与 Omega-3（EPA、DHA）联用（理论推测）：PEA 通过 PPAR-α 发挥作用，EPA 与 DHA 是促消退介质的前体，两者作用机制可能互补，但联用的人体研究尚缺。"],"contraindications":"PEA 是人体内源性脂质，耐受性总体较好，但这不等于绝对安全。长期使用、特殊人群及与其他药物合用的数据仍有限，应咨询医师。","mechanisms":[{"mechanism_id":"mech_mast_cell","score":3,"evidence_grade":"C","target_role":"secondary","notes":"肥大细胞相关作用主要来自动物和细胞研究。大鼠研究中，口服 PEA 可减轻炎症，并降低炎症组织中的肥大细胞浸润。人体镇痛试验不能证明这一机制，常规口服在人体靶组织中的作用强度也不清楚。"},{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"C","target_role":"secondary","notes":"PEA 可激活 PPAR-α。小鼠研究中，PPAR-α 缺失时其部分抗炎作用消失；大鼠炎症组织中 NF-κB 信号也有所下降。常规口服剂量能否在靶组织达到足够的受体占有率并产生可测的 NF-κB 抑制，人体中尚未确证。"}],"indications":[{"indication_id":"joint_pain","grade":"C","verdict":"benefit"},{"indication_id":"neuropathy","grade":"C","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"C","verdict":"mixed"}]},{"id":"supp_krill_oil","name":"南极磷虾油 (磷脂型 Omega-3)","en_name":"Antarctic Krill Oil (Phospholipid-bound EPA/DHA)","aliases":["磷虾油","磷脂鱼油","Krill Oil"],"summary":"南极磷虾油以磷脂结合形式提供 EPA 和 DHA。小鼠研究显示它可改变肠腔的促消退脂质介质，人体中的相关证据多来自高剂量 n-3 脂肪酸研究，常规剂量的效果尚不明确。","bioavailability_note":"磷虾油中的 EPA 和 DHA 以磷脂形式存在，与传统鱼油的甘油三酯或乙酯形态不同。比较研究显示，等量 EPA、DHA 在不同形式之间的吸收差异并不恒定，因此不能断言它吸收快两到三倍、无需胆汁乳化，或绝无鱼油常见的腥味。","typical_dose":"常用量为 500–1500 毫克/天，随餐服用。剂量应按产品标示的 EPA、DHA 和胆碱含量计算，磷虾油总重量并不等于 omega-3 含量。","functional_synergies":["与辅酶 Q10 联用（理论推测）：有观点认为磷脂有助于辅酶 Q10 融入细胞膜，但缺少相关人体研究。","与银杏叶提取物联用（理论推测）：两者都可能影响凝血功能，联用时应关注出血风险。"],"contraindications":"对甲壳类水产（虾、蟹）严重过敏者禁用。大剂量可能有轻微抗凝作用，与银杏叶提取物或抗凝、抗血小板药物合用时应关注出血风险。","mechanisms":[{"mechanism_id":"mech_spm_resolution","score":3,"evidence_grade":"B","target_role":"substrate","notes":"EPA 和 DHA 是促消退介质的前体，其生成量受剂量和炎症状态影响。磷脂型能否比其他形式更快生成消退介质，缺乏人体比较证据；人体中的介质变化多来自更高剂量的 n-3 脂肪酸研究。"},{"mechanism_id":"mech_cholinergic","score":2,"evidence_grade":"B","target_role":"substrate","notes":"磷脂酰胆碱可为身体提供胆碱。一项 17 人试点研究显示，每日 4.5 克磷虾油连续 28 天后空腹血浆胆碱升高；但常规剂量的贡献有限，脑内乙酰胆碱的变化尚未得到直接测量。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"虾青素的抗氧化作用，即化学猝灭自由基，主要来自体外证据。磷虾油中的虾青素含量随产品而异，且多以脂肪酸酯形式存在；常规剂量下能否直接清除人体自由基，尚无可靠研究。"}],"indications":[{"indication_id":"triglycerides","grade":"B","verdict":"benefit"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"benefit"},{"indication_id":"muscle_strength","grade":"C","verdict":"benefit"},{"indication_id":"pms","grade":"C","verdict":"benefit"},{"indication_id":"joint_pain","grade":"B","verdict":"mixed"}]},{"id":"supp_benfotiamine","name":"苯磷硫胺 (脂溶性维生素 B1)","en_name":"Benfotiamine (Fat-Soluble Vitamin B1)","aliases":["苯磷硫胺","脂溶性B1","S-苯甲酰硫胺单磷酸盐"],"summary":"苯磷硫胺是脂溶性维生素 B1 的前体，口服后可提高硫胺水平并支持转酮醇酶活性。人体随机试验未稳定降低所测的 AGEs，抗糖化的临床获益尚无一致证据。","bioavailability_note":"苯磷硫胺为脂溶性，口服后可提高循环硫胺及红细胞硫胺二磷酸水平。相对生物利用度因制剂、剂量和测量指标而异，不宜简单套用“上百倍”的说法。","typical_dose":"常用量为 150–300 毫克/天，早晨或午餐时服用。人体抗糖化随机试验使用的是 900 毫克/天，其结果不能直接外推至这一剂量范围。","functional_synergies":["与 R-α-硫辛酸联用（理论推测）：两者分别与糖化和氧化应激相关，理论上可从不同方面减轻高糖相关损伤，但苯磷硫胺未稳定降低 AGEs，联用对糖尿病微血管与周围神经病变的获益也缺乏直接的人体证据。"],"contraindications":"常规剂量下耐受性良好；对含硫胺化合物罕见过敏者除外。","mechanisms":[{"mechanism_id":"mech_ages_glycation","score":3,"evidence_grade":"A","target_role":"substrate","notes":"苯磷硫胺转化为硫胺二磷酸后，可支持转酮醇酶的活性，使糖代谢中间产物更多进入磷酸戊糖途径。人体随机试验中转酮醇酶活性增加，但晚期糖基化终产物（AGEs）未见稳定下降。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"苯磷硫胺在约 0.5–1 mmol/L 的体外浓度下可直接清除超氧阴离子，但常规口服后的游离药物暴露远低于该浓度。人体中直接化学清除自由基的作用尚未确立。"}],"indications":[{"indication_id":"neuropathy","grade":"B","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"C","verdict":"mixed"}]},{"id":"supp_dhm","name":"二氢杨梅素 (DHM / 藤茶提取物)","en_name":"Dihydromyricetin (DHM / Ampelopsin)","aliases":["二氢杨梅素","藤茶素","蛇葡萄素","DHM"],"summary":"二氢杨梅素是藤茶等植物中的黄酮醇类成分。动物研究显示它可影响乙醇代谢酶的表达，但人体中加快乙醛清除、缓解醉酒或宿醉的作用，尚无可靠证据。","bioavailability_note":"二氢杨梅素为天然多酚类黄酮醇，口服水溶性偏低，大鼠药代研究报告其口服生物利用度较低。微囊化制剂的临床效果尚无人体数据支持，饮酒前后的最佳服用时点也未确定。","typical_dose":"常见用量为日常 300–600 毫克/天；与饮酒相关的用量为 600–1200 毫克，于饮酒前后服用。这些剂量和服用时点都缺乏充分的人体研究。","functional_synergies":["与 NAC 联用（理论推测）：二氢杨梅素与 NAC 的作用环节不同，理论上可能互补，但联用对酒精毒性的保护效果尚无临床证据。"],"contraindications":"不应因服用二氢杨梅素而增加饮酒量，它并不能保证减轻醉酒或宿醉。孕妇和哺乳期妇女慎用。","mechanisms":[{"mechanism_id":"mech_alcohol_aldh","score":3,"evidence_grade":"C","target_role":"primary","notes":"动物实验提示二氢杨梅素可改变肝脏 ADH1 和 ALDH2 的表达，并影响乙醇处理后的血液乙醇和乙醛水平。人体中尚无可靠证据表明它变构激活 ALDH2 或降低乙醛峰值，口服后的组织暴露也有限。"},{"mechanism_id":"mech_gaba_glutamate","score":3,"evidence_grade":"C","target_role":"primary","notes":"大鼠和离体受体实验显示，二氢杨梅素可减轻部分与 GABA-A 受体相关的乙醇效应。这些研究多采用注射给药，尚不能证明常规口服后人体脑内能达到有效浓度。"},{"mechanism_id":"mech_ampk_activation","score":2,"evidence_grade":"C","target_role":"secondary","notes":"小鼠实验中，肝脏 AMPK 磷酸化增加，相关线粒体指标也有变化。常规口服剂量下，人体组织中的 AMPK 反应尚无证据，脂肪肝改善的人体效果也未得到验证。"}],"indications":[{"indication_id":"blood_glucose","grade":"C","verdict":"benefit"},{"indication_id":"ldl_cholesterol","grade":"C","verdict":"benefit"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"}]},{"id":"supp_trehalose","name":"海藻糖 (Trehalose)","en_name":"D-Trehalose","aliases":["海藻糖","天然双糖自噬剂","Trehalose"],"summary":"海藻糖是非还原性双糖，动物和细胞实验中可引起 TFEB 相关的溶酶体及自噬反应。常用口服剂量下，完整分子进入组织的量很有限，诱导脑内自噬或稳定蛋白的人体作用尚无可靠证据。","bioavailability_note":"海藻糖为非还原性双糖，小肠中的海藻糖酶可将其大部分水解为葡萄糖。完整分子进入人体组织的量有限，不能保证空腹服用即可在脑内诱导自噬。","typical_dose":"常用量为 5–15 克/天，溶于温凉水饮用。这一用量属于需计入的碳水化合物摄入，不宜视为微量。","functional_synergies":["与亚精胺联用（理论推测）：两者分别经不同通路影响自噬，理论上可能叠加，但人体中口服海藻糖诱导自噬的证据不足，联用效果未经研究。"],"contraindications":"先天性海藻糖酶缺乏者服用后可能出现渗透性腹泻或腹胀。糖尿病患者需将其中的碳水化合物计入每日总热量。","mechanisms":[{"mechanism_id":"mech_autophagy_mTOR","score":1,"evidence_grade":"D","target_role":"primary","notes":"在细胞和动物研究中，海藻糖可引起自噬及 TFEB 相关反应，但所用浓度远高于口服后组织能达到的水平。部分效应与 mTOR 无关，上游机制也有争议。人体中尚无口服诱导自噬的证据。"},{"mechanism_id":"mech_er_stress_chaperone","score":1,"evidence_grade":"D","target_role":"primary","notes":"海藻糖作为化学伴侣，在高浓度体外实验中可稳定某些蛋白。完整分子经肠道被水解，普通口服剂量难以达到所需的组织浓度；动物药代研究中脑部暴露也很低，人体中的组织效应尚未得到研究。"}],"indications":[{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"C","verdict":"mixed"}]},{"id":"supp_gynostemma","name":"绞股蓝总皂苷 (Actiponin / Gynostemma)","en_name":"Gynostemma pentaphyllum (Actiponin / Gypenosides)","aliases":["七叶胆提取物","绞股蓝皂苷","Actiponin"],"summary":"标准化绞股蓝提取物（Actiponin）每日 450 mg 的随机试验观察到腹部脂肪指标变化。AMPK 激活的证据主要来自动物与细胞，人体组织中的作用尚未直接测定。","bioavailability_note":"绞股蓝皂苷在肠道内可经细菌酶作用脱去糖基，生成苷元类产物，但并非所有皂苷都如此转化，不同成分和制剂的人体药代资料有限。建议随早午正餐服用。","typical_dose":"标准化 Actiponin 提取物 450 mg/天（或标准绞股蓝总皂苷 300-600 mg/天）","functional_synergies":["与小檗碱联用：两者都被认为作用于 AMPK 通路，联合应用的代谢改善效果尚无直接人体研究（理论推测）","与绿茶 EGCG 联用：理论上可协同促进脂肪酸氧化，缺乏人体联用数据（理论推测）"],"contraindications":"少数人可出现轻度腹泻或排便次数增加。与降糖药合用可能增加低血糖风险，应注意监测血糖。长期和妊娠期安全性资料不足，孕妇及哺乳期不建议使用。","mechanisms":[{"mechanism_id":"mech_ampk_activation","score":3,"evidence_grade":"C","target_role":"primary","notes":"绞股蓝皂苷被认为通过上游激酶促进 AMPK 的 Thr172 位点磷酸化，进而抑制乙酰辅酶 A 羧化酶，减少脂肪合成。动物肝脏中已观察到 AMPK 磷酸化增加，人体组织中是否如此尚未直接测定。"},{"mechanism_id":"mech_enos_no","score":2,"evidence_grade":"A","target_role":"secondary","notes":"绞股蓝提取物在培养内皮细胞中可促进一氧化氮释放，离体血管也可舒张。一项随机试验测得血液中 eNOS 水平升高，但它是否意味着冠脉或微血管舒张改善，尚无直接证据。"}],"indications":[{"indication_id":"body_weight","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"C","verdict":"benefit"},{"indication_id":"fatigue","grade":"C","verdict":"benefit"},{"indication_id":"endurance","grade":"C","verdict":"benefit"}]},{"id":"supp_luteolin","name":"木犀草素 (Luteolin)","en_name":"Luteolin (Peanut Shell / Chamomile Extract)","aliases":["木犀草素","花生壳提取物","Luteolin"],"summary":"木犀草素在小鼠和细胞实验中可抑制肥大细胞脱颗粒，并削弱小胶质细胞的炎症信号。常规口服剂量下能否进入脑内并产生类似作用，目前没有直接的人体证据。","bioavailability_note":"木犀草素纯品难溶于水，口服后大量经结合代谢，血浆中的游离型比例有限。随含油脂的餐食同服，或选用脂质体制剂，有助于溶解和吸收，但相关人体数据仍然有限。","typical_dose":"100 - 300 mg/天，随餐服用","functional_synergies":["与棕榈酰乙醇酰胺（PEA）联用：两者都针对神经炎症通路，联合效果尚无人体研究（理论推测）","与槲皮素联用：理论上可叠加抗组胺作用，缺乏人体联用证据（理论推测）"],"contraindications":"对花生或菊科植物过敏者应先确认提取来源，过敏风险还取决于提取物中的残留物。大剂量服用可能与降压药产生叠加的轻度降压作用。100–300 mg/天的长期安全性尚未充分确立。","mechanisms":[{"mechanism_id":"mech_mast_cell","score":3,"evidence_grade":"C","target_role":"primary","notes":"木犀草素在小鼠和细胞实验中可抑制肥大细胞活化及组胺等介质释放，并影响钙信号。单独口服木犀草素后，人体肥大细胞是否发生同样变化，目前没有试验验证。"},{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"C","target_role":"secondary","notes":"木犀草素在细胞和小鼠实验中可抑制 IκBα 与 NF-κB 信号，减少炎症因子转录。中枢 IKK 与 STAT3 的抑制只在实验模型中见到，人体脑内是否发生尚未验证。"},{"mechanism_id":"mech_senolytic","score":1,"evidence_grade":"D","target_role":"secondary","notes":"木犀草素在细胞实验中可减轻氧化应激诱导的衰老表型，但这并不等于清除衰老细胞。目前没有可靠的人体或完整动物证据显示其能选择性诱导衰老细胞凋亡。"}],"indications":[{"indication_id":"uric_acid","grade":"C","verdict":"benefit"}]},{"id":"supp_lycopene","name":"天然番茄红素 (Lycopene)","en_name":"Natural Lycopene (Tomato Extract / Lyc-O-Mato)","aliases":["番茄红素","天然番茄提取物","Lyc-O-Mato"],"summary":"番茄红素体外可有效猝灭单线态氧，但人体中的直接抗氧化贡献难以定量。一项 30 mg/天的随机试验改善了部分 DNA 氧化损伤指标，未改善脂质过氧化指标。","bioavailability_note":"番茄红素在常温结晶态下吸收较差。加工、加热和油脂共存都会影响其异构化与吸收，随含脂餐食服用较为合理，但具体提高幅度尚缺乏普遍依据。","typical_dose":"天然全谱番茄红素 15 - 30 mg/天，随午餐或晚餐服用","functional_synergies":["与锯棕榈提取物联用：两者分别涉及抗氧化与 5α-还原酶相关通路，联用对前列腺的作用尚无人体研究（理论推测）","与维生素 E 联用：理论上可互补保护脂质膜，缺乏人体联用证据（理论推测）"],"contraindications":"常规剂量下耐受性良好，极高剂量长期服用皮肤角质层可能呈现无害的天然浅橙红变色（Lycopenemia）。","mechanisms":[{"mechanism_id":"mech_direct_ros","score":3,"evidence_grade":"B","target_role":"primary","notes":"番茄红素含 11 个共轭双键，体外可物理猝灭单线态氧，报道的速率约为 α-生育酚的 100 倍以上，但这一倍数受实验条件影响。人体内的直接贡献难以定量。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"动物实验显示番茄红素可降低肝脏 NF-κB 磷酸化，细胞实验中也能减轻 TNF-α 诱导的 ICAM-1 与 NF-κB 信号。人体血管内皮或组织中的 NF-κB 是否被抑制，尚未直接证实。"},{"mechanism_id":"mech_5ar_dht","score":1,"evidence_grade":"D","target_role":"secondary","notes":"动物研究显示番茄红素可下调前列腺中 5α-还原酶 1 的基因表达，但没有证明酶被竞争性抑制。人体中的酶活性及双氢睾酮水平是否随之改变，目前没有证据。"}],"indications":[{"indication_id":"bph","grade":"C","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"male_fertility","grade":"B","verdict":"mixed"},{"indication_id":"skin_aging","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"no_benefit"}]},{"id":"supp_tocotrienols","name":"天然全谱生育三烯酚 (Tocotrienols)","en_name":"Full Spectrum Tocotrienols (EVNol SupraBio)","aliases":["生育三烯酚","红棕榈油提取物","EVNol","三烯生育酚"],"summary":"生育三烯酚在细胞和动物模型中可调节炎症信号与神经相关通路。人体试验中丙二醛等氧化指标有所下降，血清 NGF 升高，但脑内作用及降胆固醇效果的人体结论并不一致。","bioavailability_note":"α-生育酚与三烯酚竞争肝脏转运蛋白（α-TTP），因此大剂量普通维生素 E 不宜与之同服。自微乳化制剂有助于吸收，但并不能完全摆脱胆汁或食物的影响，不同异构体的吸收与保留差异明显。","typical_dose":"纯生育三烯酚（α/β/γ/δ） 50 - 200 mg/天，随餐服用","functional_synergies":["与辅酶 Q10 联用：两者作用于脂质膜的不同部位，理论上可互补抗氧化，尚无人体联用研究（理论推测）","与缩醛磷脂联用：理论上可共同维持神经膜稳定，但保护脑白质的作用尚无人体证据（理论推测）"],"contraindications":"与华法林等抗凝药合用时可能有轻度抗血小板协同作用，应关注出血风险并监测 INR，不应只限于超大剂量使用者。常规剂量下耐受性总体良好。","mechanisms":[{"mechanism_id":"mech_direct_ros","score":3,"evidence_grade":"B","target_role":"primary","notes":"生育三烯酚在脂质环境中具有抗氧化化学活性，可能参与抑制膜脂质过氧化。人体中丙二醛等指标有所下降，但这些指标不能特异证明直接捕获自由基，神经保护也不宜全部归因于此。"},{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"C","target_role":"secondary","notes":"γ- 和 δ-生育三烯酚在细胞实验中可抑制 IκBα 磷酸化，较高剂量的动物实验也观察到 NF-κB 信号变化。人体中这一靶点是否受抑制尚未测量，一般炎症指标不能替代该检测。"},{"mechanism_id":"mech_bdnf_ngf","score":2,"evidence_grade":"A","target_role":"secondary","notes":"在糖尿病周围神经病变患者中，一项随机试验观察到服用富含生育三烯酚的制剂（每日 400 mg）后血清 NGF 升高。这一结果不能推定脑内 BDNF 或 Trk 受体被激活，也不能推至较低剂量。"}],"indications":[{"indication_id":"fatty_liver","grade":"C","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"},{"indication_id":"neuropathy","grade":"B","verdict":"no_benefit"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"no_benefit"},{"indication_id":"triglycerides","grade":"B","verdict":"no_benefit"}]},{"id":"supp_gingerol","name":"生姜提取物 (姜辣素 / 姜烯酚)","en_name":"Ginger Extract (Gingerols & Shogaols)","aliases":["生姜提取物","姜酚","姜辣素","Gingerol"],"summary":"姜辣素与姜烯酚是生姜的主要辛辣成分。小型人体试验观察到结肠黏膜中部分促炎类花生酸下降，但结果不一致；NF-κB 相关作用主要见于动物和细胞模型，直接的人体抗炎作用尚未确证。","bioavailability_note":"姜辣素在肠黏膜中可较快发生葡萄糖醛酸化，游离型比例有限。6-姜烯酚由姜辣素脱水或加热转化生成，部分高浓缩超临界 CO2 萃取物富含此成分，但目前缺乏比较研究，无法判断其体内稳定性是否更优。","typical_dose":"标准化 5% 姜酚提取物 250 - 1000 mg/天，随餐或感觉反胃时服用","functional_synergies":["与朝鲜蓟提取物联用：两者都被认为可促进胆汁分泌或消化道动力，联用效果尚无人体研究（理论推测）","与姜黄素联用：理论上可叠加抗炎作用，缺乏人体联用证据（理论推测）"],"contraindications":"活动性消化性溃疡伴出血期间应慎用。胆石症患者单次服用超大剂量时，可能引起胆囊剧烈收缩。与抗凝药或抗血小板药合用时应关注出血风险，两者相互作用的临床证据并不一致。","mechanisms":[{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"C","target_role":"secondary","notes":"姜成分在细胞和动物实验中可调节 NF-κB 信号，但 p65 烷基化等具体靶点在人体中未被证实。口服后游离型姜辣素的暴露受结合代谢限制，人体黏膜中的作用尚未确定。"},{"mechanism_id":"mech_cox_lox_inhibition","score":2,"evidence_grade":"B","target_role":"secondary","notes":"姜辣素被认为可结合 COX-2 与 5-LOX 的催化部位，减少前列腺素 E2 与白三烯 B4 的合成。人体小型试验观察到结肠黏膜中部分类花生酸下降，但结果不一致，且无法区分具体的酶作用。"}],"indications":[{"indication_id":"pms","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"inflammation_markers","grade":"B","verdict":"benefit"},{"indication_id":"joint_pain","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"}]},{"id":"supp_andrographolide","name":"穿心莲内酯 (Andrographolide)","en_name":"Andrographis paniculata (Andrographolide)","aliases":["穿心莲内酯","穿心莲提取物","Andrographolide"],"summary":"穿心莲内酯在细胞和动物实验中可与 NF-κB p50 亚基的 Cys62 位点发生共价结合，抑制其活化。人体内这一靶点是否被占据尚无直接证据，已有人体研究只测到口服后的血药暴露。","bioavailability_note":"穿心莲内酯味极苦，口服后可在血中检出。文献报道的半衰期约 2–3 小时，但药代特征随制剂和剂量而变，单凭半衰期不足以确定固定的服药间隔。","typical_dose":"标准化穿心莲内酯 300 - 600 mg/天（分 2-3 次服用），连续使用 3-7 天","functional_synergies":["与黑接骨木莓联用：两者作用环节不同，理论上可互补，但缺乏人体联用研究（理论推测）"],"contraindications":"孕妇禁用：动物研究显示其可能有抗着床和流产作用，人体风险资料不足。部分人可出现食欲下降或腹泻，症状缓解后即可停用。穿心莲可引起严重过敏反应甚至过敏性休克，出现过敏征象应立即停用并就医。","mechanisms":[{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"C","target_role":"primary","notes":"穿心莲内酯的不饱和内酯环可与 NF-κB p50 亚基的半胱氨酸 62 位发生共价修饰，在细胞和动物实验中抑制其活化。人体中这一靶点是否被占据尚无直接测定，口服后的修饰程度也不确定。"},{"mechanism_id":"mech_prr_immune","score":1,"evidence_grade":"D","target_role":"secondary","notes":"淋巴细胞增殖和 NK 细胞数量等指标变化，不能证明模式识别受体被激活或训练免疫形成。部分动物研究反而显示 TLR4 相关信号下调，目前没有可靠证据支持这一机制。"}],"indications":[{"indication_id":"colds","grade":"B","verdict":"benefit"},{"indication_id":"joint_pain","grade":"B","verdict":"benefit"}]},{"id":"supp_reishi_triterpenes","name":"灵芝破壁孢子三萜 (Ganoderic Acids)","en_name":"Reishi Mushroom Triterpenes (Ganoderic Acids)","aliases":["灵芝酸","破壁灵芝孢子油","灵芝三萜","Ganoderma lucidum"],"summary":"灵芝三萜是灵芝中脂溶性的四环三萜类化合物。离体实验显示部分灵芝酸可抑制组胺释放，动物研究提示其可影响肝脏抗氧化信号；纯三萜的人体证据尚不充分。","bioavailability_note":"灵芝子实体水提物富含多糖，醇提物或破壁孢子的超临界 CO2 萃取物则富集脂溶性的灵芝酸。三萜类的肠道吸收数据有限，随含脂餐食服用较为常见，但具体吸收效率尚无人体研究。","typical_dose":"标准化灵芝三萜 300–1000 mg/天，或灵芝孢子油 500–1000 mg/天，随餐服用。这一剂量缺乏充分的人体依据，且孢子油与三萜提取物的含量不能互换。","functional_synergies":["与酵母 β-葡聚糖联用：理论上两者作用于不同的免疫通路，但缺乏联用研究（理论推测）","与水飞蓟宾联用：护肝作用叠加的效果缺乏人体证据（理论推测）"],"contraindications":"器官移植术后服用免疫抑制剂者禁用。手术前 1 周建议暂停，因其可能有轻微抑制血小板凝集的作用。灵芝制品有相关肝损伤病例报告，因果关系和具体成分仍不确定，出现肝功能异常时应停用并就医。","mechanisms":[{"mechanism_id":"mech_nrf2_are","score":2,"evidence_grade":"C","target_role":"secondary","notes":"在小鼠模型中，部分灵芝酸可影响肝脏 Nrf2 与 HO-1 相关指标。人体中尚缺口服灵芝三萜后 NQO1、HO-1 等特异指标的研究，因此护肝结论无法直接推及人体。"},{"mechanism_id":"mech_mast_cell","score":2,"evidence_grade":"D","target_role":"primary","notes":"离体大鼠肥大细胞实验中，分离出的部分灵芝酸可抑制组胺释放。这一结果来自离体体系，常规剂量的孢子油能否在人体达到相应浓度并抑制脱颗粒，目前没有证据。"},{"mechanism_id":"mech_prr_immune","score":1,"evidence_grade":"D","target_role":"secondary","notes":"灵芝三萜激活 Dectin-1 或 TLR 的证据不足，免疫细胞和干扰素指标的变化不能归因于三萜。相关受体研究主要针对灵芝多糖或真菌 β-葡聚糖，纯三萜口服诱导训练免疫的可靠研究尚未见到。"}],"indications":[{"indication_id":"triglycerides","grade":"C","verdict":"benefit"},{"indication_id":"ldl_cholesterol","grade":"C","verdict":"benefit"},{"indication_id":"fatigue","grade":"C","verdict":"benefit"},{"indication_id":"cognitive_decline","grade":"C","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"}]},{"id":"supp_colostrum","name":"牛初乳免疫球蛋白 (Colostrum / IgG 40%+)","en_name":"Bovine Colostrum (Standardized 40%+ IgG)","aliases":["牛初乳","初乳多肽","Colostrum IgG","PRPs"],"summary":"牛初乳富含免疫球蛋白 G 与富脯氨酸多肽。小型人体试验中肠通透性指标的变化并不一致，部分机制证据仅来自特定抗体或动物模型，常规产品的人体屏障作用尚未确证。","bioavailability_note":"免疫球蛋白和多肽对高温较敏感，但目前没有统一的温度阈值，活性取决于温度、时长、配方和加工方式。不宜用过烫的水冲服，可用温凉开水冲服或整粒吞服。","typical_dose":"精纯标准化初乳粉 1–5 克/天（提供 IgG 400–2000 mg），早晨空腹服用。人体试验多使用更高剂量，该剂量的屏障作用尚未得到直接验证。","functional_synergies":["与 L-谷氨酰胺联用：两者都被认为与肠上皮的维持有关，联用效果缺乏人体研究（理论推测）","与布拉氏酵母菌联用：理论上可能有益于菌群平衡，但缺乏人体联用证据（理论推测）"],"contraindications":"对牛乳蛋白（如酪蛋白）有严重过敏史者禁用。乳糖不耐受者的耐受性取决于产品中的乳糖残留，应按具体产品判断。","mechanisms":[{"mechanism_id":"mech_tight_junction","score":2,"evidence_grade":"B","target_role":"primary","notes":"牛初乳中的生长因子被认为可促进肠隐窝上皮细胞增殖，并影响紧密连接蛋白的装配。但人体中 ZO-1 和 Occludin 是否因此增加尚未直接证明，小型试验的肠通透性结果也不一致。"},{"mechanism_id":"mech_mucosal_iron_binding","score":1,"evidence_grade":"D","target_role":"secondary","notes":"乳铁蛋白可结合游离铁并抑制部分细菌，但该产品以 IgG 标准化，乳铁蛋白含量未予说明。特定抗体的研究不能推及一般 IgG，目前没有证据显示常规产品能在肠腔内通过夺铁抑制病原体。"},{"mechanism_id":"mech_prr_immune","score":1,"evidence_grade":"D","target_role":"secondary","notes":"富脯氨酸多肽被认为可调节免疫反应，但其在模式识别受体及训练免疫中的作用没有可靠研究。产品中 PRP 的含量和活性也未经标准化，目前无法把一般免疫调节效果归为该机制。"}],"indications":[{"indication_id":"colds","grade":"B","verdict":"benefit"},{"indication_id":"diarrhea","grade":"B","verdict":"mixed"},{"indication_id":"ibs","grade":"C","verdict":"mixed"}]},{"id":"supp_bacopa","name":"假马齿苋提取物 (Bacopa monnieri / Bacosides)","en_name":"Bacopa Monnieri Extract (Synapsa / Bacopin)","aliases":["假马齿苋","白花猪母菜","Bacopa","Bacosides"],"summary":"假马齿苋是传统益智草药。Meta 分析显示连续服用 12 周左右可小幅改善注意力和信息处理速度。它对 BDNF、胆碱能和单胺系统的作用多来自动物研究，人体中的结果并不一致。","bioavailability_note":"皂苷吸收较慢，空腹服用时可能引起胃肠不适。目前没有充分证据要求必须随含油正餐服用。常见人体研究周期为 4–12 周，但这一周期并不等于已证实的突触重塑过程。","typical_dose":"标准化 45-55% 假马齿苋皂苷提取物 300 - 450 mg/天，随早或午餐服用","functional_synergies":["与猴头菇提取物联用：理论上可叠加对神经营养因子通路的作用，但缺乏人体联用研究（理论推测）"],"contraindications":"空腹服用偶见恶心或肠道蠕动加快腹泻；可引起极其轻微的心率减缓，心动过缓者慎用。","mechanisms":[{"mechanism_id":"mech_bdnf_ngf","score":3,"evidence_grade":"A","target_role":"primary","notes":"一项 80 人的随机试验观察到每日 300 mg、12 周后血清 BDNF 高于安慰剂组，但另一项老年人开放研究在 12 周后未见血清 BDNF 变化。海马中 TrkB 受体与树突棘的变化主要见于动物。"},{"mechanism_id":"mech_cholinergic","score":3,"evidence_grade":"A","target_role":"primary","notes":"一项 60 人随机试验在部分时间点观察到血浆乙酰胆碱酯酶活性下降，但外周酶活性不能代表脑内的抑酶程度。大脑皮层胆碱乙酰转移酶的变化未被直接测定，所用提取物的标准化程度也与本品不同。"},{"mechanism_id":"mech_monoamine","score":3,"evidence_grade":"C","target_role":"secondary","notes":"幼龄大鼠研究中海马色氨酸羟化酶-2 与血清素转运体的表达发生变化，但这不能证明成人脑内血清素释放增加。人体随机试验未发现单胺氧化酶活性显著改变，抗焦虑作用尚无人体证据。"}],"indications":[{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"},{"indication_id":"memory","grade":"B","verdict":"mixed"},{"indication_id":"attention","grade":"B","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"C","verdict":"mixed"}]},{"id":"supp_polygala","name":"远志提取物 (Polygala tenuifolia)","en_name":"Polygala Tenuifolia Extract (Yuan Zhi)","aliases":["远志","远志皂苷","Polygala","TEN-60"],"summary":"远志提取物在动物和细胞实验中可影响 BDNF/TrkB 信号、脑内单胺代谢及 NMDA 相关的神经毒性。人体中的脑内靶点、长时程增强和速效心境作用均未得到可靠验证。","bioavailability_note":"远志的活性成分在水中有一定溶解性，但目前缺乏可靠的人体药代数据，吸收速度和生效时间应以具体产品的研究为准。","typical_dose":"水醇双提标准提取物 100–300 mg/天，早晨服用。这一范围不能视为所有远志提取物通用的有效剂量，制剂之间成分差异较大。","functional_synergies":["与苏糖酸镁联用：理论上两者作用于不同的神经通路，但缺乏联用研究（理论推测）","与 L-茶氨酸联用：理论上可能有助于放松，缺乏远志与其联用的人体证据（理论推测）"],"contraindications":"重度活动期胃炎与胃溃疡患者应慎用。生远志具轻度催吐与胃黏膜刺激性，提取物反应较轻，但仍需留意。晚间服用可能引起神经兴奋和失眠。长期使用、孕期和哺乳期的安全数据不足。","mechanisms":[{"mechanism_id":"mech_bdnf_ngf","score":3,"evidence_grade":"C","target_role":"primary","notes":"远志提取物在慢性应激大鼠中可影响海马 BDNF 与 TrkB 的 mRNA 表达，证据主要限于动物。人体中 TrkB 的快速激活及突触长时程增强尚无可靠试验证据，抗抑郁作用也不能由此推断。"},{"mechanism_id":"mech_monoamine","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物实验提示远志可改变脑内单胺相关代谢。体外实验中，部分远志寡糖酯需达到微摩尔级浓度才能抑制去甲肾上腺素转运，同时抑制三种转运体的说法缺乏人体证据。"},{"mechanism_id":"mech_gaba_glutamate","score":1,"evidence_grade":"D","target_role":"secondary","notes":"远志在培养神经元中可减轻 NMDA 诱导的损伤，但这不等于直接阻断 NMDA 离子通道。受体直接拮抗的作用，以及人体中的神经保护效果，目前都没有可靠证据。"}],"indications":[{"indication_id":"memory","grade":"C","verdict":"benefit"}]},{"id":"supp_ginkgo","name":"银杏叶标准化提取物 (Ginkgo biloba / EGb 761)","en_name":"Ginkgo Biloba Extract (EGb 761)","aliases":["银杏叶提取物","EGb 761","银杏黄酮","银杏内酯"],"summary":"标准化银杏叶提取物（EGb 761，含 24% 黄酮苷、6% 萜内酯）在轻中度痴呆患者中有小幅改善认知的 Meta 分析证据，但用于健康老人预防痴呆的大型试验结果为阴性。其拮抗血小板活化因子等血管机制主要见于体外研究。","bioavailability_note":"应选用经过脱除银杏酸处理的标准化提取物，银杏酸含量应低于 5 ppm。EGb 761 只是其中一种制剂，鲜叶或未规范制备的产品不宜与标准化提取物等同。随餐或空腹服用均可，吸收较好。","typical_dose":"标准化 EGb 761 提取物 120 - 240 mg/天（分 1-2 次服用），早晚餐服用","functional_synergies":["与磷脂酰丝氨酸联用：理论上可共同支持神经功能，但联用的认知获益缺乏人体证据（理论推测）","与辅酶 Q10 联用：理论上可共同改善微循环，尚无人体联用数据（理论推测）"],"contraindications":"即将接受大型外科手术者，以及正在服用抗凝药（如华法林）或抗血小板药（如阿司匹林、氯吡格雷）的人，应结合出血风险和具体操作评估停药时间。提前 2 周停用可作为参考，具体须由医生决定。未经脱毒处理的鲜银杏叶毒性较强，不应自行泡水饮用。","mechanisms":[{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"C","target_role":"secondary","notes":"EGb 761 在细胞中可增强 eNOS 信号，大鼠实验中产生依赖一氧化氮的降压作用。人体血流或血管舒张的变化不能单独证明 eNOS 被激活，脑基底动脉和内耳微动脉的具体机制尚未确定。"},{"mechanism_id":"mech_paf_platelet","score":1,"evidence_grade":"D","target_role":"secondary","notes":"银杏内酯类成分在体外可拮抗血小板活化因子，抑制其诱导的血小板聚集。但按常规 EGb 761 剂量计算，口服后的血药峰浓度远低于体外所需浓度，高剂量纯内酯的结果不能直接外推。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"银杏黄酮及其组分在体外具有抗氧化活性，口服后以代谢物和结合物形式存在。常规剂量能否在脑微血管内直接清除自由基，目前没有可靠的人体研究，氧化指标的变化也不能直接反推此作用。"}],"indications":[{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"},{"indication_id":"cognitive_decline","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"A","verdict":"no_benefit"},{"indication_id":"cardiovascular_events","grade":"A","verdict":"no_benefit"},{"indication_id":"memory","grade":"B","verdict":"no_benefit"},{"indication_id":"attention","grade":"B","verdict":"no_benefit"}]},{"id":"supp_holy_basil","name":"圣罗勒提取物 (Holy Basil / Tulsi)","en_name":"Holy Basil Extract (Ocimum sanctum / Tulsi)","aliases":["印度圣罗勒","神圣罗勒","Tulsi","熊果酸"],"summary":"一项 250 mg/天、8 周的随机试验显示毛发皮质醇较低，应激试验中唾液皮质醇也较低，但后者的时间与组别交互作用不显著。