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題名 | 氣相層析質譜法檢測中藥摻用西藥原料之研究=Detection of Medications Adulterated in Chinese Herb Drugs by GC/MS |
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作者姓名(中文) | 林裕峰; 馬正平; 謝善德; 鄧昭芳; 徐如瑋; 白璐; 李安榮; 張德明; 邱文君; | 書刊名 | 醫學研究 |
卷期 | 14:1 1993.07[民82.07] |
頁次 | 頁21-34 |
分類號 | 412.36 |
關鍵詞 | 中藥; 西藥; 原料; 氣相層析質譜法; 摻用; 檢測; |
語文 | 中文(Chinese) |
中文摘要 | 中藥自古即標榜藥性溫和,沒有副作用,因此深為國人所極力推崇。然而某些不肖業者為迎合患者求好心切的心理,在中藥製劑中掺入止痛、安眠藥及類固醇,則時有所聞。因此作者為進一步了解國内中藥掺入西藥之盛行率及種類,乃選取三軍總醫院腎臟科及風濕免疫科284位門診及住院病患,調查其服用中藥之盛行率;並以高敏感度及高專一性之氣相層析質譜法,檢測中藥摻用西藥之盛行率。結果發現曾經服用中藥的病患有170位,比例達到59.8%。另外,102件中藥檢體中,有23件掺混一至六種西藥成份,其盛行率高達22.5%。這些病患服用中藥的原因包括:關節痛41例,疼痛28例,補腎14例,補肝6例,補身6例,解毒2例,氣喘2例,減肥2例,退黃膽1例。檢出成分包括非固醇止痛劑mefenamic acid及ibuprofen 8例,止痛劑acetaminophen 4例,鎮定劑diazdpam 10例,安眠藥phenobarbital 1例,抗鬱劑imipramine 1例,肌肉鬆弛劑benzoxazolone 2例,抗組織胺4例,興奮劑caffenine 13例,維他命E 4例,維他命B1 10例。檢出西藥之質譜圖與標準質譜圖比對,其相似性達90%以上。我們證實國人服用中藥的比例相當高,而中藥掺用西藥的比例也相當高(22.5%)。治療關節炎的中藥有31.7%掺入西藥,且都含有非固醇止痛劑;而長期使用非固醇止痛劑,將導致慢性腎衰竭及尿毒症。腎功能不全、糖尿病、心臟病、血容量不足及年紀大等病患服用非固醇止痛劑,則其腎毒性更強。另外,長期服用安眠鎮定劑,也將導致中樞及呼吸抑制和戒斷症狀。因此這些藥品必須由西醫根據病患病情,開具醫囑並避免長期使用。若將西藥掺入中藥,則每例中藥所含之西藥成分不均勻,故很難控制其濃度;同時,若讓年老及有系統疾病之病患使用,是相當危險之事。因此,建議有關衛生單位,積極尋求防範中藥掺混西藥之措施,如加強篩檢或罰款,以維護全民之健康。 |
英文摘要 | Heb drugs have been very popular in Taiwan for a long time because they were thought to be free of side effects. However, some authors had separated analgesics, steroids and sedatives from the herb drugs through analytical methods. To better understand and asses the safety of the herb drugs made in the mainland China and Taiwan area, we investigated 102 herb drugs provided by patients from the Section of Nephrology and Rheumatology at Tri-Service General Hospital. Gas chromatography/mass spectrometry with high sensitivity and high specificity was performed. The results showed that 59.5% patients had experience of taking Chinese herb drugs. Twenty-three samples (22.5%) out of one hundred and two herb drugs were found illegally adulterated with medications. The reasons for taking herb drugs include arthritis (41 cases), pain (28 cases), improving renal function (14 cases), improving liver function (6 cases), revitalization (6 cases), detoxication (2 cases), asthma (2 cases), on a diet (2 cases) and jaundice removal (1 cases). Medications mixed in the herb drugs consisted of eight nonsteroid anti-inflammatory drugs (NSAIDs), mefenamic acid and ibuprofen; four analgesics (acetaminophen); eleven sedatives (diazepam and phenobarbital); one antidepressant (imipramine); two muscle relaxants (benzoxazolone); four antihistamines (cholrpheniramine); thirteen stimulants (caffeine); four vitamin E and ten vitamin B1. We demonstrated high prevalence of herb drug taking (59.8%) and high incidence of medications to be added into herb drug. Forty-one herb drugs from patents complaining of arthritis contained NSAIDs (20%). Long-term NSAIDs administration to patients induce chronic renal insufficiency and chronic uremia. Patients with renal function insufficiency, diabetes, heart disease, hypovolemia and old age are more susceptible to the nephrotoxic effects of NSAIDs. Furthermore, patients with long-term sedative-hypnoticusage suffer from depression in the central nervous and respiratory systems and a withdrawal syndrome. So, the NSAIDs and sedatives should be prescribed by the doctors according to patients' conditions and long term usage of these medications should be avoided. It would be dangerous to allow unqualified Chinese herb doctors to add medications with potential serious side effects into herb drugs and administer to patients with systemic diseases. In addition, it is difficult to control the amount of medications in the herb drug preparations. So, we strongly suggest the institute officials to set up policies to strengthen the screen of adulteration of herb drugs and find the persons who commit the adulterations in the herb drugs to safeguard people's health. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。