鉛污染中藥冬蟲夏草造成的鉛危害：四個案例分析

Lead Overexposure Caused by Contaminated Cordyceps, a Chinese Herbal Medicine: Four Case Reports

楊國卿(Kuo-Ching Yang) ； 賴俊雄(Jim-Shoung Lai) ； 王建民(Chien-Ming Wang) ； 劉紹興(Saou-Hsing Liou) ； 林春蓮(Chuan-Lien Lin) ； 楊燦(Tsann Yang) ； 許昭純(Chao-Chun Hsu) ； 趙秀琳(Show-Lin Chao) ； 劉淑芬(Shu-Fen Liou) ； 吳聰能(Trong-Neng Wu)

《中華職業醫學雜誌》 3卷2期 (1996/04) Pp. 73-77

摘要

衛生署的血中鉛通報系統最近接獲二位因服用冬蟲夏草中藥而造成鉛中毒案例，由於冬蟲夏草遭受鉛污染的案例尚未被報告過，此病例報告呼籲國人注意中藥的安全性。此二位病人均服用冬蟲夏草中藥以治療他們的宿疾，一位病人出現貧血、肝功能異常及週邊神經病變等鉛中毒症狀，而其血中鉛濃度達130μ g/dl；另一位病人的血中鉛濃度為46μ g/dl，但尚未出現中毒症狀。冬蟲夏草中藥粉末化驗顯示鉛濃度分別高達20,000 ppm和416 ppm。病人立即停止服用中藥，並以螫合劑治療出現症狀的鉛中毒病人後，二位病人的血中鉛濃度均降至正常範圍內。經調查鉛污染來源為冬蟲夏草中插入的鉛棒，磨粉後不易查覺鉛的存在“其後又陸續發現二件鉛污染的冬蟲夏草中藥，幸好病人未服用粉末或僅服用水煮之藥湯，沒有造成血中鉛增高情形。此報告呼籲衛生單位應對中藥重金屬污染進行廣泛調查，以避免國人暴露於鉛危害。

關鍵字

中藥 ； 冬蟲夏草 ； 鉛中毒

並列摘要

Two cases of lead overexposure, caused by the Chinese herbal medicine Cordyceps, were reported to the Department of Health in a laboratory-based blood lead surveillance program. Such unusual cases of lead poisoning have not been previously reported. These two patients took Cordyceps, herbal medicine for treatment of underlying diseases. Loss of appetite and anemic signs of lead poisoning were manifested in one patient with a blood lead level of 130 ug /dl, while the other patient was asymptomatic with a blood lead level of 46 ug /dl. The lead contents in the Cordyceps powder was revealed to be as high as 20,000 ppm. After cessation of intake in the asymptomatic patient, and cessation of intake and treatment with chelating agents in the symptomatic patient, the blood lead levels returned to normal range. Another two samples of Cordyces provided by patients were measured for the lead contents. The results revealed that the lead contents in the powder of Cordyces were 70,000 and 1046 ppm. These patients did not take the powders and not result in high blood levels. This report raises concerns about lead overexposure from unusual herbal medicine worldwide.

並列關鍵字

lead overexposure ； herbal medicine ； Cordyceps