「六神丸」によりジギタリス中毒様の症状を呈した1例

A Case of “Rokushingan”Intoxication

　生薬強心剤である「六神丸」の長期服用によりジギタリス中毒様の症状を呈した1例を経験した．症例は42歳の男性で，全身倦怠感のために「六神丸」を常用していた．嘔気，嘔吐，胸部不快感を訴えて来院．心電図ではI度房室ブロック，洞性徐脈，盆状ST低下を示し，来院時の血中ジゴキシン濃度は6.22ng／mlであった．「六神丸」の中止と体外式ペーシングにより軽快退院した．「六神丸」に含有されるセンソのジギタリス様作用によって生じたものと考えられ，原因不明のジギタリス中毒の症例をみたときは，「六神丸」や「救心」など生薬強心剤の服用歴を考慮する必要がある．

A 42-year-old man was admitted because of nausea, vomiting, and chest discomfort. He had been taking “Rokushingan”for several years because of general fatigue. On admission, the pulse rate was 36/min, and the ECG showed first degree AV block, and sagging type ST depression in leads H, HI, aV_F, and V₆. Is-chemic heart disease was ruled out because both echocardiography and coronary arteriography showed no abnormalities. The serum digoxin concentration on admission was extremely high (6.22 ng/ml), so the diag-nosis of digitalis intoxication was confirmed. However the patient had been very well and had not taken digi-talis before admission. Temporary pacing was carried out for 2 days. The serum digoxin concentration was gradually decreased, and was 0.21ng/ml on the 10 th hospital day. The symptoms subsided and the ECG findings were normalized at that time. The “digitalis intoxication” in this case was considered to be induced by “Shan -su”, which was contained in “Rokushingan” and had a cardiotropic effect like digitalis. We think it is important to ask a patient who shows the symptoms and signs of unexplained “digitalis intoxication” about habitual use of “Rokushingan ”as well as “ ” Kyushin".