圣罗勒的抗炎与 AMPK 作用尚无人体证据。","bioavailability_note":"全草水醇提取物富集挥发油与三萜类成分；气味芳香微辛，餐前或餐后随温水送服均可，亦可作为草本茶饮周期性使用。","typical_dose":"标准化 2.5% 熊果酸提取物 300 - 600 mg/天，早晚分服","functional_synergies":["与南非醉茄联用：两者都被认为有适应原作用，联用效果缺乏人体研究（理论推测）","与小檗碱联用：理论上可叠加对血糖的作用，联用时应注意低血糖风险（理论推测）"],"contraindications":"备孕期女性及孕妇应谨慎使用，动物研究显示大剂量可能有微弱的抗着床作用。圣罗勒可能轻微降低空腹血糖，与降糖药合用时可能增加低血糖风险，应监测血糖。哺乳期和长期使用的安全资料不足。","mechanisms":[{"mechanism_id":"mech_hpa_cortisol","score":3,"evidence_grade":"A","target_role":"primary","notes":"一项随机对照试验测得特定圣罗勒提取物服用 8 周后毛发皮质醇降低，应激试验中唾液皮质醇也较低。但唾液皮质醇的时间与组别交互作用不显著，不同提取物之间的效果也不能直接等同。"},{"mechanism_id":"mech_cox_lox_inhibition","score":1,"evidence_grade":"D","target_role":"secondary","notes":"圣罗勒所含丁香酚与熊果酸在体外有 COX-2 抑制活性，但人体中这一制剂在常规剂量下是否直接抑制 COX-2 或 5-LOX，目前没有可靠研究。"},{"mechanism_id":"mech_ampk_activation","score":1,"evidence_grade":"D","target_role":"secondary","notes":"圣罗勒对骨骼肌或肝脏 AMPK 的直接作用尚未在人体中得到证实。其降糖相关结果不能替代 AMPK 测量，其他植物来源熊果酸的实验也不能直接外推至此制剂。"}],"indications":[{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"B","verdict":"benefit"},{"indication_id":"attention","grade":"C","verdict":"benefit"},{"indication_id":"memory","grade":"C","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"C","verdict":"benefit"}]},{"id":"supp_ginseng","name":"人参皂苷复合体 (Panax Ginseng / Rg1, Rb1, Rg3)","en_name":"Panax Ginseng Root Extract (Standardized Ginsenosides)","aliases":["高丽参提取物","红参提取物","人参皂苷","Rg1/Rb1/Rg3"],"summary":"人参皂苷在人体小型试验中对皮质醇的影响结果不一致，动物与细胞研究提示其可影响 PGC-1α 通路和 eNOS/NO 信号。人体中的线粒体生成与血管内皮作用尚未证实。","bioavailability_note":"人参皂苷分子量较大，部分原人参二醇型皂苷需经肠道菌群脱糖基后，才能转化为 Compound K 等成分吸收入血。这一路径并非对所有皂苷都适用，转化存在明显的个体差异。建议早晨空腹或早餐前半小时服用。","typical_dose":"标准化 10-20% 人参总皂苷提取物 200 - 500 mg/天，早晨服用","functional_synergies":["与辅酶 Q10 联用：理论上可共同支持线粒体能量代谢，尚无人体联用数据（理论推测）","与银杏叶提取物联用：理论上可叠加对微循环的作用，缺乏人体证据（理论推测）"],"contraindications":"重度难以控制的原发性高血压发作期暂缓使用；急性高热感染期不宜进补；避免晚间睡前服用以防严重失眠。可能减弱华法林抗凝效果（尤以西洋参报道较多）；与降糖药联用注意低血糖；与 MAOI 合用有不良反应报告。","mechanisms":[{"mechanism_id":"mech_pgc1a_biogenesis","score":3,"evidence_grade":"C","target_role":"secondary","notes":"细胞和小鼠研究显示，人参皂苷可调节 SIRT1–PGC-1α 通路及线粒体生物发生相关指标。人体中，急性 Rg1 干预未改变运动后骨骼肌的 PGC-1α mRNA，常规制剂对人体线粒体增生的作用尚未确认。"},{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"C","target_role":"secondary","notes":"Rg1 在人体内皮细胞实验中可增加 eNOS 磷酸化及 NO 生成，大鼠实验也有相关结果。但人体中的 eNOS 特异作用尚未证实，红参引起的血流介导性舒张改善也不能单独证明 eNOS 激活。"},{"mechanism_id":"mech_hpa_cortisol","score":2,"evidence_grade":"B","target_role":"secondary","notes":"两项人体随机试验中皮质醇变化方向并不一致：一项的红参组内血清皮质醇下降，但摘要未明确组间比较；另一项两组均上升。证据不足以认定稳定的应激缓冲作用。"}],"indications":[{"indication_id":"blood_pressure","grade":"B","verdict":"benefit"},{"indication_id":"menopause","grade":"C","verdict":"benefit"},{"indication_id":"fatigue","grade":"B","verdict":"mixed"},{"indication_id":"erectile_function","grade":"B","verdict":"mixed"},{"indication_id":"memory","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"C","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"}]},{"id":"supp_astragaloside_iv","name":"黄芪甲苷 (Astragaloside IV)","en_name":"Astragaloside IV (Huang Qi Extract)","aliases":["黄芪苷IV","黄芪甲苷","Astragaloside IV"],"summary":"黄芪甲苷是黄芪中的一种环阿尔廷烷型三萜皂苷。动物研究显示其可影响 Nrf2/HO-1、eNOS 与肠道紧密连接相关指标，但人体中这些通路是否被激活尚未证实。","bioavailability_note":"普通黄芪粗提物中黄芪甲苷含量很低（不足 0.1%），口服吸收也较差。市售纯化产品的纯度从 10% 到 98% 不等，应核对具体标示。其口服生物利用度较低，动物数据不能直接代表人体。","typical_dose":"高纯黄芪甲苷 20–50 mg/天，早晨随餐服用。这一剂量并非已有充分人体有效性和长期安全性验证的标准剂量。","functional_synergies":["与辅酶 Q10 联用：理论上可共同关注心肌能量与微循环，但缺乏人体联用研究（理论推测）","与 NAC 联用：理论上可能共同支持内源抗氧化系统，但缺乏人体证据（理论推测）"],"contraindications":"自身免疫性疾病处于急性活动期者应先遵医嘱评估。现有资料不足以断言其非常安全，孕期、哺乳期及长期使用的数据尚不充分，相关人群应在医生指导下使用。","mechanisms":[{"mechanism_id":"mech_nrf2_are","score":3,"evidence_grade":"C","target_role":"secondary","notes":"在大鼠肾缺血再灌注模型中，黄芪甲苷处理后肾组织的 Nrf2 与 HO-1 表达增加。人体中 Keap1 相关作用及 HO-1 的数倍诱导尚未证实，20–50 mg/天能否在人体组织中达到有效浓度也不确定。"},{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物实验显示黄芪甲苷可改变 eNOS 磷酸化及一氧化氮生成，糖尿病大鼠的肾组织相关指标也有改善。BH4 稳定 eNOS 偶联、防止解偶联的说法，尚缺乏人体常规剂量下的直接验证。"},{"mechanism_id":"mech_tight_junction","score":2,"evidence_grade":"C","target_role":"secondary","notes":"动物肠炎模型中，口服黄芪甲苷后结肠 ZO-1 与 Occludin 等紧密连接指标有所改善。该模型的剂量较高，不能直接推定这一剂量在人体中有效。"}],"indications":[]},{"id":"supp_saw_palmetto","name":"锯棕榈提取物 (Saw Palmetto / 脂质甾醇)","en_name":"Saw Palmetto Berry Extract (Serenoa repens)","aliases":["锯叶棕提取物","沙巴棕","锯棕榈","Serenoa repens"],"summary":"部分小型研究观察到前列腺组织中的双氢睾酮降低，但样本少，多数研究使用复方或不同制剂。综合证据显示，锯棕榈单用对前列腺增生相关症状的获益很小或没有。","bioavailability_note":"活性成分主要存在于浆果的脂溶性部分。常用的是脂溶性标准化提取物，并非必须经超临界 CO2 萃取，乙醇或己烷提取物也有研究。随餐服用有助于减轻胃部不适，但不能保证完全避免胃肠道不良反应。","typical_dose":"标准化 85-95% 脂肪酸甾醇软胶囊 160 - 320 mg/天，随正餐服用","functional_synergies":["与番茄红素联用：两者分别涉及 5α-还原酶相关与抗氧化通路，联用对前列腺症状的效果缺乏人体研究（理论推测）"],"contraindications":"女性雄激素水平极低者不建议大剂量使用。备孕女性、孕期及哺乳期女性禁用。偶见胃部饱胀等轻微不适，随餐服用可减轻，但不能完全避免。与抗凝药或抗血小板药合用，以及手术前，应由医生评估。","mechanisms":[{"mechanism_id":"mech_5ar_dht","score":2,"evidence_grade":"B","target_role":"primary","notes":"小型人体研究提示部分提取物可降低前列腺组织中的双氢睾酮，但样本小，随机试验使用的又是复方。40% 至 50% 的组织降幅、头皮效果以及血清激素不变等说法，目前都缺乏依据。"},{"mechanism_id":"mech_cox_lox_inhibition","score":1,"evidence_grade":"D","target_role":"secondary","notes":"体外实验显示部分脂溶性提取物可抑制花生四烯酸代谢产物的形成。人体中直接抑制前列腺 COX-2 或 5-LOX 的证据目前缺乏。缓解前列腺炎性水肿的作用目前没有人体依据。"}],"indications":[{"indication_id":"hair_loss","grade":"B","verdict":"benefit"},{"indication_id":"bph","grade":"A","verdict":"no_benefit"}]},{"id":"supp_melatonin","name":"外源褪黑素 (Melatonin / 速释+缓释双相)","en_name":"Melatonin (Micro-dose / Dual-Release)","aliases":["褪黑素","松果体素","褪黑激素","Melatonin"],"summary":"褪黑素是人体自身分泌的节律激素。Meta 分析证实它能缓解时差、缩短入睡时间（平均约 7 分钟），作用方向取决于服用时间：傍晚服用使节律前移，清晨服用则后移。常见的“线粒体抗氧化”说法在口服剂量下缺乏人体证据。","bioavailability_note":"褪黑素口服后经肝脏广泛代谢，首过消除明显，肝脏第一相代谢消除率可高达 85%。大剂量可能引起次日晨间困倦，长期大剂量是否造成受体脱敏尚未得到证实。服药时间应依据期望的相位移动方向确定，而非统一安排在睡前。","typical_dose":"节律纠正常用 0.3–1 mg/天；时差重置可用 2–3 mg/天。2–3 mg 用于“深度神经抗氧化”缺乏确立的临床依据。服药时间应按期望的相位移动方向安排，而非统一定在睡前。","functional_synergies":["与甘氨酸镁或 L-茶氨酸联用：理论上可能与睡眠相关，但缺乏联用的人体研究（理论推测）"],"contraindications":"自身免疫性疾病严重发作期应谨慎使用，褪黑素可能激发 Th1 免疫应答。白天从事高空作业或驾车前严禁服用。孕期和哺乳期禁用。氟伏沙明（一种强效 CYP1A2 抑制剂）可明显升高褪黑素血药浓度，同服需谨慎；与华法林及其他中枢镇静药合用也需注意相互作用。","mechanisms":[{"mechanism_id":"mech_circadian_clock","score":5,"evidence_grade":"A","target_role":"primary","notes":"褪黑素是内源性 MT1 与 MT2 受体配体，作用于视交叉上核调节节律。人体研究显示 0.5 mg 口服即可使暗光褪黑素起始相位前移或后移，方向取决于给药时间，这一生理学基础已有直接证据。"},{"mechanism_id":"mech_autonomic_vagal","score":2,"evidence_grade":"B","target_role":"secondary","notes":"两项小型人体研究：健康男性单次服用 2 mg 后，平卧时心率变异性的迷走成分升高；另一项研究中 3 mg 减弱了站立时的交感神经反应。作用幅度小，且与服用时的状态有关。"},{"mechanism_id":"mech_sirtuin_activation","score":2,"evidence_grade":"C","target_role":"secondary","notes":"较高剂量的褪黑素在老龄小鼠中可增加海马 SIRT1 的表达，但表达增加不等于直接激活去乙酰化酶。该实验剂量高于常规人体用量，人体中的相关机制尚未确立。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"褪黑素具有体外自由基反应性，并可生成多种次级代谢物。人体中线粒体内的富集程度，以及常规剂量下直接清除自由基的贡献，目前都没有可靠的验证。"}],"indications":[{"indication_id":"jet_lag","grade":"A","verdict":"benefit"},{"indication_id":"sleep_onset","grade":"B","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"},{"indication_id":"migraine","grade":"B","verdict":"mixed"}]},{"id":"supp_boron","name":"柠檬酸硼 / 硼酸钠 (Boron)","en_name":"Boron (Citrate / Glycinate / Albion Bororganic)","aliases":["微量元素硼","柠檬酸硼","硼","Boron"],"summary":"硼的人体证据仅来自小样本研究：一项 8 名男性的研究观察到补硼一周后游离睾酮上升，另一项 2.5 mg/天的安慰剂对照研究未见睾酮增益。维生素 D 与炎症相关作用主要见于动物或机制假说。","bioavailability_note":"硼酸盐类吸收较好。有机螯合硼（如柠檬酸硼、甘氨酸硼）是否比无机硼胃肠耐受性更好，目前缺乏充分证据。可随早餐服用。","typical_dose":"元素硼 3–10 mg/天，随早餐服用。这一范围来自小型研究，并非公认的通用治疗剂量。","functional_synergies":["与维生素 D3、维生素 K2 联用：理论上可能影响维生素 D 代谢和钙分布，但缺乏充分的人体证据（理论推测）","与东革阿里联用：理论上可能影响游离雄激素水平，缺乏人体联用研究（理论推测）"],"contraindications":"成人可耐受最高摄入量（美国标准）为每日 20 mg，这一数值包含食物、饮水和补充剂的总量，补充时应计入膳食来源，不同地区标准可能不同。摄入过量可出现胃肠刺激及皮炎。严重慢性肾衰竭患者应限制外源硼，因肾功能受损时硼的清除可能下降。","mechanisms":[{"mechanism_id":"mech_steroid_shbg","score":2,"evidence_grade":"B","target_role":"secondary","notes":"小样本人体研究中，补充 10 mg 元素硼一周后游离睾酮上升，而 SHBG 的显著下降出现在单次给药后的测量中。样本极小，测量时点与设计也不一致，硼能否直接结合 SHBG 或稳定提高游离睾酮尚未确定。"},{"mechanism_id":"mech_nfkb_inhibition","score":1,"evidence_grade":"C","target_role":"secondary","notes":"部分人体研究观察到补硼后炎症指标有所变化，高剂量动物实验也显示 NF-κB 相关指标下降。但炎症标志物的变化不能证明 NF-κB 被抑制，常规 3–10 mg 元素硼能否产生相同作用也不明确。"}],"indications":[{"indication_id":"joint_pain","grade":"C","verdict":"benefit"},{"indication_id":"testosterone","grade":"C","verdict":"mixed"},{"indication_id":"muscle_strength","grade":"C","verdict":"mixed"}]},{"id":"supp_diosmin","name":"微粉化纯化黄酮 (地奥司明 / 橙皮苷)","en_name":"Micronized Purified Flavonoid Fraction (MPFF / Diosmin)","aliases":["地奥司明","橙皮苷","爱脉朗","MPFF","Diosmin"],"summary":"微粉化纯化黄酮（以地奥司明为主）有较多随机试验和 Meta 分析支持，可减轻慢性静脉功能不全的腿沉、水肿和痔疮急性发作症状。人体研究观察到微循环改善，静脉张力和抗炎机制主要来自动物与体外研究。","bioavailability_note":"普通地奥司明颗粒粗大、水溶性差，微粉化（微粒中径小于 2 微米）后溶解与吸收有所改善。地奥司明需经肠道转化，吸收和代谢过程较复杂，具体吸收比例的人体数据有限。建议随早晚餐分次服用。","typical_dose":"微粉化纯化黄酮（约 90% 地奥司明，其余为以橙皮苷计的其他黄酮）500–1000 mg/天，随餐服用。","functional_synergies":["与葡萄籽原花青素联用：理论上两者可分别作用于静脉与毛细血管，但缺乏人体联用研究（理论推测）","与纳豆激酶联用：临床协同与安全性均缺乏充分研究，不宜据此推定联用效果（理论推测）"],"contraindications":"常规剂量下耐受性总体良好。偶见反酸、恶心等轻微消化道反应，随餐服用有一定帮助，但不能完全避免。","mechanisms":[{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物研究显示高剂量地奥司明可改善与 NO 合酶相关的血管功能指标。但这一结果不能解释静脉张力的变化，人体中 MPFF 的静脉张力作用是否由 eNOS 与一氧化氮介导，尚无试验证明。"},{"mechanism_id":"mech_paf_platelet","score":2,"evidence_grade":"B","target_role":"secondary","notes":"小型人体研究观察到，微粉化黄酮可使踝部毛细血管红细胞流速增加，并有毛细血管通透性改善的报道。这些结果不能证明 PAF 受体拮抗，白细胞黏附与 ICAM-1 相关的说法也缺乏人体证据。"}],"indications":[{"indication_id":"venous_insufficiency","grade":"A","verdict":"benefit"}]},{"id":"supp_taurine","name":"牛磺酸 (Taurine)","en_name":"Taurine (2-Aminoethanesulfonic Acid)","aliases":["牛磺酸","牛胆素","Taurine"],"summary":"牛磺酸是细胞内的重要渗透调节物质，也参与胆汁酸结合。人体研究显示较大剂量补充可使血浆牛磺酸升高、胆汁中结合型胆汁酸比例增加，但对心肌钙泵的作用尚未在人体中证实。","bioavailability_note":"牛磺酸水溶性好，口服吸收较快。β-丙氨酸与牛磺酸共用部分转运体（TauT），两者同服的实际影响尚无充分人体数据；空腹与随餐服用的吸收差异也缺乏依据。","typical_dose":"1000 - 3000 mg/天，早晨或运动前空腹温水冲服","functional_synergies":["与甘氨酸镁联用：理论上可能与心肌电稳定相关，但缺乏人体证据（理论推测）","与 TUDCA 联用：两者都与胆汁酸代谢有关，协同效果缺乏人体证据（理论推测）"],"contraindications":"牛磺酸是体内天然存在的物质，常规剂量下耐受性总体良好。但不能因其为内源物质就认定任意大剂量或长期使用均安全。极少数人在初次大剂量空腹服用时可有轻微胃酸过多。肾功能受损者的补充资料有限，应谨慎使用。","mechanisms":[{"mechanism_id":"mech_osmolyte_calcium","score":3,"evidence_grade":"C","target_role":"primary","notes":"牛磺酸是细胞渗透质，参与细胞体积调节，在动物实验中可影响心肌细胞的钙超载及 ATP 酶相关指标。常规补充能否增强人体心肌钙泵或细胞体积调节，目前尚未直接证实。"},{"mechanism_id":"mech_er_stress_chaperone","score":3,"evidence_grade":"C","target_role":"secondary","notes":"牛磺酸可与肝细胞中疏水性的胆汁酸结合，生成亲水性的牛磺结合型胆汁酸。人体研究中，3.2 g/天、两周后胆汁中结合型胆汁酸比例增加；抑制内质网应激的作用主要见于动物，并非与 TUDCA 相同的伴侣效应。"},{"mechanism_id":"mech_etc_carrier","score":1,"evidence_grade":"D","target_role":"secondary","notes":"牛磺酸参与线粒体 tRNA 摆动位点的修饰，但它并非呼吸链中的电子载体。在 MELAS 患者的开放试验中，9–12 g/天牛磺酸使部分患者白细胞线粒体 tRNA 的修饰改善，这一结果不能推广到常规剂量。"}],"indications":[{"indication_id":"blood_pressure","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"triglycerides","grade":"B","verdict":"benefit"},{"indication_id":"inflammation_markers","grade":"B","verdict":"benefit"},{"indication_id":"muscle_cramps","grade":"C","verdict":"benefit"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"endurance","grade":"B","verdict":"mixed"},{"indication_id":"exercise_recovery","grade":"C","verdict":"mixed"}]},{"id":"supp_dgl","name":"脱甘草酸甘草 (DGL / 咀嚼型)","en_name":"Deglycyrrhizinated Licorice (DGL)","aliases":["DGL","脱甘草甜素甘草","甘草咀嚼片"],"summary":"脱甘草酸甘草（DGL）在动物研究中可增加胃黏液分泌细胞，特定脱甘草酸提取物也可改善肠道屏障指标。人体中黏膜黏蛋白的增加及胃食管保护膜的形成尚无直接证据。","bioavailability_note":"DGL 常以咀嚼片形式供应，咀嚼有助于药片崩解并与唾液混合。目前没有可靠证据表明必须依赖唾液淀粉酶才能形成保护性水凝胶，剂型也不宜认定为唯一有效形式。","typical_dose":"咀嚼片 380 - 760 mg/次，于正餐前 20 分钟或感觉反酸胃灼热时充分咀嚼咽下","functional_synergies":["与肌肽锌联用：两者都被用于胃食管黏膜保护，但联用的临床协同证据尚不充分（理论推测）","与海藻酸钠联用：理论上可叠加物理保护作用，缺乏人体协同证据（理论推测）"],"contraindications":"DGL 已脱除大部分甘草酸（残留量低于 1%），但脱除不等于完全无甘草酸。残留量、剂量和使用时间不同，仍可能出现水钠潴留、低钾或血压升高。未经脱酸的普通甘草根严禁长期连续大剂量服用。","mechanisms":[{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"一项动物肠屏障研究显示，特定脱甘草酸甘草黄酮提取物可改善肠通透性，并调节紧密连接蛋白。这一证据来自特定提取物和肠道模型，不能直接推广至所有 DGL 咀嚼片或人体胃食管。"},{"mechanism_id":"mech_mucus_layer","score":1,"evidence_grade":"D","target_role":"primary","notes":"动物研究显示，脱甘草酸甘草可使胃腺中标记的黏液分泌细胞增多，作者推测其促进黏液形成。但人体中肠道 MUC2、胃部 MUC5AC 的增加，以及前列腺素直接激活杯状细胞，目前都没有可靠证据。"}],"indications":[{"indication_id":"gastric_mucosa","grade":"B","verdict":"mixed"}]},{"id":"supp_gos","name":"低聚半乳糖 (GOS / 益生元)","en_name":"Galacto-Oligosaccharides (B-GOS / Bimuno)","aliases":["GOS","低聚半乳糖","母乳低聚糖类似物","Bimuno"],"summary":"低聚半乳糖是结肠菌群的发酵底物，人体研究中呼气氢增加，支持肠道发酵；15 g/天时双歧杆菌增加。粪便和血浆短链脂肪酸未见明显增加，对肠腔 pH 与病原菌的影响缺乏直接人体证据。","bioavailability_note":"GOS 水溶性好，口感微甜，耐酸耐热，可加入温水、咖啡或燕麦粥中服用。不同制剂可能残留乳糖或半乳糖，耐受性取决于制剂和剂量。与普通菊粉相比，胃肠产气的差异缺乏普遍证据。","typical_dose":"日常菌群支持 2.5 - 5 克/天，随早餐饮料或温水冲服","functional_synergies":["与双歧杆菌活菌制剂联用：理论上可形成合生元组合，但 GOS 不能保证活菌持久定植（理论推测）","与丁酸钠联用：两者都与结肠发酵代谢相关，联用效果缺乏人体证据（理论推测）"],"contraindications":"严重半乳糖血症（罕见遗传病）患者禁用。乳糖不耐受者的耐受性取决于制剂中是否残留乳糖或半乳糖，以及所用剂量，不宜一概而论。","mechanisms":[{"mechanism_id":"mech_scfa_fermentation","score":5,"evidence_grade":"A","target_role":"substrate","notes":"低聚半乳糖是多种结肠菌的发酵底物，人体随机试验中呼气氢增加，支持肠道发酵。但粪便和血浆短链脂肪酸未见明显增加，其发酵产物对肠腔 pH 与病原菌的影响缺乏人体直接证据。"},{"mechanism_id":"mech_mucus_layer","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物研究中，低聚半乳糖可改善西方饮食诱导的结肠黏液层破坏。人体细胞实验中，它可上调杯状细胞样细胞的 MUC2 等基因。但尚未可靠证明常规补充后人体杯状细胞分泌或黏液厚度增加。"},{"mechanism_id":"mech_tight_junction","score":2,"evidence_grade":"C","target_role":"secondary","notes":"动物肠损伤模型中，低聚半乳糖可上调 ZO-1、occludin 等紧密连接相关基因。人体直接证据不足，炎症或应激指标的变化也不能证明紧密连接得到修复。"}],"indications":[{"indication_id":"ibs","grade":"B","verdict":"mixed"},{"indication_id":"constipation","grade":"B","verdict":"mixed"},{"indication_id":"diarrhea","grade":"B","verdict":"mixed"}]},{"id":"supp_artichoke","name":"朝鲜蓟提取物 (洋蓟素 Cynarin)","en_name":"Artichoke Leaf Extract (Cynara scolymus / Cynarin)","aliases":["洋蓟提取物","洋蓟素","朝鲜蓟","Cynarin"],"summary":"人体试验中，十二指肠给予 1.92 g 叶提取物可使胆汁分泌增加，但剂量与途径均与口服不同。移行复合运动与细菌过度生长的效果缺乏直接证据，动物中的 AMPK 作用也未经人体证实。","bioavailability_note":"标准化洋蓟素制剂（标示含量在 5% 以上）味苦。苦味能否通过苦味受体引发消化道反射，并不能据此推定制剂效果。餐前或睡前服用的时间选择，也缺乏直接的人体比较研究。","typical_dose":"标准化提取物 300–800 mg/天，餐前或睡前服用。人体利胆试验的剂量与给药途径均与此不同，300–800 mg 口服的效果未经直接验证。","functional_synergies":["与生姜提取物联用：两者都被认为与消化道动力有关，联用效果缺乏人体研究（理论推测）","与 TUDCA 联用：理论上可能共同作用于胆汁流动，缺乏人体证据（理论推测）"],"contraindications":"完全性胆管梗阻（如急性胆管结石嵌顿）者禁用。胆结石及其他胆道疾病患者应先咨询医生。对菊科植物过敏者应避免使用。","mechanisms":[{"mechanism_id":"mech_ampk_activation","score":2,"evidence_grade":"C","target_role":"secondary","notes":"动物及细胞研究提示，洋蓟成分可影响肝脏中与 AMPK 磷酸化相关的信号。HMG-CoA 还原酶及脂肪肝指标的变化不能直接证明 AMPK 激活，人体中是否激活尚未证实。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"洋蓟多酚在体外有清除自由基的活性，小鼠肝损伤模型中脂质过氧化也有所下降。但脂质过氧化指标下降不能证明分子直接捕获自由基，口服后原形成分在肝组织中的直接清除贡献尚不明确。"}],"indications":[{"indication_id":"ldl_cholesterol","grade":"B","verdict":"benefit"},{"indication_id":"triglycerides","grade":"B","verdict":"benefit"},{"indication_id":"fatty_liver","grade":"B","verdict":"benefit"},{"indication_id":"gastric_mucosa","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"}]},{"id":"supp_boulardii","name":"布拉氏酵母菌 (Saccharomyces boulardii)","en_name":"Saccharomyces boulardii (CNCM I-745)","aliases":["布拉氏酵母","益生酵母","S. boulardii","Florastor"],"summary":"耐受抗生素的非致病性酵母，常用于预防抗生素相关性腹泻。其蛋白酶在实验中可降解艰难梭菌毒素，但不能保证临床上完全灭活毒素；黏膜免疫与屏障机制多来自动物和细胞研究。","bioavailability_note":"布拉氏酵母属于真菌，天然耐受阿莫西林、头孢、甲硝唑等抗细菌药物，可与抗生素同时服用。但其存活会受抗真菌药影响。定植属于过客性，停药 3–5 天随粪便自然排净。","typical_dose":"每日 250–500 mg，标示约提供 50 亿至 100 亿 CFU 活性酵母细胞，实际活菌数随菌株和制剂而异，以产品标签为准。随温水吞服，水温不超过 40°C。","functional_synergies":["与牛初乳 IgG 联用（理论推测）：两者理论上可能从不同方面支持肠道屏障，但对艰难梭菌感染与旅行者腹泻的防护效果缺乏人体证据。","与抗生素同步使用：该菌天然耐受阿莫西林、头孢、甲硝唑等抗细菌药物，可与抗生素同时服用；但其对原生态肠道菌群的保护作用属理论推测，缺乏充分的人体证据。"],"contraindications":"深静脉长期置管患者、极重度免疫缺陷或重症监护室危重患者禁用（防真菌入血血流感染）；对酵母菌过敏者禁用。","mechanisms":[{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"酵母分泌的蛋白酶可在体外降解致病大肠杆菌和艰难梭菌的毒素。小鼠结肠炎模型中 ZO-1、occludin 等屏障指标有所改善，但人体研究没有直接测量紧密连接蛋白。毒素降解与紧密连接修复是两种不同的作用。"},{"mechanism_id":"mech_prr_immune","score":2,"evidence_grade":"D","target_role":"secondary","notes":"酵母细胞壁中的甘露聚糖和 β-葡聚糖可在体外被 Dectin-1 识别。小鼠实验中肠道抗毒素 IgA 应答增强，但这不能证明人体的模式识别受体信号或免疫训练，pIgR 成倍上调也没有依据。"}],"indications":[{"indication_id":"diarrhea","grade":"B","verdict":"benefit"},{"indication_id":"ibs","grade":"B","verdict":"mixed"}]},{"id":"supp_niacin","name":"烟酸 (速释型 Nicotinic Acid / 维生素 B3)","en_name":"Niacin (Immediate-Release Nicotinic Acid)","aliases":["烟酸","速释烟酸","Nicotinic Acid","烟酸潮红型"],"summary":"速释烟酸是人体已确认的 NAD+ 合成前体，药理剂量下可升高 HDL-C，但常引起皮肤潮红。eNOS 与 AMPK 相关机制在人体中尚未确证。","bioavailability_note":"速释型在胃肠吸收很快，服用后 15–30 分钟常出现皮肤潮红、发热和刺痒，持续约 30–45 分钟，连续数日服用可逐渐耐受。速释型并非完全无肝毒性，缓释型的肝酶升高风险通常认为更高，两者都应在医生指导下使用。","typical_dose":"初次使用从 50–100 mg 开始，依耐受情况逐步增至 250–500 mg/天，随餐后立即用温水送服。该剂量远高于美国国立卫生研究院规定的成人补充剂烟酸耐受上限（每日 35 mg），应有明确适应证，并监测肝功能、血糖和尿酸。","functional_synergies":["与甜菜碱（TMG）联用：大剂量烟酸参与甲基代谢，理论上可补充甲基消耗，但缺乏证明其能预防临床相关甲基耗竭的人体证据（理论推测）","与辅酶 Q10 联用：有关改善末梢微循环的说法缺乏充分证据（理论推测）"],"contraindications":"活动性重度消化性胃溃疡、未经控制的严重肝病或痛风急性发作期禁用（烟酸与尿酸竞争肾小管排泄通道）。不可空腹以热水冲服，以免潮红剧烈。速释型也可能升高肝酶，长期高剂量使用需定期检查肝功能。与他汀联用需监测肌病，高剂量时尤其如此；烟酸可升高血糖与尿酸，糖尿病及痛风患者需监测。","mechanisms":[{"mechanism_id":"mech_nad_salvage","score":5,"evidence_grade":"A","target_role":"substrate","notes":"烟酸经 Preiss–Handler 途径，在 NAPRT 催化下转化为烟酸单核苷酸，再合成 NAD+，这是人体内已知的合成路线。人体研究已确认它是 NAD+ 的合成前体，但升高幅度取决于剂量、组织和营养状态。"},{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"C","target_role":"secondary","notes":"烟酸引起的皮肤潮红来自 GPR109A 受体激活后的前列腺素释放，并非 eNOS 激活。在糖尿病缺血等特定动物模型中可见与 eNOS 相关的血管效应，但不能外推为人体常规剂量的扩血管作用。"},{"mechanism_id":"mech_ampk_activation","score":2,"evidence_grade":"C","target_role":"secondary","notes":"有研究认为烟酸可减少肝脏甘油三酯合成和 VLDL 分泌，但这一结果并不等于 AMPK 激活。在高脂饮食小鼠的肝脏中，烟酸可间接增加 AMPK 磷酸化，但在人体中尚无直接证据。"}],"indications":[{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"mixed"}]},{"id":"supp_chromium_picolinate","name":"吡啶甲酸铬 (Chromium Picolinate)","en_name":"Chromium Picolinate","aliases":["吡啶羧酸铬","有机三价铬","Chromium"],"summary":"吡啶甲酸铬是常见的三价铬补充形式，部分人体研究报告了血糖指标改善。其放大胰岛素受体信号和激活 AMPK 的机制在人体中均未确证，铬是否为必需元素也存在争议。","bioavailability_note":"无机三价铬（氯化铬）的肠道吸收率不足 0.5%。吡啶甲酸铬的吸收率更高，美国国立卫生研究院列出的估计约为 1.2%，不同研究的数值差异较大。","typical_dose":"元素铬 200 - 500 mcg/天，随正餐服用","functional_synergies":["与小檗碱联用：两者分别作用于胰岛素受体信号和 AMPK 通路，理论上可叠加降糖效应，但缺乏人体联合应用的直接证据（理论推测）"],"contraindications":"严重肾功能不全者慎用，肝功能不全者也需谨慎。与胰岛素或其他降糖药合用时应留意低血糖，并监测血糖。常规微量补充的耐受性总体较好，但不宜超大剂量长期使用。","mechanisms":[{"mechanism_id":"mech_ampk_activation","score":1,"evidence_grade":"D","target_role":"secondary","notes":"铬可在培养的骨骼肌细胞中增强 AMPK 信号，但体内结果尚未确认。胰岛素受体的 chromodulin 放大作用在人体中也有争议。口服铬吸收很低，体外效应能否在体内达到相应浓度也不明确。"}],"indications":[{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"pcos","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"}]},{"id":"supp_carnosine","name":"L-肌肽 (L-Carnosine / 细胞防糖化分子)","en_name":"L-Carnosine (β-Alanyl-L-Histidine)","aliases":["肌肽","L-肌肽","β-丙氨酰-L-组氨酸","Carnosine"],"summary":"肌肽是由 β-丙氨酸和 L-组氨酸组成的天然二肽，可捕获部分活性羰基化合物。人体研究显示其能增加尿中相关加合物，但组织内糖化交联受抑制的证据尚不充分；血清肌肽酶也会迅速水解肌肽。","bioavailability_note":"血清中的肌肽酶会迅速水解口服的肌肽。肠溶或微粉化制剂能否显著提高组织中的蓄积，目前缺乏充分的人体证据。","typical_dose":"500 - 1000 mg/天，早晨或晚间空腹服用","functional_synergies":["与苯磷硫胺联用：二者理论上可从不同环节减少糖基化产物的生成与积累，但缺乏人体联合用药的直接证据（理论推测）"],"contraindications":"肌肽是体内天然存在的二肽，常规剂量下耐受性总体较好。但孕期及哺乳期的安全数据不足，孕妇和哺乳期女性应在医生指导下使用，不宜笼统建议常规服用。","mechanisms":[{"mechanism_id":"mech_ages_glycation","score":3,"evidence_grade":"C","target_role":"primary","notes":"肌肽分子中的咪唑环和氨基可与活性羰基化合物结合，从而捕获部分糖化中间产物。人体试验显示其能增加尿中肌肽与丙烯醛的加合物，但这一指标并不能说明组织内的糖化交联受到抑制。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"肌肽在体外可与部分活性氧反应，还能结合金属离子。但金属螯合并不等于直接清除自由基，而且口服肌肽迅速水解，它在体内的直接抗氧化贡献尚不清楚。"},{"mechanism_id":"mech_osmolyte_calcium","score":1,"evidence_grade":"D","target_role":"secondary","notes":"肌肽能够缓冲肌肉中的酸性代谢产物，这一作用较为确定。它提高肌纤维钙敏感性的证据主要来自毫摩尔浓度的离体实验，口服 500–1000 mg 后相关组织能否达到该浓度尚不确定。"}],"indications":[{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"},{"indication_id":"skin_aging","grade":"C","verdict":"mixed"}]},{"id":"supp_celery_seed_nbp","name":"芹菜籽提取物 (3-正丁基苯酞 / 3-NBP)","en_name":"Celery Seed Extract (3-n-Butylphthalide / 3-NBP)","aliases":["芹菜籽提取物","丁基苯酞","3-NBP","芹菜素内酯"],"summary":"芹菜籽提取物的活性成分是 3-正丁基苯酞（3-NBP）。药用丁苯酞的临床试验不能直接套用于这类膳食补充剂，其体外抗血小板效应也不能直接外推到口服后的人体。","bioavailability_note":"3-NBP 为脂溶性化合物，宜随含油脂的正餐服用，但“吸收提高 2–3 倍”的说法缺乏可靠依据。提取物中实际 3-NBP 含量应以产品标示为准。","typical_dose":"标准化芹菜籽提取物 100–300 mg/天，随餐服用。该剂量不等同于药用丁苯酞的临床剂量，应以产品标示的 3-NBP 含量为准。","functional_synergies":["与银杏叶标准化提取物联用：两者的抗血小板与血流改善作用理论上可叠加，但缺乏人体联合应用的可靠证据，且需关注出血风险（理论推测）"],"contraindications":"重度活动性颅内出血急性发作期禁用。与强效抗血小板药或抗凝药同服有潜在出血风险，需监测出凝血时间。","mechanisms":[{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"C","target_role":"secondary","notes":"丁苯酞可阻滞血管平滑肌的 L 型钙通道，这与 eNOS 或一氧化氮无直接关系。在特定脑缺血动物模型中可见 eNOS 相关变化，但给药途径和制剂均与膳食补充剂不同，人体中尚未确证。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"丁苯酞在脑缺血再灌注模型中可抑制线粒体通透性转换孔的开放，保护线粒体功能。这属于线粒体调节，并不等于直接捕获自由基。常规口服剂量下，它的直接抗氧化作用尚未在人体中确定。"}],"indications":[{"indication_id":"blood_pressure","grade":"B","verdict":"benefit"},{"indication_id":"uric_acid","grade":"C","verdict":"mixed"},{"indication_id":"triglycerides","grade":"C","verdict":"mixed"},{"indication_id":"anxiety_stress","grade":"C","verdict":"mixed"},{"indication_id":"low_mood","grade":"C","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"}]},{"id":"supp_urolithin_a","name":"尿石素 A (Urolithin A / Mitopure)","en_name":"Urolithin A (Mitopure)","aliases":["尿石素 A","UA","Mitopure","石榴鞣花酸肠道代谢物"],"summary":"尿石素 A 是肠道菌群由石榴鞣花丹宁转化而来的代谢物。