Recently, a cortical/nuclear barrier to GSH migration in older human lenses was demonstrated by Sweeney et al【1】

The correlations appeared to be modified, however, by serum vitamin C concentration, with little or no association between dietary and plasma glutathione among those with lower levels of serum vitamin C and stronger negative correlations among those with higher serum vitamin C levels. These findings indicate that factors regulating plasma glutathione concentration are complex and not simply related to dietary glutathione intake or supply of precursor amino acids.【2】

Eat Sulfur Rich Foods
Sulfur rich foods include broccoli, kale, mustard greens, Brussels sprouts, and watercress. Sulfur is known to be an element required for the synthesis of glutathione. It is mainly found in two amino acids: cysteine and methionine. The increased intake of glutathione reduces oxidative stress as a result of an increase in glutathione levels.【3】

Glutathione Supplements
Glutathione supplements come in the form of powder, pills, and capsules. You can also buy it in the form of gels and creams to apply on your face and body. Eating glutathione in the form of supplements pose several benefits, but it should be taken in the right amount. Santeva Health and Beauty offers excellent glutathione supplements with proper dosage prescription.【3】

Use Turmeric Extract
Turmeric is famous for its enormous benefits, and the curcumin present in it helps in increasing the glutathione levels in the body. Furthermore, it should be taken in the form of turmeric extract for excellent results. Check for high curcumin levels in turmeric before purchasing it.【3】

Work Out
Exercising is known to be one of the best ways to increase the antioxidant level in your body. Not only is it good for your health, but it is also the best activity for your mental health as well. The combination of circuit weight training and cardio increases glutathione levels the most. Along with it, you need to take an adequate amount of nutrition to ensure maximum benefits. Never miss out on exercising regularly if you want to increase the glutathione levels in your body naturally.【3】

Increase Vitamin C Intake
Vitamin C fights against the free radicals in the body by increasing the glutathione levels. You can consume Vitamin C in many forms, from natural to synthetic ones. It further helps in converting the oxidized glutathione into the active form, so it’s better to increase Vitamin C intake in your body【3】

Glutathione can regenerate oxidized vitamin C molecules through the glutathione-ascorbic acid cycle and potentially protect the lens from oxidized products of vitamin C【4】（谷胱甘肽可以再生被氧化的維生素C）

Pathophysiological mechanisms of cataract formation include deficient glutathione levels contributing to a faulty antioxidant defense system within the lens of the eye. Nutrients to increase glutathione levels and activity include lipoic acid, vitamins E and C, and selenium. Cataract patients also tend to be deficient in vitamin A and the carotenes, lutein and zeaxanthin. The B vitamin riboflavin appears to play an essential role as a precursor to flavin adenine dinucleotide (FAD), a co-factor for glutathione reductase activity. Other nutrients and botanicals, which may benefit cataract patients or help prevent cataracts, include pantethine, folic acid, melatonin, and bilberry. Diabetic cataracts are caused by an elevation of polyols within the lens of the eye catalyzed by the enzyme aldose reductase. Flavonoids, particularly quercetin and its derivatives, are potent inhibitors of aldose reductase. Glaucoma is characterized by increased intraocular pressure (IOP) in some but not all cases. Some patients with glaucoma have normal IOP but poor circulation, resulting in damage to the optic nerve. Faulty glycosaminoglycan (GAG) synthesis or breakdown in the trabecular meshwork associated with aqueous outflow has also been implicated. Similar to patients with cataracts, those with glaucoma typically have compromised antioxidant defense systems as well. Nutrients that can impact GAGs such as vitamin C and glucosamine sulfate may hold promise for glaucoma treatment. Vitamin C in high doses has been found to lower IOP via its osmotic effect. Other nutrients holding some potential benefit for glaucoma include lipoic acid, vitamin B12, magnesium, and melatonin. Botanicals may offer some therapeutic potential. Ginkgo biloba increases circulation to the optic nerve; forskolin (an extract from Coleus forskohlii) has been used successfully as a topical agent to lower IOP; and intramuscular injections of Salvia miltiorrhiza have shown benefit in improving visual acuity and peripheral vision in people with glaucoma.【5】

