#326 - AMA #65：红光疗法：前景广阔的应用、证据不一以及对健康和衰老的影响

大家好。

Hey, everyone.

欢迎收听《The Drive》播客的'随便问'（AMA）特别预览集。

Welcome to a sneak peek ask me anything or AMA episode of the drive podcast.

我是主持人彼得·阿提亚。

I'm your host, Peter Attia.

在这段简短节目结尾，我将说明如何完整访问AMA剧集，以及我们为会员提供的诸多其他权益。

At the end of this short episode, I'll explain how you can access the AMA episodes in full along with a ton of other membership benefits we've created.

或者您现在就可以前往peterattiamd.com/subscribe了解更多详情。

Or you can learn more now by going to peterattiamd.com forward slash subscribe.

闲话少叙，现在为您奉上本期'随便问'特别预览。

So without further delay, here's today's sneak peek of the Ask Me Anything episode.

欢迎来到第65期'随便问'节目。

Welcome to Ask Me Anything episode 65.

再次与我共同主持的是尼克·斯滕森。

I'm once again joined by my cohost, Nick Stenson.

在本期节目中，我们将探讨红光疗法。

In today's episode, we cover red light therapy.

这是我们经常被问及的话题。

It's a topic we get asked about all the time.

事实上，我妻子就经常问我这个问题。

In fact, wife asked me about it all the time.

所以很明显是时候做一期AMA问答了。

So it was clear that it was time for an AMA.

在这次对话中，我们将奠定红光疗法的基础知识，并解释为何它如此受重视。

In this conversation, we lay the foundation for what red light therapy is and why there is such an emphasis on it.

接着我们会分析不同形式的红光疗法及其各种治疗方式，并讨论我认为它们是否有效。

We then break down the various forms of red light therapy and their various treatments into whether or not I think they are beneficial.

换句话说，我们会逐一审查每种应用的相关数据。

In other words, we go through each application and review the data for them.

这些应用包括：针对整体衰老、皮肤健康与痤疮、伤口愈合、脱发、眼部健康、运动表现与恢复、代谢健康、普通减重、局部减脂、炎症、损伤康复以及女性痛经的红光疗法。

So these include red light therapy for aging in general, skin health and acne, wound healing, hair loss, eye health, exercise performance and recovery, metabolic health, general weight loss, spot fat loss, inflammation, injury rehab and menstrual cramps for women.

换句话说，我们将逐一详细分析相关文献。

So in other words, we go through each of these and do a detailed analysis of the literature.

最后我们会总结每个应用场景的主要收获，并通过我们制作的总结表格来解释所有你可能想了解的内容。

We close this conversation by summarizing my overall takeaways for each use case and explain via a summary table that we created that breaks down everything you might wanna know to understand this.

如果你是订阅用户，想观看本期播客的完整视频，可以在节目说明页面找到。

If you're a subscriber and you wanna watch the full video of this podcast, you can find it on the show notes page.

如果你不是订阅用户，可以在我们的YouTube页面观看视频预览。

If you're not a subscriber, you can watch a sneak peek of the video on our YouTube page.

话不多说，希望你喜欢第65期AMA问答。

So without further delay, I hope you enjoy AMA number 65.

彼得，欢迎参加新一期AMA问答。

Peter, welcome to another AMA.

你最近怎么样？

How are doing?

很好。

Good.

谢谢再次邀请我。

Thanks for having me back.

随时欢迎。

Anytime.

随时欢迎。

Anytime.

今天的AMA问答环节，我们将聚焦于单一主题——红光疗法。

So today's AMA, we are gonna focus on a single topic which is red light therapy.

这是大家频繁询问的话题，不仅来自网站和订阅者的问题，我知道你的患者们也常提及。我们整理了所有这些问题，希望通过这次对话涵盖红光疗法的定义、工作原理，并深入探讨关于它的各种主张。

This is something we get asked about a lot, not only questions from the website and subscribers, but I know through your patients as well and so we compiled all these questions and through this conversation hopefully going to cover what red light therapy is, how it can work, deep dive into some various claims out there around red light therapy.