人体随机试验观察到部分肌肉和线粒体相关标志物的变化，但自噬通量及肌力、呼吸效率的改善尚未得到统一证实。","bioavailability_note":"结晶形态水溶性极差。高纯微粉化或脂溶复配制剂口服吸收率较好，空腹或随少许油脂同服的生物利用度也较高。","typical_dose":"标准高纯尿石素 A 500 - 1000 mg/天，早晨服用","functional_synergies":["与辅酶 Q10 或 PQQ 联用：理论上，尿石素 A 清除受损线粒体，辅酶 Q10 与 PQQ 支持新生线粒体功能，但目前没有人体联合应用的证据（理论推测）","与 NMN 或 NR 联用：理论上可同时提高 NAD+ 水平，但尚无人体联合研究（理论推测）"],"contraindications":"常规剂量下耐受性总体较好，孕产妇及哺乳期暂无充分安全性数据，建议咨询医生。","mechanisms":[{"mechanism_id":"mech_mitophagy_pink1","score":4,"evidence_grade":"A","target_role":"primary","notes":"尿石素 A 可调节肌肉中 PINK1/Parkin 通路的相关标志物。一项人体随机试验在 500 mg/天组的肌肉活检中测得磷酸化 Parkin 增加，分析主要为组内前后比较。自噬通量和临床效应仍未确定。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"在睡眠剥夺的小鼠模型中，尿石素 A 可降低海马的 NF-κB 及 NLRP3 相关信号。人体炎症指标的变化不能单独证明 NF-κB 受到抑制，cGAS–STING 与 NLRP3 通路也不等同于 NF-κB，人体证据目前仍然不足。"}],"indications":[{"indication_id":"muscle_strength","grade":"B","verdict":"mixed"},{"indication_id":"endurance","grade":"B","verdict":"mixed"}]},{"id":"supp_nadh","name":"还原型辅酶 I (NADH / PANMOL)","en_name":"Reduced β-Nicotinamide Adenine Dinucleotide (NADH)","aliases":["还原型辅酶 I","NADH","PANMOL-NADH","β-NADH"],"summary":"NADH 是线粒体复合体 I 的内源电子供体。口服补充能否以完整形式到达线粒体，目前缺乏直接证据；已有的人体研究多为与辅酶 Q10 联用，无法归因于 NADH 本身。","bioavailability_note":"NADH 较易被胃酸和空气中的湿气氧化。肠溶微囊化包衣制剂有助于减少胃酸破坏，但没有证据表明必须使用某一种专利微囊。口服后完整 NADH 的吸收与组织分布尚不清楚。","typical_dose":"肠溶包衣稳定型 NADH 10 - 20 mg/天，早晨空腹服用","functional_synergies":["与辅酶 Q10 联用：两者都参与线粒体电子传递，但目前的联合试验无法区分 NADH 自身的贡献，慢性疲劳的改善也未得到确证（理论推测）","与 D-核糖联用：理论上可从电子供体与核苷酸原料两方面支持能量代谢，但缺乏人体证据（理论推测）"],"contraindications":"极少数高敏个体晚间服用可能导致神经兴奋、轻度入睡困难，建议晨起空腹服用。孕期、哺乳期及长期使用的安全数据有限，应咨询医生后使用。","mechanisms":[{"mechanism_id":"mech_monoamine","score":1,"evidence_grade":"D","target_role":"secondary","notes":"NADH 参与内源的 BH4 还原循环，这是已知的生化反应，但不能据此推断口服补充会产生同样效果。目前没有人体研究证明常规口服 NADH 能增加脑内 BH4 再生、酪氨酸羟化酶活性或突触多巴胺。"},{"mechanism_id":"mech_gsh_synthesis","score":1,"evidence_grade":"D","target_role":"secondary","notes":"NADH 在体内可经转氢反应生成 NADPH，为谷胱甘肽还原酶提供电子，这属于内源代谢。口服 NADH 能否到达这一环节尚不清楚，未见人体研究证明 10–20 mg 口服剂量能增加组织 NADPH 或谷胱甘肽还原。"}],"indications":[{"indication_id":"fatigue","grade":"B","verdict":"mixed"}]},{"id":"supp_d_ribose","name":"D-核糖 (D-Ribose)","en_name":"D-Ribose","aliases":["D-核糖","核糖粉","Ribose"],"summary":"D-核糖可为核苷酸及 ATP 合成提供原料。高剂量核糖在部分运动研究中加快了肌肉 ATP 的恢复，但人体研究的剂量和结果并不一致，不能视为普遍效果。","bioavailability_note":"天然存在的戊糖，无需消化酶即可经小肠被动扩散吸收入血，起效较快，可溶于温水或黑咖啡中饮用。","typical_dose":"5 - 15 g/天，分次随餐或训练/疲劳期冲饮","functional_synergies":["与辅酶 Q10、乙酰肉碱及镁联用（理论推测）：四者理论上可共同支持心肌能量代谢，但该组合的人体证据有限，心肌细胞能量底物匮乏的改善尚未得到证实。","与肌酸联用（理论推测）：D-核糖理论上可为核苷酸池的恢复提供原料，肌酸则负责瞬时高能磷酸键的缓冲，两者的联合效果缺乏人体证据。"],"contraindications":"单次大剂量（10 g 及以上）可能引起明显低血糖，空腹时更易出现，但并非只在空腹时发生；欧洲食品安全局记录过单次 10 g 后的明显低血糖。糖尿病患者或正在服用降糖药者应随餐分次服用，并注意监测血糖。","mechanisms":[{"mechanism_id":"mech_phosphagen_buffer","score":1,"evidence_grade":"D","target_role":"substrate","notes":"D-核糖可经核糖激酶生成 5-磷酸核糖，进而参与核苷酸合成，为 ATP 等核苷酸提供骨架原料。它不同于磷酸肌酸的瞬时能量缓冲，不属于磷酸肌酸缓冲系统。一项人体研究中高剂量核糖加快了部分运动后的 ATP 恢复，但未证明肌酸激酶缓冲增强。"},{"mechanism_id":"mech_etc_carrier","score":1,"evidence_grade":"D","target_role":"substrate","notes":"D-核糖可为 ATP 等核苷酸的合成提供原料，从而影响细胞的能量储备，但它并不是线粒体电子传递链的载体。目前没有可靠证据显示口服 D-核糖能在复合体之间传递电子。"}],"indications":[{"indication_id":"fatigue","grade":"C","verdict":"mixed"},{"indication_id":"endurance","grade":"C","verdict":"mixed"},{"indication_id":"exercise_recovery","grade":"C","verdict":"mixed"}]},{"id":"supp_methylene_blue","name":"药用级亚甲蓝 (USP Methylene Blue)","en_name":"Methylene Blue (USP Pharmaceutical Grade)","aliases":["亚甲蓝","美蓝","USP 级亚甲蓝","Methylthioninium Chloride"],"summary":"亚甲蓝是强效 MAO-A 抑制剂，在离体线粒体体系中可转移电子。它绕过线粒体复合体、改善认知的作用在人体中尚未确证，并且与血清素能药物合用可引起严重不良反应。","bioavailability_note":"口服吸收较好，脂溶性较强，但能否穿透血脑屏障并在神经元与心肌中达到有效浓度，目前缺乏直接的人体证据。必须严格使用 USP 医药级（严禁工业染色级以防重金属中毒）。","typical_dose":"常见的认知优化剂量表述为 0.5–1 mg/kg 体重/天，但按 70 kg 成人计约为 35–70 mg，与通常单次 10–30 mg 的说法不一致，该剂量也并非已确立的认知优化方案。亚甲蓝是有重要相互作用的药物，应由临床人员评估和管理。","functional_synergies":["与红光或近红外光照射联用：理论上可增强线粒体的电子传递，但没有可靠人体证据表明能使突触 ATP 倍增（理论推测）","与辅酶 Q10 联用：理论上两者都参与线粒体电子传递，但缺乏人体联合应用的证据（理论推测）"],"contraindications":"绝对禁忌：严禁与任何 SSRI/SNRI 抗抑郁药、单胺氧化酶抑制剂（MAOI）及曲马多、利奈唑胺、哌替啶等血清素能药物合用（其具有较强 MAO-A 抑制活性，可能诱发致命血清素综合征）。G6PD 缺乏症（蚕豆病）患者禁用（有溶血风险）。孕期禁用（胎儿毒性）。肾功能受损者及正在服用其他药物者，使用前需评估相互作用。尿液变蓝绿色属正常代谢排泄现象。","mechanisms":[{"mechanism_id":"mech_monoamine","score":4,"evidence_grade":"B","target_role":"primary","notes":"亚甲蓝是强效 MAO-A 抑制剂，纯化酶实验中的 Ki 约为 27 nmol/L。人体中突触递质升高尚未被直接测定，但它与血清素能药物合用时的血清素综合征风险已有药品说明书警示。"},{"mechanism_id":"mech_etc_carrier","score":2,"evidence_grade":"D","target_role":"primary","notes":"亚甲蓝可在离体线粒体体系中转移电子，理论上能在复合体受阻时维持电子传递。但有研究未能重现其在复合体 III 受阻后的旁路恢复，人体口服后是否存在同样的旁路作用，目前尚无定论。"},{"mechanism_id":"mech_cholinergic","score":2,"evidence_grade":"D","target_role":"secondary","notes":"亚甲蓝在体外可抑制胆碱酯酶，并与毒蕈碱受体结合。这些结果来自离体实验，常规口服条件下能否提高人体海马的乙酰胆碱或改善记忆，目前没有证据。"}],"indications":[{"indication_id":"cognitive_decline","grade":"B","verdict":"mixed"},{"indication_id":"memory","grade":"C","verdict":"mixed"},{"indication_id":"attention","grade":"C","verdict":"mixed"}]},{"id":"supp_dihydroberberine","name":"二氢小檗碱 (Dihydroberberine / DHB)","en_name":"Dihydroberberine (GlucoVantage)","aliases":["二氢小檗碱","DHB","GlucoVantage","还原型黄连素"],"summary":"二氢小檗碱是小檗碱的还原型形式，口服后可在体内转化为小檗碱并提高其血浆暴露。人体药代研究样本很小，人体内的 AMPK 激活尚未直接证明。","bioavailability_note":"二氢小檗碱在体内可转化为小檗碱，并能提高血浆中小檗碱的暴露。但现有人体药代研究样本很小，与盐酸小檗碱的剂量和制剂不能直接等效，胃肠反应的发生率也缺乏可靠比较。","typical_dose":"100 - 200 mg，每日 1-2 次，高碳水化合物餐前 15 分钟服用","functional_synergies":["与 R-α-硫辛酸联用（理论推测）：两者理论上都可能促进肌肉对葡萄糖的摄取，但二氢小檗碱能否在人体内激活 AMPK 尚未证明，该联用也缺乏人体证据。","与二甲双胍的代谢管理思路相近（理论推测）：其用于胰岛素抵抗或代谢综合征的人体效果尚未确立。"],"contraindications":"低血糖发作期慎用。与胰岛素或其他降糖药联用时应监测血糖，警惕低血糖。孕妇及哺乳期禁用。长期使用的安全资料不足；该物质可能影响 CYP3A4 等肝药酶及转运体，合用其他药物时需谨慎。","mechanisms":[{"mechanism_id":"mech_autophagy_mTOR","score":3,"evidence_grade":"C","target_role":"secondary","notes":"在部分小鼠模型中，二氢小檗碱可影响 mTOR 相关信号，例如卵巢功能不全模型中的 Rheb/mTOR 通路。但这些结果没有直接证明常规口服剂量下人体 mTORC1 被阻滞，也没有证明自噬通量增加。"},{"mechanism_id":"mech_tight_junction","score":2,"evidence_grade":"C","target_role":"secondary","notes":"小鼠结肠炎模型中，二氢小檗碱可提高紧密连接蛋白及黏蛋白相关指标。局部肠道暴露使这一结果具有生物学合理性，但目前没有同机制的人体直接证据，回肠 ZO-1 上调及菌群介导的路径也尚未被证实。"},{"mechanism_id":"mech_ampk_activation","score":2,"evidence_grade":"D","target_role":"secondary","notes":"二氢小檗碱在离体线粒体实验中可影响呼吸，小檗碱的动物研究也显示通路变化。但这些结果不能直接证明口服二氢小檗碱能在人体内激活 AMPK，作用浓度能否达到也不明确。"}],"indications":[{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"}]},{"id":"supp_piperlongumine","name":"胡椒长明碱 (Piperlongumine)","en_name":"Piperlongumine (Piplartine)","aliases":["胡椒长明碱","荜茇酰胺","Piplartine"],"summary":"胡椒长明碱在细胞实验中可优先杀伤部分诱导衰老的细胞，作用靶点仍在研究中。人体中的选择性清除效果尚未证实，目前也没有经验证的口服脉冲方案。","bioavailability_note":"胡椒长明碱是亲脂性生物碱，随含脂肪的膳食同服能否提高吸收，目前缺乏可靠证据。间歇性脉冲式摄入的做法同样缺乏经人体验证的依据。","typical_dose":"常见的脉冲方案为 100–300 mg/天，每季度或每月连续服用 2–3 天。但这一方案缺乏经验证的人体剂量、安全性和清除效果依据，不宜作为常规建议。","functional_synergies":["与槲皮素或漆黄素联用：多种清除剂组合的效果尚未在人体中验证（理论推测）","清除衰老细胞后配合亚精胺诱导自噬：尚无人体证据支持（理论推测）"],"contraindications":"目前仍处于前沿研究阶段，缺乏人体安全性数据。孕妇、哺乳期女性及严重肝肾功能不全者不建议使用；其他人如要尝试，也不宜长期连续服用。","mechanisms":[{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"C","target_role":"secondary","notes":"小鼠实验中，腹腔给药的胡椒长明碱可抑制炎症刺激后的脑内 NF-κB 信号，与口服补充的暴露条件不同。衰老细胞分泌的炎性因子（SASP）在人体中是否被抑制，目前没有可靠研究。"},{"mechanism_id":"mech_senolytic","score":2,"evidence_grade":"D","target_role":"primary","notes":"胡椒长明碱在部分衰老细胞实验中可优先杀伤衰老细胞，相关研究提示 OXR1 等可能参与其中。选择性清除的机制和具体靶点尚未完全确定，口服后人体中的清除效果也没有可靠研究。"}],"indications":[]},{"id":"supp_cycloastragenol","name":"环黄芪醇 (Cycloastragenol / TA-65)","en_name":"Cycloastragenol (TA-65)","aliases":["环黄芪醇","TA-65","三萜皂苷元","黄芪精粹"],"summary":"环黄芪醇在动物和细胞研究中可影响端粒酶相关指标。人体随机试验结果并不一致：低剂量组血细胞端粒长度有所增加，但端粒酶活性在组间无显著差异，人体端粒酶激活尚未确定。","bioavailability_note":"环黄芪醇是由黄芪甲苷脱去糖基得到的皂苷元，分子结构比黄芪甲苷简单，但其分子量并非减半，口服吸收的优势也不能仅凭脂溶性推定。","typical_dose":"常见的补充剂量为 5–25 mg/天，早晨空腹服用。该剂量并非已确立的抗衰标准剂量，长期安全性及肿瘤相关风险仍不确定。","functional_synergies":["与活性叶酸和甲基 B12 联用：理论上可同时支持 DNA 甲基化与端粒维护，但缺乏人体联合应用的证据（理论推测）","与黄芪多糖联用：免疫调节与端粒作用的叠加效果尚无人体研究（理论推测）"],"contraindications":"活动性恶性肿瘤或未经治疗的肿瘤病史患者慎用（端粒酶激活具有潜在双刃剑效应，肿瘤微环境需严密评估）。长期使用的安全性和肿瘤相关风险尚不明确，应由医生评估后使用。","mechanisms":[{"mechanism_id":"mech_telomerase_activation","score":3,"evidence_grade":"C","target_role":"primary","notes":"动物和细胞研究提示环黄芪醇可影响端粒酶 TERT 相关的表达。人体随机试验中，低剂量组血细胞平均端粒长度有所增加，高剂量组未达显著；12 个月的端粒酶活性在组间也无显著差异，人体端粒酶激活尚未确定。"}],"indications":[{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"}]},{"id":"supp_ergothioneine","name":"麦角硫因 (L-Ergothioneine / MitoPrime)","en_name":"L-Ergothioneine (EGT)","aliases":["麦角硫因","EGT","MitoPrime","长寿维生素之王"],"summary":"麦角硫因是通过 OCTN1 转运体被细胞摄取的含硫氨基酸衍生物，口服吸收已在人体研究中得到证实。其在人体内直接清除自由基、保护线粒体和抗炎的作用尚未得到确认。","bioavailability_note":"OCTN1 转运体分布于骨髓、肝、肾及部分神经元等组织中，成熟红细胞的表达并不明显。口服吸收已在人体研究中得到证实，但组织中的滞留时间不能统一表述为数月。","typical_dose":"标准 L-麦角硫因 5 - 10 mg/天，随餐服用","functional_synergies":["与谷胱甘肽（GSH）联用（理论推测）：麦角硫因理论上可在线粒体和细胞核等部位发挥作用，GSH 参与胞质还原态的维持，两者可能在氧化防御中互相补充，但联用的人体证据尚缺。","与天然虾青素联用（理论推测）：两者理论上可分别作用于膜相与基质相的氧化过程并相互补充，但联用的人体证据尚缺。"],"contraindications":"麦角硫因尚非公认的必需维生素。短期人体研究耐受性良好，但不能证明长期无毒，长期使用的安全性仍需更多数据。","mechanisms":[{"mechanism_id":"mech_direct_ros","score":2,"evidence_grade":"D","target_role":"primary","notes":"麦角硫因经 OCTN1 转运体被细胞摄取，在体外能与铁、铜等金属离子结合，并能与氧化剂反应。但它口服后能否在人体内直接清除自由基，目前尚无机制特异性指标的确证。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"D","target_role":"secondary","notes":"细胞实验提示麦角硫因可调节 NF-κB/p65 相关的炎症反应，动物口服研究中也观察到骨保护作用。但炎症介质下降并不等于 NF-κB 被抑制，常规人体剂量下的作用尚未确立。"},{"mechanism_id":"mech_etc_carrier","score":1,"evidence_grade":"D","target_role":"secondary","notes":"麦角硫因对线粒体的保护作用仍在研究中，这并不等于它充当呼吸链的电子传递载体。目前没有可靠研究证明它在复合体之间传递电子，人体研究只证实了它的摄取。"}],"indications":[{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"},{"indication_id":"memory","grade":"B","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"C","verdict":"mixed"}]},{"id":"supp_glynac","name":"甘氨酸 + NAC 复合物 (GlyNAC)","en_name":"GlyNAC (Glycine + N-Acetylcysteine)","aliases":["GlyNAC","甘氨酸与乙酰半胱氨酸协同组方","贝勒医学院抗衰长寿配方"],"summary":"甘氨酸与 N-乙酰半胱氨酸（NAC）联用可为谷胱甘肽合成提供两种原料。较高剂量的人体试验显示老年受试者红细胞和肌肉谷胱甘肽指标有所改善，但整体反应并不一致，部分改善见于事后亚组分析。","bioavailability_note":"NAC 具有特殊巯基气味，甘氨酸自带温润微甜口感，两者粉末按 1:1 至 1:1.2 重量比例混合后溶于凉白开或温水饮用，但吸收速度缺乏人体数据支持。","typical_dose":"甘氨酸 1.5–3 g 加 NAC 1.2–2.4 g/天，分早晚两次空腹或随少许主食服用。此处剂量低于 Kumar 等试验中每公斤体重 100 mg/天的甘氨酸和 NAC 用量，不能直接套用该试验的效果。","functional_synergies":["与硒代甲硫氨酸联用（理论推测）：甘氨酸与 NAC 提供谷胱甘肽合成的原料，硒则参与 GPx 催化残基的组成，两者理论上可共同支持谷胱甘肽的利用，但联用的人体协同效果尚缺乏直接证据。","与硫辛酸联用（理论推测）：硫辛酸理论上可参与谷胱甘肽体系的氧化还原循环，但二者联用的人体协同效果缺乏直接证据。"],"contraindications":"活动性消化道溃疡急性发作期慎用（高浓度 NAC 可能会对破损胃黏膜产生黏液溶解刺激）。NAC 可引起恶心、腹泻；与硝酸甘油合用可能加重头痛并引起低血压，需谨慎。","mechanisms":[{"mechanism_id":"mech_gsh_synthesis","score":5,"evidence_grade":"A","target_role":"substrate","notes":"甘氨酸和 NAC 分别提供谷胱甘肽合成所需的甘氨酸与半胱氨酸，这是该组合的核心作用。人体试验直接测得较高剂量下红细胞和肌肉中谷胱甘肽指标改善，但反应受基线状态和剂量影响，人群之间差异较大。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"D","target_role":"secondary","notes":"NAC 在细胞实验中可抑制炎症刺激下的 NF-κB 活性。人体试验报告了 hs-CRP、TNF-α 等炎症指标的变化，但这些指标不能证明 NF-κB 受到抑制，该组合在人体中的作用尚未直接证实。"}],"indications":[{"indication_id":"muscle_strength","grade":"C","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"C","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"C","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"C","verdict":"mixed"}]},{"id":"supp_sodium_ascorbate","name":"活性抗坏血酸 / 脂质体维生素 C","en_name":"Sodium Ascorbate / Liposomal Vitamin C","aliases":["抗坏血酸钠","脂质体维C","缓冲型维生素C","Buffered Vitamin C"],"summary":"抗坏血酸是水相中的主要电子供体，也是胶原羟化酶的必需辅因子，其胶原作用已由坏血病研究确认。脂质体及缓冲型制剂的吸收优势因产品和试验而异，eNOS 相关作用的人体证据有限。","bioavailability_note":"普通抗坏血酸单次超过 500 mg 时，吸收率降至约 30%，并易引起腹泻。脂质体型单次可耐受 1000–2000 mg。脂质体及缓冲型制剂的吸收与血药浓度变化因配方和试验而异，不能一概认为都经淋巴绕过 SVCT1，也不能保证峰值固定提高 2–3 倍或半衰期都延长。","typical_dose":"脂质体维生素 C 或抗坏血酸钠常用剂量为 1000–3000 mg/天，分次随餐或空腹服用。1–3 g/天可引起胃肠不适；美国成人维生素 C 总摄入上限为每日 2 g，超过该量应谨慎。","functional_synergies":["与天然维生素 E 或生育三烯酚联用（理论推测）：维生素 C 可在水相中还原已氧化的脂相维生素 E 自由基，二者在抗氧化网络中相互配合。","与胶原蛋白三肽联用（理论推测）：维生素 C 是脯氨酰与赖氨酰羟化酶的辅因子，理论上可参与胶原的正常成熟，但三肽与维生素 C 联用对胶原合成的人体效果尚缺乏直接证据。"],"contraindications":"严重血色病（血铁沉积症）患者慎用超高剂量，维生素 C 会促进肠道非血红素铁吸收。肾结石或高草酸尿患者应将用量控制在每日 1000 mg 以内，但这类人群并不存在适用于所有人的确定安全剂量，需咨询医生。抗坏血酸钠含钠，限钠者应计入总钠摄入量。","mechanisms":[{"mechanism_id":"mech_collagen_synthesis","score":5,"evidence_grade":"A","target_role":"substrate","notes":"抗坏血酸能使胶原羟化酶活性中心的铁保持还原态，是胶原正常成熟所必需的辅因子。坏血病及补充后的恢复已确立了它对结缔组织形成的必要作用，但胶原交联还涉及其他酶。"},{"mechanism_id":"mech_direct_ros","score":5,"evidence_grade":"B","target_role":"primary","notes":"抗坏血酸是经典的水相电子供体，可直接还原多种氧化剂，并能帮助再生维生素 E。但它对羟自由基的实际保护受反应位置和竞争浓度限制，人体指标也不能分别证明它清除每一种指定自由基。"},{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物和细胞实验中，长期维生素 C 处理可增加血管中的 BH4 和 NOS 活性，提示它可能有助于维持 eNOS 偶联。人体口服后的这一机制尚未直接确证，血管功能的变化本身也不足以证明 BH4 稳定。"}],"indications":[{"indication_id":"uric_acid","grade":"B","verdict":"benefit"},{"indication_id":"colds","grade":"B","verdict":"mixed"},{"indication_id":"iron_deficiency","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"no_benefit"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"no_benefit"}]},{"id":"supp_sod_glisodin","name":"麦醇溶蛋白包埋超氧化物歧化酶 (GliSODin SOD)","en_name":"GliSODin Melon SOD (Melon Extract + Gliadin)","aliases":["GliSODin","哈密瓜 SOD","麦醇溶蛋白包埋 SOD","抗氧化原酶"],"summary":"GliSODin 是以麦醇溶蛋白包被的甜瓜提取物，含有 SOD 活性。一项运动员人体试验中补充后红细胞 SOD 活性升高，但未测定 Nrf2 相关指标，也无法区分补充来源与人体内源酶。","bioavailability_note":"口服的 SOD 蛋白会受到胃内消化环境的影响。目前没有可靠证据表明未包埋的 SOD 在胃中全部失活，也没有证据证明该制剂能使完整的酶经肠道入血。","typical_dose":"标准 GliSODin（标示 SOD 活性 500–1000 IU）每日 250–500 mg，早晨空腹服用。mg 与 SOD 活性单位的换算依产品检测方法而异，应以具体产品标签为准。","functional_synergies":["与还原型谷胱甘肽或 NAC 联用（理论推测）：超氧化物歧化酶（SOD）理论上可将超氧阴离子转化为过氧化氢，再由谷胱甘肽过氧化物酶还原，但口服 SOD 能否在人体组织中发挥作用尚未确证。","与天然虾青素联用（理论推测）：两者理论上可分别在酶促途径与脂质相中发挥抗氧化作用，但联用的人体证据尚缺。"],"contraindications":"乳糜泻患者或小麦过敏者不宜使用（制剂含小麦蛋白载体），重度乳糜泻或严重小麦麸质过敏者应禁用。","mechanisms":[{"mechanism_id":"mech_direct_ros","score":2,"evidence_grade":"D","target_role":"primary","notes":"SOD 催化超氧阴离子歧化，属于酶催化反应，并非小分子直接猝灭。但补充的植物来源酶经口后能否在人体组织中直接发挥作用尚未确证，血液 SOD 活性的升高也无法区分补充来源与人体内源酶。"},{"mechanism_id":"mech_nrf2_are","score":1,"evidence_grade":"D","target_role":"secondary","notes":"运动员人体试验中补充后红细胞 SOD 活性升高，但未测定 Nrf2、NQO1 或 HO-1 等指标。动物研究观察到抗氧化酶活性变化，但不能据此确立人体中的 Nrf2/ARE 激活，派氏结介导的机制也未证实。"},{"mechanism_id":"mech_mast_cell","score":1,"evidence_grade":"D","target_role":"secondary","notes":"有研究观察到该制剂可减轻紫外线引起的日光性红斑，但红斑的变化不能证明肥大细胞被稳定。目前也没有可靠的人体研究直接测量其口服后对肥大细胞脱颗粒、组胺或类胰蛋白酶的影响。"}],"indications":[{"indication_id":"fatigue","grade":"C","verdict":"mixed"},{"indication_id":"anxiety_stress","grade":"C","verdict":"mixed"}]},{"id":"supp_black_cumin_tq","name":"黑种草籽油提取物 (百里醌 / Thymoquinone)","en_name":"Black Seed Oil (Thymoquinone / Nigella Sativa)","aliases":["黑种草油","百里醌","Thymoquinone","Nigella Sativa Oil"],"summary":"黑种草籽油的主要活性成分是百里醌。其稳定肥大细胞、抑制炎症介质的作用主要来自动物和细胞研究，人体内的作用强度和剂量仍不明确，油中百里醌含量也因原料和工艺差异较大。","bioavailability_note":"冷榨黑种草籽油中的百里醌含量随原料和工艺而变化，不能统一按 0.5%–1.5% 计算。标准化百里醌提取物的含量更可控，宜随含健康脂肪的正餐同服。","typical_dose":"冷榨黑种草籽油每日 1000–2000 mg；或标准化百里醌每日 20–50 mg，但后者缺少充分的人体长期剂量依据，使用前宜咨询医生。","functional_synergies":["与槲皮素联用：两者理论上都可作用于肥大细胞的介质释放，但缺乏人体联合应用的证据（理论推测）","与姜黄素联用：理论上可叠加抗炎作用，但缺乏人体证据（理论推测）"],"contraindications":"孕妇不建议大剂量摄入（可能具有微弱刺激子宫平滑肌的作用），妊娠期的安全性资料不足。有低血压或正在服用降压药者需监测血压。正在使用降糖药、降压药或抗凝药、抗血小板药者，应注意药物作用的叠加。","mechanisms":[{"mechanism_id":"mech_mast_cell","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物实验中，百里醌可降低过敏模型中血浆的肥大细胞蛋白酶指标，提示它能影响肥大细胞的介质释放。但人体过敏症状的研究不能单独证明肥大细胞脱颗粒受到直接抑制，人体中的直接作用和强度尚不明确。"},{"mechanism_id":"mech_nrf2_are","score":2,"evidence_grade":"C","target_role":"secondary","notes":"动物实验中，百里醌可促进 Nrf2 入核，并使 HO-1 和 NQO1 增加，细胞实验也观察到类似的 HO-1 诱导。但直接共价修饰 Keap1 的机制证据不足，常规口服后人体中的效应尚未确定。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"小鼠实验显示，口服百里醌可降低炎症组织中 p65 和 IκBα 的磷酸化，提示 NF-κB 通路受到一定调节。这一结果来自动物模型，人体在常规口服暴露下的作用目前尚未得到确认。"},{"mechanism_id":"mech_cox_lox_inhibition","score":2,"evidence_grade":"D","target_role":"secondary","notes":"百里醌在体外可抑制 5-脂氧酶及白三烯合成相关的酶活。人体口服后的靶点占用和作用强度尚不清楚，目前没有可靠研究显示常规口服剂量能直接抑制人体的 COX-2 或 5-LOX 酶活。"}],"indications":[{"indication_id":"ldl_cholesterol","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"allergic_rhinitis","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"}]},{"id":"supp_plasmalogens","name":"扇贝来源天然缩醛磷脂 (Scallop Plasmalogens)","en_name":"Scallop-derived Purified Plasmalogens","aliases":["缩醛磷脂","扇贝缩醛磷脂","Plasmalogens","烯醚键甘油磷脂"],"summary":"扇贝缩醛磷脂在化学和动物研究中显示出抗氧化及神经保护的迹象。认知方面的人体试验结果属于探索性，人群有限，不能视为已证实的轻度认知障碍治疗方法。","bioavailability_note":"扇贝缩醛磷脂取自扇贝外套膜，其乙烯醚键对氧化较敏感。口服后会经过消化和脂质重塑，不能断言完整分子直接进入脑内。","typical_dose":"高纯扇贝缩醛磷脂 1 - 2 mg/天，随早餐或午餐服用","functional_synergies":["与磷脂酰丝氨酸（PS）及 DHA 联用（理论推测）：三者均为神经膜的脂质成分，理论上可能共同影响突触膜的脂质环境，但对神经营养因子信号的促进作用缺乏人体证据。","与猴头菇提取物联用（理论推测）：缩醛磷脂可提供膜脂原料，猴头菇成分理论上可能刺激神经营养因子相关信号，但两者联用的人体证据尚缺。"],"contraindications":"对贝类及海洋海鲜过敏者应避免食用扇贝来源的产品。常规剂量下耐受性总体良好。","mechanisms":[{"mechanism_id":"mech_bdnf_ngf","score":3,"evidence_grade":"C","target_role":"secondary","notes":"小鼠实验中，膳食缩醛磷脂可增加海马的 BDNF 信号，且敲低 BDNF 或 TrkB 后相关效应减弱。一项 12 周人体随机试验中血浆 BDNF 在组间没有显著差异，人体神经营养因子通路的证据仍然有限。"},{"mechanism_id":"mech_direct_ros","score":2,"evidence_grade":"D","target_role":"primary","notes":"缩醛磷脂的乙烯醚键可与氧化物或自由基发生反应，化学和膜模型中表现出牺牲式保护。但它在人体中是否直接捕获自由基，以及每日 1–2 mg 能否在脑内达到这样的作用，目前尚不清楚。"},{"mechanism_id":"mech_autophagy_mTOR","score":1,"evidence_grade":"D","target_role":"secondary","notes":"动物模型中观察到淀粉样病理的变化，但这不能说明 mTOR 受抑制或溶酶体自噬清除 β-淀粉样蛋白增加。目前没有常规口服扇贝缩醛磷脂诱导人体自噬的可靠研究。"}],"indications":[{"indication_id":"memory","grade":"B","verdict":"mixed"},{"indication_id":"attention","grade":"B","verdict":"mixed"},{"indication_id":"fatigue","grade":"C","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"B","verdict":"no_benefit"}]},{"id":"supp_phosphatidylcholine","name":"大豆/蛋黄卵磷脂 (高纯多烯磷脂酰胆碱 / PC)","en_name":"Phosphatidylcholine (Polyenylphosphatidylcholine / PC)","aliases":["卵磷脂","磷脂酰胆碱","高纯 PC","多烯磷脂酰胆碱"],"summary":"磷脂酰胆碱（PC）是细胞膜的主要磷脂成分之一，约占膜磷脂的 40–50%。口服后可提供胆碱，小型人体研究支持血浆胆碱升高，但它对膜结构、肠屏障和中枢乙酰胆碱的具体作用尚未在人体中确证。","bioavailability_note":"纯度是关键：普通市售大豆卵磷脂的 PC 含量约 20%，宜选择标注 PC 纯度 50–90% 的浓缩制剂。口服 PC 多经过水解、吸收和重组，不宜把“吸收率超过 90%”视为所有制剂的通用数据。","typical_dose":"高纯 PC（含活性磷脂酰胆碱 1000 - 3000 mg/天），随餐服用","functional_synergies":["与牛磺熊去氧胆酸（TUDCA）或水飞蓟宾联用：理论上可辅助胆汁流动与肝脏脂质代谢，但缺乏人体联合应用的证据（理论推测）","与 α-GPC 或胞磷胆碱联用：理论上可同时提供膜磷脂与胆碱原料，但中枢胆碱增加的人体证据不足（理论推测）"],"contraindications":"肠道菌群严重失调者长期超大剂量服用时，特定厌氧菌可能将其代谢生成三甲胺（TMA）。TMA 在肝脏经 FMO3 氧化为 TMAO，FMO3 活性较弱时 TMA 相对积累而 TMAO 生成减少。建议配合水溶性膳食纤维。","mechanisms":[{"mechanism_id":"mech_cholinergic","score":3,"evidence_grade":"B","target_role":"substrate","notes":"口服 PC 消化后可释放胆碱，小型人体研究中血浆胆碱升高。胆碱可作为乙酰胆碱合成的原料，但血浆胆碱升高不等于中枢乙酰胆碱增加，目前没有常规口服 PC 直接提高人体突触乙酰胆碱的可靠证据。"},{"mechanism_id":"mech_methylation_sam","score":3,"evidence_grade":"B","target_role":"substrate","notes":"PC 来源的胆碱可在线粒体中逐步氧化为甜菜碱，甜菜碱再经 BHMT 途径为同型半胱氨酸提供甲基。小型人体研究测得血浆胆碱和甜菜碱升高，但未直接测定该剂量下的甲基通量或 SAM 再生幅度。"},{"mechanism_id":"mech_tight_junction","score":1,"evidence_grade":"D","target_role":"secondary","notes":"磷脂是细胞膜的重要组成部分，动物实验中口服 PC 可减轻炎症诱导的胃肠通透性增加。但这更多体现为黏液表面屏障的保护，尚未证明普通 PC 能直接加固 ZO-1 或 Occludin 等紧密连接结构。"}],"indications":[{"indication_id":"fatty_liver","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"B","verdict":"no_benefit"}]},{"id":"supp_agmatine","name":"硫酸胍基丁胺 (Agmatine Sulfate)","en_name":"Agmatine Sulfate","aliases":["胍基丁胺","Agmatine","超级精氨酸","内源性神经调质"],"summary":"胍基丁胺由 L-精氨酸经精氨酸脱羧酶生成，动物和体外研究提示它可作用于 NMDA 受体、咪唑啉受体和一氧化氮合酶。人体中的口服吸收、脑内暴露和靶点作用强度均未确定，目前不能视为已证实的神经保护剂。","bioavailability_note":"胍基丁胺易溶于水。其在人体肠道的吸收途径和程度尚未确立，入脑的量也不清楚，与膳食精氨酸竞争转运的程度同样未定，因此不能断言空腹服用就能增强入脑。","typical_dose":"500 - 1500 mg/天，分早晨或运动前/睡前空腹服用","functional_synergies":["与 L-茶氨酸或苏糖酸镁联用：理论上可从其他途径调节与谷氨酸相关的兴奋性，但缺乏人体联合应用的证据（理论推测）","与 L-瓜氨酸联用：理论上两者都可能影响一氧化氮相关的血流，但人体证据不足（理论推测）"],"contraindications":"与左旋多巴类帕金森药物合用须经医生评估。正在服用强效抗抑郁药者应在医生指导下使用，剂量由医生根据耐受情况决定。长期使用的安全资料有限。","mechanisms":[{"mechanism_id":"mech_monoamine","score":2,"evidence_grade":"C","target_role":"secondary","notes":"大鼠实验显示，注射胍基丁胺可改变背缝核 5-HT 神经元的放电活动及相关受体表达。但注射途径与口服补充不同，α2 和咪唑啉受体的作用也不能直接等同于单胺合成或转运的调节，人体效应未知。"},{"mechanism_id":"mech_gaba_glutamate","score":2,"evidence_grade":"D","target_role":"primary","notes":"体外结合实验提示，胍基丁胺作用于 NMDA 受体的多胺相关位点，拮抗精胺样的增强作用。直接阻断通道所需的浓度更高，并且没有常规口服剂量下人体脑内 NMDA 受体占用的测量数据。"},{"mechanism_id":"mech_enos_no","score":2,"evidence_grade":"D","target_role":"secondary","notes":"离体主动脉实验中可见胍基丁胺影响 eNOS 磷酸化、cGMP 及舒张反应，大鼠缺血模型中脑内 eNOS 表达也有改变。但这些结果未能确立口服后的内皮偶联与扩血管作用，“选择性激活 eNOS”目前缺乏依据。"}],"indications":[{"indication_id":"neuropathy","grade":"C","verdict":"mixed"}]},{"id":"supp_uridine","name":"尿苷单磷酸 (Uridine Monophosphate / UMP)","en_name":"Uridine Monophosphate (UMP)","aliases":["尿苷酸","UMP","5'-UMP","肯尼迪脑营养三联核心"],"summary":"尿苷是细胞合成 RNA 与膜磷脂的原料之一，尿苷单磷酸（UMP）常作为补充剂使用。动物研究显示尿苷可影响胆碱能和多巴胺相关指标，但 UMP 对人体记忆及脑内神经递质的作用尚未确证。","bioavailability_note":"游离尿苷易被肠道与肝脏降解，二钠盐形式的 UMP 水溶性较高。但 UMP 口服后会经去磷酸化并被代谢，不能断言完整的 UMP 分子直接穿过血脑屏障。舌下含服或吸收率极高的说法也缺少可靠的人体数据。","typical_dose":"250 - 500 mg/天，早晨或随工作学习期服用","functional_synergies":["与 DHA、α-GPC 或胞磷胆碱联用：理论上可为膜磷脂合成提供原料，但 Souvenaid 这类多成分配方的效果不能直接等同于这些成分的任意组合（理论推测）","与 B 族维生素（B6、B9、B12）联用：理论上有助于核酸代谢，但缺乏人体联合应用的证据（理论推测）"],"contraindications":"极少数个体大剂量晚间服用可能导致精神充沛而影响入眠，建议早午间服用。","mechanisms":[{"mechanism_id":"mech_cholinergic","score":3,"evidence_grade":"C","target_role":"secondary","notes":"在暴露量高于常见人体补充水平的动物实验中，膳食 UMP 可增加纹状体乙酰胆碱的含量及释放，提示其可能通过磷脂代谢间接影响胆碱能系统。