（白內障形成的病理生理機制包括谷胱甘肽水平不足，導致晶狀體內的抗氧化防御系統出現故障。提高谷胱甘肽水平和活性的營養素包括硫辛酸、維生素E和C以及硒。白內障患者也往往缺乏維生素A和胡蘿卜素、葉黃素和玉米黃質。維生素B核黃素似乎作為黃素腺嘌呤二核苷酸（FAD）的前體發揮著重要作用，FAD是谷胱甘肽還原酶活性的輔助因子。其他可能有益于白內障患者或有助于預防白內障的營養素和植物藥包括泛堿、葉酸、褪黑素和越橘。糖尿病性白內障是由醛糖還原酶催化的晶狀體內多元醇升高引起的。黃酮類化合物，尤其是槲皮素及其衍生物，是醛糖還原酶的有效抑制劑。青光眼的特征是在一些但并非所有病例中眼壓升高。一些青光眼患者眼壓正常，但循環不良，導致視神經受損。與房水流出相關的小梁網中的糖胺聚糖（GAG）合成或分解缺陷也有牽連。與白內障患者類似，青光眼患者的抗氧化防御系統通常也受損。維生素C和硫酸氨基葡萄糖等能影響GAG的營養素可能有助于治療青光眼。高劑量的維生素C通過滲透作用降低眼壓。其他對青光眼有潛在益處的營養素包括硫辛酸、維生素B12、鎂和褪黑素。植物學可能提供一些治療潛力。銀杏葉增加視神經的循環；forskolin（一種從Coleus Forskolii中提取的提取物）已被成功用作降低眼壓的外用藥物；肌肉注射丹參對青光眼患者的視力和周邊視力有改善作用。）

In addition, Sethna et al. (1983) observeda loss in a-glutamylcysteine synthetase activity in old humanlenses. 【6】.

We conclude from this analysis that the evidence for a causal role of oxidation is strong for nuclear, but substantially lower for cortical and posterior subcapsular cataracts. The preponderance of evidence suggests that exposure to increased levels of molecular oxygen accelerates the age-related opacification of the lens nucleus, leading to nuclear cataract. Factors in the eye that maintain low oxygen partial pressure around the lens are, therefore, important in protecting the lens from nuclear cataract.（較高的氧分壓會導致核性白內障）【7】

Most of the events associated with the formation of cortical cataracts are different from those seen in nuclear cataracts. Opacification of the nucleus is not accompanied by detectable damage to the structure of nuclear fiber cells. By contrast, cortical cataracts are associated with extensive disruption of cell structure and the wholesale precipitation of intracellular proteins. Nuclear cataracts occur uniformly throughout the center of the lens, while cortical cataracts initially involve small clusters of cortical fiber cells. Unlike nuclear opacification, damage to cortical fiber cells is not a necessary consequence of aging. Most individuals never have any evidence of cortical cataracts, while everyone develops some degree of nuclear opacity with age.（皮質性白內障不是衰老的必然結果）【7】

Nuclear cataracts are widely associated with poorer diet, lower socioeconomic status, nonprofessional status and lower educational achievement [2,13]. The specific risk factors associated with these general socioeconomic categories have been difficult to discern. Clinical trials using vitamin supplementation to lower the risk of cataracts have been unsuccessful or had minimal impact, at least over the typical 5- to 10-year duration of these studies. Some supplements have potentially harmful systemic effects when used at high doses, and 1 recent study reported an increased incidence of cataract surgery in subjects taking vitamin C supplements (but not those taking multivitamin supplements or diets high in vitamin C) [14]. Smoking is a consistent risk factor for nuclear cataracts. The risk of nuclear cataracts increases with the amount and duration of smoking, adding confidence to the existence of a causal relationship between smoking and nuclear opacities. Two studies from diverse ethnic groups identified larger lens size as a risk factor for nuclear cataracts [15,16]. Longitudinal studies showed that having a larger lens conferred increased risk of developing nuclear opacities over a 5-year follow-up period [17]. Epidemiological studies have also associated living in a region with increased ambient temperature with increased lens hardening and risk of developing nuclear cataract [6]. Although it may be difficult to establish whether higher ambient temperature is the variable responsible for the higher incidence of nuclear cataracts in these studies, recent laboratory investigations have supported this hypothesis [18]. Finally, studies of twins and examination of familial associations have suggested that about one third of the risk of nuclear cataracts is hereditary, although the genes involved have not been identified [19,20].（性白內障廣泛與較差的飲食、較低的社會經濟地位、非專業地位和較低的教育成就有關）

