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中药葶苈子中毒致多器官功能衰竭 1 例报告。

Multiorgan failure caused by Chinese herbal medicine Xanthii Fructus poisoning: a case report.

机构信息

Department of Poisoning and Occupational Diseases, Emergency Medicine, Cheeloo College of Medicine, Qilu Hospital of Shandong University, Shandong University, Jinan, 250012, Shandong, China.

School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.

出版信息

BMC Complement Med Ther. 2023 Jul 31;23(1):273. doi: 10.1186/s12906-023-04105-6.

Abstract

BACKGROUND

Xanthii Fructus was used in the treatment of rhinitis and related nasal disease. It is the most commonly used chemically active component in compounds formulated for the treatment of rhinitis. However, poisoning, resulting in serious consequences, can easily occur owing to cocklebur overdose, improper processing, or usage without processing.

CASE PRESENTATION

We reported on a 55-year-old man who experienced allergic rhinitis for 2.5 years. He ingested unprocessed Xanthii Fructus for 2 months as treatment. However, he developed anorexia; nausea; abdominal pain; general weakness; hiccups; oliguria and anuria; significantly elevated serum alanine aminotransferase, aspartate aminotransferase, and creatinine levels; and abnormalities in blood coagulation series. Nutritional support; daily drugs for liver protection, gastric protection, inflammation reduction; fresh plasma; and cryoprecipitate infusion were administered. Continuous venovenous hemodialysis (Prismaflex ST100) was also administered. However, the patient's multiple organ failure gradually worsened, ultimately leading to death.

CONCLUSION

Xanthii Fructus poisoning affects multiple systems, and its clinical manifestations are complex. Therefore, it is easily misdiagnosed and missed. Along with careful inquiry of medical and medication history, early diagnosis and intervention are vital for a successful treatment. It is also important to educate people and create awareness about this poisoning. Therefore, this intractable case has great clinical significance.

摘要

背景

苍耳子用于治疗鼻炎和相关鼻部疾病。它是治疗鼻炎的复方制剂中最常用的活性化学成分。但是,由于苍耳子过量、加工不当或未经加工使用,容易发生中毒,导致严重后果。

病例介绍

我们报告了一名 55 岁男性,他患有过敏性鼻炎 2.5 年。他作为治疗方法,未经加工地摄入苍耳子 2 个月。但是,他出现了食欲不振、恶心、腹痛、全身无力、呃逆、少尿和无尿;血清丙氨酸氨基转移酶、天冬氨酸氨基转移酶和肌酐水平显著升高;以及凝血系列异常。给予了营养支持;每天给予肝脏保护、胃保护、抗炎药物;新鲜血浆和冷沉淀输注。还给予了持续静脉-静脉血液透析(Prismaflex ST100)。然而,患者的多器官功能衰竭逐渐恶化,最终导致死亡。

结论

苍耳子中毒影响多个系统,其临床表现复杂。因此,容易误诊和漏诊。除了仔细询问病史和用药史外,早期诊断和干预对于成功治疗至关重要。教育人们并提高对这种中毒的认识也很重要。因此,这个棘手的病例具有重要的临床意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5587/10388452/2ed76284f284/12906_2023_4105_Fig1_HTML.jpg

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