这可能包括对皮肤健康、伤口愈合、脱发、视力、运动表现与恢复、代谢健康、减脂、炎症、慢性疼痛等多方面的潜在影响。

This can include potential effect on skin health, wound healing, hair loss, eyesight, exercise performance and recovery, metabolic health, fat loss, inflammation, chronic pain and a lot more.

综上所述，在我们正式开始前，你还有什么想补充的吗？

So with all that said, anything you want to add before we get rolling into it?

两件不相关的事。

Two unrelated things.

我注意到今天你的播客有个小访客，正和你一起待着呢。

I noticed you have a little visitor for the podcast today, hanging out with you there.

希望他对这个话题感兴趣，并且会喜欢。

Hopefully, he's interested and this is something he'll like.

其次，我想补充说，这些问题是我妻子特别要求我问的。

And secondly, I would add that my wife is specifically asking me these questions.

所以她非常热衷于购买一大堆红光治疗设备，我让她先等等，等我们为这期节目做完研究，至少能了解它是否有价值、价值在哪里。

So she's very keen to buy a whole bunch of red light things and I asked her to just hold off until we did the research for this episode so that we could at least have a sense of if there's value there where it is.

不过我不确定她是否是订阅用户。

I don't know if she's a subscriber though.

如果她不是的话，这可能是她订阅的原因。

So if she's not, this might be the one that she subscribes for.

我很欣赏当妻子问你医学问题时，你会说'让我发一集播客给你'，而不是像其他人那样直接告诉她答案。

I respect that when your wife asks you medical questions, you say, let me send you a podcast episode instead of telling her the answer like everyone else.

很高兴看到你身体力行，连对家人也是如此。

So it's good to know you practice what you preach even through your direct family.

好的。

Okay.

第一个问题，我认为有必要先解释一下，当我们说红光疗法时，这到底指的是什么？

First question, I think it's gonna be helpful to just explain when we say red light therapy, what does that even mean?

对。

Yeah.

如果不先理解一些物理学原理和定义光与波的基本概念，你就无法评估这些说法是否合理——这些概念会在评估过程中反复出现。

You can't do this without at least having some understanding of the physics and the principles that define light and waves come up over and over and over again as you try to evaluate the plausibility of the claims that are made here.

当我们坐在这里观察世界时，我们看到的光其实包含各种可见颜色。

So when we're sitting here looking out at the world, we're looking at light and there's visible colors of light.

或许我应该退一步说明。

Maybe I should take a step back.

光以波的形式存在，确切地说是非常短的波。

Light exists as waves and they're very short waves to be clear.

而声波则非常非常长。

So sound waves are really, really long.

光波的波长非常非常短，显然波长还可以更短得多，比如我们之前播客详细讨论过的紫外线。

Light waves are really, really short and then obviously waves can get much, much shorter and you can get into UV, which we've talked about in detail on a previous podcast.

比紫外线波长更短的是X射线，而比X射线更短的则是伽马射线。

Then even shorter than that would be x rays and then even shorter than that are gamma rays.

因此随着波长变短，能量会变得更强大。

So as wavelengths get shorter, the energy gets more powerful.

但如果我们只关注可见光，其波长范围大约从380纳米（偏紫色）到最长端的780纳米（红光区域），大约是前者的两倍。

But if we just focus on light, visible light runs the gamut from about three eighty nanometers, which would be purple ish and then all the way at the longest end about twice that 780 nanometers is where red light is.

所以当人们谈论红光疗法时，主要指的是这个非常狭窄波段内的光。

So when people talk about red light therapy, they're mostly talking about light that is in that very narrow band.

举个例子，白光其实是混合了这整个波长范围的所有光线。

So for example, again, a white light is giving you all mixed across that entire range.

而红光则更为集中。

Red light would be more narrowly focused.

还需要理解的是——我们今天也会稍作讨论——广义的光疗不仅涉及整个可见光波段，还包括所谓的近红外光。

It's also important to understand that, and we'll talk about this a little bit today, phototherapy in general involves wavelengths across that entire band of visible light but it also includes something called near infrared.

