Aconite poisoning over 5 years: A case series in Hong Kong and lessons towards herbal safety

被引：43

作者：

Sammy Pak Lam Chen

Sau Wah Ng

Wing Tat Poon

Chi Kong Lai

Teresa Man Shan Ngan

Man Li Tse

Thomas Yan Keung Chan

Albert Yan Wo Chan

Tony Wing Lai Mak

机构：

[1] Hospital Authority Toxicology Reference Laboratory, Princess Margaret Hospital, Hospital Authority, Laichikok, Lai King Hill Road

[2] Chief Pharmacists Office, Hospital Authority, Hong Kong

[3] Hong Kong Poison Information Centre, Hospital Authority, Hong Kong

[4] Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong

来源：

Drug Safety | 2012年 / 35卷 / 7期

关键词：

Aconitum-napellus; Herbal-medicines; Poisoning; Traditional-Chinese-medicine;

D O I：

10.2165/11597470-000000000-00000

中图分类号：

学科分类号：

摘要：

Background: Aconite poisoning is a severe, life-threatening poisoning related to the use of traditional Chinese medicine (TCM). Despite current legislation, repeated poisoning cases are steadily encountered. Objective: The aim of the study was to summarize the clinical features and to elucidate the causative and contributory factors leading to aconite poisoning. Methods: This study was conducted within the Hospital Authority Toxicology Reference Laboratory, which is the sole tertiary referral clinical toxicology laboratory in Hong Kong. This retrospective study reviewed all confirmed aconite poisoning cases handled by a clinical toxicology laboratory between April 2004 and July 2009. The diagnosis in all cases was confirmed biochemically by detecting aconitum alkaloids in urine specimens. Additionally, herbal specimens were morphologically identified and herbal formulae were studied and transcribed. The cause of poisoning for each case was determined whenever possible. Results: Fifty-two cases were examined in this aconite poisoning case series. Neurological, cardiovascular and gastrointestinal toxicities were encountered in 49 (94.2%), 46 (88.5%) and 31 (59.6%) patients, respectively. The poisoning was severe in 6 (11.5%) patients, moderate in 17 (32.7%) patients and mild in 29 (55.8%) patients. Amongst 44 patients (84.6%) in whom the underlying reasons of poisoning could be determined, four major causes were found. These included overdose-prescription of a higher than recommended dosage of aconite herbs in 17 (32.7%) cases; 'hidden' poisoning (the aconite herb was not prescribed but dispensed inadvertently) in 17 (32.7%) cases; usage of inadequately processed herbs in 7 (13.5%) cases; and dispensary error in 2 (3.9%) cases. No case fatality was recorded. Conclusion: In the majority of cases in this series, the causes of poisoning can be traced to poor-quality herbs, poor quality of prescription practice, or dispensary errors. The quality issues of TCM practice should be critically addressed to minimize this poisoning threat. © 2012 Springer International Publishing AG. All rights reserved.

引用

页码：575 / 587

页数：12

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