臺灣中藥摻西藥趨勢分析

Trend Analysis of Chinese Herbal Medicines Adulteration in Taiwan

自從美國醫學協會（Institute of Medicine）於1999 年提出“To Err Is Human”之報告後，病人安全成為世界各國關切的議題，提昇醫療及用藥安全無庸置疑已是全球醫療發展的共同目標。中藥摻加西藥是用藥安全中一項重要的問題，因此本研究的目的乃在於藉由分析臺灣地區自1983 年至2002 年中藥摻西藥檢出的結果進行分析，以了解使用傳統中藥被摻加西藥的狀況，作為未來我國擬訂政策參考依據。本研究採用回顧性（retrospect）研究方法，蒐集1983 年至2002 年行政院衛生署藥物食品檢驗局、臺北市政府衛生局1997 年2 月至2002 年及高雄市政府衛生局2000 年6 月至2002 年之中藥檢出西藥電腦資料進行整理予以評估。研究的結果顯示：中藥摻西藥送檢案件檢出率平均在13.0﹪左右，其中若依檢體來源區分第一類合法廠商、醫療機構者中藥摻西藥檢出率平均8.4﹪；第二類不列入醫療管理行為場所卻提供藥品者中藥摻西藥檢出率平均25.2﹪。若以檢出西藥檢體別區分依送驗指定主治效能排名，依序為風濕類、類固醇類、感冒鎮咳類、止痛類、精神安定類為主，若依經常檢出之成分排名則有caffeine、acetaminophen、hydrochlorothiazide、indomethacin、及diazepam 等最常見。

Since “To Err Is Human” was annunciated by U.S. Institute of Medicine, theissue of patient safety about the development of increasing medical quality andmedication safety has been further concerned by global countries. The Chinese herbalmedicines adulteration has also to be important question of patient safety. Thus, weanalyze the trend by reviewing the Chinese herbal medicines adulteration data from1983 to 2002 in Taiwan for future sanitation policy decision-making purposes.The Chinese herbal medicines adulteration data review was obtainedretrospectively from Bureau of Food and Drug Analysis of Department of HealthExecutive Yuan between 1983 and 2002, Department of Health of Taipei CityGovernment between 1997 and 2002 and Department of Health of Kaohsiung CityGovernment between 2000 Jun and 2002. The results of research analysis shows: theadulterated rate of Chinese herbal medicines adulteration is in received sample averagearound 13.0%. On average 8.4% of sample from category I registered medicine orhealthcare provider is adulterated. In sample from category II unsupervisedmedicine-providing sources the rate averages 25.2%. The major indication of addedchemical substances in order is rheumatism, steroid, respiratory tractinfection/coughing, anesthesia, and tranquilizer. Most frequently seen ingredientsinclude caffeine, acetaminophen, hydrochlorothiazide, indomethacin and diazepam.