中药士的宁中毒：病例系列。

Strychnine poisoning due to traditional Chinese medicine: a case series.

机构信息

Hospital Authority Toxicology Reference Laboratory, Princess Margaret Hospital, Hospital Authority, Hong Kong.

出版信息

F1000Res. 2021 Sep 15;10:924. doi: 10.12688/f1000research.73072.2. eCollection 2021.

DOI:10.12688/f1000research.73072.2

PMID:35169461

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8817065/

Abstract

Strychnine poisoning is rare but possibly fatal. The most reported sources of strychnine poisoning include rodenticides and adulterated street heroin. Here we report a case series of an unusual cause of strychnine poisoning - , a herb known as "maqianzi" in traditional Chinese medicine (TCM). All cases of strychnine poisoning confirmed by the Hospital Authority Toxicology Reference Laboratory (HATRL, the highest-level clinical toxicology laboratory in Hong Kong) between May 2005 and May 2018 were reviewed. Twelve cases of strychnine poisoning were recorded, and was the exclusive source. Ten (83%) patients presented with muscle spasms, and four (33%) developed typical conscious convulsions. The poisoning was severe in two (17%) patients, moderate in three (25%) and mild in eight (58%). No case fatality was recorded. Three (25%) patients were TCM practitioners and two (17%) were laymen who bought the herb themselves without a proper prescription. The practice of TCM is becoming popular in different parts of the world amid the COVID-19 pandemic. The spectrum of clinical features of strychnine poisoning secondary to are similar to those arising from different origins. Eliciting a history of TCM use, apart from exposure to rodenticides and drugs of abuse, may allow timely diagnosis in patients with compatible clinical features. Enhancement of TCM safety could minimize the hazard.

摘要

马钱子碱中毒较为罕见，但可能致命。马钱子碱中毒最常见的原因包括老鼠药和掺假的街头海洛因。本研究报告了一组马钱子碱中毒的不常见病因病例，马钱子是一种中药（TCM），又名“马钱子”。回顾了 2005 年 5 月至 2018 年 5 月期间，由香港医管局毒物化验所（香港最高级别的临床毒理学实验室）确认的所有马钱子碱中毒病例。共记录了 12 例马钱子碱中毒病例，均由引起。10 例（83%）患者出现肌肉痉挛，4 例（33%）出现典型的意识抽搐。2 例（17%）患者中毒严重，3 例（25%）中度，8 例（58%）轻度。无死亡病例。3 例（25%）患者为中医从业者，2 例（17%）为自行购买该草药而未按规定开具处方的非专业人士。在 COVID-19 大流行期间，中医在世界不同地区的应用越来越普及。因引起的马钱子碱中毒的临床特征与因其他原因引起的中毒相似。除了接触老鼠药和滥用药物外，询问中医使用史可能有助于对具有相似临床特征的患者及时做出诊断。加强中医安全性可将危害降到最低。