Fushimi R, Koh T, Iyama S, Yasuhara M, Tachi J, Kohda K, Amino N, Miyai K
Central Laboratory for Clinical Investigation, Osaka University Hospital, Japan.
Ther Drug Monit. 1990 May;12(3):242-5. doi: 10.1097/00007691-199005000-00005.
Immunoreactive digoxin-like activity was observed in Chinese medicine, KYUSHIN tablet, taken popularly in Japan without prescription. The antibodies used in the assays of digoxin reacted with Chan-su, the major effective component of KYUSHIN, which contained cardiotonic steroids with similar chemical structure as digoxin. One tablet of KYUSHIN had digoxin-like immunoreactivity equivalent to 1.9, 1.5, and 72 micrograms of digoxin measured by three different commercial kits. These different equivalences may be attributed to differences in cross-reactivity of the antibody used in the immunoassays. Two healthy volunteers took two KYUSHIN tablets three times a day, a typical dose, and digoxin-like immunoreactivity reached almost 0.4 micrograms/L in 0.5 day. Therapeutic drug monitoring should be interpreted carefully in patients taking Chinese medicines, many of which contain the Chan-su component.
在日本无需处方即可广泛服用的中药救心丸中观察到了免疫反应性地高辛样活性。地高辛检测中使用的抗体与救心丸的主要有效成分蟾酥发生反应，蟾酥含有与地高辛化学结构相似的强心甾体。通过三种不同的商业试剂盒测量，一片救心丸的地高辛样免疫反应性相当于1.9、1.5和72微克地高辛。这些不同的等效值可能归因于免疫分析中使用的抗体交叉反应性的差异。两名健康志愿者每天服用两次救心丸，每次两片，这是典型剂量，地高辛样免疫反应性在0.5天内达到近0.4微克/升。对于服用中药的患者，治疗药物监测应谨慎解读，因为许多中药都含有蟾酥成分。