所以这基本上涵盖了大约400到1100纳米的整个范围。

So that basically runs the gamut from about 400 to 1,100 nanometers.

我认为最简单的理解方式是红光疗法，其波长范围大约在620到780纳米，而近红外则紧邻其后，波长稍长，大约在790到1400纳米。

So I think the easiest way to think about this is red light therapy, which runs about six twenty to seven eighty nanometers and then near infrared, which is right adjacent to that, the next thing up in terms of length, which is about seven ninety to 1,400.

再次强调，如果你记不住其他内容，只需记住当人们谈论红光疗法时，他们指的是620到780纳米这一红色可见光区域的波长，而近红外虽然不可见（明确地说，你看不到它），但波长稍长，大约在790到1400纳米。

So again, if you forget everything else, just remember when people talk about red light therapy, they're talking about wavelengths that are just in that red visible area of six twenty to seven eighty and then often they talk about near infrared as well, which is not visible to be clear, you don't see it and it's just a little bit longer, seven ninety to 1,400 nanometers.

我们会反复回到这个话题，因为在某些情况下，你看不到它的事实可能实际上让它变得更危险。

We'll come back to this over and over again because there are some instances where the fact that you can't see it might actually make it a little more dangerous.

关于红光疗法，能否再详细解释一下它有什么特别之处，为什么我们今天讨论的各种说法中如此强调它？

Double clicking on red light therapy, can we explain a little bit more about what is special about it and why there's so much emphasis on it as talked about for the various claims that we'll speak about today?

听过我们关于紫外线播客的听众可能还记得我在UVA和UVB之间做的区分，这主要取决于它们的穿透能力。

People who listened to our podcast on ultraviolet light may recall a distinction I made between UVA and UVB, which came down to the degree of penetration.

同样地，当你思考红光疗法时，记住波长越长，穿透能力越强，尽管能量较低。

And so similarly when you think about red light therapy and you remember that the longer a wavelength the more it can penetrate, albeit with less energy.

红光的有趣之处在于它处于一个恰到好处的点，比其他形式的可见光有更强的穿透能力。

What makes red light interesting is it is sort of at this sweet spot where it has some capacity to penetrate more so than other forms of visible light.

这部分正是它有趣的原因之一。

That's sort of part of what makes this interesting.

红光或近红外光能达到的确切深度，某种程度上取决于光束的组织方式。

Now, the exact depth that's reached by the red light or the near infrared is kind of a function of how the light beams are organized.

那么相干性如何——也就是波长之间对齐的程度有多大？

So what is the amount of coherence, which is how much do the wavelengths line up with each other?

如果所有波长都是相干的，波峰波谷位置一致，穿透力就会更强。

So if the wavelengths are all coherent, the peaks and valleys are in the same place, it's going to have more penetrance.

其次是它们在完全同一方向上的对齐程度如何？

And then what's the extent to which they're all aligned in the exact same direction?

这被称为准直性。

That's called collimation.

换句话说，光线不是发散传播，而是全部指向完全相同的方向。

So in other words, the light isn't spreading but rather it's all pointed in the exact same direction.

最后还有强度问题，我们会稍微讨论下瓦特和焦耳的区别——因为人们查看这些设备时，有时会看到以瓦特为单位的信息，有时则是焦耳，当然两者之间有明确的换算关系，而且总体而言能量也很重要。

And then finally you have the intensity and we'll talk a little bit about the difference between Watts and Joules because if people are looking at these devices, sometimes they give you information in watts and sometimes they give you information in joules, which of course there's a very clear relationship between them and of course broadly speaking energy matters as well.

因此当你综合考虑所有这些因素时，我认为人们在评估这些设备时可能忽略了一个非常重要的原理：在大多数情况下，红光的穿透深度远不及人们想象的那么深。

So when you take all of that into account though, the really important principle that I think gets perhaps missed when people evaluate these things is that for the most part, red light can't penetrate nearly as much as people think it can.

好的。

Okay.

如果红光是通过LED灯发出的（这也是最常见的方式），它大约只能穿透皮肤2到3毫米。

If red light is being delivered by LEDs, which is the most common way that it is, it's gonna be able to penetrate about two to three millimeters into skin.