剂量和物种差异较大，人体效应尚未确定。"},{"mechanism_id":"mech_monoamine","score":2,"evidence_grade":"C","target_role":"secondary","notes":"有动物研究提示尿苷类物质影响纹状体的多巴胺传递，部分结果来自 UMP 与 DHA 的联合配方。多巴胺受体密度的变化方向和人体意义均未确定，不能据此认为 UMP 单独改善人体动力或受体敏感性。"},{"mechanism_id":"mech_bdnf_ngf","score":2,"evidence_grade":"D","target_role":"secondary","notes":"UTP 等核苷酸可激活 P2Y2 受体，细胞实验中该受体与 NGF/TrkA 信号存在相互作用。但这些细胞结果不能直接外推到 UMP：UMP 与 TrkB 通路的关系，以及口服后人体 BDNF 和 NGF 信号的变化，目前都没有直接证据。"}],"indications":[{"indication_id":"neuropathy","grade":"C","verdict":"mixed"}]},{"id":"supp_lumbrokinase","name":"地龙蛋白提取物 (蚓激酶 / Lumbrokinase)","en_name":"Lumbrokinase (Earthworm Protein Extract)","aliases":["蚓激酶","地龙蛋白","特异性纤溶酶组分","Boluoke"],"summary":"蚓激酶提取自红蚯蚓，是一组具有丝氨酸蛋白酶活性的多肽。人体随机试验中观察到 t-PA 活性和 D-二聚体升高、纤维蛋白原下降，但完整活性酶经口进入血液的程度尚未确定。","bioavailability_note":"蚓激酶是大分子蛋白酶，口服后能否以完整活性形式进入血液尚未确定。肠溶包衣和空腹服用在常见说法中被视为重要，但目前并非已证实的必要条件，也不能保证完整吸收。","typical_dose":"标准化蚓激酶产品常标示活性约 600,000–1,200,000 U，每日 1–2 次，餐前 1 小时或睡前用温水送服。不同产品的活性单位未必可互换，应以具体产品标示为准。","functional_synergies":["与纳豆激酶合用：两者的溶栓作用理论上可叠加，但出血风险增加，且缺乏联合应用的人体证据（理论推测）","与银杏叶制剂合用：两者的抗血小板作用理论上可叠加，但出血风险增加，且缺乏联合应用的人体证据（理论推测）"],"contraindications":"重度出血性疾病、颅内活动性出血及大手术前后 2 周禁用。与华法林或其他抗凝药、抗血小板药、纳豆激酶或银杏叶制剂合用可能增加出血风险，需由医生评估。华法林可用凝血酶原时间（PT/INR）监测，但 PT/INR 不能可靠反映所有直接口服抗凝药的抗凝强度。","mechanisms":[{"mechanism_id":"mech_fibrinolysis","score":4,"evidence_grade":"A","target_role":"primary","notes":"蚓激酶可作用于纤维蛋白。人体随机研究中观察到 t-PA 活性和 D-二聚体升高、纤维蛋白原下降，纤溶相关的人体指标确有改变。但体外的纤维蛋白水解不能证明完整酶在人体中直接粉碎微血栓，直接酶切的贡献尚未确定。"},{"mechanism_id":"mech_paf_platelet","score":3,"evidence_grade":"A","target_role":"secondary","notes":"一项多中心研究中，部分患者的血液及血浆黏度指标可能改善，这属于血液流变学的变化。它并不能证明蚓激酶拮抗 PAF 受体，目前也没有证据显示它能特异性占据人体的 PAF 受体。"}],"indications":[{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"}]},{"id":"supp_pycnogenol","name":"法国海岸松树皮提取物 (碧容健 / Pycnogenol)","en_name":"French Maritime Pine Bark Extract (Pycnogenol)","aliases":["碧容健","Pycnogenol","法国松树皮提取物","低聚原花青素高纯复合物"],"summary":"法国海岸松树皮提取物，含原花青素与酚酸类成分，在小型人体试验中可增强依赖一氧化氮的血管舒张。内皮功能的改善有人体数据支持，但具体靶点与直接抗氧化作用的人体证据仍不充分。","bioavailability_note":"水溶性良好，小分子酚酸可在 30 分钟内入血。低聚原花青素经肠道微生物分解为代谢物（如 M4/M6），但各代谢物能否持续发挥临床作用，缺乏充分的人体药代与药效证据。","typical_dose":"标准化 Pycnogenol 50 - 200 mg/天，随餐服用","functional_synergies":["与 L-精氨酸或 L-瓜氨酸联用（理论推测）：两者理论上可为一氧化氮合成提供底物，碧容健也可能影响 eNOS 相关信号，但其对 eNOS 催化活性的增强尚未直接测定，联用效果缺乏人体证据。","与维生素 C 联用（理论推测）：维生素 C 参与胶原羟化，碧容健的胶原相关作用仍属小样本的初步信号，两者联用对血管结缔组织的效果缺乏人体证据。"],"contraindications":"耐受性总体良好。个别人空腹服用后可能出现轻微胃部不适，建议随餐服用。与降压药或抗凝、抗血小板药合用时可能产生叠加作用，临床相互作用证据有限，应在医生指导下使用。","mechanisms":[{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"B","target_role":"primary","notes":"小型人体试验显示，每日 180–200 mg 可增强依赖一氧化氮的血管舒张，NOS 抑制剂能消除该增强。eNOS 转录上调和 NO 生成本身未直接测定，改善幅度与适用人群的证据仍有限。"},{"mechanism_id":"mech_collagen_synthesis","score":2,"evidence_grade":"B","target_role":"secondary","notes":"一项 20 人的非对照研究在皮肤活检中见到 HAS-1 表达增加，胶原合成相关基因也呈增加趋势。这是小样本的机制性信号，缺少对照组，也没有证明胶原生成、交联或血管壁修复的直接结果。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"体外实验证明提取物能清除超氧阴离子和过氧亚硝酸盐，但这一结果不能直接推广到人体。口服后母体多酚的浓度与代谢都限制了它在全身的直接清除作用，能否在血管内直接保护 NO 尚未证实。人体氧化应激指标的下降也无法区分直接清除与间接抗氧化。"}],"indications":[{"indication_id":"venous_insufficiency","grade":"B","verdict":"benefit"},{"indication_id":"joint_pain","grade":"B","verdict":"benefit"},{"indication_id":"menopause","grade":"B","verdict":"benefit"},{"indication_id":"pms","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"eye_health","grade":"C","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"}]},{"id":"supp_hawthorn","name":"山楂叶花标准化提取物 (WS 1442 / 山楂黄酮)","en_name":"Hawthorn Leaf and Flower Extract (WS 1442)","aliases":["山楂提取物","WS 1442","山楂原花青素","Crataegus"],"summary":"山楂叶花标准化提取物是常见的传统心血管植物药。动物实验提示它可影响 eNOS/NO 信号，但人体 FMD 试验未显示稳定的剂量反应，冠脉与心肌作用的人体证据并不充分。","bioavailability_note":"黄酮苷类在肠道经乳糖酶根皮苷水解酶（LPH）转化为苷元后可被吸收，人体血药浓度的变化规律尚缺乏充分数据，建议规律服用。","typical_dose":"标准化山楂叶花提取物（含原花青素 18.75%）300 - 900 mg/天，分早晚随餐服用","functional_synergies":["与辅酶 Q10 联用（理论推测）：山楂提取物理论上可能影响冠状动脉血管舒张相关信号，辅酶 Q10 则参与心肌线粒体的电子传递，两者联用对心肺耐力的改善缺乏人体证据。","与牛磺酸及镁联用（理论推测）：三者理论上都可能与心肌钙稳态相关，但山楂成分对心肌钙调节的作用缺乏人体证据，联用效果也未经验证。"],"contraindications":"心衰患者不应以山楂替代标准治疗，服用西药的心衰患者需在医生监测下使用。与地高辛等强心苷类药物同服，理论上可叠加增强作用，临床证据不足，应由医生评估。不同工艺和成分的山楂制剂不能直接等同于 WS 1442。","mechanisms":[{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"C","target_role":"primary","notes":"在小鼠实验中，WS 1442 可恢复血管周围脂肪组织的 eNOS 磷酸化与 NO 信号。人体口服研究中，标准化山楂提取物未显示 FMD 的剂量反应，常规剂量能否持续激活冠脉 eNOS 尚未证实。"},{"mechanism_id":"mech_osmolyte_calcium","score":1,"evidence_grade":"D","target_role":"secondary","notes":"这一机制的依据来自内皮细胞实验，而非心肌细胞。WS 1442 在内皮细胞中抑制 SERCA 并影响钙信号，但没有证据表明它能使心肌 SERCA2a 敏化或在不增加耗氧的前提下增强收缩。该机制在人体中尚无支持。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"体外实验显示山楂提取物可清除活性氧。LDL 氧化与 ICAM-1 的变化不能等同于直接清除，循环中有效成分的浓度与作用强度也不确定。"}],"indications":[{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"no_benefit"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"no_benefit"}]},{"id":"supp_rutin","name":"芦丁 / 羟乙基芦丁 (Rutin / Troxerutin)","en_name":"Rutin / Troxerutin (Vitamin P)","aliases":["芦丁","芸香苷","维生素 P","曲克芦丁","Troxerutin"],"summary":"芦丁与羟乙基芦丁（曲克芦丁）是传统上用于毛细血管脆弱与静脉功能的黄酮类药物。口服后可在人体血浆中检出，但内皮紧密连接、血小板与自由基相关机制多停留在动物和体外阶段。","bioavailability_note":"天然芦丁水溶性较低，口服后主要在肠道被转化为槲皮素及其结合代谢物。羟乙基芦丁（曲克芦丁）水溶性高，与芦丁是不同的化合物，两者的剂量、吸收率与临床数据不能互换。","typical_dose":"标准芦丁或曲克芦丁 300 - 600 mg/天，随餐服用","functional_synergies":["与维生素 C 联用（理论推测）：芦丁理论上可减少维生素 C 的氧化损耗，维生素 C 也参与胶原羟化，但芦丁对血管胶原基底膜的作用缺乏人体证据，联用效果未经验证。","与微粉化地奥司明（MPFF）联用（理论推测）：两者理论上都可能影响静脉与微循环功能，但联用对深静脉回流与淋巴微循环的改善缺乏人体证据。"],"contraindications":"常规使用耐受性良好，孕早期大剂量使用建议咨询妇产科医生。","mechanisms":[{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"小鼠膳食研究显示，芦丁能改善冷应激后肠道 ZO-1、occludin 和 claudin-1 的表达。毛细血管内皮的黏附连接与这里的上皮紧密连接并不相同，人体口服后对紧密连接蛋白的作用仍不确定。"},{"mechanism_id":"mech_paf_platelet","score":1,"evidence_grade":"D","target_role":"secondary","notes":"兔血小板体外实验中，芦丁在数十至数百微摩尔浓度下能抑制 PAF 诱导的钙反应。这些浓度远高于通常口服后未结合母体药物的暴露水平，受体特异性占据也没有得到证实，目前不能作为人体抗血小板作用的依据。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"无细胞实验显示，曲克芦丁可影响羟自由基和超氧阴离子的捕获信号。口服芦丁后人体内主要检出槲皮素及其结合代谢物，芦丁原形能否直接清除超氧、减轻红细胞膜脂质过氧化，尚无人体证据。"}],"indications":[{"indication_id":"venous_insufficiency","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"benefit"}]},{"id":"supp_glucosamine_sulfate","name":"D-硫酸氨基葡萄糖 (Glucosamine Sulfate 2KCl)","en_name":"Glucosamine Sulfate (2KCl)","aliases":["硫酸氨基葡萄糖","硫酸氨糖","葡糖胺","Glucosamine"],"summary":"硫酸氨基葡萄糖是软骨中糖胺聚糖合成的原料。口服后可在关节滑液中检出，但它能否在人体软骨中促进基质修复尚未直接证实，临床效果因盐型和制剂而异。","bioavailability_note":"硫酸盐形式（2KCl）的临床研究较多，但不同盐型与商品制剂的临床效果存在差异，不能断言硫酸盐均明显优于盐酸盐。口服后原形药的系统生物利用度不能由旧的 90% 胃肠吸收估计直接推算，药品资料曾估计其约为 25%，测量方法也有局限。","typical_dose":"硫酸氨糖 1500 mg/天（单次或分 2-3 次随餐服用）","functional_synergies":["与硫酸软骨素和 MSM 联用：三者临床上常被组合使用，协同修复作用属理论推测。","与乳香酸（AKBA）联用：理论上可减轻滑膜炎性渗出，人体协同证据不足（理论推测）。"],"contraindications":"传统原料由虾蟹壳甲壳素提取，对甲壳类海鲜严重过敏者需选择玉米发酵植物型氨糖；糖尿病患者常规剂量不影响 HbA1c，但大剂量初期建议常规监测血糖。有与华法林合用致 INR 升高的病例报告，服用抗凝药者需监测。","mechanisms":[{"mechanism_id":"mech_joint_cartilage_ecm","score":3,"evidence_grade":"C","target_role":"substrate","notes":"犬的同位素示踪研究显示，口服标记氨糖可进入关节软骨并被软骨细胞利用。人体药代研究中，常规剂量后滑液氨糖中位浓度约为 4.34 μM。但这尚不能证明常规剂量能在人体软骨中显著促进基质修复。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"小鼠膳食研究中，硫酸氨糖降低了结肠炎模型中 NF-κB 相关的表达。在软骨细胞中抑制 NF-κB p65 核易位的结果主要来自实验模型，尚未在常规口服剂量的人体关节中得到确认。"}],"indications":[{"indication_id":"joint_pain","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"C","verdict":"mixed"},{"indication_id":"falls","grade":"C","verdict":"mixed"}]},{"id":"supp_chondroitin","name":"硫酸软骨素钠 (Chondroitin Sulfate Sodium)","en_name":"Chondroitin Sulfate (Bovine / Avian Sodium Salt)","aliases":["硫酸软骨素","软骨素钠","Chondroitin","CSA/CSC"],"summary":"硫酸软骨素是软骨基质中的大分子糖胺聚糖，负电荷结构使其能吸纳水分、维持软骨弹性。人体开放研究测得了软骨降解标志物的变化，但外源分子能否修复人体软骨或抑制降解酶，尚无直接证据。","bioavailability_note":"硫酸软骨素是分子量约 10–30 kDa 的大分子多糖。口服后可检出不同分子量的相关成分，但完整分子经淋巴吸收并向关节富集的程度尚不确定。原料方面，宜选用高纯医药级产品。","typical_dose":"高纯硫酸软骨素 800 - 1200 mg/天，随餐服用","functional_synergies":["与硫酸氨糖联用：临床上常合用，协同增效属理论推测。","与低分子透明质酸钠联用：理论上可同时影响滑液黏度与软骨弹性，人体证据不足（理论推测）。"],"contraindications":"结构上与肝素相近，正在使用抗凝药物（华法林、肝素等）者需遵医嘱监测出凝血指标。与华法林合用可能影响 INR，这一风险并非只在高剂量抗凝时才需注意。","mechanisms":[{"mechanism_id":"mech_joint_cartilage_ecm","score":2,"evidence_grade":"B","target_role":"secondary","notes":"硫酸软骨素带负电的糖链有助于保持软骨基质水合。人体开放研究观察到降解标志物 Coll2-1 发生变化，细胞实验也显示其能降低 ADAMTS-5 表达。这些结果不能证明外源多糖直接进入人体软骨，也不能说明它直接抑制降解酶。"},{"mechanism_id":"mech_cox_lox_inhibition","score":1,"evidence_grade":"D","target_role":"secondary","notes":"培养的成骨细胞实验显示，硫酸软骨素能影响炎症刺激下 PGE2 及相关酶的表达。这属于细胞因子或酶表达的变化，并不等同于直接结合并抑制 COX-2 或 5-LOX，人体中也缺少靶点证据。"}],"indications":[{"indication_id":"joint_pain","grade":"B","verdict":"mixed"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"mixed"}]},{"id":"supp_msm","name":"二甲基砜 (MSM / OptiMSM)","en_name":"Methylsulfonylmethane (MSM / OptiMSM)","aliases":["二甲基砜","MSM","有机硫","OptiMSM","生物活性硫"],"summary":"二甲基砜是一种有机硫化合物，常用于关节与结缔组织的营养补充。它能否作为软骨或胶原的硫供体，目前没有人体证据；抗炎与 NF-κB 相关效应主要来自动物实验。","bioavailability_note":"二甲基砜易溶于水。小肠吸收快速且完全、可自由穿透细胞膜并均匀分布于全身组织的说法，缺乏充分的人体证据。选用经多重蒸馏提纯的原料，有助于降低重金属残留的风险。","typical_dose":"1000–3000 mg/天，随餐分次服用。在严重软骨不适或运动康复期，可渐进增至 4000–6000 mg/天。这一较高剂量长期使用的获益尚未确立。","functional_synergies":["与氨糖和软骨素联用：三者常被一起使用，胶原二硫键相关的协同作用属理论推测。","与姜黄素联用：理论上可减轻运动后延迟性肌肉酸痛与滑膜炎，人体协同证据不足（理论推测）。"],"contraindications":"初次大剂量服用时，少数人可能出现胃肠不适或排气增多，建议从 1000 mg/天起始，每周逐步递增，这类胃肠反应不应被解释为有益的代谢作用。晚间服用是否提高兴奋度缺乏充分证据，若出现兴奋或睡眠不适，可改为早午餐服用。","mechanisms":[{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"C","target_role":"secondary","notes":"小鼠口服实验中，较高剂量的 MSM 降低了胃组织的 NF-κB 表达与炎症指标。这一结果来自特定剂量与组织的动物模型，不能直接推论为常规口服剂量在人体软骨中阻断 IκBα 或降低细胞因子。"},{"mechanism_id":"mech_joint_cartilage_ecm","score":1,"evidence_grade":"D","target_role":"secondary","notes":"二甲基砜能提供有机硫，但它作为胶原二硫键催化剂或软骨硫供体的作用未获证实。欧盟营养与健康声称登记资料中，支持其作为硫来源的相关声称未获充分证实。"},{"mechanism_id":"mech_gsh_synthesis","score":1,"evidence_grade":"D","target_role":"secondary","notes":"人体研究中，运动后血浆谷胱甘肽及其比值的变化结果并不一致。这些变化不能说明 MSM 硫进入转硫途径，也没有证据表明它供应了 GSH 合成的底物或辅因子，供硫机制尚未证实。"}],"indications":[{"indication_id":"skin_aging","grade":"C","verdict":"benefit"},{"indication_id":"joint_pain","grade":"B","verdict":"mixed"},{"indication_id":"exercise_recovery","grade":"C","verdict":"mixed"},{"indication_id":"allergic_rhinitis","grade":"C","verdict":"mixed"}]},{"id":"supp_hyaluronic_acid","name":"低分子透明质酸钠 (Low Molecular Hyaluronic Acid)","en_name":"Low Molecular Weight Sodium Hyaluronate (HA)","aliases":["透明质酸","玻尿酸","口服透明质酸钠","HA"],"summary":"低分子透明质酸钠保水性强，可在关节滑液与皮肤中发挥保水作用。部分人体研究以症状为主要指标，症状改善不能证明其经 CD44 途径促进内源透明质酸合成的机制。","bioavailability_note":"传统超大分子透明质酸（分子量超过 1000 kDa）口服吸收较差。大鼠药代研究显示，口服吸收受分子量影响，50 kDa 和 300 kDa 制剂的吸收都很少。放射性示踪也不能单独证明完整分子能高效靶向关节或皮肤。","typical_dose":"低分子高纯透明质酸钠 100 - 200 mg/天，随餐或温水吞服","functional_synergies":["与胶原蛋白三肽联用（理论推测）：胶原是真皮与软骨基质的重要结构成分，透明质酸则与保水及润滑相关，两者理论上可共同支持皮肤与关节的功能，但联用的人体证据尚缺。","与硫酸软骨素联用（理论推测）：两者理论上都可能影响关节滑液的黏度与流变性质，但联用的人体协同效果缺乏证据。"],"contraindications":"总体耐受性良好，透明质酸是人体天然存在的成分。严重活动性肿瘤患者不宜自行超大剂量长期补充，应先咨询医生。关于长期口服促进肿瘤血管生成的说法，目前缺乏直接临床证据。","mechanisms":[{"mechanism_id":"mech_joint_cartilage_ecm","score":3,"evidence_grade":"C","target_role":"secondary","notes":"大鼠实验中，不同分子量的透明质酸口服后，滑液中透明质酸相关指标上升，软骨 MMP 表达下降。口服后经 CD44 激活 HAS-2 并增加人体滑液分泌的过程未获直接证实，人体症状改善也不能证明这一机制。"},{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"小鼠口服实验中，35 kDa 透明质酸增加了结肠上皮 ZO-1 表达并改善感染模型的屏障。该分子量不同于本品的 50–200 kDa，细胞外保水也不等于紧密连接增强，人体角质形成细胞中的相关机制尚未证实。"}],"indications":[{"indication_id":"skin_aging","grade":"B","verdict":"benefit"},{"indication_id":"joint_pain","grade":"C","verdict":"mixed"}]},{"id":"supp_uc2","name":"非变性 II 型胶原蛋白 (UC-II / Undenatured Type II Collagen)","en_name":"Undenatured Type II Collagen (UC-II)","aliases":["UC-II","非变性二型胶原","活性 II 型胶原蛋白","口服免疫耐受胶原"],"summary":"非变性 II 型胶原取自鸡胸软骨，保留了天然三螺旋构象。动物实验显示口服后可诱导免疫耐受，并减轻软骨退化；一项人体随机试验显示其改善部分症状，但口服耐受机制尚未在人体中确证。","bioavailability_note":"与常用的水解胶原肽相比，本品每日用量为 40 mg。不同规格产品中非变性 II 型胶原的含量并不相同，部分规格标示为 10 mg，应以产品标示为准。服用时应避免高温，以免破坏其天然三螺旋构象。","typical_dose":"每日 40 mg，具体规格不同，非变性 II 型胶原含量以产品标示为准。睡前、空腹服用的要求缺乏充分证据，可按产品说明服用，并避免用高温热水送服。","functional_synergies":["与氨糖和软骨素联用：三者常被组合使用，协同修复作用属理论推测。","与乳香酸（AKBA）联用：理论上可减轻滑膜炎性反应，人体协同证据不足（理论推测）。"],"contraindications":"对鸡肉或禽类蛋白严重过敏者慎用，服用前应核查原料来源及具体制剂。服用时需保持三螺旋天然构象，切勿咀嚼或倒入沸水中饮用。","mechanisms":[{"mechanism_id":"mech_oral_immune_tolerance","score":3,"evidence_grade":"C","target_role":"primary","notes":"小鼠实验显示，口服 II 型胶原后，派氏结树突细胞与 Foxp3+ 调节性 T 细胞参与免疫耐受，因此这是有动物证据支持的候选机制。动物模型与本品及人体骨关节炎并不完全等同，人体中的派氏结摄取尚未确证。"},{"mechanism_id":"mech_joint_cartilage_ecm","score":3,"evidence_grade":"C","target_role":"secondary","notes":"大鼠研究显示，口服 UC-II 后软骨组织学恶化减轻。另一种天然 II 型胶原在人体部分亚组中观察到 CTX-II 变化，但制剂不同，不能直接套用到 UC-II。症状评分改善也不能证明软骨基质被修复。"}],"indications":[{"indication_id":"joint_pain","grade":"B","verdict":"benefit"}]},{"id":"supp_cla","name":"共轭亚油酸 (CLA / Tonalin c9,t11 & t10,c12)","en_name":"Conjugated Linoleic Acid (CLA / Tonalin)","aliases":["共轭亚油酸","CLA","Tonalin","异构亚油酸"],"summary":"共轭亚油酸是多种异构体的混合物，反刍动物食品中以 c9,t11 为主。人体研究结果并不一致，部分研究提示 t10,c12 异构体可能增加氧化应激并损害胰岛素敏感性，减脂作用的人体证据不足。","bioavailability_note":"纯油溶性游离脂肪酸或甘油三酯形态，随含适量健康油脂的正餐同服，有助于消化吸收。","typical_dose":"标准化 CLA（含 80% 活性异构体 50:50 比例）3000 - 4000 mg/天，分次随餐服用","functional_synergies":["与左旋肉碱联用：减脂协同作用尚未确立，属理论推测。","与绿茶提取物联用：减脂协同作用尚未确立，属理论推测。"],"contraindications":"重度肥胖合并极度脂肪肝患者需在营养师指导下使用。部分人体试验提示 t10,c12 异构体可能增加氧化应激并损害胰岛素敏感性，脂肪肝或代谢异常者应谨慎。补充剂常见的 50:50 比例混合物并非唯一有效形式，其他比例的产品不应一概视为劣质，应选择异构体组成标示清楚的产品。","mechanisms":[{"mechanism_id":"mech_cpt_shuttle","score":3,"evidence_grade":"C","target_role":"secondary","notes":"CLA 不是肉碱类物质，不直接参与脂酰肉碱穿梭。小鼠实验中，部分条件下肌肉或脂肪组织的肉碱棕榈酰转移酶活性有所增加。人体交叉试验中，每日 3.8 g 混合 CLA 未改善测得的脂肪氧化，人体证据不一致。"},{"mechanism_id":"mech_ampk_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"脂蛋白脂肪酶活性受抑制的现象本身，不能说明 AMPK 被激活。AMPK 相关效应主要见于小鼠和细胞模型，且随异构体、组织和剂量而异，人体口服后尚无可靠的 AMPK 特异指标证实。"},{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"C","target_role":"secondary","notes":"动物实验中，部分条件下 CLA 可下调 NF-κB 相关信号，不同异构体的炎症效应方向则不一致。c9,t11 作为 PPAR-γ 弱激动剂的说法，以及 TNF-α 下降，都不能单独证明人体 NF-κB 被抑制。"}],"indications":[{"indication_id":"body_weight","grade":"A","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"muscle_strength","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"A","verdict":"no_benefit"},{"indication_id":"triglycerides","grade":"A","verdict":"no_benefit"}]},{"id":"supp_dandelion_root","name":"蒲公英根与朝鲜蓟复合提取 (Dandelion & Artichoke)","en_name":"Dandelion Root & Artichoke Leaf Extract","aliases":["蒲公英根提取物","利胆草本复合","MMC 胃肠动力素"],"summary":"蒲公英根与朝鲜蓟复合草本，传统上用于利胆与消化不适。一项 20 人交叉试验中，朝鲜蓟提取物经十二指肠给药后胆汁分泌增加（途径与剂量均与本复方不同），小肠运动及 SIBO 预防等作用尚未得到证明。","bioavailability_note":"本复方为植物水提或醇提物，菊粉与苦味成分的含量随原料部位和提取工艺而变化。可饭前 15–30 分钟温水冲服或胶囊吞服，但通过苦味受体反射促进消化液分泌的机制尚未作为统一机制确立。","typical_dose":"复合提取物 500 - 1000 mg/天，正餐前 15 分钟或睡前服用","functional_synergies":["与姜辣素（生姜提取物）联用：理论上可同时促进胃排空与小肠运动，临床协同疗效尚未确立，属理论推测。","与水飞蓟宾联用：理论上可辅助肝脏解毒与胆汁排泄，协同疗效尚未确立，属理论推测。"],"contraindications":"完全性机械性胆道狭窄梗阻或急性化脓性胆囊炎禁用。胆石症或其他胆道疾病患者应先由医生评估。对菊科植物（Compositae）严重过敏者慎用。","mechanisms":[{"mechanism_id":"mech_scfa_fermentation","score":3,"evidence_grade":"C","target_role":"substrate","notes":"蒲公英根多糖在小鼠结肠炎模型中可改善短链脂肪酸与肠道屏障相关指标。菊粉作为发酵底物在理论上合理，但本复方的菊粉含量与可发酵剂量并不明确，目前不能证明它能提高盲肠丁酸。"},{"mechanism_id":"mech_nrf2_are","score":2,"evidence_grade":"C","target_role":"secondary","notes":"小鼠肠道研究中，蒲公英根多糖提高了肠组织 Nrf2、HO-1 和 NQO1 相关指标。这一证据针对特定多糖与肠道模型，不能外推到本复方的酚酸在人体肝脏中抵御胆汁酸反流的作用。"},{"mechanism_id":"mech_er_stress_chaperone","score":1,"evidence_grade":"D","target_role":"secondary","notes":"一项 20 人交叉试验中，十二指肠给予 1.92 g 朝鲜蓟提取物后胆汁分泌增加。这一结果不能说明分子伴侣作用，BSEP 与碳酸氢盐分泌也未得到确证。内质网应激的相关效应目前仅有 HepG2 细胞证据。"}],"indications":[{"indication_id":"gastric_mucosa","grade":"C","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"C","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"C","verdict":"mixed"},{"indication_id":"triglycerides","grade":"C","verdict":"mixed"}]},{"id":"supp_triphala","name":"三果宝标准化提取物 (Triphala / 诃子+余甘子+毛诃子)","en_name":"Triphala Extract (Standardized Tannins)","aliases":["三果宝","Triphala","藏药三果汤","诃子毛诃子余甘子三联"],"summary":"三果宝由诃子、毛诃子和余甘子组成，传统上用于肠道调理。大鼠实验显示其可改变菌群并提高紧密连接相关指标，人体小型试验中菌群反应个体差异明显，未报告短链脂肪酸增加。","bioavailability_note":"三果宝富含多酚与单宁类成分，在结肠经微生物代谢后生成尿石素类代谢物。代谢物的生成量取决于配方成分与个体菌群。睡前空腹优于其他服用时间的证据不足。","typical_dose":"标准化提取物（含单宁 40–50%）500–1500 mg/天。睡前空腹优于其他服用时间的证据不足，可按产品说明服用。","functional_synergies":["与布拉氏酵母菌联用：分泌型 IgA 由宿主产生，布拉氏酵母菌本身不分泌 IgA，协同效果尚未确立（理论推测）。","与车前子壳（Psyllium）联用：二者都有润肠作用，理论上可叠加，协同效果尚未确立（理论推测）。"],"contraindications":"孕妇慎用（具有微弱下气行血特性）；腹泻急性发作期暂缓使用。长期或大剂量使用可能形成排便依赖，目前不能保证无依赖及肠道黑变风险，连续服用时应留意排便习惯的变化。","mechanisms":[{"mechanism_id":"mech_scfa_fermentation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"大鼠口服研究显示，三果宝可改变菌群并增加短链脂肪酸相关指标。但菌群组成变化不等于丁酸生成，人体小型随机试验也未报告短链脂肪酸增加，且并非所有梭菌都有害。"},{"mechanism_id":"mech_tight_junction","score":3,"evidence_grade":"C","target_role":"secondary","notes":"大鼠口服研究中，三果宝提高了肠道 ZO-1 与 claudin-1 的表达，并改善了通透性相关指标。鞣质与黏膜蛋白形成的保护膜不等于紧密连接修复，人体“肠漏”改善也未得到证实。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"secondary","notes":"体外实验显示，三果宝及其组分具有自由基反应与抗氧化活性，其中多酚类成分可清除自由基。这不能证明口服后有系统性的直接清除作用，人体吸收与菌群代谢也存在明显的个体差异。"}],"indications":[{"indication_id":"constipation","grade":"C","verdict":"mixed"},{"indication_id":"body_weight","grade":"C","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"C","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"C","verdict":"mixed"},{"indication_id":"triglycerides","grade":"C","verdict":"mixed"}]},{"id":"supp_iron_bisglycinate","name":"双甘氨酸螯合铁 (Ferrochel Iron)","en_name":"Ferrous Bisglycinate Chelate (Ferrochel)","aliases":["螯合铁","弱酸铁","双甘氨酸铁","Ferrochel"],"summary":"双甘氨酸螯合铁是有机螯合形式的补铁剂，系统评价显示它可改善部分人群的血红蛋白。胃肠不良反应不能保证完全避免，线粒体与黏膜抗菌等机制也缺乏直接的人体证据。","bioavailability_note":"与硫酸亚铁相比，吸收效率通常更高，但不能断言恒为 3–4 倍。植酸、多酚等成分可能影响吸收。胃肠不良反应同样不能保证完全避免。","typical_dose":"元素铁 20 - 45 mg/天（视贫血或铁蛋白储备水平而定），随餐服用","functional_synergies":["与维生素 C 联用：维生素 C 有助于铁的吸收，联用对血红素合成的实际影响尚未评估（理论推测）。","与叶酸、维生素 B12 联用：三者都与红细胞生成相关，但效果因贫血病因而异，不能保证治愈所有大小细胞性贫血，应先明确病因。"],"contraindications":"未确诊缺铁者严禁盲目长期大剂量摄入；遗传性血色病（Hemochromatosis）患者绝对禁用。必须定期监测血清铁蛋白（Ferritin）。铁剂可影响左甲状腺素、四环素类和喹诺酮类药物的吸收，合用时应按药品说明分开服用。","mechanisms":[{"mechanism_id":"mech_etc_carrier","score":3,"evidence_grade":"C","target_role":"substrate","notes":"铁是铁硫簇与血红素的组成元素，缺铁会损害含铁的呼吸链蛋白。大鼠缺铁后肌肉琥珀酸脱氢酶活性下降，注射补铁后回升。人体研究中观察到的是部分人群血红蛋白改善，线粒体电子传递链的作用未被直接测定。"}],"indications":[{"indication_id":"iron_deficiency","grade":"A","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"C","verdict":"mixed"},{"indication_id":"falls","grade":"C","verdict":"mixed"}]},{"id":"supp_copper_bisglycinate","name":"双甘氨酸螯合铜 (Copper Bisglycinate)","en_name":"Copper Bisglycinate Chelate","aliases":["螯合铜","双甘氨酸铜","Albion 铜","元素铜"],"summary":"铜是细胞色素 c 氧化酶、Cu/Zn-SOD 与赖氨酰氧化酶的必需辅因子，但长期每天补锌超过 25–30 mg 会减少铜吸收。补铜对胶原交联指标的影响，取决于原有的铜营养状态。","bioavailability_note":"双甘氨酸螯合铜是有机螯合形式。人体不同铜制剂的相对生物利用度尚未确立，与其他矿物质的竞争及胃肠刺激也不能保证完全避免。","typical_dose":"元素铜 1–2 mg/天，随餐服用。长期补锌时，锌铜比例并非必须固定，应结合总摄入量与缺铜风险进行评估。","functional_synergies":["与甘氨酸锌联用：长期补锌可减少铜吸收，合用时应结合总摄入与缺铜风险评估铜的补充量，固定比例并非必须。","与铁剂联用：铜蓝蛋白参与铁的氧化与转运，临床联用获益尚未确立，属理论推测。"],"contraindications":"肝豆状核变性（Wilson's Disease，铜代谢障碍）患者绝对禁用；无缺铜风险且未补锌者无需额外单补高剂量铜。美国成人铜的每日摄入上限为 10 mg（包括食物与补充剂），应合并计算。","mechanisms":[{"mechanism_id":"mech_collagen_synthesis","score":4,"evidence_grade":"A","target_role":"substrate","notes":"铜是赖氨酰氧化酶（LOX）的必需辅因子。低铜饮食可降低皮肤中该酶活性，补充后回升。小型安慰剂对照试验中，每日 2 mg 甘氨酸铜可改变交联相关指标。补铜的增益取决于原有铜状态，铜充足者不宜假定额外补充会继续增强交联。"},{"mechanism_id":"mech_direct_ros","score":1,"evidence_grade":"D","target_role":"substrate","notes":"铜是 Cu/Zn-SOD（SOD1）的金属辅因子，该酶通过催化歧化超氧阴离子发挥作用，补充铜并不等于直接捕获自由基。高剂量补锌改变的是红细胞铜锌超氧化物歧化酶活性，反映的是铜依赖酶的变化。"}],"indications":[{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"neuropathy","grade":"C","verdict":"mixed"}]},{"id":"supp_maca","name":"秘鲁玛咖高浓提取物 (Maca / 玛咖烯与玛咖酰胺)","en_name":"Peruvian Maca Extract (Standardized Macamides)","aliases":["玛咖","秘鲁人参","玛咖提取物","Lepidium meyenii","Macamides"],"summary":"玛咖含玛咖酰胺与玛咖烯等活性成分，其中玛咖酰胺是脂肪酸酰胺，玛咖烯主要为不饱和脂肪酸衍生物。人体随机试验结果并不一致，激素变化受治疗顺序影响，精子质量与生育获益尚不确定。","bioavailability_note":"熟化明胶化处理可去除部分难以消化的生淀粉。明胶化是否为必需条件目前没有证据确定，也没有可靠证据表明它能使玛咖酰胺的人体吸收浓度成倍提高。","typical_dose":"明胶化高浓玛咖提取物 1500–3000 mg/天，早晨或随早餐服用。1.5–3 g 的研究多针对特定根粉或制剂，不能直接换算为高浓缩提取物的剂量。","functional_synergies":["与东革阿里（Tongkat Ali）联用（理论推测）：东革阿里对游离睾酮的影响在人体中结果不一致，玛咖对性腺轴激素的作用也缺乏稳定证据，两者联用的协同效果尚未验证。","与南非醉茄联用（理论推测）：两者理论上都可能降低皮质醇水平，而皮质醇升高可能抑制性腺轴，但该联用的人体证据缺乏。"],"contraindications":"甲状腺肿大或缺碘者需注意（传统生玛咖含微量硫苷，熟化明胶化后大幅减少）；常规服用的激素依赖风险尚无充分证据。","mechanisms":[{"mechanism_id":"mech_monoamine","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物实验中，高剂量玛咖石油醚提取物可增加脑组织的多巴胺和去甲肾上腺素。玛咖酰胺能在无细胞实验中抑制 FAAH，但 FAAH 属于内源性大麻素代谢酶，并非单胺靶点。人体中的多巴胺与 CB1 效应均未得到证实。"},{"mechanism_id":"mech_steroid_shbg","score":2,"evidence_grade":"A","target_role":"secondary","notes":"随机试验直接测得了性腺轴激素的变化，但样本小，且存在治疗顺序效应，其他人群中结果为阴性。这些结果不能证明玛咖稳定地调节 GnRH 释放，也不能说明它提高了 Leydig 细胞或卵巢的类固醇合成敏感度。"},{"mechanism_id":"mech_hpa_cortisol","score":2,"evidence_grade":"A","target_role":"secondary","notes":"22 人随机交叉试验中，皮质醇与 ACTH 下降主要见于先安慰剂后玛咖的序列，另一序列不显著。较高剂量提取物也降低了应激小鼠的血清皮质酮，但人体 CRH 的稳定抑制尚无证据，“肾上腺疲劳”也不是确立的诊断。"