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Users of traditional Chinese medicine
safety awareness raising
Zhongshan Hospital Director of traditional Chinese medicine, Guangzhou University of traditional Chinese medicine subsidiary divisions Mei Quan
From "aristolochic acid incident" to the "Yun died of poisoning event", then to the frequent injections of adverse events, has always been considered a safe and effective medicine exactly what was wrong? Zhongshan Hospital Director of traditional Chinese medicine, Guangzhou University of traditional Chinese medicine subsidiary divisions Mei Quanxi said, while the Chinese medicine safety problem occurs because a lot, but result in most major security incidents of Chinese medicine, one of the most fundamental and universal problem is the lack of consumer awareness of the safety of Chinese herbal medicine.
Chinese medicine is not absolutely safe non-toxic
Entrusted by the Medical Association of Guangdong Province, March 2005 I participated in a medical malpractice. South China Agricultural University in a student due to stomach bleeding caused by oral administration and help him tablets and admission to a top three hospitals in Guangzhou. Active conservative treatment, basic control in patients with gastric bleeding, physician (Western medicine) give Yunnan baiyao orally, 4 g, 3 times a day. Patients from 12 o'clock noon until 10 o'clock serving Yunnan baiyao around 11 grams in total, the next crisis occurred at 4 o'clock in the morning, after rescuing invalid (do not take any Yunnan baiyao poisoning toxin-first aid measures), coma 5 days after the death of patients. Organized by the Guangzhou medical malpractice for the first time, conclusion of blood for patients died, not part of the medical malpractice. Patients ' family members against made a second medical malpractice. I attended the second organized by the provincial medical association's medical malpractice, conclusion of overdosage with Yunnan baiyao poisoning deaths for patients belonging to medical malpractice.
Yunnan baiyao instructions marked: 0.25~0.5 grams 3~4 times a day. Daily dose exceeds the 2~4 grams can cause poisoning. This event was taken within 10 hours in Yunnan baiyao 11 g, acute overdosage, and the patients themselves was a man of blood you are extremely weak. Root cause of this event is a physician does not know Yunnan baiyao toxic not only ultra-dosing, and in patients with symptoms of poisoning detoxification treatment after the failure to make timely and targeted, lead poisoning death of patients.
Think of "aristolochic acid incident" caused by United Kingdom and the United States, and Spain, and Austria, and Egypt, and Malaysia, the Philippines, Japan and other countries have banned the import and use of traditional Chinese medicine and Chinese patent medicines containing aristolochic acid, a list of dozens of species. "Aristolochic acid event" traditional Chinese medicine in a foreign country is very large, many have gradually accept foreigners ' fear and rejection of traditional Chinese medicine TCM, resistance. Reported at home and abroad in patients with acute renal failure is caused by large doses of medication for a long time, more than 20~50 times of Chinese Pharmacopoeia requirements. Belgium poisoning in patients taking guangfangji on average for 12 months, domestic clinical patient years of using longdanxiegan pills, up more than 20 years.
On October 28, 2006, Phoenix ", a tiger and discussion on" proposed by CSU Professor Zhang Gongyao "let the exiting of traditional Chinese medicine national health care system" debate. Zhang Gongyao in reply to host "why do you want to abolish the traditional Chinese medicine" question, said: "first Chinese medicine is not science; the second Chinese medicines have toxic effects on the human body, can cause deaths. ”
Security issues affecting the safety of the patient not only of traditional Chinese medicine, and hampers the process of traditional Chinese medicine to the world, is of a more serious impact to the survival of traditional Chinese medicine. Therefore, the security problems of traditional Chinese medicine has to be taken seriously when, old "Chinese herbal medicine safe non-toxic" wrong views must be clarified.
