中藥學堂
總論與興奮劑篇
總論與興奮劑篇
中藥運動禁藥觀念建立與高風險中藥材（二）
◎文／藥師楊佳蒨
國際案例顯示，有多起中藥成分導致運動員非故意違規的案例，包括運動員因服用含去甲烏藥鹼的蓮子（心）、黃柏/黃蘗等中藥或保健品而尿液檢測陽性，或因麝香製劑導致類固醇圖譜異常，被判定違規。2,4,9,10運動員常因增強體能、恢復疲勞等目的而誤用含禁藥成分的中藥，加上部分傳統中藥複方、養生製劑與保健食品亦可能因標示不清、含未揭露成分或遭非法摻偽而引發非故意違規。2,10,11
綜整研究資料來看，現有檢測技術對中藥禁藥成分具備高度敏感性與特異性，使中藥造成的陽性反應更難被忽略。而中藥複方、基質效應（matrix effect）及運動員知識不足是非故意違規的主要風險來源。2,4,7,8,9,10因此建立運動員及醫藥專業人員具備「中藥亦可能含禁藥活性成分」之基本知識是刻不容緩。所有具交感神經刺激、類固醇樣活性、心血管作用或未明標示成分之中藥材或保健品皆應列為高風險。完善的用藥教育、查驗產品來源、避免賽前臨時服用未明成分之中藥製品，是預防非故意違規的關鍵。 
（待續）

參考資料：
2.	Determination of Doping Higenamine in Chinese Herbal Medicines and Their Concentrated Preparations by LC-MS/MS. Lin YA, Hsu MC. Journal of Pharmaceutical and Biomedical Analysis. 2024;246:116188.
4.	Traditional Chinese Medicine and Sports Drug Testing: Identification of Natural Steroid Administration in Doping Control Urine Samples Resulting From Musk (Pod) Extracts. Thevis M, Schänzer W, Geyer H, et al. British Journal of Sports Medicine. 2013;47(2):109-14.
7.	Ambient Ionization Mass Spectrometry for Rapid Screening of Illegal Adulteration in Traditional Chinese Medicines: A Review. Yang F, Shen W, Ying J. Analytical Methods : Advancing Methods and Applications. 2026.
8.	Recent Advances in Mass Spectrometry for the Detection of Doping. Thomas A, Thevis M. Expert Review of Proteomics. 2024 Jan-Jan;21(1-3):27-39.
9.	Chinese Herbal Medicine Significantly Impacts the Haematological Variables of the Athlete Biological Passport. Chang WC, Wang CY, Liu WY, et al. International Journal of Environmental Research and Public Health. 2021;18(18):9533.
10. Rasch Model Analysis of Herbal Medicine Consumption and Doping Risk Awareness Among Athletes. Park JH,  Yoon J, Lee S, et al. Scientific Reports. 2025; 10.1038/s41598-025-29444-x.
11. Potential Propensity of Traditional Herbal Materials Ingested by Collegiate Athletes in South China for Their Consuming Health Care. Qin YQ, Cheng CS, Jiang Y, et al. Medicine. 2021;100(44):e27635.


（本文作者為彰化基督教醫院中醫藥局主任）