而红外光可以穿透得更深一些，因为记住它的波长更长，大概能达到5到10毫米的深度。

Now infrared light can go a little bit deeper because remember it's a longer wavelength and it can reach probably five to 10 millimeters.

如果红光是由激光器发出的（因为激光是更聚焦的光能形式），它的穿透深度可能会显著提高。

Now, if red light is delivered by a laser, because again, you now have a more focused form of light energy, it could penetrate significantly higher than that.

可以达到1到4厘米。

It could go from one to four centimeters.

所以再次强调，光线的组织方式对其穿透深度起着重要作用。

So again, keep in mind the way that the light is organized plays a significant role in the depth that it can penetrate.

现在，如果你开始思考我们将要讨论的一些应用场景，比如红光疗法，请始终记住：如果某种光只能穿透1到3毫米，那么它很难产生某些宣传中所声称的深远效果。

Now, if you start to think about some of the applications we're going to talk about, when you start to think about red light therapy, just keep in the back of your mind, if something can only penetrate one to three millimeters, it's going to be difficult for it to have some of the profound effects that are sometimes claimed.

即使某种光线能穿透10毫米或1厘米深度（这已经相当深了），也不清楚它是否能产生显著效果。

Even if something can penetrate 10 millimeters or a centimeter, which would be quite deep, it's not clear that that's going to be able to have a significant effect.

因此，作为一般经验法则，应用越表浅，我认为在我们讨论这些案例时其效果就越可信。

And so, as a general rule of thumb, the more superficial the application, the more plausible I think it's going to be as we go through these.

在讨论各种具体主张及其潜在益处前，最后一个基础问题是：组织暴露在红光下通常会发生什么？

Last foundational question before we get to the various claims and where this could be beneficial or not is, in general what happens when the tissue is exposed to red light?

这是个重要且如你所说具有基础性的问题。

This is an important and as you said foundational question.

要产生任何生物效应，光线必须被其照射的细胞或组织中的某些光敏分子吸收。

So to have any biologic effect, the light needs to be absorbed by some photosensitive molecule within the cell or tissue that it's hitting.

这些被称为发色团的光敏分子吸收光线后，会引起局部化学变化或光化学反应。

And so the absorption of light by these photosensitive molecules, which are called chromophores, cause a localized chemical change or a photochemical reaction.

其中最有趣的可能是细胞色素c氧化酶（简称CCO）。

Now the most interesting of these is probably something called cytochrome c oxidase or CCO.

它是线粒体内电子传递链的组成部分，通常红光疗法的支持者都认为细胞色素c氧化酶（CCO）是主要作用靶点，因此也是红光产生生物效应的中介物质。

It's a component of the electron transport chain within mitochondria And generally speaking, most people who are proponents of red light therapy point to cytochrome c oxidase or CCO as the main target and therefore the mediating effect of the biologic impact of red light.

红光和近红外波长似乎确实能激发细胞色素c氧化酶的活性，从而增加后续ATP的生成。

So red light and near infrared wavelengths do seem to excite cytochrome c oxidase and its activity then increases subsequent ATP production.

相反，蓝光和绿光波长——记住这些波长更短、穿透力较弱但能量更强——似乎会降低CCO的活性，从而减少ATP的产生。

Conversely, blue and green wavelengths, remember these are shorter, less penetrant but more powerful, seem to decrease the activity of CCO and subsequently decrease ATP production.

现在我们来探讨红光疗法在不同应用场景中可能有益或无效的各种说法。

Now kind of getting into various claims of where red light therapy can be beneficial or not.

我认为或许可以先从已知的红光疗法整体抗衰老理念开始讨论。

I think it helped to maybe start with what do we know about the idea that red light therapy can combat aging as a whole.

感谢收听本期《The Drive》的AMA抢先体验节目。

Thank you for listening to today's sneak peek AMA episode of The Drive.

如果您想收听完整的AMA内容，您需要成为高级会员。

If you're interested in hearing the complete version of this AMA, you'll want to become a premium member.

对我来说，在不依赖付费广告的情况下提供所有这些内容极为重要。

It's extremely important to me to provide all of this content without relying on paid ads.

