急性马桑中毒的临床表现及救治  

Acute poisoning caused by Coriaria sinica Maxim:clinical presentation and management

作　　者：谢立璟[1,2] 丁茂柏[1] 孙承业[1] 

机构地区：[1]中国疾病预防控制中心职业卫生与中毒控制所,北京100050 [2]中国协和医科大学公共卫生学院,北京100730

出　　处：《药物不良反应杂志》2008年第6期429-431,共3页Adverse Drug Reactions Journal

摘　　要：马桑(Coriaria sinica Maxim)是一种中草药,含有多种倍半萜酯类物质,主要毒性成分为马桑内酯和吐丁内酯等。马桑内酯和吐丁内酯为γ-氨基丁酸受体拮抗剂,能兴奋中枢神经系统,增强脊髓反射,产生惊厥。马桑全株有毒,尤以未成熟果实为最。人摄取马桑果15～60g可致中毒。小鼠肌肉注射马桑内酯的LD50为1.75mg/kg。儿童误食马桑果中毒不时有所报道。通常服用马桑后0.5～3h出现中毒症状。早期症状为恶心、呕吐、头晕、头痛、胸闷、腹部不适等,继之为焦虑、烦躁不安、血压升高、呼吸加快、全身抽搐。患者可因呼吸心跳骤停而死亡。处理方法为洗胃,导泻,给予地西泮或苯巴比妥,以及对症支持治疗。Coriaria sinica Maxim is a Chinese herbal medicine. The plant contains sesquiterpene lactons, of which the main toxic components are coriamyrtin, turin, etc. Coriamyrtin and tutin are a antagonist of y-aminobutyric acid receptor. They cause the stimulation of the central nervous system and the enhancement of the spinal cord reflex, leading to convulsions. All parts of the plants are toxic, especially in unripe fruits. Ingesting the fruits 15 - 60 g may cause intoxication. The LD50 of coriamyrtin in mice by intramuscular injection is 1.75 mg/kg. Reports of accidental poisoning in children who eating the fruits are frequent. Generally, the onset time of intoxication symptoms after ingestion of Coriaria sinica Maxim is 0.5 - 3 h. Early symptoms of Coriaria sinica Maxim poisoning are nausea, vomiting, dizziness, headache, chest distress, abdominal disomfort. Anxiety, restlessness, increased blood pressure, accelerated respiration, generalized convulsion follow. The patients often died from cardiopulmonary arrest. Management includes gastric lavage, catharsis, administration with diazepam or phenobarbital, symptomatic and supportive treatment.

关 键 词：马桑 中毒 临床表现 治疗 

分 类 号：R595.4[医药卫生—内科学]