}],"indications":[{"indication_id":"erectile_function","grade":"B","verdict":"mixed"},{"indication_id":"male_fertility","grade":"B","verdict":"mixed"},{"indication_id":"menopause","grade":"B","verdict":"mixed"},{"indication_id":"fatigue","grade":"B","verdict":"mixed"},{"indication_id":"anxiety_stress","grade":"C","verdict":"mixed"},{"indication_id":"low_mood","grade":"C","verdict":"mixed"},{"indication_id":"testosterone","grade":"B","verdict":"no_benefit"}]},{"id":"supp_schisandra","name":"北五味子标准化提取物 (Schisandra Chinensis)","en_name":"Schisandra Chinensis Berry Extract","aliases":["五味子","北五味子","Schisandra","五味子醇甲"],"summary":"北五味子是中医传统药材，主要活性成分为五味子木脂素类，如五味子醇甲与五味子乙素。其调节应激轴、激活 Nrf2 及影响雌激素代谢的作用，多来自动物或体外研究，人体证据尚不充分。","bioavailability_note":"木脂素属于脂溶性成分。不同水煎剂和标准化乙醇提取物的木脂素含量差异较大（如标示为 2–9%），口服暴露也不一致，因此不能认为所有产品都吸收良好、活性确切。","typical_dose":"标准化提取物 500 - 1000 mg/天，分次随餐服用","functional_synergies":["与红景天联用（理论推测）：红景天与北五味子理论上可分别从抗疲劳与应激调节方面发挥作用，但二者联用的人体效果尚未确立。","与水飞蓟宾联用（理论推测）：两者理论上都可能与肝脏抗氧化相关通路有关，但联用对化学性或酒精性肝损伤的人体获益尚未确立。"],"contraindications":"急性胃酸过多、消化性溃疡活动期以及急性病毒性感染初期恶寒高热时不宜大剂量使用。北五味子体外可抑制 CYP3A4/5；南五味子的人体研究显示可增加咪达唑仑和他克莫司的暴露。两个物种不宜直接等同，联用窄治疗窗药物时需由专业人员评估。","mechanisms":[{"mechanism_id":"mech_hpa_cortisol","score":3,"evidence_grade":"C","target_role":"secondary","notes":"大鼠应激模型中，五味子组的下丘脑 CRH 表达与血清皮质酮下降，NPY 无显著变化。小鼠慢性应激实验中，五味子醇甲也降低了血清皮质酮与 ACTH。这些结果来自啮齿动物，人体中降低皮质醇峰值或调节 NPY 的证据尚未可靠确立。"},{"mechanism_id":"mech_nrf2_are","score":3,"evidence_grade":"C","target_role":"secondary","notes":"小鼠口服实验中，五味子乙素以 25–100 mg/kg 上调了肝脏 Nrf2、NQO1 和 GST，研究提示活性代谢物参与其中。这是较高剂量的单体实验，不能直接等同于常规提取物，人体中也未见 NQO1 或 HO-1 诱导的证据。"},{"mechanism_id":"mech_estrogen_detox","score":1,"evidence_grade":"D","target_role":"secondary","notes":"体外人肝细胞实验显示，北五味子提取物可抑制 CYP3A4/5 的代谢，同时诱导 CYP3A4 mRNA。这些结果针对药物代谢酶，没有测定人体雌激素的代谢分流，因此不能说明它有利于雌激素解毒。"}],"indications":[{"indication_id":"muscle_strength","grade":"B","verdict":"benefit"},{"indication_id":"menopause","grade":"B","verdict":"benefit"},{"indication_id":"fatty_liver","grade":"C","verdict":"mixed"}]},{"id":"supp_oxymatrine","name":"苦参提取物 (氧化苦参碱 / 苦参碱)","en_name":"Oxymatrine / Matrine (Sophora Flavescens)","aliases":["氧化苦参碱","苦参碱","苦参提取物","Oxymatrine"],"summary":"氧化苦参碱是苦参中的生物碱，动物与细胞实验显示其影响 TGF-β1 与 TLR4 信号。随机安慰剂对照试验（每日 900 mg）中，部分复查者的肝纤维化评分有所改善，但该剂量高于本品记录的 200–600 mg/天。","bioavailability_note":"氧化苦参碱水溶性良好，口服后部分可经肝脏酶系脱氧转化为苦参碱。口服吸收并不完全：大鼠药代研究测得绝对口服生物利用度约为 26%，该数值不能直接当作人体值。","typical_dose":"高纯氧化苦参碱 200–600 mg/天，随餐服用。口服肝纤维化试验采用的是每日 900 mg，不能直接证明 200–600 mg/天有效。长期自行使用的安全性资料不足。","functional_synergies":["与水飞蓟宾联用（理论推测）：两者理论上都可能与肝脏的抗氧化及纤维化相关过程有关，但联用对肝纤维化的人体效果尚未验证。","与 NAC 联用（理论推测）：NAC 可为谷胱甘肽合成提供原料，氧化苦参碱的抗纤维化作用在人体中尚未完全确证，两者联用的效果缺乏人体证据。"],"contraindications":"大剂量可能引起轻度胃部不适或恶心，建议随餐服用；孕妇严格禁用；中枢神经运动抑制剂使用者需遵医嘱。长期自行使用的安全性资料不足，高剂量动物实验中还观察到肝损伤，不宜自行长期大剂量服用。","mechanisms":[{"mechanism_id":"mech_nfkb_inhibition","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物脑缺血模型中，氧化苦参碱下调了脑组织的 TLR4、MyD88 和 NF-κB 相关表达。细胞实验中 p65 入核减少，小鼠肠炎减轻，但整体 NF-κB 报告信号未改变。这些结果尚不能证明它在人体常规口服剂量下强力切断炎症转录。"},{"mechanism_id":"mech_collagen_synthesis","score":2,"evidence_grade":"A","target_role":"secondary","notes":"人体口服试验中，胶原周转标志物下降，且仅部分受试者复查活检。这不代表促进胶原交联，也不能证明人体 Smad 通路受抑。静脉给药的研究中血清 TGF-β1 下降，但口服后 Smad 磷酸化是否受抑尚未直接证实。"},{"mechanism_id":"mech_mast_cell","score":2,"evidence_grade":"D","target_role":"secondary","notes":"细胞实验中，RBL-2H3 细胞的组胺与脱颗粒指标下降；动物皮炎改善也不能单独证明体内脱颗粒受阻。口服后能否在人体中达到有效组织暴露尚不清楚，嗜酸性粒细胞也不宜与肥大细胞等同。"}],"indications":[{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"}]},{"id":"supp_inositol","name":"肌醇与手性肌醇复合体 (Myo & D-Chiro Inositol 40:1)","en_name":"Myo-Inositol & D-Chiro-Inositol (40:1 Ratio)","aliases":["肌醇","手性肌醇","40:1 黄金比例肌醇","Inositol / DCI","维生素 B8"],"summary":"肌醇与 D-手性肌醇参与胰岛素相关的细胞信号。部分 PCOS 随机试验观察到 SHBG 升高、游离睾酮下降，但不能说明其普遍有效，40:1 也并非已确证的最佳比例。","bioavailability_note":"纯水溶性醇类粉末，自带清润甘甜，推荐与温水冲服，早晚随餐或空腹各一次。","typical_dose":"肌醇（Myo-Inositol）2000–4000 mg 与 D-手性肌醇（DCI）50–100 mg/天。40:1 并非已严格确证的必需或最佳比例，具体配比应以临床证据和产品说明为准。","functional_synergies":["与活性甲基叶酸（5-MTHF）联用（理论推测）：两者理论上都可能与卵母细胞成熟及神经管闭合相关，但该联用的人体证据尚缺。","与小檗碱或二氢小檗碱联用（理论推测）：两者理论上都可能影响外周胰岛素敏感性，但联用对胰岛素敏感性及黑棘皮体征的改善缺乏人体证据。"],"contraindications":"总体耐受性良好。切忌单独超大剂量长期摄入纯 DCI（大剂量纯 DCI 会阻碍卵巢局部 MI 摄取，损害卵子质量）。不能保证恢复排卵。孕期使用需遵医嘱，一项孕期 PCOS 随机试验未发现每日 4 g 肌醇改善所研究的妊娠结局。","mechanisms":[{"mechanism_id":"mech_steroid_shbg","score":3,"evidence_grade":"A","target_role":"secondary","notes":"随机试验直接测得了 SHBG 与游离睾酮等激素指标。部分 PCOS 试验观察到 SHBG 升高、游离睾酮下降。这一效应能否归因于纠正高胰岛素血症，并普遍、大幅出现，证据尚不足，不同配方间的一致性也不确定。"},{"mechanism_id":"mech_ampk_activation","score":3,"evidence_grade":"C","target_role":"secondary","notes":"动物实验中既有 AMPK 与 GLUT4 相关的增加，也有相反的 AMPK 抑制结果，效应具有情境依赖性。肌醇磷酸聚糖与 GLUT4 信号不等同于 AMPK 激活，人体中也缺少 AMPK 特异性标志物的证据。"},{"mechanism_id":"mech_gaba_glutamate","score":2,"evidence_grade":"C","target_role":"secondary","notes":"小鼠实验中，饮水补充肌醇后，海马 GABA 及部分 GABA 受体亚基表达升高。这不能推断肌醇直接激动 GABA-A 受体。5-HT2 属血清素受体，不能作为 GABA 能激活的证据，人体的受体作用与临床获益也未确证。"}],"indications":[{"indication_id":"pcos","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"}]}],"rubric":{"strength_scale":{"title":"机制作用强度评分体系 (Mechanism Strength Scale, 1-5)","description":"星级只回答一个问题：如果分子在体内达到了口服常规剂量下能达到的浓度，它对这个靶点的作用有多强、多核心。证据是否充分由证据等级单独表示，两者互不扣分。浓度在人体内根本达不到的机制，按 1-2 星计。","levels":[{"score":5,"label":"5星 · 定义性作用","badge_color":"emerald","description":"这是该分子最具代表性的作用方式：直接充当反应底物或核心载体，或在可达浓度下就能明显驱动通路。例如肌酸之于磷酸肌酸缓冲、萝卜硫素之于 Nrf2。"},{"score":4,"label":"4星 · 主要作用","badge_color":"teal","description":"作用明确且较强，是该分子主要的药效来源之一。"},{"score":3,"label":"3星 · 中等作用","badge_color":"blue","description":"有明确的生物学活性，但幅度中等，或属于多靶点分子的次要通道。"},{"score":2,"label":"2星 · 弱作用","badge_color":"amber","description":"作用较弱、间接，或只在较高组织浓度下才明显，单独驱动该通路的能力有限。"},{"score":1,"label":"1星 · 理论作用","badge_color":"slate","description":"只在体外高浓度下观察到，或机制与该分子的实际作用方式不符，口服后基本不起作用。"}]},"evidence_levels":{"title":"机制证据等级 (Evidence Levels, A-D)","levels":[{"grade":"A","label":"A级 · 人体高等级临床证据","description":"人体 RCT 或 Meta 分析中直接测到该机制的特异性标志物变化（如 NQO1 诱导、血液 NAD+ 升高、肌肉磷酸肌酸升高）。只有临床结局有效、机制本身没在人体测过的，不算 A 级。"},{"grade":"B","label":"B级 · 小型人体试验 / 确切药代支持","description":"小样本人体研究测到了相关标志物；或人体药代数据证明口服常规剂量能达到作用浓度，且有动物模型支持。"},{"grade":"C","label":"C级 · 哺乳动物体内模型确证","description":"机制只在完整动物模型中被证实。人体临床结局即使有效，只要机制仅在动物中验证，也归入 C 级。"},{"grade":"D","label":"D级 · 体外/无细胞/理论推导","description":"只有细胞、酶学或分子对接数据，或所需浓度远高于口服后人体能达到的水平。"}]},"target_roles":[{"code":"primary","name":"主靶点 (Primary)","desc":"分子发挥核心作用的直接结合受体、酶活调节位点或直接理化清除靶标"},{"code":"secondary","name":"次级多效靶点 (Secondary)","desc":"由主靶点下游级联反应触发，或多靶点配体中的辅助调节效应"},{"code":"substrate","name":"底物/辅因子 (Substrate/Cofactor)","desc":"不直接作为信号刺激，而是充当酶促反应原料、电子载体或能量介质"}]},"assessment":{"rating_scale":[{"value":0,"label":"没有","tag":"几乎没有"},{"value":1,"label":"偶尔","tag":"每周 1–2 天"},{"value":2,"label":"经常","tag":"每周 3–5 天"},{"value":3,"label":"几乎每天","tag":"每周 6–7 天"}],"domains":[{"category_id":"redox","name":"运动恢复与氧化负担","en_name":"Redox Homeostasis & Defense","color":"#10b981","icon":"🛡️","subtitle":"运动后恢复得怎么样，以及吸烟、油烟等日常氧化负担","questions":[{"id":"q_redox_recovery","type":"freq","text":"运动或体力活之后，肌肉酸痛、浑身疲惫要两三天以上才缓过来","hint":"比如爬山、搬家或一次较重的训练之后","why":"恢复慢可能和训练量、睡眠、营养有关，相关的补充剂研究多看运动后酸痛和恢复。","indications":["exercise_recovery","fatigue"]},{"id":"q_redox_smoke","type":"fact","text":"吸烟，或每天较长时间待在二手烟、厨房油烟、粉尘较多的环境里","why":"这些是公认的氧化负担来源。这一题只用来判断这方面的负担，本身不对应某种补充剂。","indications":[]}],"primary_mechanisms":["mech_gsh_synthesis","mech_nrf2_are","mech_direct_ros"],"recommended_supplement_ids":["supp_nac","supp_sulforaphane","supp_astaxanthin","supp_liposomal_gsh"]},{"category_id":"inflammation_immune","name":"过敏与炎症","en_name":"Immune & Inflammatory Signaling","color":"#ef4444","icon":"🔥","subtitle":"鼻子和眼睛的过敏症状、关节晨僵，以及体检里的炎症指标","questions":[{"id":"q_immune_allergy","type":"freq","text":"打喷嚏、流鼻涕、鼻子痒或眼睛痒","hint":"比如换季、接触花粉或尘螨时","why":"这是过敏性鼻炎的典型表现。","indications":["allergic_rhinitis"]},{"id":"q_immune_stiff","type":"freq","text":"早上起床时，手指、膝盖等关节发僵或疼痛","hint":"活动一会儿会好一些的也算","why":"晨僵常见于骨关节炎和炎症性关节病。晨僵超过 1 小时、关节红肿的，应先看医生。","indications":["joint_pain"]},{"id":"q_immune_crp","type":"fact","text":"体检时超敏 C 反应蛋白（hs-CRP）偏高","hint":"化验单上常写作 hs-CRP 或超敏 CRP","why":"这是最常用的慢性低度炎症指标。感冒、受伤后几周内查的结果不算。","indications":["inflammation_markers"]}],"primary_mechanisms":["mech_spm_resolution","mech_nfkb_inhibition","mech_cox_lox_inhibition"],"recommended_supplement_ids":["supp_omega3_spm","supp_curcumin","supp_quercetin","supp_boswellia_akba"]},{"category_id":"mitochondria_energy","name":"疲劳与精力","en_name":"Bioenergetics & Mitochondria","color":"#f59e0b","icon":"⚡","subtitle":"睡醒后的精神状态和日常体力","questions":[{"id":"q_mito_tired","type":"freq","text":"睡够 7 小时以上，醒来还是觉得累、没精神","why":"疲劳的原因很多，报告里会一并提示值得做的检查。","indications":["fatigue"]},{"id":"q_mito_stamina","type":"freq","text":"体力明显不如从前，走路稍多一点、爬两三层楼就觉得累","why":"这一题看日常耐力。如果是活动后胸闷、气短越来越明显，请勾选上面“需要就医”的那一项。","indications":["endurance","fatigue"]}],"primary_mechanisms":["mech_etc_carrier","mech_mitophagy_pink1","mech_nad_salvage","mech_pgc1a_biogenesis"],"recommended_supplement_ids":["supp_coq10","supp_urolithin_a","supp_nmn","supp_pqq","supp_alcar"]},{"category_id":"metabolism_longevity","name":"血糖、血脂与体重","en_name":"Nutrient Sensing & Longevity","color":"#8b5cf6","icon":"⏳","subtitle":"饭后困倦、体检里的血糖血脂，以及腰围","questions":[{"id":"q_meta_sleepy","type":"freq","text":"吃完一顿米饭、面食较多的饭后，困得想睡","why":"饭后明显犯困有时和餐后血糖波动有关，但也很常见于睡眠不足。","indications":["blood_glucose"]},{"id":"q_meta_labs","type":"fact","text":"体检提示空腹血糖、糖化血红蛋白或甘油三酯偏高，或者有脂肪肝","hint":"只要其中一项是就选“是”","why":"这些指标比症状更能说明代谢情况。","indications":["blood_glucose","triglycerides","fatty_liver"]},{"id":"q_meta_waist","type":"fact","text":"腰围：男性 90 厘米及以上，女性 85 厘米及以上","hint":"软尺绕肚脐上方一圈，平静呼气时量","why":"这是我国成人中心型肥胖的标准，腹部脂肪多和血糖、血脂问题关系密切。","indications":["body_weight"]}],"primary_mechanisms":["mech_ampk_activation","mech_sirtuin_activation","mech_autophagy_mTOR"],"recommended_supplement_ids":["supp_berberine","supp_dihydroberberine","supp_chromium_picolinate","supp_spermidine"]},{"category_id":"neurotransmitters","name":"注意力、记忆与情绪","en_name":"Neurotransmission & Plasticity","color":"#06b6d4","icon":"🧠","subtitle":"能不能集中注意力、记性好不好、情绪和兴趣","questions":[{"id":"q_neuro_focus","type":"freq","text":"注意力难集中，看书、开会或工作时容易走神","why":"注意力差最常见的原因是睡眠不足和压力大。","indications":["attention"]},{"id":"q_neuro_memory","type":"freq","text":"记性变差，刚说过的事、刚放下的东西转头就忘","why":"偶尔健忘很正常。如果明显、持续地变差，尤其是年纪较大的人，应找医生评估。","indications":["memory"]},{"id":"q_neuro_mood","type":"freq","text":"心情低落，或者对平时喜欢的事提不起兴趣","why":"如果这种情况持续两周以上、几乎每天都有，请勾选上面“需要就医”中关于情绪的那一项。","indications":["low_mood"]}],"primary_mechanisms":["mech_cholinergic","mech_bdnf_ngf"],"recommended_supplement_ids":["supp_magnesium_threonate","supp_alpha_gpc","supp_lions_mane","supp_uridine"]},{"category_id":"endocrine_hpa","name":"睡眠与压力","en_name":"Endocrine, Hormones & HPA Axis","color":"#ec4899","icon":"🌙","subtitle":"入睡、夜里醒来和紧张焦虑","questions":[{"id":"q_endo_onset","type":"freq","text":"躺下 30 分钟以上还睡不着","why":"这是失眠最常见的一种表现。","indications":["sleep_onset"]},{"id":"q_endo_wake","type":"freq","text":"半夜醒来后很难再睡着，或者比想起的时间早醒很多","why":"睡眠中途醒来和早醒影响的是睡眠质量。打鼾很响、夜里憋醒的，要先排查睡眠呼吸暂停。","indications":["sleep_quality"]},{"id":"q_endo_anxious","type":"freq","text":"感到紧张、焦虑，或者心里的事放不下","why":"这一题看压力和焦虑程度。","indications":["anxiety_stress"]}],"primary_mechanisms":["mech_hpa_cortisol","mech_gaba_glutamate"],"recommended_supplement_ids":["supp_ashwagandha","supp_theanine","supp_apigenin","supp_phosphatidylserine","supp_glycine"]},{"category_id":"epigenetics_methylation","name":"B 族维生素与偏头痛","en_name":"Epigenetics & Methylation","color":"#6366f1","icon":"🧬","subtitle":"维生素 B12、叶酸是否可能不足，以及偏头痛","questions":[{"id":"q_meth_labs","type":"fact","text":"体检提示同型半胱氨酸偏高，或维生素 B12、叶酸偏低","why":"同型半胱氨酸偏高最常见的原因是 B12 或叶酸不足。","indications":["b12_folate_deficiency"]},{"id":"q_meth_risk","type":"fact","text":"基本不吃肉、蛋、奶，或者长期服用二甲双胍、奥美拉唑等抑酸药","why":"这些是维生素 B12 不足最常见的原因。","indications":["b12_folate_deficiency"]},{"id":"q_meth_migraine","type":"freq","text":"偏头痛发作：一侧或两侧搏动性头痛，常伴恶心、怕光怕吵","hint":"按过去 4 周发作的天数选","why":"有几种补充剂在预防偏头痛上有人体证据。新出现的剧烈头痛请先就医。","indications":["migraine"]}],"primary_mechanisms":["mech_methylation_sam","mech_telomerase_activation"],"recommended_supplement_ids":["supp_5_mthf","supp_methyl_b12","supp_tmg","supp_same"]},{"category_id":"vascular_endothelial","name":"血压与循环","en_name":"Vascular & Endothelial Function","color":"#14b8a6","icon":"🫀","subtitle":"血压，以及小腿发胀、脚踝浮肿","questions":[{"id":"q_vasc_legs","type":"freq","text":"傍晚小腿发胀、发沉，或者脚踝一按一个坑","hint":"久坐、久站后更明显的也算","why":"这是下肢静脉回流不好的常见表现。单侧突然肿胀、疼痛的，请立即就医。","indications":["venous_insufficiency"]},{"id":"q_vasc_bp","type":"fact","text":"血压偏高：高压 130 及以上或低压 85 及以上，或者医生说过血压偏高","hint":"按最近几次测量的结果","why":"我国标准中 130–139/85–89 属于正常高值，140/90 及以上是高血压。","indications":["blood_pressure"]}],"primary_mechanisms":["mech_enos_no","mech_paf_platelet"],"recommended_supplement_ids":["supp_citrulline","supp_beetroot_nitrate","supp_grape_seed_opc","supp_nattokinase"]},{"category_id":"barrier_matrix","name":"关节与皮肤","en_name":"Barriers & Extracellular Matrix","color":"#84cc16","icon":"🧱","subtitle":"关节活动时的不适，以及皮肤老化","questions":[{"id":"q_barr_joint","type":"freq","text":"上下楼、下蹲或活动之后，膝盖、腰等关节疼痛或发僵","why":"这是骨关节炎最常见的表现。","indications":["joint_pain"]},{"id":"q_barr_skin","type":"fact","text":"皮肤明显比同龄人干燥、松弛，或者皱纹增多","why":"这一题看皮肤老化，相关的补充剂研究多看皮肤弹性和含水量。","indications":["skin_aging"]}],"primary_mechanisms":["mech_tight_junction","mech_joint_cartilage_ecm","mech_oral_immune_tolerance"],"recommended_supplement_ids":["supp_glutamine","supp_zinc_carnosine","supp_uc2","supp_collagen_tripeptide"]},{"category_id":"microbiome_host","name":"肠胃","en_name":"Microbiome-Host Axis","color":"#d97706","icon":"🌱","subtitle":"排便和腹胀、反酸等肠胃不适","questions":[{"id":"q_micro_constip","type":"freq","text":"便秘：排便费力、大便干硬，或者感觉排不干净","hint":"每周排便少于 3 次的，选“经常”或“几乎每天”","indications":["constipation"]},{"id":"q_micro_loose","type":"freq","text":"大便稀、不成形，或者腹泻","why":"如果伴有便血、黑便或体重下降，请勾选上面“需要就医”的对应项。","indications":["diarrhea","ibs"]},{"id":"q_micro_bloat","type":"freq","text":"吃完饭后腹胀、肠鸣、排气多，或者反酸、胃部不适","why":"这类症状常见于肠易激综合征和功能性消化不良。","indications":["ibs","gastric_mucosa"]}],"primary_mechanisms":["mech_scfa_fermentation","mech_er_stress_chaperone"],"recommended_supplement_ids":["supp_boulardii","supp_sodium_butyrate","supp_resistant_starch","supp_triphala","supp_dandelion_root"]}],"red_flags":{"title":"开始前：先排除需要就医的情况","intro":"下面这些情况可能是疾病信号，补充剂处理不了，也不该拖着。只要勾选了任意一项，报告将不再给出补充剂推荐，请先去医院查清楚原因。","items":[{"id":"rf_weight_loss","text":"近 6 个月没刻意减肥，体重却下降了 5% 以上"},{"id":"rf_chest","text":"胸痛、胸闷，或活动后气短越来越明显"},{"id":"rf_bleeding","text":"便血、黑便、呕血或咳血"},{"id":"rf_fever","text":"反复发热或夜间盗汗超过 2 周"},{"id":"rf_neuro","text":"新出现的剧烈头痛、一侧肢体无力或麻木、说话含糊"},{"id":"rf_jaundice","text":"皮肤或眼白发黄，或尿色像浓茶"},{"id":"rf_swallow","text":"吞咽困难，或持续呕吐、腹痛不缓解"},{"id":"rf_mood","text":"持续两周以上情绪低落、对什么都提不起兴趣，或有伤害自己的念头","note":"可拨打心理援助热线 12356；如有紧急危险请立即拨打 120 或 110。"}],"blocked_title":"请先就医，暂不推荐补充剂","blocked_text":"您勾选了需要就医排查的情况。这些症状需要医生面诊和检查来明确原因，自行服用补充剂可能延误诊断。下方的领域评分仅供您就诊时参考，可以把它给医生看。"},"special_populations":{"title":"以下情况请勾选（不影响评分，但会给出用药提醒）","items":[{"id":"sp_pregnant","text":"怀孕、备孕或哺乳期"},{"id":"sp_drugs","text":"正在长期服用处方药"},{"id":"sp_minor","text":"未满 18 岁"},{"id":"sp_organ","text":"有肝病或肾病"},{"id":"sp_surgery","text":"两周内要做手术或拔牙"}],"caution_text":"您勾选了需要特别谨慎的情况。以下推荐只是方向参考，开始服用前请先咨询医生或药师，并在“组方分析”页的安全检查里核对与处方药的相互作用。"},"disclaimer":"本问卷是自我观察工具，不是诊断。分数高只说明这方面的不适比较多，不代表患有某种疾病。推荐只基于数据库中的人体研究和作用机制，效果因人而异。如果症状持续或加重，请就医。","fact_scale":[{"value":3,"label":"是"},{"value":0,"label":"不是"}],"unsure_label":{"freq":"说不好","fact":"不知道 / 没查过"},"intro":"按过去 4 周的情况，估计每种不适大概每周有几天出现，不用很精确。拿不准就选“说不好”，这一题不会计入得分。","nonspecific":{"fatigue":"疲劳的原因很多：睡眠不足或睡眠呼吸暂停、缺铁或贫血、甲状腺功能减退、维生素 B12 缺乏、抑郁焦虑、血糖问题和一些药物都可能引起。持续一个月以上的疲劳，先查清原因比直接吃补充剂更重要。","low_mood":"情绪低落可能和压力、睡眠、甲状腺功能、贫血有关，也可能是抑郁。持续两周以上、影响生活的，请找医生或心理专业人员评估。","sleep_onset":"睡不好常和作息、压力、咖啡因和饮酒、夜里憋醒（睡眠呼吸暂停）、疼痛或夜尿有关。打鼾很响或白天特别困的人，应先排查睡眠呼吸暂停。","sleep_quality":"睡不好常和作息、压力、咖啡因和饮酒、夜里憋醒（睡眠呼吸暂停）、疼痛或夜尿有关。打鼾很响或白天特别困的人，应先排查睡眠呼吸暂停。","attention":"注意力和记性变差，常见于睡眠不足、压力大、情绪低落、甲状腺功能减退和维生素 B12 缺乏。","memory":"注意力和记性变差，常见于睡眠不足、压力大、情绪低落、甲状腺功能减退和维生素 B12 缺乏。"},"global_elevation":{"title":"不适遍布多个方面","text":"您在大多数方面的得分都偏高。这种情况下，不太可能是缺了哪几种补充剂，更常见的是睡眠不足、长期压力、情绪问题，或者某种需要查明的身体疾病同时影响了很多方面。建议先去医院做一次基础检查，并把这份结果给医生看；暂不推荐补充剂。","labs":["lab_cbc","lab_iron","lab_thyroid","lab_b12","lab_vitd","lab_glucose"]}},"safety":{"severity_levels":[{"id":"critical","label":"禁止合用","rank":4},{"id":"high","label":"高风险","rank":3},{"id":"moderate","label":"需注意","rank":2},{"id":"low","label":"提示","rank":1}],"risk_flags":[{"id":"bleeding","name":"出血风险叠加","icon":"🩸","desc":"这些成分各自有轻度的抗血小板或纤溶作用，单用时影响通常不大，但几种叠加后出血倾向会更明显。手术、拔牙前 1-2 周应停用，出现牙龈出血、瘀斑增多时要警惕。","stack_thresholds":[{"count":2,"severity":"moderate"},{"count":3,"severity":"high"}],"supplements":{"supp_omega3_spm":"每天超过 3 g 时可轻度抑制血小板聚集","supp_krill_oil":"含 EPA/DHA，作用与鱼油相同","supp_ginkgo":"有出血事件的病例报告","supp_nattokinase":"具有纤溶活性","supp_lumbrokinase":"具有纤溶活性","supp_curcumin":"有抗血小板作用，与华法林合用有 INR 升高的报告","supp_resveratrol":"有抗血小板作用","supp_grape_seed_opc":"有轻度抗血小板作用","supp_pycnogenol":"有轻度抑制血小板聚集的作用","supp_tocotrienols":"维生素 E 家族成员，有抗血小板作用","supp_celery_seed_nbp":"丁苯酞类成分有抗血小板作用","supp_reishi_triterpenes":"可抑制血小板聚集","supp_gingerol":"高剂量时有抗血小板作用","supp_glucosamine_sulfate":"与华法林合用有 INR 升高的报告","supp_chondroitin":"结构与肝素类物质相似"}},{"id":"serotonergic","name":"血清素过量风险","icon":"🧠","desc":"这些成分都会提高大脑中的血清素水平。两种以上同用，有引发血清素综合征的风险，表现为烦躁、出汗、心跳加快、肌肉抽动、发热，严重时可危及生命。","stack_thresholds":[{"count":2,"severity":"high"}],"supplements":{"supp_5_htp":"血清素的直接前体","supp_same":"参与单胺类递质的合成","supp_methylene_blue":"强效的 MAO-A 抑制剂，会减慢血清素的分解","supp_rhodiola":"有较弱的 MAO 抑制作用"}},{"id":"hypoglycemia","name":"血糖过低风险","icon":"🍬","desc":"这些成分都可能降低血糖。叠加使用，尤其是空腹服用或同时在用降糖药时，可能出现心慌、手抖、出冷汗等低血糖症状。","stack_thresholds":[{"count":2,"severity":"moderate"}],"supplements":{"supp_berberine":"人体试验证实可降低血糖","supp_dihydroberberine":"作用与小檗碱相同","supp_r_ala":"可改善胰岛素敏感性；东亚人群有诱发自身免疫性低血糖的报告","supp_chromium_picolinate":"可能轻度降低血糖","supp_gynostemma":"可能降低血糖","supp_holy_basil":"可能降低空腹血糖","supp_ginseng":"可能降低血糖"}},{"id":"hypotension","name":"血压过低风险","icon":"🫀","desc":"这些成分都有一定的降压作用。几种叠加，或者本身血压偏低、正在服用降压药的人，可能出现起身时头晕、乏力。","stack_thresholds":[{"count":2,"severity":"low"},{"count":3,"severity":"moderate"}],"supplements":{"supp_beetroot_nitrate":"硝酸盐转化为一氧化氮后扩张血管","supp_citrulline":"增加一氧化氮的生成","supp_black_cumin_tq":"可轻度降低血压","supp_celery_seed_nbp":"可轻度降低血压","supp_hawthorn":"有扩血管作用","supp_coq10":"可轻度降低血压","supp_nattokinase":"小型试验中可轻度降低血压","supp_theanine":"高剂量时可使血压略降"}},{"id":"sedation","name":"镇静作用叠加","icon":"😴","desc":"这些成分都有一定的镇静或助眠作用。叠加后白天可能犯困、反应变慢，服用后不要开车或进行高空作业。","stack_thresholds":[{"count":2,"severity":"low"},{"count":3,"severity":"moderate"}],"supplements":{"supp_melatonin":"促进入睡","supp_apigenin":"有轻度镇静作用","supp_ashwagandha":"有镇静、抗焦虑作用","supp_glycine":"睡前服用可改善睡眠","supp_bacopa":"部分人服用后会犯困"}},{"id":"hepatic","name":"肝脏负担叠加","icon":"🧪","desc":"这些成分都有导致肝损伤的病例报告。多种一起长期服用时，建议定期检查肝功能；出现乏力、食欲差、皮肤或眼白发黄、尿色变深时应立即停用并就医。","stack_thresholds":[{"count":2,"severity":"moderate"}],"supplements":{"supp_ashwagandha":"有多例草药性肝损伤报告","supp_curcumin":"有肝损伤病例报告，高吸收配方中较多","supp_egcg":"浓缩提取物高剂量时有肝损伤报告","supp_niacin":"大剂量（尤其是缓释型）有肝毒性","supp_reishi_triterpenes":"灵芝粉有肝损伤病例报告"}},{"id":"zinc_excess","name":"锌摄入叠加","icon":"⚖️","desc":"两种含锌产品同时吃，锌总量容易偏高。长期每天超过 40 mg 会抑制铜的吸收，可能导致缺铜性贫血和神经症状。请核对两者的元素锌含量之和。","stack_thresholds":[{"count":2,"severity":"moderate"}],"supplements":{"supp_zinc_picolinate":"锌补充剂","supp_zinc_carnosine":"每份含有元素锌"}},{"id":"cyp3a4","name":"抑制药物代谢（CYP3A4 等）","icon":"💊","desc":"这些成分可抑制肝脏代谢药物的酶（主要是 CYP3A4）或药物转运蛋白，使部分处方药的血药浓度升高。","stack_thresholds":[],"supplements":{"supp_berberine":"抑制 CYP3A4、CYP2D6、CYP2C9 及 P-糖蛋白","supp_dihydroberberine":"与小檗碱相同","supp_resveratrol":"抑制 CYP3A4、CYP2C9","supp_quercetin":"抑制 CYP3A4","supp_curcumin":"尤其是含胡椒碱的配方","supp_schisandra":"抑制 CYP3A4"}},{"id":"immune_stim","name":"免疫激活","icon":"🛡️","desc":"这些成分会刺激免疫反应，可能抵消免疫抑制剂的作用，自身免疫病活动期也应谨慎。","stack_thresholds":[],"supplements":{"supp_beta_glucan":"激活先天免疫细胞","supp_reishi_triterpenes":"有免疫调节作用","supp_astragaloside_iv":"有免疫调节作用","supp_cycloastragenol":"有免疫调节作用","supp_elderberry":"可刺激细胞因子释放","supp_andrographolide":"有免疫调节作用"}}],"drug_classes":[{"id":"anticoagulant","name":"抗凝药","examples":"华法林、利伐沙班、阿哌沙班、达比加群","rules":[{"flag":"bleeding","severity":"high","note":"与抗凝药叠加会明显增加出血风险，合用前请咨询医生。"},{"supplement":"supp_coq10","severity":"low","note":"结构与维生素 K 相似，有减弱华法林效果的个案报告，但一项小型随机试验没有发现 INR 改变，证据不一致。开始或停用后可加测一次 INR（仅限华法林）。"},{"supplement":"supp_d3_k2","severity":"high","note":"维生素 K2 会直接对抗华法林的作用，服用华法林者不要自行补充（仅限华法林）。"},{"supplement":"supp_ginseng","severity":"moderate","note":"有减弱华法林效果的报告，证据主要来自西洋参，对人参（亚洲参）是否同样存在尚不确定。开始或停用后建议加测 INR（仅限华法林）。"},{"supplement":"supp_glucosamine_sulfate","severity":"moderate","note":"有服用华法林期间开始服用或加量氨基葡萄糖后 INR 升高、甚至严重出血的报告，发生率不清楚。服用华法林者开始、停用或改变剂量后要加测 INR（仅限华法林）。"},{"supplement":"supp_chondroitin","severity":"moderate","note":"INR 升高的报告主要来自氨基葡萄糖和软骨素的复方产品。服用华法林者开始、停用或改变剂量后，建议加测一次 INR（仅限华法林）。"}],"depletions":[]},{"id":"antiplatelet","name":"抗血小板药","examples":"阿司匹林、氯吡格雷、替格瑞洛","rules":[{"flag":"bleeding","severity":"high","note":"与抗血小板药叠加会增加出血风险，合用前请咨询医生。"