为此，我们的工作完全依靠会员支持才得以实现。

To do this, our work is made entirely possible by our members.

作为回报，我们提供独家会员专属内容和远超免费用户所能获得的额外福利。

And in return, we offer exclusive member only content and benefits above and beyond what is available for free.

因此，若您想将这一领域的知识提升到新高度，我们的目标是确保会员获得的回报远超订阅价格。

So if you wanna take your knowledge of this space to the next level, it's our goal to ensure members get back much more than the price of the subscription.

高级会员享有多重权益：

Premium membership includes several benefits.

首先，每期节目都配有详尽全面的播客节目笔记，涵盖我们讨论的每个话题、论文、人物及相关内容。

First, comprehensive podcast show notes that detail every topic, paper, person, and thing that we discuss in each episode.

坊间传言，没有哪家的节目笔记能与我们媲美。

And the word on the street is nobody's show notes rival ours.

其次，每月推出的'问我任何事'(AMA)特别节目。

Second, monthly ask me anything or AMA episodes.

这些节目针对订阅者提问给出深度解答，通常聚焦单一主题，旨在为会员特别关注的话题提供极其清晰详尽的解析。

These episodes are comprised of detailed responses to subscriber questions typically focused on a single topic and are designed to offer a great deal of clarity and detail on topics of special interest to our members.

当然，您同样可以获取这些AMA节目的配套笔记。

You'll also get access to the show notes for these episodes, of course.

第三，您将收到我们由专业研究分析师团队精心制作的优质通讯

Third, delivery of our premium newsletter, which is put together by our dedicated team of research analysts.

这份通讯涵盖长寿领域的广泛主题，比我们的免费周刊提供更详尽的内容

This newsletter covers a wide range of topics related to longevity and provides much more detail than our free weekly newsletter.

第四，您将获得私人播客订阅源，可收听所有节目（包括AMA问答），且不含您现在听到的这种常规播客介绍

Fourth, access to our private podcast feed that provides you with access to every episode, including AMA's sans the spiel you're listening to now and in your regular podcast feed.

第五，会员专享播客《精华集锦》——我们精选往期节目中最精彩的片段制作而成

Fifth, the Qualys, an additional member only podcast we put together that serves as a highlight reel featuring the best excerpts from previous episodes of the drive.

这是快速了解往期内容的好方法，无需逐一听完每期节目

This is a great way to catch up on previous episodes without having to go back and listen to each one of them.

最后，我们还会持续增加其他会员福利

And finally, other benefits that are added along the way.

若想了解更多并享受这些会员专属权益，请访问peterattiamd.com/subscribe

If you wanna learn more and access these member only benefits, you can head over to peterattiamd.com forward slash subscribe.

您也可以在YouTube、Instagram和Twitter上找到我，账号均为PeterAttiaMD

You can also find me on YouTube, Instagram, and Twitter, all with the handle PeterAttiaMD.

您也可以在苹果播客或您使用的任何播客平台上给我们留下评价。

You can also leave us review on Apple Podcasts or whatever podcast player you use.

本播客仅用于一般信息目的，不构成医疗、护理或其他专业医疗服务的实践，包括提供医疗建议。

This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice.

不构成医患关系。

No doctor patient relationship is formed.

使用本播客信息及链接材料需用户自行承担风险。

The use of this information and the materials linked to this podcast is at the user's own risk.

本播客内容不可替代专业医疗建议、诊断或治疗。

The content on this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

用户不应因自身医疗状况而忽视或延迟获取医疗建议，应就此类情况寻求专业医疗人员的帮助。

Users should not disregard or delay in obtaining medical advice from any medical condition they have and they should seek the assistance of their healthcare professionals for any such conditions.

最后，我严肃对待所有利益冲突事项。关于我的全部披露及投资或顾问的公司信息，请访问peterateamd.com/about，该页面会保持最新且完整的披露清单。

Finally, I take all conflicts of interest very seriously For all of my disclosures and the companies I invest in or advise, please visit peterateamd.com slash about where I keep an up to date and active list of all disclosures.