歷年來中藥檢出西藥成分及來源變遷分析

SUCCESSIVE CHANGES IN ADULTERANTS IN CHINESE HERBAL MEDICINES AND THEIR SOURCES DURING THE FISCAL YEARS 1982-1995

統計本局自七十二～八十四年度受理衛生行政機關、司法檢警情治機關送驗中藥摻加西藥案件，予以分析，結果如次，受理之中藥摻加西藥屬服務案件者，其檢出率平均在三成左右，涵蓋抽查案件則檢出率約在一成五左右。第一類屬合法廠商、醫療機構之中藥摻加西藥之檢出率約在4～26%之間，其中中醫醫院、藥廠絕少檢出。第二類依法不得販售提供藥品者，其檢出率在18～50%之間。自七十二至八十四年度檢出西藥成分數增加近三倍。每件檢體平均檢出西藥個數，從七十二、三年度之1. 8個，漸增至近三年度來之3.0～3.3個成分。檢出西藥之檢體中，以一個檢體同時檢出二、三、四、五個成分者居多，合計約占六成左右，近年來有一個檢體檢出六個成分者約占一成，亦有檢出七、八個成分者。檢出西藥檢體依送驗指定主治效能排名，依序為風濕類、止痛類、感冒鎮咳類、類固醇類、精神安定類為主，然檢出之西藥成分常與指定主治效能或指定之檢驗成分無關。經常檢出之成分依序為caffeine, acetaminophen, hydrochlorothiazide, indomethacin, diazepam, chlorzoxazone and ethoxybenzamide等。

In this study, the data on synthetic drugs added as adulterants in Chinese herbal medicines which we tested during the fiscal years 1982-1995 were collected and analyzed. The results showed that about 30% of the samples obtained from the consumer centers of the local health bureaus had been adulterated. However, if the samples also included those randomly sampled by the local health bureau officers from the market, there were only 15% of the total samples found adulterated. In the first category of supply sources of Chinese herbal medicines which included legal manufacturers of Chinese herbal medicines, and medicare units (hospital and clinics of traditional Chinese medicine), approximately 4-26% of the sources were found to have provided adulterated Chinese herbal medicines during the period of the above named fiscal years, and adulteration in samples from the hospitals and legal manufactures of Chinese herbal medicines was extremely rare. In the second category which included Chinese Kung-fu stores, folk medicine stores, unlicensed practitioners and others, the detectable rate was approximately 18-50% for the same period. The amount of synthetic drugs adulterated for fiscal year 1995 is threefold than fiscal year 1982. The mean number of adulterants in each sample was 1.8 in 1983 and 1984 and the number gradually increased to 3.0-3.3 in the current three years, almost a twofold increase. About 60% of the samples contained two to five kinds of adulterants in these years except for 1982. In current years, about 10% of the samples had been found to contain six adulterants per each drug and there were also samples each containing even seven or eight adulterants. Categorized by their indications, the commonly added adulterants were antirheumatics, analgesics, anticold-antitussives, steroids, and tranquilizers. From our analysis, the adulterants added in the Chinese herbal medicines were not necessarily associated with the labeled indications. The adulterants were, in the order of frequency of use, caffeine, acetaminophen, hydrochlorothiazide, indomethacin, diazepam, chlorzoxazone and ethoxybenzamide.