}],"depletions":[{"lab_id":"lab_iron","nutrient":"铁","applies_to":"长期服用小剂量阿司匹林","grade":"B","effect":"lowers_levels","action":"awareness_only","note":"一项老年人大型试验中，长期服用小剂量阿司匹林的人贫血更多、铁蛋白更低，可能与慢性少量出血有关。出现乏力、脸色苍白时查血常规和铁蛋白，并查明原因。"}]},{"id":"serotonergic_drug","name":"SSRI / SNRI 等血清素类药物","examples":"舍曲林、氟西汀、帕罗西汀、文拉法辛、度洛西汀、曲马多、曲坦类偏头痛药","rules":[{"supplement":"supp_methylene_blue","severity":"critical","note":"亚甲蓝与这类药物合用可引发严重的血清素综合征，已有死亡病例，绝对不能合用。"},{"supplement":"supp_5_htp","severity":"high","note":"叠加后血清素过量的风险高，不应自行合用。"},{"supplement":"supp_same","severity":"high","note":"可能增强药物作用并诱发血清素综合征，需在医生监测下使用。"},{"supplement":"supp_rhodiola","severity":"moderate","note":"有较弱的 MAO 抑制作用，合用需谨慎。"},{"supplement":"supp_melatonin","severity":"high","note":"仅限氟伏沙明：它会使褪黑素的血药浓度升高数十倍。"},{"supplement":"supp_ginkgo","severity":"moderate","note":"SSRI/SNRI 本身会轻度增加出血倾向，与银杏合用有出血事件的报告。因果关系尚不确定，合用时留意牙龈出血、瘀斑等情况。"}],"depletions":[]},{"id":"maoi","name":"MAO 抑制剂","examples":"苯乙肼、司来吉兰、雷沙吉兰、利奈唑胺","rules":[{"supplement":"supp_methylene_blue","severity":"critical","note":"亚甲蓝本身就是 MAO 抑制剂，叠加可引发致命的血清素综合征。"},{"supplement":"supp_5_htp","severity":"critical","note":"叠加可引发严重的血清素综合征。"},{"supplement":"supp_l_tyrosine","severity":"critical","note":"酪氨酸是去甲肾上腺素的前体，与 MAO 抑制剂合用可引起高血压危象。"},{"supplement":"supp_same","severity":"high","note":"可能诱发血清素综合征。"},{"supplement":"supp_rhodiola","severity":"moderate","note":"有较弱的 MAO 抑制作用，叠加需谨慎。"},{"supplement":"supp_ginseng","severity":"moderate","note":"与 MAO 抑制剂合用有失眠、躁动等不良反应报告。"}],"depletions":[]},{"id":"antidiabetic","name":"降糖药","examples":"二甲双胍、胰岛素、格列美脲等磺脲类、DPP-4 抑制剂、SGLT2 抑制剂","rules":[{"flag":"hypoglycemia","severity":"moderate","note":"与降糖药叠加可能引起低血糖，开始服用后要多监测血糖，必要时请医生调整药量。"},{"supplement":"supp_niacin","severity":"moderate","note":"大剂量烟酸会升高血糖，可能削弱降糖药的效果。"}],"depletions":[{"lab_id":"lab_b12","nutrient":"维生素 B12","applies_to":"二甲双胍","grade":"A","effect":"clinical_deficiency","action":"test_periodically","note":"长期服用二甲双胍会降低 B12 水平，用得越久风险越高。药品说明书建议定期检测 B12；出现手脚麻木、贫血时更要检查。"}]},{"id":"antihypertensive","name":"降压药","examples":"氨氯地平、缬沙坦、贝那普利、美托洛尔、氢氯噻嗪","rules":[{"flag":"hypotension","severity":"moderate","note":"与降压药叠加可能使血压过低，注意监测血压，起身时动作放慢。"},{"supplement":"supp_egcg","severity":"moderate","note":"绿茶提取物会明显降低纳多洛尔的吸收，使降压效果减弱。服用纳多洛尔的人避免同时使用；这个结果不能直接推广到所有 β 受体阻滞剂（仅限纳多洛尔）。"},{"supplement":"supp_melatonin","severity":"moderate","note":"一项小型试验中，服用硝苯地平控释片的人每晚加服 5 mg 褪黑素后血压反而升高。服用硝苯地平者合用后要监测血压（仅限硝苯地平）。"},{"supplement":"supp_iron_bisglycinate","severity":"moderate","note":"铁剂会明显减少甲基多巴的吸收，使血压控制变差。服用甲基多巴的人，两者至少间隔 2 小时，并监测血压（仅限甲基多巴）。"},{"supplement":"supp_d3_k2","severity":"low","note":"噻嗪类利尿剂会减少钙从尿中排出，同时大剂量补充维生素 D 可能使血钙升高，肾功能差或有甲状旁腺疾病时风险更大。可定期查血钙（仅限噻嗪类利尿剂）。"}],"depletions":[{"lab_id":"lab_electrolytes","nutrient":"钾","applies_to":"其中的氢氯噻嗪等噻嗪类利尿剂","grade":"A","effect":"clinical_deficiency","action":"test_periodically","note":"噻嗪类利尿剂会增加钾从尿中流失，开始服用或加量后几天到几周内可能出现低钾。需要定期查血钾，补钾要由医生决定。"},{"lab_id":"lab_electrolytes","nutrient":"钠","applies_to":"其中的氢氯噻嗪等噻嗪类利尿剂","grade":"A","effect":"clinical_deficiency","action":"test_periodically","note":"噻嗪类利尿剂可能引起低钠血症，多见于用药头几周。低钠通常和体内水分有关，不能自行通过多吃盐来纠正。"}]},{"id":"pde5_nitrate","name":"PDE5 抑制剂 / 硝酸酯类","examples":"西地那非、他达拉非、硝酸甘油、单硝酸异山梨酯","rules":[{"supplement":"supp_beetroot_nitrate","severity":"moderate","note":"两者都通过一氧化氮扩张血管，理论上可能叠加降压。食物来源的硝酸盐与处方硝酸酯类药物并不相同，直接证据有限，合用时留意头晕、低血压。"},{"supplement":"supp_citrulline","severity":"moderate","note":"瓜氨酸会增加一氧化氮生成，与这类药物合用可能让血压进一步下降，但直接证据有限。合用时留意头晕等低血压症状。"},{"supplement":"supp_nac","severity":"high","note":"仅限硝酸甘油等硝酸酯类：NAC 会增强其扩血管作用，可引起低血压和剧烈头痛。"},{"supplement":"supp_glynac","severity":"moderate","note":"GlyNAC 含有 NAC。一项试验中，NAC 与硝酸甘油合用后剧烈头痛等不良反应明显增多，也可能加重低血压（仅限硝酸酯类）。"}],"depletions":[]},{"id":"sedative","name":"镇静催眠药","examples":"地西泮、阿普唑仑、唑吡坦、右佐匹克隆、镇静类抗组胺药","rules":[{"flag":"sedation","severity":"moderate","note":"与镇静催眠药叠加会加重嗜睡和反应迟钝，服用后不要驾车。"},{"supplement":"supp_berberine","severity":"moderate","note":"小檗碱会抑制部分安眠药的代谢。一项小型研究中，连续服用小檗碱后咪达唑仑的血药浓度升高约 40%，镇静作用可能增强；对其他安眠药的影响尚不清楚。"}],"depletions":[]},{"id":"immunosuppressant","name":"免疫抑制剂","examples":"环孢素、他克莫司、西罗莫司、吗替麦考酚酯","rules":[{"flag":"cyp3a4","severity":"high","note":"会升高环孢素、他克莫司等药物的血药浓度，可能导致中毒，器官移植患者不要自行服用。"},{"flag":"immune_stim","severity":"high","note":"会刺激免疫反应，可能抵消免疫抑制剂的作用，器官移植患者不要自行服用。"},{"supplement":"supp_boulardii","severity":"high","note":"布拉氏酵母菌是活的酵母，免疫力被抑制的人（如器官移植后）有发生真菌血流感染的报告。服用免疫抑制剂期间不要自行服用，确需使用请先咨询移植团队。"}],"depletions":[{"lab_id":"lab_magnesium","nutrient":"镁","applies_to":"他克莫司、环孢素","grade":"B","effect":"clinical_deficiency","action":"test_periodically","note":"他克莫司和环孢素会增加镁从尿中流失，引起低镁血症，常见于用药头几周。需要定期查血镁，是否补镁由移植团队决定。"}]},{"id":"statin","name":"他汀类降脂药","examples":"阿托伐他汀、辛伐他汀、瑞舒伐他汀","rules":[{"supplement":"supp_niacin","severity":"moderate","note":"大剂量烟酸与他汀合用会增加肌肉损伤的风险，出现肌肉酸痛、无力时要及时就医。美国药品说明书特别指出，中国患者服用辛伐他汀时不建议合用每天 1 g 以上的烟酸。"},{"flag":"cyp3a4","severity":"moderate","note":"会升高辛伐他汀、阿托伐他汀等经 CYP3A4 代谢的他汀浓度，增加肌病风险；瑞舒伐他汀受影响较小。"}],"depletions":[{"lab_id":"","nutrient":"辅酶 Q10","applies_to":"","grade":"A","effect":"lowers_levels","action":"awareness_only","note":"他汀会降低血液中辅酶 Q10 的水平，但这不代表组织缺乏，也不说明需要常规补充。补充辅酶 Q10 能否缓解他汀引起的肌肉疼痛，研究结论不一致。"}]},{"id":"digoxin","name":"地高辛","examples":"地高辛","rules":[{"supplement":"supp_hawthorn","severity":"moderate","note":"山楂有强心作用，与地高辛叠加需在医生监测下使用。"},{"supplement":"supp_berberine","severity":"moderate","note":"小檗碱可抑制 P-糖蛋白，可能升高地高辛的血药浓度。目前证据主要来自动物实验，合用时建议监测地高辛浓度。"},{"supplement":"supp_dihydroberberine","severity":"moderate","note":"二氢小檗碱是小檗碱的衍生物，可能有类似作用，但没有直接的人体研究。合用时建议监测地高辛浓度。"},{"supplement":"supp_ginseng","severity":"moderate","note":"人参可能干扰部分地高辛血药浓度的检测方法，让结果偏高或偏低，进而误导调药。测地高辛浓度前请告诉医生你在服用人参。"},{"supplement":"supp_ashwagandha","severity":"moderate","note":"南非醉茄可能干扰部分地高辛血药浓度的检测方法，让结果失真。测地高辛浓度前请告诉医生。"},{"supplement":"supp_d3_k2","severity":"moderate","note":"大剂量维生素 D 如果导致血钙升高，会增加地高辛引起心律失常的风险。服用地高辛的人补充维生素 D 时应定期查血钙。"}],"depletions":[]},{"id":"levothyroxine","name":"左甲状腺素","examples":"优甲乐、雷替斯","rules":[{"supplement":"supp_iron_bisglycinate","severity":"moderate","note":"铁会明显减少左甲状腺素的吸收，两者至少间隔 4 小时服用；如果服用时间改变，6–8 周后复查甲状腺功能。"},{"supplement":"supp_magnesium_bisglycinate","severity":"low","note":"镁会减少左甲状腺素的吸收，两者至少间隔 4 小时服用。"},{"supplement":"supp_magnesium_threonate","severity":"low","note":"镁会减少左甲状腺素的吸收，两者至少间隔 4 小时服用。"},{"supplement":"supp_zinc_picolinate","severity":"low","note":"锌可能减少左甲状腺素的吸收，建议间隔 4 小时服用。"},{"supplement":"supp_ashwagandha","severity":"moderate","note":"可能升高甲状腺素水平，合用期间要复查甲状腺功能。"},{"supplement":"supp_l_tyrosine","severity":"low","note":"酪氨酸是甲状腺素的合成原料，合用期间要关注甲状腺功能。"},{"supplement":"supp_chromium_picolinate","severity":"moderate","note":"一项小型研究中，同时服用吡啶甲酸铬会降低左甲状腺素的吸收。两者应间隔数小时服用，必要时复查甲状腺功能。"},{"supplement":"supp_calcium_d_glucarate","severity":"moderate","note":"钙剂与左甲状腺素同服会减少吸收。D-葡萄糖二酸钙虽未专门研究、含钙量也较少，仍建议与左甲状腺素间隔 4 小时。"}],"depletions":[]},{"id":"levodopa","name":"左旋多巴","examples":"多巴丝肼（美多芭）、卡左双多巴（息宁）","rules":[{"supplement":"supp_p5p","severity":"low","note":"维生素 B6 会削弱单方左旋多巴的效果；含卡比多巴或苄丝肼的复方制剂一般不受影响。"},{"supplement":"supp_agmatine","severity":"moderate","note":"可能影响多巴胺能药物的作用，不要在没有医生指导时合用。"},{"supplement":"supp_l_tyrosine","severity":"moderate","note":"与左旋多巴竞争吸收和进入大脑的转运体，可能降低药效，两者应间隔服用。"},{"supplement":"supp_iron_bisglycinate","severity":"moderate","note":"铁剂会减少左旋多巴的吸收，可能让运动症状变差。两者尽量分开服用，留意症状变化。"},{"supplement":"supp_5_htp","severity":"high","note":"有 5-羟色氨酸与卡比多巴合用后出现硬皮病样疾病的罕见报告。服用左旋多巴类药物的人，不要在没有专科医生指导的情况下开始服用 5-HTP。"}],"depletions":[{"lab_id":"","nutrient":"维生素 B6","applies_to":"卡左双多巴（息宁）","grade":"B","effect":"clinical_deficiency","action":"test_periodically","note":"长期服用卡比多巴/左旋多巴可能导致 B6 缺乏，极少数人出现癫痫发作。药品说明书建议定期评估 B6；补充 B6 要在医生指导下进行。"}]},{"id":"hormone_therapy","name":"他莫昔芬 / 芳香化酶抑制剂","examples":"他莫昔芬、来曲唑、阿那曲唑","rules":[{"supplement":"supp_dim","severity":"moderate","note":"可能降低他莫昔芬活性代谢物的水平，乳腺癌治疗期间请先咨询肿瘤科医生。"},{"supplement":"supp_resveratrol","severity":"low","note":"有微弱的雌激素样作用，激素敏感型肿瘤患者应谨慎。"},{"supplement":"supp_curcumin","severity":"moderate","note":"一项小型试验中，大剂量姜黄素加胡椒碱会降低他莫昔芬活性代谢物的浓度。乳腺癌治疗期间服用姜黄素前，请先咨询肿瘤科医生（仅限他莫昔芬）。"}],"depletions":[]},{"id":"acid_suppressant","name":"抑酸药（长期服用）","examples":"奥美拉唑、雷贝拉唑、艾司奥美拉唑等质子泵抑制剂；法莫替丁","rules":[{"supplement":"supp_iron_bisglycinate","severity":"moderate","note":"长期抑酸可能让口服铁剂效果变差，单纯错开服用时间也不一定能解决。补铁期间要复查血红蛋白和铁蛋白，看是否有效。"}],"depletions":[{"lab_id":"lab_magnesium","nutrient":"镁","applies_to":"质子泵抑制剂（奥美拉唑等），法莫替丁未证实","grade":"A","effect":"clinical_deficiency","action":"test_periodically","note":"长期服用质子泵抑制剂（通常一年以上）可能引起低镁血症，少数人三个月就出现。长期服用的人可定期查血镁，同时服用利尿剂或地高辛时更要注意。"},{"lab_id":"lab_b12","nutrient":"维生素 B12","applies_to":"","grade":"B","effect":"clinical_deficiency","action":"awareness_only","note":"长期抑酸（通常两年以上）会影响食物中 B12 的吸收，与 B12 缺乏有关。有手脚麻木、贫血、素食等其他风险时，建议检测。"},{"lab_id":"lab_iron","nutrient":"铁","applies_to":"","grade":"B","effect":"clinical_deficiency","action":"awareness_only","note":"胃酸减少会影响铁的吸收，长期服用与缺铁有关。出现贫血时要查铁蛋白，并排查其他原因。"}]},{"id":"diuretic","name":"利尿剂","examples":"呋塞米、托拉塞米、氢氯噻嗪、吲达帕胺","rules":[{"supplement":"supp_d3_k2","severity":"moderate","note":"噻嗪类利尿剂会减少钙从尿中排出，同时大剂量补充维生素 D 可能使血钙升高，肾功能差或有甲状旁腺疾病时风险更大。可定期查血钙（仅限噻嗪类利尿剂）。"}],"depletions":[{"lab_id":"lab_electrolytes","nutrient":"钾","applies_to":"呋塞米等袢利尿剂及氢氯噻嗪等噻嗪类","grade":"B","effect":"clinical_deficiency","action":"test_periodically","note":"利尿剂会增加钾从尿中流失，开始服用或加量后几天到几周内可能出现低钾，剂量越大风险越高。需要定期查血钾，补钾要由医生决定。"},{"lab_id":"lab_electrolytes","nutrient":"钠","applies_to":"尤其是氢氯噻嗪、吲达帕胺","grade":"B","effect":"clinical_deficiency","action":"test_periodically","note":"利尿剂可能引起低钠血症，多见于用药头几周。低钠可能是钠流失，也可能是体内水分过多，不能自行通过多吃盐来纠正。"},{"lab_id":"lab_magnesium","nutrient":"镁","applies_to":"","grade":"B","effect":"clinical_deficiency","action":"test_periodically","note":"利尿剂会增加镁从尿中流失，引起低镁血症，有时还会让低钾难以纠正。长期服用、有抽筋等症状或血钾偏低时，可查血镁。"},{"lab_id":"lab_calcium","nutrient":"钙","applies_to":"呋塞米等袢利尿剂（噻嗪类反而减少钙排出）","grade":"B","effect":"clinical_deficiency","action":"test_periodically","note":"袢利尿剂会增加钙从尿中流失，可能使血钙降低。长期大剂量使用时，可定期查血钙。"}]},{"id":"anticonvulsant","name":"抗癫痫药","examples":"苯妥英、卡马西平、苯巴比妥、丙戊酸、奥卡西平","rules":[{"supplement":"supp_ginkgo","severity":"high","note":"有病情控制良好的癫痫患者服用银杏后再次发作的报告，涉及丙戊酸、苯妥英等药物。原因尚不完全清楚，服用抗癫痫药的人最好避免银杏。"},{"supplement":"supp_5_mthf","severity":"moderate","note":"补充叶酸（包括活性叶酸）可能降低苯妥英等药物的血药浓度，曾有诱发癫痫发作的报告。是否补充及剂量要和医生商量，并监测药物浓度。"}],"depletions":[{"lab_id":"lab_vitd","nutrient":"维生素 D","applies_to":"尤其是苯妥英、苯巴比妥、卡马西平等肝酶诱导类药物","grade":"B","effect":"lowers_levels","action":"test_periodically","note":"这类药会加速维生素 D 的分解，长期服用的人维生素 D 偏低更常见，并影响骨骼健康。可定期查 25-羟维生素 D，按结果补充。"},{"lab_id":"lab_folate","nutrient":"叶酸","applies_to":"苯妥英、卡马西平、奥卡西平、丙戊酸","grade":"B","effect":"lowers_levels","action":"test_periodically","note":"长期服用后叶酸水平可能降低。补叶酸可能影响部分抗癫痫药的血药浓度，需在医生指导下进行。"},{"lab_id":"lab_b12","nutrient":"维生素 B12","applies_to":"苯妥英、苯巴比妥","grade":"B","effect":"lowers_levels","action":"test_periodically","note":"长期服用苯妥英或苯巴比妥的人 B12 可能偏低。出现手脚麻木、贫血时建议检测。"},{"lab_id":"lab_electrolytes","nutrient":"钠","applies_to":"奥卡西平","grade":"B","effect":"clinical_deficiency","action":"test_periodically","note":"奥卡西平可能引起明显的低钠血症，多发生在用药头三个月。出现头痛、恶心、乏力、意识模糊时要及时查血钠。"}]},{"id":"corticosteroid","name":"长期口服糖皮质激素","examples":"泼尼松、甲泼尼龙、地塞米松","rules":[],"depletions":[{"lab_id":"","nutrient":"钙","applies_to":"","grade":"B","effect":"lowers_levels","action":"supplement_on_medical_advice","note":"糖皮质激素会减少钙的吸收、加速骨量流失。血钙通常仍然正常，不能反映骨骼情况。长期服用的人，补钙、补维生素 D 和骨密度检查应听从医生安排。"},{"lab_id":"lab_electrolytes","nutrient":"钾","applies_to":"泼尼松等有盐皮质激素作用的激素","grade":"B","effect":"clinical_deficiency","action":"test_periodically","note":"糖皮质激素会增加钾的流失，剂量较大或同时服用利尿剂时更容易出现低钾。可定期查血钾。"}]},{"id":"oral_contraceptive","name":"口服避孕药","examples":"炔雌醇复合制剂（如优思明、妈富隆）","rules":[{"supplement":"supp_melatonin","severity":"moderate","note":"含雌激素的避孕药会减慢褪黑素的代谢，一项研究中褪黑素的血药浓度高出约 4–5 倍。合用时从小剂量开始，留意白天犯困。"}],"depletions":[{"lab_id":"lab_folate","nutrient":"叶酸","applies_to":"","grade":"B","effect":"lowers_levels","action":"awareness_only","note":"荟萃分析显示服用者血液叶酸偏低，但对现在的低剂量配方证据不一致。计划停药备孕时，按常规提前补充叶酸即可。"},{"lab_id":"lab_b12","nutrient":"维生素 B12","applies_to":"","grade":"B","effect":"lowers_levels","action":"awareness_only","note":"服用后测得的血清 B12 可能下降，但多数并不是真正缺乏，部分原因是结合蛋白发生变化。结果偏低时，结合症状判断，必要时加测 MMA。"}]},{"id":"methotrexate","name":"甲氨蝶呤","examples":"甲氨蝶呤（类风湿关节炎、银屑病等）","rules":[{"supplement":"supp_5_mthf","severity":"moderate","note":"活性叶酸可能影响甲氨蝶呤的效果，不能自行用它替代医生开的叶酸或亚叶酸。是否服用、剂量和时间都要由医生决定。"}],"depletions":[{"lab_id":"lab_folate","nutrient":"叶酸","applies_to":"","grade":"B","effect":"lowers_levels","action":"supplement_on_medical_advice","note":"甲氨蝶呤会对抗叶酸的作用。治疗类风湿关节炎等疾病时，医生通常会同时开叶酸或亚叶酸来减少副作用，剂量和服用时间请严格遵医嘱。"}]},{"id":"isoniazid","name":"异烟肼","examples":"异烟肼（抗结核或潜伏结核预防）","rules":[{"supplement":"supp_methylene_blue","severity":"high","note":"异烟肼有一定的单胺氧化酶抑制作用，与亚甲蓝合用可能增加血清素综合征的风险。服用异烟肼期间不要自行服用亚甲蓝。"},{"supplement":"supp_egcg","severity":"moderate","note":"异烟肼和绿茶提取物都可能损伤肝脏，有两者同时使用期间发生急性肝炎的报告。抗结核治疗期间避免服用高浓度绿茶提取物。"}],"depletions":[{"lab_id":"","nutrient":"维生素 B6","applies_to":"","grade":"A","effect":"clinical_deficiency","action":"supplement_on_medical_advice","note":"异烟肼会干扰 B6 的代谢，可能引起手脚麻木等周围神经病变。营养不良、糖尿病、饮酒、孕妇等高风险人群，指南建议同时补充 B6，请遵医嘱。"},{"lab_id":"","nutrient":"烟酸（维生素 B3）","applies_to":"","grade":"A","effect":"clinical_deficiency","action":"supplement_on_medical_advice","note":"异烟肼可能妨碍烟酸的合成，极少数人出现糙皮病（皮炎、腹泻、精神症状），营养不良者风险更高。出现这些症状要及时就医。"}]}]},"indications":{"grade_definitions":[{"grade":"A","label":"A 级 · 证据充分","description":"多项设计良好的人体随机对照试验，或其荟萃分析，结论基本一致。"},{"grade":"B","label":"B 级 · 证据中等","description":"至少一项像样的随机对照试验或荟萃分析，但样本不大、质量参差或结果不完全一致。"},{"grade":"C","label":"C 级 · 证据初步","description":"只有小型、开放标签或预试验性质的人体研究，结论还不可靠。"},{"grade":"D","label":"D 级 · 基本没有人体证据","description":"只有动物或细胞研究，或只是推测。"}],"verdicts":[{"id":"benefit","label":"有效","description":"研究总体显示有改善。"},{"id":"mixed","label":"结果不一","description":"有的研究有效，有的无效，或效果很小。"},{"id":"no_benefit","label":"无效","description":"研究得比较充分，但总体没有看到改善。"}],"study_types":{"meta_analysis":"荟萃分析","systematic_review":"系统综述","rct":"随机对照试验","crossover_rct":"交叉随机对照试验","open_label":"开放标签研究","cohort":"队列研究","other":"其他人体研究"},"goals":[{"id":"longevity","name":"长期健康","icon":"🌱","indications":[{"id":"all_cause_mortality","name":"全因死亡风险","keywords":["长寿","寿命","死亡率"]},{"id":"cardiovascular_events","name":"心梗、中风等心脑血管事件","keywords":["心梗","中风","脑卒中","心脏病"]},{"id":"falls","name":"老年人跌倒","keywords":["跌倒","摔倒","平衡"]}]},{"id":"sleep_mood","name":"睡眠与情绪","icon":"🌙","indications":[{"id":"sleep_onset","name":"入睡困难","keywords":["失眠","睡不着"]},{"id":"sleep_quality","name":"睡眠质量","keywords":["失眠","睡眠","早醒","多梦"]},{"id":"jet_lag","name":"倒时差","keywords":["时差","倒班"]},{"id":"anxiety_stress","name":"焦虑与压力","keywords":["焦虑","压力","紧张"]},{"id":"low_mood","name":"情绪低落","keywords":["抑郁","情绪"]}]},{"id":"brain","name":"大脑与认知","icon":"🧠","indications":[{"id":"memory","name":"记忆力","keywords":["记忆","健忘"]},{"id":"attention","name":"注意力与专注","keywords":["专注","脑雾","注意力"]},{"id":"cognitive_decline","name":"老年认知减退","keywords":["认知","老年痴呆","阿尔茨海默"]},{"id":"migraine","name":"预防偏头痛","keywords":["头痛","偏头痛"]}]},{"id":"energy_exercise","name":"精力与运动","icon":"⚡","indications":[{"id":"fatigue","name":"疲劳与精力","keywords":["疲劳","乏力","精力"]},{"id":"muscle_strength","name":"肌肉力量与肌肉量","keywords":["增肌","肌肉","力量"]},{"id":"endurance","name":"耐力表现","keywords":["耐力","有氧"]},{"id":"exercise_recovery","name":"运动后恢复与肌肉酸痛","keywords":["恢复","酸痛"]},{"id":"muscle_cramps","name":"肌肉痉挛（抽筋）","keywords":["抽筋","痉挛"]}]},{"id":"cardiometabolic","name":"心血管与代谢","icon":"❤️","indications":[{"id":"blood_pressure","name":"血压偏高","keywords":["高血压","血压"]},{"id":"ldl_cholesterol","name":"低密度脂蛋白胆固醇偏高","keywords":["胆固醇","血脂"]},{"id":"triglycerides","name":"甘油三酯偏高","keywords":["血脂","甘油三酯"]},{"id":"blood_glucose","name":"血糖与胰岛素抵抗","keywords":["血糖","糖尿病","胰岛素"]},{"id":"body_weight","name":"体重与体脂","keywords":["减肥","减脂","体重"]},{"id":"fatty_liver","name":"脂肪肝与肝酶","keywords":["脂肪肝","转氨酶","护肝"]},{"id":"uric_acid","name":"尿酸偏高","keywords":["痛风","尿酸"]},{"id":"venous_insufficiency","name":"静脉曲张与腿部浮肿","keywords":["静脉曲张","水肿","痔"]}]},{"id":"gut","name":"肠胃","icon":"🌿","indications":[{"id":"ibs","name":"肠易激综合征","keywords":["肠易激","腹胀","腹痛"]},{"id":"constipation","name":"便秘","keywords":["便秘"]},{"id":"diarrhea","name":"腹泻（含抗生素相关腹泻）","keywords":["腹泻","拉肚子"]},{"id":"gastric_mucosa","name":"胃黏膜保护与消化不良","keywords":["胃","消化不良","胃炎"]}]},{"id":"immune_inflammation","name":"免疫与炎症","icon":"🛡️","indications":[{"id":"colds","name":"感冒的预防与病程","keywords":["感冒","免疫力"]},{"id":"allergic_rhinitis","name":"过敏性鼻炎","keywords":["过敏","鼻炎"]},{"id":"inflammation_markers","name":"炎症指标（如 CRP）","keywords":["炎症","CRP"]}]},{"id":"joint_bone","name":"关节与骨骼","icon":"🦴","indications":[{"id":"joint_pain","name":"骨关节炎疼痛","keywords":["关节","关节炎","膝盖"]},{"id":"bone_density","name":"骨密度","keywords":["骨质疏松","骨密度","补钙"]}]},{"id":"skin_eye_nerve","name":"皮肤、眼睛与神经","icon":"✨","indications":[{"id":"skin_aging","name":"皮肤弹性与保湿","keywords":["皮肤","皱纹","美容"]},{"id":"eye_health","name":"黄斑与视力保护","keywords":["眼睛","视力","黄斑"]},{"id":"neuropathy","name":"周围神经病变（麻木刺痛）","keywords":["麻木","神经痛","糖尿病神经病变"]},{"id":"hair_loss","name":"脱发","keywords":["脱发","掉发"]}]},{"id":"hormone_reproductive","name":"激素与生殖","icon":"⚖️","indications":[{"id":"testosterone","name":"男性睾酮水平","keywords":["睾酮","雄激素"]},{"id":"erectile_function","name":"勃起功能","keywords":["勃起","性功能","勃起功能障碍"]},{"id":"male_fertility","name":"男性生育力（精子质量）","keywords":["精子","备孕","不育"]},{"id":"pcos","name":"多囊卵巢综合征","keywords":["多囊"]},{"id":"menopause","name":"更年期症状","keywords":["更年期","潮热"]},{"id":"pms","name":"经前期综合征与痛经","keywords":["经前","痛经"]},{"id":"bph","name":"前列腺增生的排尿症状","keywords":["前列腺","尿频"]}]},{"id":"nutrient_status","name":"营养缺乏","icon":"🩸","indications":[{"id":"iron_deficiency","name":"缺铁与缺铁性贫血","keywords":["贫血","缺铁"]},{"id":"b12_folate_deficiency","name":"维生素 B12 / 叶酸缺乏","keywords":["B12","叶酸","同型半胱氨酸"]},{"id":"vitamin_d_deficiency","name":"维生素 D 缺乏","keywords":["维生素D","维D"]}]}]},"lifestyle":{"groups":[{"id":"exercise","name":"运动","icon":"🏃"},{"id":"sleep","name":"睡眠","icon":"🌙"},{"id":"mind","name":"心理与社交","icon":"🧘"},{"id":"diet","name":"饮食","icon":"🥗"},{"id":"other","name":"其他","icon":"♨️"}],"screening":{"title":"开始运动前的自查","items":["医生说过你有心脏问题，只能做医生建议的运动","运动时、或最近一个月休息时，出现过胸痛","因为头晕失去平衡，或曾经晕倒","有骨骼或关节问题，运动会加重","正在服用降压药或心脏病药物"],"advice":"如果有任何一项符合，开始运动前请先让医生评估，确定适合的强度和类型。"},"items":[{"id":"ls_aerobic","group":"exercise","name":"中等强度有氧运动","en_name":"Moderate-Intensity Aerobic Exercise","aliases":["Zone 2","快走","慢跑","骑车","游泳"],"protocol":{"frequency":"每周 3–5 次","duration":"每周累计 150–300 分钟","intensity":"中等强度：呼吸加快、能说完整句子但唱不了歌","starter":"每天快走 10–15 分钟，适应后再逐渐加时间"},"tips":["快走、骑车、游泳、跳舞都算，选能坚持的","零散的几分钟活动也算数，可以累计","如果同时做力量训练，两者都要保留"],"cautions":"有心脏病、未控制的高血压或糖尿病并发症（如足部溃疡、严重神经病变），先请医生评估再开始。使用胰岛素或磺脲类降糖药的人，运动前后注意监测血糖，预防低血糖。运动中出现胸痛、明显气短、头晕或心慌，立即停下并就医。","screening":true,"summary":"证据最充分的生活方式之一：随机试验证实能提高耐力、降低血压和体重（A级），大型研究还显示经常运动的人心血管事件和死亡风险更低（B级）。","mechanisms":[{"mechanism_id":"mech_pgc1a_biogenesis","score":4,"evidence_grade":"A","target_role":"primary","notes":"规律的中等强度训练后，人体肌肉活检显示线粒体含量增加。PGC-1α 本身在训练后并不总是持续升高，增加的主要是线粒体数量和功能。"},{"mechanism_id":"mech_glut4_insulin","score":4,"evidence_grade":"A","target_role":"primary","notes":"随机对照研究用钳夹技术测得，有氧训练后胰岛素敏感性提高。该试验没有直接测量 GLUT4 转位，具体分子环节仍属推断。"},{"mechanism_id":"mech_autonomic_vagal","score":3,"evidence_grade":"A","target_role":"secondary","notes":"多项运动试验报告，与迷走神经相关的心率变异性指标有所改善，但幅度因人群和训练方案而异。"}],"indications":[{"indication_id":"endurance","grade":"A","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"A","verdict":"benefit"},{"indication_id":"body_weight","grade":"A","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"benefit"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"fatty_liver","grade":"B","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"B","verdict":"benefit"},{"indication_id":"low_mood","grade":"B","verdict":"benefit"},{"indication_id":"memory","grade":"B","verdict":"mixed"}],"slot":"day","timing_tip":"一天中任何时间都可以，固定时间更容易坚持；睡前 1 小时内避免剧烈运动"},{"id":"ls_hiit","group":"exercise","name":"高强度间歇训练（HIIT）","en_name":"High-Intensity Interval Training","aliases":["间歇跑","4×4 训练","HIIT"],"protocol":{"frequency":"每周 2–3 次，两次之间至少隔一天","duration":"热身后 4 组 × 4 分钟高强度，组间 3 分钟轻松活动，最后放松，共约 30–40 分钟","intensity":"高强度：只能说几个字，约最大心率的 85–95%（按年龄估算的心率只是参考，服用β受体阻滞剂时不准）","starter":"先有 4–6 周规律有氧基础，再从 6 组 × 30 秒加速开始，组间慢走 1–2 分钟"},"tips":["可以替代一部分中等强度有氧，时间更省","高强度段在快走、爬坡、单车上做都可以","每周 2–3 次的高强度时间总量不大，平时仍要保持其他活动","注意恢复，不要天天做"],"cautions":"冠心病、心律失常、未控制的高血压、近期心脏事件或运动时胸痛的人，未经医生评估不要做。严重的糖尿病视网膜病变、足部溃疡也需要医生评估。平时不运动的人不要直接从 HIIT 开始。使用胰岛素或磺脲类降糖药的人，运动前后注意监测血糖，预防低血糖。","screening":true,"summary":"用更短的时间提高心肺耐力（A级），对血糖、体重也有帮助（B级），对血压和血脂的结果不一。适合已经有运动基础的人。","mechanisms":[{"mechanism_id":"mech_pgc1a_biogenesis","score":4,"evidence_grade":"A","target_role":"primary","notes":"一项采用 4 分钟间歇的小型随机比较研究测得肌肉线粒体含量及相关标志物增加，但没有不运动的对照组。"},{"mechanism_id":"mech_glut4_insulin","score":4,"evidence_grade":"A","target_role":"secondary","notes":"一项采用 4×4 方案的小型随机试验，用钳夹技术测得外周胰岛素敏感性提高；GLUT4 转位没有被直接测量。"