High sunlight exposure has been consistently associated with an increased risk of cortical cataracts. The risk of cortical cataract attributable to sunlight is effectively eliminated by wearing a brimmed hat or plastic glasses, making sunlight exposure a preventable risk [21]. In spite of the evidence supporting a role for sunlight in cortical cataracts, the contribution of higher sunlight exposure to the total cataract burden appears to be modest. In most studies, sunlight did not contribute significantly to the risk of nuclear or posterior subcapsular opacities. Furthermore, the increased risk of cortical cataract provided by the highest levels of sunlight exposure in a typical population is only about 10% [22]. A more significant risk of developing cortical cataracts is typically associated with being female, of African heritage and having a family member with cortical cataracts [23,24,25,26,27,28]. Twin studies and family associations suggest that 50–60% of the risk of developing cortical cataracts is hereditary. The first human mutations associated with age-related cortical cataracts were recently identified in EPH2A, a gene encoding a transmembrane tyrosine kinase [29,30]. It has not been determined whether it is loss of the kinase activity or the potential adhesive function of the protein that underlies these opacities. As with nuclear cataracts, lens size was identified as a significant risk factor for cortical cataracts. However, unlike nuclear cataracts, the increased prevalence and incidence of cortical opacities were linked to having a smaller, not a larger lens [15,16,17,31]. Several studies have shown that diabetics also have an increased risk of developing cortical cataracts and PSCs, although diabetics with well-controlled blood sugar develop a similar spectrum of age-related cataracts as nondiabetics [32,33].（戴好帽子）【7】

Substantial data suggest that, with increasing age, the lens nucleus becomes more susceptible to oxidation [7]. The cytoplasm of all cells is in a ‘reducing environment’. That is, oxidation is inhibited and substances that are capable of being oxidized or reduced are in the reduced state. The tripeptide glutathione is one of the most important reducing agents in the cytoplasm. Glutathione levels are extremely high in peripheral lens fiber cells, where glutathione is synthesized and reduced [35]. Reduced glutathione reaches the lens nucleus by diffusion from the surface cells through the abundant network of gap junctions in the lateral membranes of the fiber cells [36,37]. With increasing age, a greater percentage of the glutathione in the nucleus is found in the oxidized state, as glutathione disulfide or glutathione-protein mixed disulfides. In nuclear cataracts, the proportion of glutathione that is oxidized increases further [7,35]. In spite of this, glutathione levels in the outer cortex of the lens remain high in older lenses and in nuclear cataracts. Therefore, the increase in oxidized glutathione in the nucleus is direct evidence of local oxidation during aging and in nuclear cataracts. It also suggests that, with increasing age, the lens nucleus becomes less able to repair oxidative damage.(隨著年齡的增長，細胞核中更多的谷胱甘肽以氧化狀態存在，如谷胱甘肽二硫化物或谷胱甘肽-蛋白質混合二硫化物。在核性白內障中，被氧化的谷胱甘肽比例進一步增加)【7】

Persons with uncontrolled diabetes often rapidly develop cataracts.【7】

糖尿病人容易導致白內障

The metabolically active cells of the lens also have very high levels of antioxidants, like glutathione. Therefore, lenses are probably less exposed to and better protected from endogenous oxidants than most other cell types.【7】