Improper use of proprietary Chinese medicine, Chinese medicine injection
In August 2006, the United Kingdom drug safety body when you are testing a drug called the effect of Aloe Vera capsule and found the drugs in the mercury content of more than United Kingdom standard 117,000 times times. United Kingdom Government then ordered the blocking of Chinese medicine, traditional Chinese medicine "harmful" investigation into "an unprecedented tough stage". At the same time, also made in China contain mercury, arsenic, such as the bezoar detoxification pills (tablets) of proprietary Chinese medicines, such as security issues.
Angongniuhuang, liushen pill pills, bezoar detoxification pills such as traditional Chinese medicines containing mercury, arsenic, a toxic substance. In recent years, the bezoar detoxification adverse reactions occurring with an upward trend, attracted the attention of experts and scholars. From 1960 to the present, bezoar detoxification of Chinese medical periodical reports on adverse reactions is about more than 70 employees. According to expert analysis, realgar may be due to bezoar detoxification (WAN) security-the main cause of the problem. Although the drug in China, as managing prescription drug, but the bezoar detoxification are home to many people standing drug, many patients taking this drug is not carried out under the guidance of doctors, and often free to increase the dose, extension of the time.
Traditional Chinese medicine injection security events occur frequently in recent years, has attracted widespread attention. At present, the society generally believe that adverse reactions caused by injections of mainly due to the quality of the injection itself causes so many health care unit refused to use traditional Chinese medicine injection, and even some total negation of traditional Chinese medicine injection.
In fact, the injections of adverse reactions occurring factors are multidimensional, include not only traditional Chinese medicine injection flaw in itself an objective problem, also includes traditional Chinese medicine injection in clinical use in the course of human factors are not normative. I actually work in the observation, injections of adverse reactions, mostly caused by improper for clinical use. Improper use of common clinical reasons: using traditional Chinese medicine injection does not permit compatibility is unreasonable, overdosage, improper choice of solvent, speed drops too fast, change the way the infusion of injections, ignore the special population use taboo, dispensing non-standard operation and so on.
Unreasonable in the Western United
West reasonably compatible application can really improve the efficacy of pharmaceutical sciences, reduce drug side effects. Clinical practice but in the long term and pharmacology studies have shown that some application compatibility in the Western drug efficacy to reduce, increase in side effects. Therefore, Chinese and Western medicine combined with incompatibility. Our Chinese and Western medicine for unreasonable combined with common compatibility of abnormal phenomena that occur, findings and summarizes the compatibility mechanism, found cause side effects there are 5 main reasons for the increase in question.
Reason 12 drug toxicity is similar to drug combination appears after similar drug side effects are added. Sanguisorba officinalis, knotweed, five times, including tannins of traditional Chinese medicine and Western medicine such as tetracycline, rifampin, both hepatic toxicity, may cause drug-induced hepatitis.
Reason 2 when combined with Western medicines in toxic compounds. Realgar, such as arsenic-containing medicine and preparation, such as with the bezoar detoxification pills, liushen pill and nitrates, sulfates with the suits, arsenic in the body can be oxidized to poisonous arsenic trioxide, arsenic poisoning can cause.
Reason 3 Chinese medicine can increase Western medicine's side effects. Such as almond, Peach kernel, such as Gingko cyanide glucoside from Chinese medicine can increase anesthesia, sedation and cough medicine, such as sodium thiopental, codeine and other pulmonary Central inhibition effect, side effects increase serious the patient died of respiratory failure; ephedra, calcium-containing mineral drugs, such as gypsum, cuttlebone excitation maps speed up heart rate, strengthen heart drug sensitivity of cardiac glycosides, thus increasing cardiac toxicity.
When combined with Western medicines in reason 4 aggravated or caused by complications, caused by drug-induced disease and allergic reactions. Deer antler, liquorice with glucocorticoid hormone-like substances, and stimulate the gastric mucosa of the combination of aspirin and other salicylate derivatives can be induced peptic ulcer; isatis, andrographis Paniculata and houttuynia cordata injection, velvet fine combination of penicillin g and injection, increases the risk of allergy.