}],"indications":[{"indication_id":"endurance","grade":"A","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"body_weight","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"}],"slot":"day","timing_tip":"安排在不连续的两天；避免睡前 2–3 小时内做"},{"id":"ls_resistance","group":"exercise","name":"抗阻（力量）训练","en_name":"Resistance Training","aliases":["力量训练","举铁","撸铁","弹力带"],"protocol":{"frequency":"每周 2–3 次","duration":"每次 20–45 分钟，覆盖腿、臀、背、胸、肩等主要肌群","intensity":"每个动作 2–3 组、每组 8–12 次，最后几次感觉吃力","starter":"自重深蹲、扶墙俯卧撑、臀桥、弹力带划船各 2 组，每周 2 次"},"tips":["重量随能力慢慢加，动作标准比重量重要","同一部位练完休息约 48 小时再练","老年人同样获益，可以从弹力带和坐站练习开始","全天蛋白质吃够有助于增肌，不必练完立刻补"],"cautions":"有未控制的高血压、严重的糖尿病视网膜病变、近期手术或急性关节损伤时，先咨询医生。用力时不要憋气。使用胰岛素或磺脲类降糖药的人，运动前后注意监测血糖，预防低血糖。","screening":true,"summary":"增加肌肉力量和肌肉量的首选方法（A级），还能降低血压、改善体型（A级）。大型研究显示，有力量训练习惯的人死亡和心血管风险更低（B级）。","mechanisms":[{"mechanism_id":"mech_muscle_protein_synthesis","score":5,"evidence_grade":"A","target_role":"primary","notes":"人体示踪剂和肌肉活检研究直接测得，力量训练后肌原纤维蛋白合成增加。增加幅度和持续时间受进食和训练水平影响。"},{"mechanism_id":"mech_glut4_insulin","score":3,"evidence_grade":"A","target_role":"secondary","notes":"随机比较研究用钳夹技术测得，力量训练后胰岛素敏感性提高；但没有直接证实 GLUT4 转位。"}],"indications":[{"indication_id":"muscle_strength","grade":"A","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"A","verdict":"benefit"},{"indication_id":"body_weight","grade":"A","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"benefit"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"B","verdict":"benefit"},{"indication_id":"low_mood","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"bone_density","grade":"B","verdict":"benefit"},{"indication_id":"falls","grade":"B","verdict":"mixed"}],"slot":"day","timing_tip":"同一部位隔约 48 小时再练；可以和有氧安排在同一天"},{"id":"ls_walking","group":"exercise","name":"每日步行","en_name":"Daily Walking","aliases":["步数","日行万步","走路"],"protocol":{"frequency":"每天","duration":"全天累计步数逐步增加，7000 步左右可以作为参考目标；从较低基础往上加就有好处","intensity":"日常步速即可，快走更好","starter":"在现在的日均步数上每天多走 500–1000 步，适应后再加"},"tips":["饭后走 10–15 分钟可以降低餐后血糖（主要来自短期研究，不能替代降糖药）","用手机或手环记步数，便于循序渐进","久坐时每小时起身走几分钟","普通步速走路不完全等于中等强度有氧，有条件时加快步速"],"cautions":"大多数人都可以做。下肢关节疼痛明显时，可以换成骑车或游泳；有足部溃疡、严重神经病变、平衡很差或运动时胸闷气短的人，先请医生评估。使用胰岛素或磺脲类降糖药的人，运动前后注意监测血糖，预防低血糖。","screening":false,"summary":"门槛最低的运动。大型研究显示，每天步数越多，死亡和心血管风险越低（B级）；对血压、血糖、体重和情绪有帮助（B级），但单靠走路对坏胆固醇基本没有作用。","mechanisms":[{"mechanism_id":"mech_glut4_insulin","score":2,"evidence_grade":"B","target_role":"secondary","notes":"一项小型随机交叉研究发现，单次 60 分钟快走后肌肉胰岛素敏感性提高。每天 7000 步、不限步速时效果是否相同尚不确定。"}],"indications":[{"indication_id":"all_cause_mortality","grade":"B","verdict":"benefit"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"benefit"},{"indication_id":"low_mood","grade":"B","verdict":"benefit"},{"indication_id":"endurance","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"body_weight","grade":"B","verdict":"benefit"},{"indication_id":"falls","grade":"B","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"no_benefit"}],"slot":"day","timing_tip":"饭后走 10–15 分钟最方便，也能降低餐后血糖"},{"id":"ls_tai_chi","group":"exercise","name":"太极拳","en_name":"Tai Chi","aliases":["太极"],"protocol":{"frequency":"每周 2–3 次","duration":"每次 40–60 分钟，坚持 12 周以上；防跌倒的研究多坚持 24 周","intensity":"低到中等强度","starter":"跟着视频或社区课程练 15 分钟"},"tips":["对平衡和防跌倒尤其有用，适合中老年人","最好先跟老师学，动作更规范","膝关节不好可以减小下蹲幅度"],"cautions":"膝关节疼痛的人注意降低下蹲幅度。平衡很差或近期跌倒过的人，在有人陪同、有扶手的地方练习，最好参加有指导的课程。出现胸痛、明显头晕或关节痛加重时停下。","screening":false,"summary":"防跌倒和缓解膝关节炎疼痛的证据较强（A级），对睡眠、血压、疲劳、焦虑和认知也有帮助（B级）。动作缓和，适合中老年人。","mechanisms":[{"mechanism_id":"mech_autonomic_vagal","score":2,"evidence_grade":"A","target_role":"secondary","notes":"一项为期 12 周的小型随机试验测得高频心率变异性增加。心率变异性是受呼吸影响的间接指标，它与临床获益之间的关系尚不明确。"}],"indications":[{"indication_id":"falls","grade":"A","verdict":"benefit"},{"indication_id":"joint_pain","grade":"A","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"B","verdict":"benefit"},{"indication_id":"cognitive_decline","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"benefit"},{"indication_id":"fatigue","grade":"B","verdict":"benefit"},{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"}],"slot":"day","timing_tip":"早晨或傍晚都可以，跟课程练更规范"},{"id":"ls_yoga","group":"exercise","name":"瑜伽","en_name":"Yoga","aliases":["哈他瑜伽","阴瑜伽"],"protocol":{"frequency":"每周 2–3 次","duration":"每次 45–60 分钟，坚持 8–12 周以上","intensity":"以低到中等强度的体式、呼吸与放松为主","starter":"每天 10–15 分钟的入门课程"},"tips":["初学选哈他、阴瑜伽等温和类型","不要追求高难度体式，初学不要做用力的呼吸法","呼吸和放松是多数研究课程的一部分"],"cautions":"青光眼、未控制的高血压、颈椎或腰椎问题、骨质疏松、平衡差的人，需要调整体式，避免倒立和深度扭转。孕期可以做经过调整的孕期瑜伽，但避免高温瑜伽。最好在有资质的老师指导下练习。","screening":false,"summary":"对缓解焦虑和降低血压有帮助（B级）；对情绪、睡眠、关节痛和更年期症状，研究结果不一。研究中的课程多比简单的拉伸更系统。","mechanisms":[{"mechanism_id":"mech_autonomic_vagal","score":2,"evidence_grade":"A","target_role":"secondary","notes":"一项小型试验发现高频心率变异性升高，但规模更大、方案相近的试验没有发现改善。心率变异性是间接指标，也会受呼吸方式影响。"}],"indications":[{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"benefit"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"},{"indication_id":"joint_pain","grade":"B","verdict":"mixed"},{"indication_id":"menopause","grade":"B","verdict":"mixed"},{"indication_id":"fatigue","grade":"B","verdict":"mixed"}],"slot":"day","timing_tip":"空腹或饭后 2 小时以上再练"},{"id":"ls_cbti","group":"sleep","name":"失眠认知行为疗法（CBT-I）","en_name":"Cognitive Behavioral Therapy for Insomnia","aliases":["CBT-I","刺激控制","睡眠限制","失眠"],"protocol":{"frequency":"通常 4–8 次课程，每周 1 次","duration":"6–8 周，可面谈、小组或使用经过验证的数字化程序","intensity":"行为疗法，需要每天记录睡眠日记","starter":"先做两件事：每天固定时间起床；躺下后睡不着就离开卧室，困了再回床（不必盯着时钟，大约 20 分钟）"},"tips":["核心是刺激控制、睡眠限制、固定起床时间，以及调整对睡眠的担忧","只做起步的两件事还不是完整疗法，睡眠时间窗需要根据睡眠日记逐步调整","头一两周可能更困，这很常见；如果困到影响安全，请和医生调整方案","长期效果通常比安眠药更持久，是慢性失眠的首选治疗"],"cautions":"睡眠限制初期白天会更困，如果困得明显，不要开车或做高空作业。双相情感障碍、癫痫、白天严重嗜睡、未治疗的睡眠呼吸暂停的人，应先评估，并在医生指导下进行。","screening":false,"summary":"慢性失眠的首选治疗：改善入睡和睡眠质量的证据为 A 级，还能改善抑郁情绪（A级）和白天疲劳（B级）。","mechanisms":[{"mechanism_id":"mech_sleep_homeostasis","score":4,"evidence_grade":"A","target_role":"primary","notes":"针对“睡眠限制”这一组成部分的随机拆分试验发现，睡眠压力增加、睡前思绪活跃程度降低，深睡眠 δ 波的相对占比上升，但绝对功率没有增加。“床与清醒的条件联系被打破”这一环节仍缺少直接证据。"}],"indications":[{"indication_id":"sleep_onset","grade":"A","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"A","verdict":"benefit"},{"indication_id":"low_mood","grade":"A","verdict":"benefit"},{"indication_id":"fatigue","grade":"B","verdict":"benefit"},{"indication_id":"anxiety_stress","grade":"B","verdict":"mixed"}],"slot":"bedtime","timing_tip":"困了才上床，睡不着就起来；第二天仍按时起床"},{"id":"ls_sleep_regularity","group":"sleep","name":"固定作息时间","en_name":"Regular Sleep-Wake Schedule","aliases":["规律作息","固定起床"],"protocol":{"frequency":"每天，包括周末","duration":"长期","intensity":"起床时间尽量每天接近（例如波动在 30–60 分钟以内，这是实用建议，不是硬性标准）","starter":"先固定起床时间，入睡时间会慢慢跟上"},"tips":["周末补觉尽量不超过平时起床时间 1 小时，但确实缺觉时先补够","保证有 7–9 小时的睡眠机会","如需午睡，短一点、早一点"],"cautions":"不要为了固定早起而长期压缩睡眠，白天严重犯困时请调整。倒班工作者或有生物钟紊乱的人，需要个体化的作息方案。","screening":false,"summary":"观察性研究提示，作息越不规律的人死亡和心血管风险越高，但结果并不完全一致；主动调整作息能否降低这些风险、改善睡眠，也还没有定论。做起来几乎没有成本。","mechanisms":[{"mechanism_id":"mech_autonomic_vagal","score":2,"evidence_grade":"A","target_role":"secondary","notes":"一项 16 人的随机交叉试验发现，连续 12 晚固定作息后静息 RMSSD 升高。这只是间接的心脏自主神经指标，不能说明效果持久，也不能解释长期健康结局。"}],"indications":[{"indication_id":"all_cause_mortality","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"}],"slot":"morning","timing_tip":"每天同一时间起床，包括周末"},{"id":"ls_morning_light","group":"sleep","name":"早晨光照","en_name":"Morning Light Exposure","aliases":["晒太阳","光照疗法","光疗"],"protocol":{"frequency":"每天","duration":"起床后 1 小时内，户外 15–30 分钟；或按说明书的距离使用 10000 lux 光疗灯 20–30 分钟","intensity":"户外自然光即可，阴天也比室内亮得多；光疗灯选带防紫外线的，睁眼即可，不要盯着看","starter":"早上出门走一走，比如步行通勤或在户外吃早饭"},"tips":["坐在窗边比到户外暗得多，尽量出门","不要直视太阳","晚睡晚起型的人尤其有用","不要为了晒光而少睡"],"cautions":"光疗可能引起头痛、眼睛疲劳或烦躁。双相情感障碍患者使用强光疗可能诱发躁狂，需在医生指导和监测下使用；眼病患者或正在服用光敏药物的人，使用光疗灯前请咨询医生。长时间户外注意防晒。","screening":false,"summary":"光照疗法改善抑郁的证据较强（A级），机制是校准生物钟。对入睡和睡眠质量的研究结果不一；慢性失眠首选失眠认知行为疗法。","mechanisms":[{"mechanism_id":"mech_circadian_clock","score":4,"evidence_grade":"A","target_role":"primary","notes":"早晨的光通过视网膜作用于生物钟，可使夜间褪黑素开始分泌的时间提前。单独用光的对照实验照射了 3 小时；30 分钟照光的研究同时使用了褪黑素和调整作息，单独照光的效果无法分离。"}],"indications":[{"indication_id":"low_mood","grade":"A","verdict":"benefit"},{"indication_id":"sleep_onset","grade":"B","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"}],"slot":"morning","timing_tip":"起床后 1 小时内到户外"},{"id":"ls_evening_light","group":"sleep","name":"晚间减少强光与屏幕","en_name":"Evening Light & Screen Reduction","aliases":["睡前不看手机","蓝光"],"protocol":{"frequency":"每天","duration":"睡前至少 30–60 分钟，越早越好","intensity":"调暗室内灯光，减少手机、电脑等屏幕使用","starter":"睡前 30 分钟手机放到卧室外"},"tips":["暖色、低亮度的灯光更好","只开手机“夜间模式”在研究中改善有限，减少使用更实际","可以用阅读、拉伸、洗热水澡代替刷手机"],"cautions":"一般人都可以做。","screening":false,"summary":"夜间强光会推迟生物钟，但睡前少用手机对入睡和睡眠质量的研究结果不一；对记忆力的证据只有一项小型试验（C级）。成本低，可以作为好习惯。","mechanisms":[{"mechanism_id":"mech_circadian_clock","score":3,"evidence_grade":"A","target_role":"primary","notes":"在生物学上的夜晚减少足够强的光照，可减少光对褪黑素的抑制和对生物钟的推迟。对照实验测量了褪黑素时间，但部分实验的光照比日常用手机更强或更久。"}],"indications":[{"indication_id":"memory","grade":"C","verdict":"benefit"},{"indication_id":"sleep_onset","grade":"B","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"}],"slot":"bedtime","timing_tip":"睡前至少 30–60 分钟调暗灯光、放下手机"},{"id":"ls_mindfulness","group":"mind","name":"正念冥想","en_name":"Mindfulness Meditation","aliases":["冥想","MBSR","正念减压"],"protocol":{"frequency":"每天","duration":"标准课程为 8 周（如正念减压 MBSR），每天练习 20–45 分钟","intensity":"安静坐着或躺着，把注意力放在呼吸和身体感觉上","starter":"每天 10 分钟的引导冥想音频"},"tips":["走神很正常，发现了就把注意力带回来","固定时间练习更容易坚持","App 适合入门，但效果不能等同于有老师指导的 8 周课程"],"cautions":"少数人冥想时会感到明显不适，有严重创伤经历、精神病性症状或正处于严重抑郁发作的人风险更高。如果练习后更难受，缩短时间或在专业人员指导下进行。冥想不能替代需要的心理或药物治疗。","screening":false,"summary":"缓解焦虑和压力的证据较强（A级），对情绪低落和睡眠也有帮助（B级）。对注意力、偏头痛和血压的研究结果不一。","mechanisms":[{"mechanism_id":"mech_hpa_cortisol","score":3,"evidence_grade":"A","target_role":"secondary","notes":"对照研究直接测量了皮质醇，荟萃分析显示正念减压课程后皮质醇平均下降，但研究间差异很大；一项随机应激测试研究未发现皮质醇变化。"}],"indications":[{"indication_id":"anxiety_stress","grade":"A","verdict":"benefit"},{"indication_id":"low_mood","grade":"B","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"B","verdict":"benefit"},{"indication_id":"attention","grade":"B","verdict":"mixed"},{"indication_id":"migraine","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"}],"slot":"day","timing_tip":"每天固定时间练习，早晨或睡前都可以"},{"id":"ls_slow_breathing","group":"mind","name":"慢呼吸练习","en_name":"Slow-Paced Breathing","aliases":["腹式呼吸","共振呼吸","4-6 呼吸"],"protocol":{"frequency":"每天 1–2 次","duration":"每次 5–15 分钟","intensity":"大约每分钟 6 次（舒适即可）：轻柔地吸气 4–5 秒，呼气 5–6 秒","starter":"紧张时做 10 次缓慢、轻柔的呼吸"},"tips":["用鼻子吸气、腹部起伏，不要刻意吸得很深","可以用计时 App 或节拍跟练","睡前做有助于放松（对入睡的证据还有限）"],"cautions":"出现头晕、手麻时恢复正常呼吸。不要憋气或强行拉长呼吸。有严重肺部疾病的人请咨询医生。不能替代降压治疗。","screening":false,"summary":"几分钟就能做的放松方法，对缓解焦虑有帮助（B级）。对睡眠和血压的研究结果不一。","mechanisms":[{"mechanism_id":"mech_autonomic_vagal","score":4,"evidence_grade":"A","target_role":"primary","notes":"慢呼吸会即时放大随呼吸起伏的心率波动，对照研究测得心率变异性和压力感受性反射的变化。这些波动部分来自呼吸本身的机械作用，不能完全等同于迷走神经张力提高。"}],"indications":[{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"sleep_onset","grade":"C","verdict":"mixed"}],"slot":"bedtime","timing_tip":"睡前做 5–10 分钟，白天紧张时也可以随时做"},{"id":"ls_cbt","group":"mind","name":"认知行为疗法（CBT）","en_name":"Cognitive Behavioral Therapy","aliases":["心理治疗","CBT","心理咨询"],"protocol":{"frequency":"通常每周 1 次","duration":"一般 8–20 次会谈，也可使用经过验证的自助或数字化课程","intensity":"与治疗师一起识别和调整负面想法与回避行为，并布置家庭作业","starter":"先学会记录“情境—想法—情绪”，留意哪些想法反复出现"},"tips":["焦虑和抑郁的首选心理治疗之一","失眠、肠易激综合征、慢性疼痛、更年期症状都有专门的 CBT 方案，自己记录想法只是入门","中重度抑郁时，可与药物治疗联合","找有资质的心理治疗师或医院心理科"],"cautions":"有伤害自己的打算时，请立即拨打 120 或去急诊。严重抑郁时请先就医，不要只靠自助练习。心理援助热线 12356 可以作为补充。","screening":false,"summary":"抑郁、焦虑和肠易激综合征的一线心理治疗（A级），针对性的方案对关节疼痛和更年期症状也有帮助（B级）。","mechanisms":[{"mechanism_id":"mech_autonomic_vagal","score":2,"evidence_grade":"A","target_role":"secondary","notes":"荟萃分析发现，认知行为疗法后部分心率变异性指标升高，但并非所有指标都有变化。这只是伴随的生理变化，尚不能证明疗效是通过迷走神经实现的。"}],"indications":[{"indication_id":"low_mood","grade":"A","verdict":"benefit"},{"indication_id":"anxiety_stress","grade":"A","verdict":"benefit"},{"indication_id":"ibs","grade":"A","verdict":"benefit"},{"indication_id":"joint_pain","grade":"B","verdict":"benefit"},{"indication_id":"menopause","grade":"B","verdict":"benefit"}],"slot":"all_day","timing_tip":"每周固定时间的会谈，加上平时的练习"},{"id":"ls_social","group":"mind","name":"社交联系","en_name":"Social Connection","aliases":["孤独","社交","志愿服务"],"protocol":{"frequency":"每周数次","duration":"长期","intensity":"与家人朋友见面或通话、参加团体活动或志愿服务","starter":"这周约一位朋友见面或打一次电话"},"tips":["让你感到被支持的关系尤其重要","兴趣小组、运动团体可以同时满足运动和社交","照顾者和独居老人尤其需要","研究中的社交干预多是持续、有组织的联系，一次电话只是开始"],"cautions":"一般人都可以做。","screening":false,"summary":"孤独和社交隔离与更高的死亡和心血管风险相关（观察性研究）；主动增加社交能否降低这些风险，或改善情绪和认知，研究结果不一。对缓解焦虑和压力有一定帮助（B级）。","mechanisms":[],"indications":[{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"mixed"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"B","verdict":"mixed"}],"slot":"all_day","timing_tip":"每周安排几次见面或通话"},{"id":"ls_mediterranean","group":"diet","name":"地中海饮食","en_name":"Mediterranean Diet","aliases":["地中海","健康饮食"],"protocol":{"frequency":"每天","duration":"长期饮食模式","intensity":"以蔬菜、水果、全谷物、豆类、坚果和橄榄油为主，适量鱼和禽肉，少吃红肉、加工肉和甜食","starter":"每天一小把（约 30 克）原味坚果，用全谷物替换一半精白米面"},"tips":["不必照搬西餐，中式饮食也能按这个结构调整","每周吃两次鱼","炒菜用油换成橄榄油（主要研究用的是特级初榨橄榄油），或菜籽油","坚果和橄榄油用来替换其他油脂，而不是额外加","不喝酒的人不需要为此开始喝酒"],"cautions":"对坚果或鱼过敏的人请选择替代食物。肾病患者对钾和蛋白质的限制因人而异，请按医嘱调整。","screening":false,"summary":"降低心血管事件的证据最强的饮食模式（A级，PREDIMED 等试验），还与更低的死亡风险、更好的血糖和甘油三酯、更低的炎症指标相关（B级）。","mechanisms":[{"mechanism_id":"mech_nfkb_inhibition","score":2,"evidence_grade":"A","target_role":"secondary","notes":"一项小型随机交叉研究发现，与富含饱和脂肪的西式饮食相比，地中海饮食期间单核细胞的 NF-κB 活化较低。这一变化是否带来临床获益尚未证实。"},{"mechanism_id":"mech_scfa_fermentation","score":2,"evidence_grade":"A","target_role":"substrate","notes":"地中海饮食中的膳食纤维可为肠道菌群提供发酵底物。一项饮食加运动的试验发现粪便短链脂肪酸增加，但之后的一项试验未见显著变化；粪便浓度也不能直接反映实际产量。"}],"indications":[{"indication_id":"cardiovascular_events","grade":"A","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"triglycerides","grade":"B","verdict":"benefit"},{"indication_id":"inflammation_markers","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"B","verdict":"mixed"}],"slot":"all_day","timing_tip":"三餐都按这个结构安排"},{"id":"ls_time_restricted","group":"diet","name":"限时进食","en_name":"Time-Restricted Eating","aliases":["轻断食","16:8","间歇性禁食"],"protocol":{"frequency":"每天","duration":"每天进食时间集中在 8–10 小时以内，不需要更短","intensity":"进食窗口外只喝水、无糖茶或黑咖啡","starter":"晚饭后不再吃东西，先做到夜间 12 小时空腹，再逐步缩短进食窗口"},"tips":["把进食窗口放在白天更好，避免很晚吃饭","减重效果很大一部分来自总热量减少","窗口内吃够蛋白质和优质食物，避免肌肉流失"],"cautions":"孕期和哺乳期、未成年人、有进食障碍史、体重过低或体弱的人不建议尝试。使用胰岛素或磺脲类降糖药的人可能发生低血糖，服用 SGLT2 抑制剂（如达格列净、恩格列净）的人空腹时间长有酮症酸中毒风险，必须先咨询医生。需要随餐服用药物的人，也请先咨询医生。","screening":false,"summary":"效果和普通的少吃差不多：对体重、血糖、血压的研究结果不一，对甘油三酯有一定帮助（B级），对坏胆固醇基本没有作用。适合觉得“控制时间”比“控制份量”更容易的人。","mechanisms":[{"mechanism_id":"mech_circadian_clock","score":2,"evidence_grade":"A","target_role":"secondary","notes":"一项 8 小时进食窗口试验测得外周血生物钟基因节律改变，但另一项 8 小时交叉试验未发现肌肉核心生物钟基因表达变化。全身生物钟是否被重新校准、以及它是否带来获益，仍未证实。"}],"indications":[{"indication_id":"triglycerides","grade":"B","verdict":"benefit"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"B","verdict":"mixed"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"no_benefit"}],"slot":"all_day","timing_tip":"三餐和零食都放在 8–10 小时内，最好在白天"},{"id":"ls_alcohol","group":"diet","name":"减少饮酒","en_name":"Alcohol Reduction","aliases":["戒酒","少喝酒","酒精"],"protocol":{"frequency":"长期","duration":"长期","intensity":"不喝酒最好；如果喝，每天酒精不超过 15 克（这是上限，不是安全量）。按酒量和度数计算：330 毫升 5% 的啤酒约含 13 克酒精","starter":"先记录一周的饮酒量，再定减少目标"},"tips":["不喝酒的人不需要开始喝","少量饮酒有益健康的说法已被较新的研究质疑","平时少喝不能抵消一次喝很多","避免空腹喝和睡前喝，酒精会让后半夜睡眠变差","聚会时可以准备无醇饮品"],"cautions":"长期大量饮酒的人，大幅减量或停酒前请先就医，可能出现严重戒断反应；出现抽搐、幻觉、意识混乱时立即就医。孕期和备孕期不要饮酒。服用镇静催眠药、阿片类药物时，以及开车前，不要喝酒。有酒精性肝病的人通常需要完全戒酒。","screening":false,"summary":"减少饮酒能降低血压（A级），观察性研究显示减量或戒酒与更低的死亡风险相关（B级）；对血糖、体重、脂肪肝和睡眠的研究结果不一。","mechanisms":[],"indications":[{"indication_id":"blood_pressure","grade":"A","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"C","verdict":"mixed"},{"indication_id":"fatty_liver","grade":"C","verdict":"mixed"},{"indication_id":"sleep_quality","grade":"C","verdict":"mixed"}],"slot":"all_day","timing_tip":"如果喝，避免空腹和睡前喝"},{"id":"ls_fiber","group":"diet","name":"增加膳食纤维","en_name":"Dietary Fiber Increase","aliases":["粗粮","全谷物","膳食纤维"],"protocol":{"frequency":"每天","duration":"长期","intensity":"每天总共 25–30 克（包括已经吃到的），来自全谷物、豆类、蔬菜、水果","starter":"每天加一份豆类或燕麦，用两周或更长时间逐步增加"},"tips":["增加纤维的同时多喝水（医生要求限制饮水的人除外）","加得太快会胀气，循序渐进","燕麦、豆类偏可溶性纤维，不同纤维作用不同","食物来源比纤维补充剂更全面"],"cautions":"有肠梗阻病史、炎症性肠病伴肠道狭窄或胃轻瘫的人，请先咨询医生。肠易激综合征的人增加豆类、麸皮等容易胀气的食物要放慢，按耐受程度调整。出现腹痛加重、呕吐或明显腹胀时请就医。","screening":false,"summary":"高纤维饮食与更低的死亡和心血管风险相关（B级），能改善坏胆固醇、血糖、血压、体重和便秘（B级）。对肠易激综合征的效果因纤维种类而异。","mechanisms":[{"mechanism_id":"mech_scfa_fermentation","score":4,"evidence_grade":"A","target_role":"substrate","notes":"可发酵纤维为肠道菌群提供底物，一项全谷物随机交叉试验测得粪便丁酸增加。效果因纤维种类和个人菌群而异，粪便浓度也不能代表总产量。"}],"indications":[{"indication_id":"all_cause_mortality","grade":"B","verdict":"benefit"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"benefit"},{"indication_id":"ldl_cholesterol","grade":"B","verdict":"benefit"},{"indication_id":"blood_glucose","grade":"B","verdict":"benefit"},{"indication_id":"body_weight","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"benefit"},{"indication_id":"constipation","grade":"B","verdict":"benefit"},{"indication_id":"triglycerides","grade":"B","verdict":"mixed"},{"indication_id":"ibs","grade":"B","verdict":"mixed"}],"slot":"all_day","timing_tip":"分散到三餐里，同时多喝水"},{"id":"ls_salt","group":"diet","name":"减盐","en_name":"Sodium Reduction","aliases":["低盐","少盐","高血压饮食"],"protocol":{"frequency":"每天","duration":"长期","intensity":"每天食盐不超过 5 克（约 2000 毫克钠）；酱油、咸菜、加工食品里的盐也要算上","starter":"用限盐勺，看食品标签上的钠含量，少吃咸菜和加工肉"},"tips":["口味会在几周内适应","用醋、葱姜蒜、香料提味","可以考虑低钠盐（含钾），但先看下面的注意事项"],"cautions":"肾病、血钾偏高，或正在服用保钾利尿剂、ACEI/ARB 类降压药的人，使用含钾的低钠盐前请咨询医生，以免血钾过高。肾上腺功能不全、反复低钠血症、医生另有用盐要求的人，请遵医嘱。","screening":false,"summary":"降低血压的证据最强的饮食调整之一（A级）；大型试验显示用低钠盐（含钾）可减少心血管事件（B级）。对死亡风险的研究结果不一。","mechanisms":[{"mechanism_id":"mech_enos_no","score":3,"evidence_grade":"A","target_role":"secondary","notes":"一项小型随机交叉研究发现，限盐后由一氧化氮介导的血管内皮舒张功能改善；但没有证实内皮型一氧化氮合酶的表达发生变化。"}],"indications":[{"indication_id":"blood_pressure","grade":"A","verdict":"benefit"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"benefit"},{"indication_id":"all_cause_mortality","grade":"B","verdict":"mixed"}],"slot":"all_day","timing_tip":"做饭时用限盐勺，少用酱料"},{"id":"ls_sauna","group":"other","name":"桑拿","en_name":"Sauna Bathing","aliases":["芬兰浴","汗蒸","热疗"],"protocol":{"frequency":"每周 2–4 次","duration":"每次 10–20 分钟","intensity":"芬兰式干蒸，常见 80–90°C；温度低一些、时间短一些也可以，以舒适为准","starter":"从 5–10 分钟开始，出来后补充水分"},"tips":["相关研究大多来自芬兰的观察性研究，因果关系还不确定","蒸完体重下降主要是水分，不是减脂","蒸完慢慢起身，避免头晕","不能替代运动"],"cautions":"不稳定心绞痛、近期心肌梗死、严重主动脉瓣狭窄、有症状的低血压或体位性低血压的人不要蒸。发烧、急性生病、脱水时不要蒸；出现头晕、胸痛、心慌立即出来。孕期避免，不要在饮酒后蒸。备孕的男性注意：小型研究发现规律桑拿会暂时降低精子数量和活力。","screening":false,"summary":"芬兰的观察性研究显示，常蒸桑拿的人死亡和心血管风险更低（B级），对耐力也有帮助（B级），但这些研究不能证明因果关系。","mechanisms":[{"mechanism_id":"mech_heat_shock","score":3,"evidence_grade":"B","target_role":"primary","notes":"小型无对照的人体研究测得，桑拿后热休克相关基因出现反应，其中包括每次 15 分钟、80–90°C 的多次桑拿。标志物有反应不等于有临床获益。"}],"indications":[{"indication_id":"all_cause_mortality","grade":"B","verdict":"benefit"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"benefit"},{"indication_id":"endurance","grade":"B","verdict":"benefit"},{"indication_id":"blood_pressure","grade":"B","verdict":"mixed"},{"indication_id":"body_weight","grade":"B","verdict":"mixed"},{"indication_id":"cognitive_decline","grade":"C","verdict":"mixed"},{"indication_id":"colds","grade":"C","verdict":"mixed"}],"slot":"day","timing_tip":"可以放在运动后；饮酒后、身体不适时不要蒸"},{"id":"ls_cold","group":"other","name":"冷暴露","en_name":"Cold Exposure","aliases":["冷水澡","冬泳","冰浴"],"protocol":{"frequency":"每周数次","duration":"冷水淋浴 30 秒–3 分钟，或冷水浸泡数分钟","intensity":"以能控制呼吸为限，不追求更冷更久","starter":"洗澡最后 30 秒切换冷水"},"tips":["人体证据目前很有限，主要是主观感受和短期生理变化","研究中的冷水浸泡（10–15 分钟）和几十秒冷水澡不是一回事","力量训练后反复长时间冷水浸泡可能削弱增肌效果；短时冷水澡的影响还不清楚","冬泳一定要结伴，循序渐进"],"cautions":"突然入冷水会引起不自主的急促喘气，可能呛水或诱发心律失常、血压骤升：心血管疾病、心律失常、未控制的高血压、雷诺现象患者先请医生评估，避免突然入水。对冷过敏（冷荨麻疹）的人不要做。慢慢入水、脸保持在水面以上，不要憋气或刻意过度换气。不要独自下冷水，提前准备好出水和复温的办法，饮酒后禁止冬泳。","screening":false,"summary":"对情绪、压力、运动恢复和预防感冒的研究结果不一，证据有限。目前更像一种个人偏好，而不是有明确获益的方法。","mechanisms":[{"mechanism_id":"mech_cold_thermogenesis","score":3,"evidence_grade":"B","target_role":"primary","notes":"短时冷水浸泡会使血液中去甲肾上腺素升高，反复短时冷水淋浴可减弱遇冷时的急促喘气反应。在这么短的时长下，能否激活棕色脂肪 UCP1、带来有意义的长期产热，尚未证实。"}],"indications":[{"indication_id":"anxiety_stress","grade":"B","verdict":"mixed"},{"indication_id":"low_mood","grade":"B","verdict":"mixed"},{"indication_id":"exercise_recovery","grade":"B","verdict":"mixed"},{"indication_id":"colds","grade":"B","verdict":"mixed"}],"slot":"day","timing_tip":"不要紧接在力量训练后做；一定在可以随时出水的地方"},{"id":"ls_smoking_cessation","group":"other","name":"戒烟","en_name":"Smoking Cessation","aliases":["戒烟","尼古丁","电子烟"],"protocol":{"frequency":"一次性改变，长期保持","duration":"通常需要 8–12 周的戒断支持","intensity":"定一个戒烟日，配合戒烟药物（尼古丁替代、伐尼克兰等）和行为支持","starter":"记录一周的吸烟时间和触发场景，找出最难的时刻"},"tips":["药物加行为支持的成功率明显高于单靠意志力","可以去医院的戒烟门诊","8–12 周是常见疗程，有人需要更久","复吸很常见，不等于失败，可以再试"],"cautions":"戒烟药物请在医生或药师指导下使用；孕期以行为支持为主，用药需与医生商量。