Additional support for oxygen exposure in the etiology of nuclear cataracts came from studies of patients undergoing vitrectomy, the destruction and removal of the vitreous gel that is typically performed during retinal surgery. Many studies have documented very high rates of nuclear cataract formation (60–95%) within 2 years after vitrectomy surgery, and vitreoretinal surgeons counsel their patients that they will probably require cataract surgery months to a few years after vitrectomy [71,72,73,74]. As mentioned above, oxygen levels near the posterior of the human lens are very low in eyes with an intact vitreous gel (approx. 1% O2). Oxygen levels near the lens increased markedly during vitrectomy and remained significantly elevated for months afterward [58]. Patients with ischemic diabetic retinopathy had significantly lower oxygen in their vitreous and were less likely than nondiabetics to have cataract surgery after vitrectomy [75,76]. Our group recently completed an analysis of lens opacification following vitrectomy, using Scheimpflug photography to document the progression of nuclear opacification [Holekamp et al., Am J Ophthalmol, in press]. We found that the lenses of patients with ischemic diabetic retinopathy had lower age-adjusted nuclear opacity at baseline than those of nondiabetics and did not show a significant increase in nuclear opacification after a 1-year follow-up. By contrast, diabetics without ischemic retinopathy and nondiabetics showed rapid progression of nuclear opacity 6 and 12 months after vitrectomy. By 1 year after vitrectomy, 50% of the nonischemic patients had cataract surgery. These data are consistent with the hypothesis that vitrectomy leads to cataract formation by increasing the exposure of the lens to oxygen.【7】（波切導致核性白內障）

If exposure of the lens to increased oxygen can cause nuclear cataracts, it is important to understand how the low-oxygen environment around the lens is maintained in eyes that do not undergo vitrectomy. Substantial data suggest that the intact vitreous body protects against nuclear cataract and is essential to maintain the low-oxygen environment at the posterior surface of the lens. It is widely appreciated that the vitreous gel undergoes gradual collapse with age (‘vitreous syneresis’). This process begins with the formation of fluid-filled lacunae near the center of the vitreous gel, which progressively coalesce. The collagen fibrils of the vitreous aggregate around the edges of these liquid-filled areas. Eventually, the collapse of the gel and the aggregation of the collagen fibrils create traction on the retina, often leading to the full or partial separation of the remaining vitreous from the retina (posterior vitreous detachment). Although the vitreous liquefies to some degree in all individuals, the extent of loss of gel vitreous can vary greatly between subjects of the same age. Postmortem studies showed that the vitreous of subjects over 50 years ranged from a nearly intact gel to one that was completely or extensively liquefied（大量數據表明，完整的玻璃體可以防止核性白內障，對于維持晶狀體后表面的低氧環境至關重要。）【7】

Eyes with more liquefied vitreous are more likely to have nuclear opacities [78]. In subjects between 50 and 70 years old, the state of the vitreous was a better predictor of nuclear opacity than was age. Based on these data, we concluded that the intact gel vitreous preserved the low-oxygen environment around the lens by preventing mixing of the vitreous fluid (fig. ?(fig.2a).2a). In this view, oxygen diffuses into the vitreous gel from the larger retinal vessels. Microelectrode studies in animals showed that most of this oxygen is consumed by the nearby retina [79]. The consumption of oxygen by the retina maintains an oxygen gradient in the gel near the surface of the retina. However, if the gel is removed, any movements of the head or eye would result in the movement of the vitreous fluid, carrying oxygen away from the retina, mixing it with the vitreous and delivering it to the lens. In this way, the vitreous gel does not inhibit the diffusion of oxygen, but prevents its rapid distribution by fluid mixing (fig. ?(fig.2b2b).【7】（液化程度較高的玻璃體容易導致核性白內障）

?上述是【7】中的Fig.2

?A combination of DADS and NAC completely prevented cataractogenesis, and all of the treated animals survived APAP toxicity. 【9】（DADS+NAC配合能阻止白內障）

Cysteamine suppresses cataract formation induced by selenite in rats, suggesting that cysteamine can be used as a pharmaceutical intervention to prevent or delay cataract formation.(半胱胺抑制亞硒酸鹽誘導的大鼠白內障形成，提示半胱胺可作為藥物干預來預防或延遲白內障形成。)【10】

Fill Up on Antioxidants
In a 2008 study of 35,551 women, researchers found that those who consumed the most lutein and zeaxanthin (antioxidants found in yellow or dark-green leafy vegetables) had an 18% lower chance of developing cataracts than those who consumed the least amount of lutein and zeaxanthin.（補充葉黃素和玉米黃質）【11】

Get Your Omega-3 Fatty Acids
Known to fight inflammation, omega-3 fatty acids can help shield your eyes from cataract development, according to a 2005 study. Looking at data on 71,083 women, the study's authors discovered that those with a higher intake of omega-3s (found in oily fish like salmon and sardines, as well as in flaxseed) had a reduced risk of cataracts.3【11】（omega-3）