5 reasons to change certain media components in the body or to the environment may be increased side effects. Some Chinese medicines can promote the release of monoamine neurotransmitters, combined with monoamine oxidase inhibitors can make side reinforced, in severe cases can cause hypertensive crisis. Such as ephedrine, furazolidone and spirit of traditional Chinese medicine, glibenclamide, flagyl etc; high traditional Chinese medicine containing potassium ions, such as dandelion, money, grassland, and Loofah, diuretics and potassium antisterone, Dapsone pteridine combination may cause hyperkalemia; containing organic acids TCM Hawthorn, smoked, acidification of the body, such as schisandra environment, combined with sulfa drugs may reduce its solubility and precipitated crystals in the urine, causing hematuria; and nitrofurantoin, combined with aspirin, and indomethacin could increase absorption of the latter in the kidney and aggravate kidney toxicity.
These issues do not say that ordinary people, that is, medical staff knows very little about. Therefore, strengthening the security of application compatibility in the Western publicity and popularity of knowledge is necessary.
Proprietary Chinese medicines containing Western medicines use problems
Currently, this type of problem is the least pay attention to the problem. Registered in traditional Chinese medicine in China, there is more than 200 species of Chinese and Western medicine compound, that is, with the chemical drug of proprietary Chinese medicine. Common anti-cold drugs containing acetaminophen and chlorpheniramine, antihypertensive drugs with hydrochlorothiazide, antidiabetic drugs glibenclamide, cough and asthma medicines containing ephedrine, which often appear in the use of proprietary Chinese medicine in clinical issues.
Diabetes pills contain glyburide in the Western medicine compound, used in the treatment of type 2 diabetes results are obvious. But there are many diabetic patients are not aware of diabetes pills in Western pharmaceutical ingredients, that is pure Chinese medicine preparations, free people of high blood sugar, and arbitrarily increase the amount of, free in combination with other hypoglycemic Western medicine, much less concerned about the incompatibility with other Western medicine, so as to take diabetes pills which are experiencing serious adverse reactions. In fact, is only suitable for patients with type 2 diabetes mellitus diabetes pills, and is not generally suitable for patients with light, especially the rise in blood sugar is not only those who meet the diagnostic criteria for diabetes mellitus, and should not be selected.
Diabetes pill glyburide overdose caused by low blood sugar, taking diabetes pills low blood sugar caused by excessive shock or death cases have been reported. In addition, diabetes pills should be taken before meals, try to avoid medication before going to bed at night. Basic knowledge in many patients, and even a few of these doctors do not know, leading to their irrational use of award-winning.
Of the cold-resistant proprietary Chinese medicine with Western medicine abuse are more prominent. This kind of proprietary Chinese medicine such as speed 39 granule and a sense of catching a cold tablets, capsules, vitamin c silver warp films, colds and influenza, resistant and susceptible spirit with the spirit of the Qing, strong cold tablets contain paracetamol. Sold in China's Western medicine treatment of cold medicine, such as the tainuolin sustained-release tablets, paracetamol, codeine tablets, Tylenol, sharp pain, white and black films, a hundred day and night clothing such as Ning, Paracetamol tablets contain paracetamol. These two types of Chinese and Western medicine cannot take, otherwise easily lead to acetaminophen overdose, not only toxic to liver and kidney are obvious, and damage to digestive system.
I often hear people say, good effect of combined with Chinese and Western medicine for colds. What is more, one doctor told me about his experience in treating colds: "39 cold granule two bags, melting water, or wine white and black. If heavy cold by taking vitamin c yinqiao, the effect is very good! "so patients despite the cold to get well faster, but the liver and kidney damage, but it is the worst. The doctor may not know for acetaminophen toxicity, are more likely to be the doctor does not know these three kinds of medicines containing paracetamol. Regardless of the cause, all point to the physician's medication safety knowledge is not enough.
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