安非他酮不适合有癫痫或进食障碍史的人。正在服用氯氮平、茶碱等药物的人，戒烟后药物浓度可能升高，请告知医生。戒断期可能出现失眠、烦躁、焦虑，情绪明显变化时请就医。","screening":false,"summary":"戒烟能显著降低死亡和心血管风险（B级，来自大型长期研究）；戒烟后焦虑和情绪往往会改善，而不是变差（B级）。","mechanisms":[{"mechanism_id":"mech_autonomic_vagal","score":3,"evidence_grade":"B","target_role":"secondary","notes":"在一项戒烟项目的小型队列中，停用尼古丁贴片后，成功戒烟者的心率变异性指标更高；但是否戒烟不是随机分配的。"},{"mechanism_id":"mech_enos_no","score":2,"evidence_grade":"B","target_role":"secondary","notes":"人体研究显示戒烟后内皮依赖性血管舒张功能改善。这些是与一氧化氮相关血管功能的间接指标，不能证明内皮型一氧化氮合酶本身的变化；戒烟者也不是随机分组的。"}],"indications":[{"indication_id":"all_cause_mortality","grade":"B","verdict":"benefit"},{"indication_id":"cardiovascular_events","grade":"B","verdict":"benefit"},{"indication_id":"anxiety_stress","grade":"B","verdict":"benefit"},{"indication_id":"low_mood","grade":"B","verdict":"benefit"},{"indication_id":"sleep_quality","grade":"B","verdict":"mixed"},{"indication_id":"blood_glucose","grade":"B","verdict":"mixed"},{"indication_id":"inflammation_markers","grade":"B","verdict":"mixed"},{"indication_id":"erectile_function","grade":"B","verdict":"mixed"}],"slot":"all_day","timing_tip":"定好戒烟日，记录想吸烟的时刻和场景"}],"rules":[{"id":"r_creatine_resistance","kind":"synergy","lifestyle":["ls_resistance"],"supplements":["supp_creatine"],"title":"力量训练 + 肌酸","desc":"肌酸增加力量和肌肉量的证据，几乎都来自配合力量训练的试验；不训练时单吃肌酸，效果很小。两者一起做，才是研究中真正有效的组合。"},{"id":"r_light_melatonin","kind":"synergy","lifestyle":["ls_morning_light"],"supplements":["supp_melatonin"],"title":"早晨光照 + 晚上褪黑素","desc":"早晨的光和晚上的褪黑素都能把生物钟往前调，方向一致。研究中两者同用，生物钟提前得比单用任何一种更多，适合晚睡晚起、想把作息往前调的人。褪黑素要在晚上用，不要早上吃。"},{"id":"r_antioxidant_training","kind":"interference","lifestyle":["ls_aerobic","ls_hiit","ls_resistance"],"supplements":["supp_sodium_ascorbate","supp_tocotrienols"],"title":"规律训练 + 大剂量抗氧化剂","desc":"几项随机试验发现，训练期间每天服用大剂量维生素 C（约 1 克）和维生素 E，会削弱一部分训练带来的适应，比如线粒体增加和胰岛素敏感性改善，但并非所有研究结果一致。规律训练的人，不建议长期服用大剂量抗氧化剂。"},{"id":"r_cold_resistance","kind":"interference","lifestyle":["ls_cold","ls_resistance"],"title":"力量训练后马上冷水浸泡","desc":"随机试验发现，每次力量训练后都做 10 分钟左右的冷水浸泡，12 周后肌肉和力量的增长都比主动放松少。想增肌的话，把冷水浸泡和力量训练错开，或安排在不练力量的日子。短时间冷水澡的影响还不清楚。"},{"id":"r_trf_meal_supps","kind":"tip","lifestyle":["ls_time_restricted"],"supplement_slots":["pre_meal","with_meal"],"title":"限时进食 + 随餐服用的补充剂","desc":"餐前和随餐服用的补充剂，都安排在进食时间内；需要空腹服用的，可以放在进食时间开始前。"},{"id":"r_fish_omega3","kind":"tip","lifestyle":["ls_mediterranean"],"supplements":["supp_omega3_spm","supp_krill_oil"],"title":"地中海饮食 + 鱼油","desc":"地中海饮食建议每周吃两次鱼，已经能提供不少 EPA 和 DHA。平时吃鱼多的人再补鱼油，额外获益可能更小；吃鱼少的人才更值得考虑。"},{"id":"r_fiber_prebiotics","kind":"tip","lifestyle":["ls_fiber"],"supplements":["supp_resistant_starch","supp_gos"],"title":"增加膳食纤维 + 益生元","desc":"抗性淀粉、低聚半乳糖也是可发酵的纤维，会和饮食中增加的纤维叠加。同时加量更容易胀气，建议一样一样慢慢加。"},{"id":"r_fasting_hypoglycemia","kind":"caution","severity":"moderate","lifestyle":["ls_time_restricted"],"risk_flag":"hypoglycemia","title":"限时进食 + 可能降血糖的补充剂","desc":"空腹时间变长后，再服用可能降低血糖的成分，更容易出现心慌、手抖、出冷汗等低血糖表现。这类成分放在进食时间内随餐服用；正在用降糖药的人请先咨询医生。"},{"id":"r_exercise_hypoglycemia","kind":"caution","severity":"low","lifestyle":["ls_aerobic","ls_hiit","ls_resistance"],"risk_flag":"hypoglycemia","title":"运动 + 可能降血糖的补充剂","desc":"运动本身会降低血糖，再加上可能降血糖的成分，空腹运动时更容易出现低血糖。运动前吃点东西，留意头晕、手抖、出冷汗。"},{"id":"r_sauna_hypotension","kind":"caution","severity":"moderate","lifestyle":["ls_sauna"],"risk_flag":"hypotension","title":"桑拿 + 可能降血压的补充剂","desc":"桑拿时血管扩张，血压会暂时下降；再加上可能降压的成分，蒸完起身时更容易头晕甚至晕倒。蒸的时间短一些，出来后慢慢起身，及时补水。"},{"id":"r_cbti_sedation","kind":"caution","severity":"low","lifestyle":["ls_cbti"],"risk_flag":"sedation","title":"失眠认知行为疗法 + 有镇静作用的补充剂","desc":"睡眠限制阶段白天本来就容易犯困，再加上有镇静作用的成分，白天可能更困。开车或做危险工作前留意自己的状态，并告诉指导你的医生或治疗师你在用哪些补充剂。"}]},"labs":{"groups":[{"id":"nutrient","name":"营养素水平"},{"id":"metabolic","name":"代谢与心血管"},{"id":"safety","name":"器官功能与用药监测"},{"id":"hormone","name":"激素与炎症"}],"tests":[{"id":"lab_vitd","group":"nutrient","name":"25-羟维生素 D","en_name":"25-hydroxyvitamin D [25(OH)D]","aliases":["维生素D","25OHD","25(OH)D"],"specimen":"静脉血（血清）","prep":"不需要空腹","what":"反映最近几周到几个月从晒太阳、食物和补充剂获得的维生素 D 总量。多少算“最佳”目前没有定论，单凭这一项也不能解释骨痛等症状的原因。","when":["怀疑骨软化、不明原因骨痛或近端肌肉无力，或血钙偏低时","骨质疏松、脆性骨折、吸收不良等情况下，结果会影响治疗决定时","打算长期每天服用 2000 IU 以上（尤其接近 5000 IU）之前","健康成年人不建议常规筛查；按推荐量（每天 600–800 IU）预防性补充一般不需要先测"],"thresholds":[{"label":"缺乏风险","value":"< 12 ng/mL（< 30 nmol/L）"},{"label":"可能不足","value":"12–20 ng/mL（30–50 nmol/L）"},{"label":"多数人足够","value":"≥ 20 ng/mL（≥ 50 nmol/L）"},{"label":"可能出现不良反应","value":"> 50 ng/mL（> 125 nmol/L）"}],"caveats":["2024 年美国内分泌学会指南没有给出预防疾病的目标值，各机构采用的界值也不一样。","结果随季节和检测方法变化。","大剂量补充时还需要看血钙；单凭 25(OH)D 高不能判断中毒。"],"indications":["bone_density","vitamin_d_deficiency"],"supplements":[{"supplement_id":"supp_d3_k2","role":"test_before","retest_weeks":0,"grade":"B","note":"常用剂量每天 2000–5000 IU，已接近或超过成人通常的上限 4000 IU。长期大剂量服用前，最好先测一次，按缺乏程度决定剂量。按推荐量预防性补充则不需要先测。"},{"supplement_id":"supp_d3_k2","role":"monitor","retest_weeks":12,"grade":"B","note":"大剂量补充 3 个月左右可复查一次，看是否达到目标、有没有过量。剂量稳定后一般不需要反复测。"}]},{"id":"lab_b12","group":"nutrient","name":"维生素 B12","en_name":"Serum vitamin B12 (cobalamin), with methylmalonic acid when borderline","aliases":["B12","钴胺素","甲基丙二酸","MMA"],"specimen":"静脉血（血清）；结果处于灰区时可加测甲基丙二酸（MMA）","prep":"按化验单要求，部分医院要求空腹","what":"测血液中维生素 B12 的总量。结果处于中间灰区时，不能可靠判断身体是否真的缺乏，这时加测 MMA 更有帮助。","when":["不明原因的大细胞性贫血、舌炎、手脚麻木、记忆力下降时","长期素食、做过胃或肠道手术、萎缩性胃炎，或长期服用二甲双胍、抑酸药的人出现相关症状时","最好在开始补充之前抽血；但出现明显神经症状时不要为了等结果而推迟治疗"],"thresholds":[{"label":"缺乏","value":"< 180 pg/mL（< 133 pmol/L）"},{"label":"灰区，建议加测 MMA","value":"180–350 pg/mL（133–258 pmol/L）"},{"label":"缺乏可能性较小","value":"> 350 pg/mL（> 258 pmol/L）"}],"caveats":["最近吃过 B12 补充剂或打过针，数值会升高，但不代表缺乏已经纠正。","血常规正常不能排除 B12 缺乏。","MMA 会随年龄和肾功能下降而升高。"],"indications":["fatigue","cognitive_decline","neuropathy","b12_folate_deficiency"],"supplements":[{"supplement_id":"supp_methyl_b12","role":"test_before","retest_weeks":0,"grade":"A","note":"怀疑缺乏时，最好先抽血确认并查找原因（比如吸收障碍），再开始补充。只是饮食摄入不足（如长期素食）的预防性补充，不必等检测。"},{"supplement_id":"supp_5_mthf","role":"test_before","retest_weeks":0,"grade":"B","note":"贫血时如果只补叶酸，可能掩盖同时存在的 B12 缺乏，而神经损伤会继续加重。补叶酸前应先查 B12。"}]},{"id":"lab_folate","group":"nutrient","name":"叶酸","en_name":"Serum or red-cell folate","aliases":["叶酸","红细胞叶酸"],"specimen":"静脉血（血清）；必要时测红细胞叶酸","prep":"部分检测要求空腹，最好在开始补充前抽血","what":"血清叶酸反映最近几天的摄入，红细胞叶酸反映较长时间的水平。两种检测都受方法影响，血清叶酸会随饮食和补充剂很快变化。","when":["不明原因的大细胞性贫血，或饮食差、饮酒多、吸收不良、服用影响叶酸的药物时","治疗巨幼细胞性贫血前，要和 B12 一起查","备孕和孕早期补充叶酸不需要等检测"],"thresholds":[{"label":"血清叶酸偏低","value":"< 3 ng/mL（< 6.8 nmol/L）"},{"label":"红细胞叶酸足够","value":"> 140 ng/mL（> 317 nmol/L）"}],"caveats":["刚吃过饭或补充剂会让血清叶酸升高。","不同医院的检测方法差别较大，请以化验单范围为准。","预防胎儿神经管缺陷的证据来自普通叶酸，活性叶酸能否同样有效还没有证实。"],"indications":["b12_folate_deficiency"],"supplements":[{"supplement_id":"supp_5_mthf","role":"test_before","retest_weeks":0,"grade":"C","note":"怀疑缺乏时可以先测，同时查 B12。作为治疗，活性叶酸的证据不如普通叶酸充分；备孕的预防性补充不需要先测。"}]},{"id":"lab_homocysteine","group":"nutrient","name":"同型半胱氨酸","en_name":"Plasma total homocysteine","aliases":["Hcy","同型半胱氨酸"],"specimen":"静脉血（血浆），需要及时分离","prep":"最好空腹 8–12 小时","what":"同型半胱氨酸升高可能与叶酸、B12、B6 不足有关，也可能来自肾功能下降、年龄或药物，单看这一项不能判断缺的是哪种营养素。","when":["怀疑 B12 或叶酸缺乏、但其他检测结果不明确时，作为辅助判断","高血压患者的评估中，我国指南把它列为参考项目之一","不要只凭这一项结果去选择 B 族维生素"],"thresholds":[{"label":"高同型半胱氨酸（我国高血压指南）","value":"≥ 15 μmol/L"}],"caveats":["抽血后放置太久才分离，数值会假性升高。","降低同型半胱氨酸不能代替控制血压、血脂等基础治疗。","我国的脑卒中预防试验用的是普通叶酸加降压药，不能直接套用到活性叶酸上。"],"indications":["b12_folate_deficiency"],"supplements":[]},{"id":"lab_iron","group":"nutrient","name":"铁蛋白与铁代谢","en_name":"Ferritin and transferrin saturation","aliases":["铁蛋白","转铁蛋白饱和度","血清铁"],"specimen":"静脉血：铁蛋白、血清铁、转铁蛋白（计算转铁蛋白饱和度）","prep":"测转铁蛋白饱和度时最好早上空腹；抽血前 24 小时不要吃铁剂","what":"铁蛋白反映身体储存的铁，转铁蛋白饱和度反映血液中可用的铁。铁蛋白在炎症时会升高，所以“正常”不一定代表不缺铁。","when":["不明原因的贫血、乏力，或月经量多、经常献血、胃肠道疾病、吸收不良时","有炎症或慢性病时，加测转铁蛋白饱和度","补铁之前先确认缺铁并查找原因"],"thresholds":[{"label":"储存铁耗竭（WHO，健康成人）","value":"铁蛋白 < 15 ng/mL"},{"label":"缺铁（美国血液学会 2026）","value":"铁蛋白 ≤ 30 ng/mL"},{"label":"有炎症时缺铁（WHO）","value":"铁蛋白 < 70 ng/mL"},{"label":"转铁蛋白饱和度偏低","value":"< 20%"}],"caveats":["感染、炎症、肝病和肿瘤都会让铁蛋白升高，可能掩盖缺铁。","小细胞贫血也可能是地中海贫血，不一定是缺铁，需要查明原因。","孕期的铁指标会变化，产前预防性补铁可按医嘱进行。"],"indications":["fatigue","iron_deficiency"],"supplements":[{"supplement_id":"supp_iron_bisglycinate","role":"test_before","retest_weeks":0,"grade":"A","note":"不缺铁时补铁没有好处，长期过量还可能伤害肝脏等器官。补铁前应先确认缺铁，并查明原因（如月经过多、消化道出血）。"},{"supplement_id":"supp_iron_bisglycinate","role":"monitor","retest_weeks":12,"grade":"A","note":"补铁约 3 个月后复查铁蛋白，看储存是否恢复；有贫血的人要更早复查血红蛋白。"},{"supplement_id":"supp_iron_bisglycinate","role":"interference","retest_weeks":0,"grade":"B","note":"刚吃过铁剂会让血清铁和转铁蛋白饱和度暂时升高。抽血前 24 小时不要吃。"}]},{"id":"lab_cbc","group":"nutrient","name":"血常规","en_name":"Complete blood count (hemoglobin, MCV)","aliases":["血红蛋白","贫血","MCV"],"specimen":"静脉血（全血）","prep":"不需要空腹","what":"测血红蛋白和红细胞大小（MCV）等。能发现贫血，但不能说明原因；营养素缺乏时血常规也可能正常。","when":["不明原因乏力、脸色苍白、活动后气短，或怀疑出血时","怀疑缺铁、缺 B12 或叶酸时，和相应检测一起做","治疗确诊的营养性贫血时，用来观察效果"],"thresholds":[{"label":"贫血（非孕女性，WHO 2024）","value":"血红蛋白 < 120 g/L"},{"label":"贫血（男性，WHO 2024）","value":"血红蛋白 < 130 g/L"},{"label":"小细胞","value":"MCV < 80 fL"},{"label":"大细胞","value":"MCV > 100 fL"}],"caveats":["请以化验单上按年龄、性别给出的范围为准；孕期、高海拔、吸烟都会影响结果。","血常规正常不能排除缺铁、缺 B12 或缺叶酸。","只补叶酸可以改善贫血，但同时存在的 B12 缺乏造成的神经损伤会继续。"],"indications":["fatigue","iron_deficiency","b12_folate_deficiency"],"supplements":[]},{"id":"lab_magnesium","group":"nutrient","name":"血清镁","en_name":"Serum magnesium","aliases":["镁"],"specimen":"静脉血（血清）","prep":"一般不需要空腹","what":"测血液中的镁浓度。能发现明显的低镁或高镁，但和体内总储量关系不大，结果正常也不能排除缺镁。","when":["不明原因的抽筋、无力、心律失常，或低钾、低钙时","长期腹泻、吸收不良、饮酒多，或长期服用抑酸药、利尿剂时","肾功能下降的人补镁前","健康人按常用量补镁，不需要专门检测"],"thresholds":[{"label":"低镁血症","value":"< 0.75 mmol/L（部分医院用 < 0.70）"},{"label":"严重低镁","value":"< 0.50 mmol/L"}],"caveats":["溶血会让结果假性升高。","血镁可能在体内储存恢复之前就回到正常。","肾功能明显下降时镁容易蓄积，补镁要在医生指导下进行。"],"indications":["muscle_cramps"],"supplements":[]},{"id":"lab_zinc_copper","group":"nutrient","name":"血清锌与铜","en_name":"Serum zinc and copper (with ceruloplasmin when needed)","aliases":["锌","铜","铜蓝蛋白"],"specimen":"静脉血（血清锌、血清铜，必要时测铜蓝蛋白）","prep":"锌最好早上空腹抽血","what":"帮助判断锌或铜是否缺乏或过量。两者都受炎症、进食和时间影响，不能准确反映体内总储量。","when":["伤口难愈合、味觉改变、脱发等，且有饮食不足或吸收不良的可能时","不明原因贫血、白细胞减少或走路不稳、手脚麻木，尤其是做过减重手术或长期大量补锌的人，应查铜","长期大剂量补锌时，按需复查铜"],"thresholds":[{"label":"血清锌偏低（女性）","value":"< 70 μg/dL（< 10.7 μmol/L）"},{"label":"血清锌偏低（男性）","value":"< 74 μg/dL（< 11.3 μmol/L）"},{"label":"提示缺铜","value":"血清铜 < 12 μmol/L 且铜蓝蛋白 < 0.20 g/L"}],"caveats":["感染或炎症时锌会下降，单次偏低不能确诊。","怀孕、服用雌激素或有炎症时，铜和铜蓝蛋白会升高，可能掩盖缺铜。","铜和铜蓝蛋白都低，也可能是肝豆状核变性（Wilson 病），不一定是营养缺乏。"],"indications":["hair_loss"],"supplements":[{"supplement_id":"supp_zinc_picolinate","role":"monitor","retest_weeks":12,"grade":"B","note":"长期每天补锌 30 mg 以上（包括食物和所有补充剂），会妨碍铜的吸收，严重时导致贫血和神经损伤。长期大剂量补锌时，可约 3 个月查一次铜。"},{"supplement_id":"supp_zinc_carnosine","role":"monitor","retest_weeks":12,"grade":"B","note":"这种成分也含锌，和其他含锌产品一起长期服用时，同样要注意锌的总量，必要时查铜。"},{"supplement_id":"supp_copper_bisglycinate","role":"test_before","retest_weeks":0,"grade":"B","note":"不缺铜时补铜没有必要。怀疑缺铜时，先查血清铜和铜蓝蛋白，再决定是否补充。"}]},{"id":"lab_glucose","group":"metabolic","name":"空腹血糖与糖化血红蛋白","en_name":"Fasting plasma glucose and HbA1c","aliases":["血糖","HbA1c","糖化"],"specimen":"空腹血糖：静脉血浆；糖化血红蛋白：静脉全血","prep":"空腹血糖需要至少 8 小时不进食（可以喝水）；糖化血红蛋白不需要空腹","what":"空腹血糖反映抽血当时的血糖，糖化血红蛋白（HbA1c）反映过去 2–3 个月的平均血糖。两者都可能漏掉只在餐后升高的情况，这时需要做口服葡萄糖耐量试验。","when":["有多饮、多尿、消瘦等症状，或不明原因手脚麻木时","超重或肥胖、有糖尿病家族史、得过妊娠糖尿病、有脂肪肝或多囊卵巢综合征的人","已有糖尿病或糖尿病前期，开始服用可能影响血糖的补充剂时，尤其是同时在用降糖药"],"thresholds":[{"label":"空腹血糖受损（我国标准）","value":"6.1–6.9 mmol/L"},{"label":"糖尿病前期（美国标准）","value":"空腹 5.6–6.9 mmol/L，或 HbA1c 5.7%–6.4%"},{"label":"糖尿病","value":"空腹 ≥ 7.0 mmol/L，或 HbA1c ≥ 6.5%（需复查确认）"}],"caveats":["没有明显高血糖症状时，诊断糖尿病需要重复检测确认。","贫血、近期输血、血红蛋白异常会让 HbA1c 不准。","家用血糖仪的结果不能用来诊断。"],"indications":["blood_glucose","body_weight","fatty_liver","neuropathy","pcos"],"supplements":[{"supplement_id":"supp_berberine","role":"monitor","retest_weeks":12,"grade":"B","note":"小檗碱有降血糖作用。糖尿病患者使用时约 3 个月复查糖化血红蛋白；同时用降糖药的人要更早、更勤地测血糖，警惕低血糖。"},{"supplement_id":"supp_niacin","role":"monitor","retest_weeks":8,"grade":"C","note":"大剂量烟酸会升高血糖。有糖尿病或糖尿病前期的人，开始服用后约 2 个月复查血糖。"}]},{"id":"lab_lipids","group":"metabolic","name":"血脂","en_name":"Lipid panel (LDL-C, HDL-C, triglycerides)","aliases":["胆固醇","LDL","甘油三酯","血脂四项"],"specimen":"静脉血（血清）","prep":"多数情况下可以不空腹；按我国标准判断时最好空腹 12 小时","what":"测总胆固醇、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯，用来评估心血管风险。是否需要治疗，要结合年龄、血压、血糖、吸烟等整体风险判断。","when":["40 岁以下每 2–5 年查一次，40 岁以上每年至少一次（我国 2023 年血脂指南）","有心血管病、糖尿病、高血压、肥胖、吸烟或早发心血管病家族史的人","开始降脂措施前后，用来评估效果","服用紫檀芪时可复查 LDL-C"],"thresholds":[{"label":"LDL-C 边缘升高","value":"3.4–4.1 mmol/L"},{"label":"LDL-C 升高","value":"≥ 4.1 mmol/L"},{"label":"甘油三酯边缘升高","value":"1.7–2.3 mmol/L"},{"label":"甘油三酯升高","value":"≥ 2.3 mmol/L"},{"label":"HDL-C 偏低","value":"< 1.0 mmol/L"}],"caveats":["以上界值适用于低风险人群的一级预防；高风险人群的 LDL-C 目标更低，请遵医嘱。","甘油三酯受最近饮食、饮酒影响很大。","HDL-C 是风险指标，不是需要用补充剂去“提高”的目标。"],"indications":["cardiovascular_events","ldl_cholesterol","triglycerides","body_weight","fatty_liver"],"supplements":[{"supplement_id":"supp_omega3_spm","role":"monitor","retest_weeks":8,"grade":"B","note":"用鱼油帮助降甘油三酯时，约 2 个月后复查血脂看效果。处方级大剂量鱼油（每天 4 g）的证据，不能直接套用到普通剂量上。"},{"supplement_id":"supp_pterostilbene","role":"monitor","retest_weeks":8,"grade":"B","note":"一项小型试验发现，单独服用紫檀芪（每天 100–250 mg）会升高 LDL-C。有心血管风险的人开始服用后，约 2 个月复查血脂。"},{"supplement_id":"supp_niacin","role":"monitor","retest_weeks":8,"grade":"C","note":"在医生指导下用烟酸调血脂时，需要复查血脂看效果。"}]},{"id":"lab_uric_acid","group":"metabolic","name":"血尿酸","en_name":"Serum uric acid","aliases":["尿酸","痛风"],"specimen":"静脉血（血清）","prep":"空腹；按我国标准诊断需在正常饮食下、不同日期测两次","what":"反映尿酸的生成与排出是否平衡。尿酸高不等于痛风，痛风发作时尿酸也可能是正常的。","when":["怀疑痛风、有痛风石或尿酸结石病史时","服用大剂量烟酸之前和服用期间"],"thresholds":[{"label":"高尿酸血症（我国 2024 年指南）","value":"≥ 420 μmol/L（约 7.0 mg/dL）"},{"label":"痛风降尿酸治疗目标","value":"180–300 μmol/L"}],"caveats":["饮酒、饮食、肾功能和降尿酸药都会影响结果。","痛风发作期间测得的尿酸可能偏低，发作过后需要复查。"],"indications":["uric_acid"],"supplements":[{"supplement_id":"supp_niacin","role":"monitor","retest_weeks":24,"grade":"A","note":"烟酸会升高尿酸，可能诱发痛风。开始服用前测一次，加量期间复查，之后约每 6 个月查一次。"},{"supplement_id":"supp_sodium_ascorbate","role":"interference","retest_weeks":0,"grade":"C","note":"大剂量维生素 C 可能让部分医院的检测方法测出偏低的尿酸。结果和症状不符时，告诉医生你在服用维生素 C。"}]},{"id":"lab_liver","group":"safety","name":"肝功能","en_name":"Liver enzymes (ALT, AST) and bilirubin","aliases":["ALT","AST","转氨酶"],"specimen":"静脉血（血清）：谷丙转氨酶（ALT）、谷草转氨酶（AST）、胆红素","prep":"单查肝功能一般不需要空腹","what":"ALT 和 AST 升高提示肝细胞受损，胆红素帮助判断有无黄疸或胆汁淤积。肝功能正常不能排除所有肝病。","when":["出现皮肤或眼白发黄、尿色变深、右上腹不适、明显乏力时","已知脂肪肝或以前肝功能异常","服用大剂量烟酸之前和服用期间","服用有肝损伤报告的补充剂时，一旦出现上述症状应立即停用并检查"],"thresholds":[{"label":"明显的肝损伤信号","value":"ALT 或 AST 超过正常上限 5 倍"},{"label":"转氨酶升高同时伴胆红素升高","value":"胆红素 > 42.8 μmol/L（2.5 mg/dL）"}],"caveats":["剧烈运动或肌肉损伤后 AST 也会升高。","只有间接胆红素升高，可能是 Gilbert 综合征或溶血，不一定是肝病。","对植物类补充剂，约 2 个月复查是经验性的预防措施，不能保证避免严重肝损伤；出现症状要立即就医。"],"indications":["fatty_liver"],"supplements":[{"supplement_id":"supp_niacin","role":"monitor","retest_weeks":8,"grade":"A","note":"烟酸可能引起肝损伤。服用前测一次，加量期间和之后定期复查，约每 2 个月一次。"},{"supplement_id":"supp_egcg","role":"monitor","retest_weeks":8,"grade":"C","note":"绿茶提取物有少见但可能严重的肝损伤报告。长期服用时可约 2 个月查一次肝功能；出现乏力、黄疸、尿色变深要立即停用并就医。"},{"supplement_id":"supp_curcumin","role":"monitor","retest_weeks":8,"grade":"C","note":"姜黄和姜黄素补充剂（包括高吸收配方）有肝损伤报告。长期服用时可约 2 个月查一次肝功能，出现症状立即停用。"},{"supplement_id":"supp_ashwagandha","role":"monitor","retest_weeks":8,"grade":"C","note":"南非醉茄有胆汁淤积型肝损伤的报告。长期服用时可约 2 个月查一次肝功能，出现症状立即停用。"}]},{"id":"lab_kidney","group":"safety","name":"肾功能","en_name":"Serum creatinine and eGFR (cystatin C when needed)","aliases":["肌酐","eGFR","胱抑素C"],"specimen":"静脉血（血清肌酐，必要时测胱抑素 C）；尿白蛋白肌酐比需另查尿液","prep":"不需要空腹；抽血前 12 小时避免大量吃肉","what":"根据血肌酐计算估算肾小球滤过率（eGFR）。肌酐受肌肉量、吃肉和某些补充剂影响，eGFR 不能发现所有肾病，必要时要同时查尿白蛋白。","when":["已知或怀疑肾病、有糖尿病或高血压时","肾功能可能下降的人，在补镁等需要经肾排出的补充剂之前","服用肌酸的人查肾功能时，要告诉医生"],"thresholds":[{"label":"肾功能下降（持续 3 个月以上提示慢性肾病）","value":"eGFR < 60 mL/min/1.73 m²"},{"label":"肾功能明显下降（G4 期）","value":"eGFR 15–29 mL/min/1.73 m²"},{"label":"尿白蛋白升高","value":"尿白蛋白肌酐比 ≥ 30 mg/g"}],"caveats":["单次 eGFR 偏低不能诊断慢性肾病；短时间内明显下降要尽快就医。","肌肉量大、刚吃过大量肉或剧烈运动后，肌酐会偏高。"],"indications":["blood_pressure","blood_glucose"],"supplements":[{"supplement_id":"supp_creatine","role":"interference","retest_weeks":0,"grade":"B","note":"肌酸会让血肌酐升高、eGFR 估算偏低，但真实的肾功能并没有下降。查肾功能时请告诉医生；结果偏低时可加测胱抑素 C 来判断。"},{"supplement_id":"supp_magnesium_bisglycinate","role":"test_before","retest_weeks":0,"grade":"B","note":"只针对已知或怀疑肾功能下降的人：镁主要经肾排出，肾功能差时容易蓄积，补镁前要先查肾功能。健康人不需要专门检测。"},{"supplement_id":"supp_magnesium_threonate","role":"test_before","retest_weeks":0,"grade":"B","note":"只针对已知或怀疑肾功能下降的人：镁主要经肾排出，肾功能差时容易蓄积，补镁前要先查肾功能。健康人不需要专门检测。"}]},{"id":"lab_electrolytes","group":"safety","name":"血钾与血钠","en_name":"Serum potassium and sodium","aliases":["钾","钠","电解质"],"specimen":"静脉血（血清）","prep":"不需要空腹","what":"血钠主要反映体内水分是否平衡，血钾对心脏和肌肉功能很重要。两者都不能完全反映体内总量。","when":["严重或持续腹泻、脱水、不明原因无力或严重抽筋时","有高血压或肾病，或正在服用利尿剂等影响钾、钠的药物时"],"thresholds":[{"label":"低钠血症","value":"血钠 < 135 mmol/L"},{"label":"严重低钠","value":"血钠 < 125 mmol/L"},{"label":"低钾血症","value":"血钾 < 3.5 mmol/L"},{"label":"高钾血症","value":"血钾 > 5.0–5.5 mmol/L（各机构不同）"},{"label":"严重高钾（急症）","value":"血钾 ≥ 6.5 mmol/L"}],"caveats":["抽血时溶血、止血带扎太久或反复握拳，会让血钾假性升高。","有严重症状或心电图异常时，即使数值没到界值也要紧急处理。"],"indications":["muscle_cramps","diarrhea","blood_pressure"],"supplements":[]},{"id":"lab_calcium","group":"safety","name":"血钙","en_name":"Serum calcium (albumin-corrected)","aliases":["钙","高钙血症"],"specimen":"静脉血（血清总钙，通常同时测白蛋白）","prep":"一般不需要空腹","what":"测血液中的钙，包括与蛋白结合的部分。用白蛋白校正后的数值只是估算，必要时直接测离子钙更准确。","when":["明显抽筋、手脚发麻、无力，或有肾病、甲状旁腺疾病时","评估骨质疏松或怀疑骨软化时","大剂量补充维生素 D 期间，尤其是有肾病、甲状旁腺功能亢进等高钙风险的人"],"thresholds":[{"label":"成人参考范围（示例）","value":"2.12–2.62 mmol/L（以化验单为准）"}],"caveats":["白蛋白偏低时，校正钙可能误判，结果矛盾时应直接测离子钙。","血钙正常不能说明钙摄入或维生素 D 是否足够。"],"indications":["bone_density"],"supplements":[{"supplement_id":"supp_d3_k2","role":"monitor","retest_weeks":4,"grade":"A","note":"补充维生素 D 可能让原本隐藏的高钙血症显现出来。大剂量（每天 5000 IU 左右）开始后约 1 个月查一次血钙。"}]},{"id":"lab_inr","group":"safety","name":"凝血功能（INR）","en_name":"Prothrombin time / INR","aliases":["INR","凝血","华法林监测"],"specimen":"静脉血（枸橼酸钠抗凝管）","prep":"不需要空腹","what":"凝血酶原时间和国际标准化比值（INR）主要用来调整华法林剂量，不能直接反映维生素 K 水平或总体出血风险。","when":["服用华法林期间，按抗凝门诊的安排定期检测","服用华法林时开始、停用或改变任何补充剂之后，要加测一次","不明原因出血、瘀斑增多时","不吃华法林的人，不需要因为服用补充剂而查 INR"],"thresholds":[{"label":"未服药时的参考范围","value":"0.8–1.1"},{"label":"华法林常见目标范围","value":"2.0–3.0（具体目标遵医嘱）"}],"caveats":["INR 不能用来监测利伐沙班、阿哌沙班、达比加群等新型抗凝药。","INR 正常不能排除血小板相关的出血风险。"],"indications":[],"supplements":[]},{"id":"lab_thyroid","group":"hormone","name":"甲状腺功能","en_name":"TSH with free T4","aliases":["TSH","甲功","FT4"],"specimen":"静脉血（促甲状腺激素 TSH，加游离甲状腺素 FT4）","prep":"一般不需要空腹；复查时尽量在同一时间段抽血","what":"TSH 和 FT4 一起用来判断甲状腺功能偏低或偏高。单查 TSH 可能漏掉垂体引起的问题，急性疾病期间的结果也可能暂时异常。","when":["出现怕冷、便秘、体重增加、脱发、心慌、手抖、消瘦等提示甲状腺问题的症状组合时（单一症状不足以说明问题）","有 1 型糖尿病或其他自身免疫病、新发房颤，或抑郁、焦虑原因不明时","已有甲状腺病或正在服用左甲状腺素，需要定期复查","服用南非醉茄期间出现甲状腺相关症状时"],"thresholds":[{"label":"甲减","value":"TSH 高于上限且 FT4 低于下限"},{"label":"亚临床甲减，可考虑治疗","value":"TSH ≥ 10 mIU/L（间隔 3 个月两次）"},{"label":"甲亢","value":"TSH 低于下限且 FT4 或 FT3 高于上限"}],"caveats":["孕期有专门的参考范围。","大剂量生物素（常见于护发产品）会干扰检测，抽血前请告诉医生。","急性病期间尽量不要测，除非怀疑甲状腺就是病因。"],"indications":["fatigue","constipation","hair_loss","low_mood"],"supplements":[{"supplement_id":"supp_ashwagandha","role":"monitor","retest_weeks":6,"grade":"C","note":"南非醉茄可能影响甲状腺功能，美国国家补充与整合健康中心不建议甲状腺病患者使用。服用期间出现心慌、怕热、消瘦等症状要及时检查。"}]},{"id":"lab_testosterone","group":"hormone","name":"睾酮","en_name":"Morning total testosterone (with SHBG when needed)","aliases":["睾酮","雄激素"],"specimen":"静脉血（总睾酮，必要时测性激素结合球蛋白 SHBG）","prep":"男性在早上 7–10 点空腹抽血，前一晚睡好","what":"男性用来判断睾酮是否偏低，女性用来判断雄激素是否偏高。结果受抽血时间、SHBG 和检测方法影响，单凭这一项不能诊断性腺功能减退或多囊卵巢综合征。","when":["男性有性欲下降、勃起功能障碍、晨勃消失等症状时；偏低时要另选一天早上复查","男性不育、不明原因贫血或骨量减少时","女性怀疑雄激素过多或多囊卵巢综合征时","在服用号称“提升睾酮”的补充剂之前，有症状应先就医评估"],"thresholds":[{"label":"男性睾酮偏低（美国泌尿学会）","value":"< 300 ng/dL（< 10.4 nmol/L），需两次早晨结果"},{"label":"男性参考下限（美国内分泌学会）","value":"264 ng/dL（9.2 nmol/L）"},{"label":"女性明显偏高，需尽快就医","value":"> 144 ng/dL（> 5 nmol/L）"}],"caveats":["男女参考范围不同；生病、睡眠不足、肥胖和药物都会影响结果。","口服避孕药会改变雄激素和 SHBG 的结果。"],"indications":["testosterone","erectile_function","male_fertility","pcos"],"supplements":[]},{"id":"lab_hscrp","group":"hormone","name":"超敏 C 反应蛋白","en_name":"High-sensitivity C-reactive protein","aliases":["hsCRP","CRP","炎症指标"],"specimen":"静脉血（血清）","prep":"不需要空腹","what":"超敏 C 反应蛋白（hs-CRP）是一种非特异的炎症指标，可以辅助评估心血管风险，但不能说明炎症的原因和部位。","when":["心血管风险难以判断、结果可能影响预防决策时","数值超过 10 mg/L 时，病情稳定后 2–3 周复查","不建议用 hs-CRP 来挑选或评估“抗炎”补充剂"],"thresholds":[{"label":"心血管风险较低","value":"< 1 mg/L"},{"label":"风险中等","value":"1–3 mg/L"},{"label":"风险较高","value":"> 3 mg/L"},{"label":"可能有急性炎症","value":"> 10 mg/L"}],"caveats":["近期感染、受伤、手术和慢性炎症病都会让 CRP 升高，应在身体稳定时检测。","这些界值来自美国人群，用于我国人群时需要医生综合判断。"],"indications":["inflammation_markers"],"supplements":[]}]},"audit":{"checked":"2026-11-13","citations":1542,"pubmed":1111,"doi":13,"retracted":0,"concern":0}}