Consider Herbal Medicine
Animal-based research has shown that bilberry (an herb rich in antioxidants) and turmeric (an anti-inflammatory compound found in the curry spice turmeric) can help prevent the development of cataracts.4【11】（玉米黃質+葉黃素）

Somehow, many people, after being inflicted by cataracts, end up believing they can’t do much about it, which is totally wrong. Remember, “It’s never too late to prevent your vision from further harm” and “prevention is better than cure” holds up truer than even ever coping with cataracts.【12】（防止視力進一步受損永遠都不晚）

1：正確飲食

食物在幫助你獲得最佳眼部健康方面起著至關重要的作用。調整你的飲食習慣可以在很大程度上確保你的眼睛盡可能長時間保持健康和功能。

首先，在你的飲食計劃中加入抗氧化劑和富含谷胱甘肽的食物。西蘭花、蘆筍、菠菜和抱子甘藍等綠色蔬菜被認為是真正對眼睛有益的食物。同樣，鱷梨、葡萄柚和草莓富含谷胱甘肽，有助于保持眼睛健康。

如果你對食用大量生水果和蔬菜的想法不太滿意，你也可以將它們用作混合果汁和冰沙。

含有葉黃素和玉米黃質的食物對眼睛健康也有重要意義，因為它們含有類胡蘿卜素，也存在于眼睛的晶狀體中。這些食物包括雞蛋、羽衣甘藍、蕪菁和玉米，不僅可以預防白內障，還可以預防黃斑變性。

這不僅關系到你的飲食中應該包含哪些有助于保護眼睛和視力的東西，還關系到你從飲食中排除的東西。因此，一定要遠離白糖及其加工替代品，如高果糖玉米糖漿（實際上是由轉基因玉米生產的）。眾所周知，這種富含糖的食物會刺激白內障的生長。【12】

5: Use Shades
Apart from the fact that it makes you look like a rockstar, but will also help you lower the risk of getting cataracts. Researchers are now certain about the UV light’s potential to harm your eyes, damaging the proteins found within the lens of your eyes.

So, whichever brand you want to pick up for your next pair of sunglasses, make sure to pick the one offering 99% – 100% protection against UVA and UVB rays, in addition to other features you desire to have in those.（佩戴防護紫外線眼鏡）

定期做眼科檢查

全面眼科檢查的重要性怎么強調都不過分，尤其是如果你年齡在40到64歲之間，最好每2到4年重復一次檢查。如果你65歲及以上，每1到2年進行一次考試。【12】

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直接補充無效

每天分別補充500mg和1g的脂質體谷胱甘肽，堅持兩周，細胞和血漿谷胱甘肽分別增加25%和28%

靜脈補充谷胱甘肽25%導致肝臟紊亂

過量運動對身體會造成氧化應激，減少體內谷胱甘肽水平

NAC（N-乙酰半胱氨酸)是補充谷胱甘肽的有效方法。口服NAC后，NAC經過腸道吸收，在肝臟代謝產生半胱氨酸，半胱氨酸是谷胱甘肽的限速底物，除非肝功能受損，補充NAC可以有效增加身體的谷胱甘肽水平

健康受試者連續4天每天使用1g x 4的撲熱息痛，發現受試者的體內谷胱甘肽水平顯著減低，但補充NAC可以維持受試者的谷胱甘肽水平不變。

補充NAD+前體同樣可以提升谷胱甘肽水平

臨床研究發現，連續8周每天4杯綠茶，可以增加血液中抗氧化物，增加血液中的谷胱甘肽水平。[17] 補充硫辛酸[18], 硒,[19]水飛薊素（Silymarin）,[20]都可以提升體內谷胱甘肽水平

改善飲食質量可以增加谷胱甘肽水平。 增加全食物，蔬菜水果等，可以增加谷胱甘肽水平，當中以含有機硫抗氧化物的食物，包括蘆筍、牛油果、黃瓜、豆類、菠菜、木瓜等效果最為顯著，但加熱會降解有機硫抗氧化物，所以生吃或降低加熱溫度和減少加熱時間會有幫助

結論：

谷胱甘肽是身體重要抗氧化物，對改善身體健康有顯著作用：

1． 口服普通劑型的谷胱甘肽效率不高，但堅持每天使用較高劑量，持之以恒會有一定效果，但停止使用后效果變消失；

2． 谷胱甘肽有一定的美白效果，但只對紫外線引致的黑色素有局部和暫時性的效果；

3． 容易吸收的劑型的谷胱甘肽可以改善吸收和抗氧化效果；

4． NAC是谷胱甘肽的前體，可能是補充谷胱甘肽性價比較高，效果較好的營養素；

5． 其他補充谷胱甘肽的方法，包括增加含有機硫化抗氧化物的蔬果，綠茶、硫辛酸、硒和水飛薊素等。增加其他抗氧化物例如維生素C和E雖然不能直接增加谷胱甘肽，但可以分擔抗氧化作用，減少谷胱甘肽的氧化流失；

6． 補充谷胱甘肽前體：NAC和甘氨酸，可能對抗衰老和有關的代謝指標有幫助。

上述內容來自【13】

乙酰半胱氨酸和萊菔硫烷一起補充【14】

補充半胱氨酸和甘氨酸【15】

α-硫辛酸【16】

一些食物，也有助于提高谷胱甘肽水平，比如，一些香料，姜黃⑥、肉桂和豆蔻，甜菜也有助于增強谷胱甘肽酶的活性【16】

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富含硫的食物、乳清蛋白、牛奶薊、NAC、α-硫辛酸、硒、甲基化成分、維生素C和E、牛肝、骨頭湯、定期鍛煉【17】

強調生酮飲食（沒啥意義）【18】

谷胱甘肽(Glutataione)，關鍵由三種碳水化合物構成：谷氨酰胺，甘氨酸和半胱氨酸。【18】

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根據【19】???藥物舌下含服與口服最大的區別就是舌下含服沒有首過效應，是將藥丸咬碎以后直接置于舌的下方，直接通過舌下毛細血管吸收入血的一種給藥方式。

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根據【20】中的對照實驗，谷胱甘肽應該含服。

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【21】中的一篇由B J Mills, R D Lindeman, C A Lang發表的題為《Effect of zinc deficiency on blood glutathione level缺鋅對血谷胱甘肽水平的影響》論文中，鋅的缺乏會導致身體的谷胱甘肽水平降低。

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Reference：

【1】Glutathione: a vital lens antioxidant - PubMed

【2】Dietary glutathione intake in humans and the relationship between intake and plasma total glutathione level

【3】Lesson 101: How to take Glutathione Effectively? | Santeva Health and Beauty - Santeva?

【4】Glutathione Improves the Antioxidant Activity of Vitamin C in Human Lens and Retinal Epithelial Cells: Implications for Vitreous Substitutes

【5】

Natural therapies for ocular disorders, part two: cataracts and glaucoma

【6】Age-related changes in glutathione synthesis in the eye lens?

【7】Oxidative Damage and the Prevention of Age-Related Cataracts

【8】Coffee brew intake can prevent the reduction of lens glutathione and ascorbic acid levels in HFD-fed animals - PubMed

【9】?Prevention of acetaminophen-induced cataract by a combination of diallyl disulfide and N-acetylcysteine

【10】Cysteamine prevents the development of lens opacity in a rat model of selenite-induced cataract - PubMed?

【11】How to Prevent Cataracts Naturally

【12】?Cataract Prevention | Tips to Prevent Cataracts Naturally | IrisVision

【13】?谷胱甘肽：美白效果一般，抗衰老效果驚人 - 知乎

【14】提升谷胱甘肽水平：要巧干不要蠻干

【15】怎樣自然提高“谷胱甘肽 ”這一 身體中強大的抗氧化劑水平？_研究

【16】什么是谷胱甘肽？如何補充谷胱甘肽? - 知乎

【17】?谷胱甘肽的作用_增強谷胱甘肽的11種方法-貴陽新東方烹飪學院

【18】

怎樣自然提高“谷胱甘肽 ”這一 身體中強大的抗氧化劑水平？ - 嗶哩嗶哩

【19】口服與舌下含服藥物有何不同?_有問必答_快速問醫生

【20】https://yuchi.blog.csdn.net/article/details/123415925

【21】如何提高身體內谷胱甘肽水平？?

總結

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