近日，市民陈先生因肠胃不适，买了一盒藿香正气水，喝下去瞬间感觉味道不对，“这个味道简直了！像73度烧酒！”他很是纳闷，查看说明书后发现，竟含有40%-50%的酒精。15日入伏后，作为家中常备药，他特地又买了一盒藿香正气口服液，成分显示不含酒精。对此，陈先生十分纠结并求助记者，“到底哪种是正宗的老方子？该怎么选呢？”
左为藿香正气口服液，右为藿香正气水
藿香正气水含酒精，这些情况服用需甄别
江苏省中西医结合医院药学部何丹丹副主任中药师接受采访时称，这两种藿香正气制剂为市面上常见的品种，大家在选择时，应注意区分其名称和成分，藿香正气水含有酒精，藿香口服液不含酒精。“藿香正气水中含有40%-50%的酒精，在其药品说明书和《中药药典》中均有相关说明。”她解释道：“这主要与制备工艺有关，藿香正气方剂最早出现于唐代，最初为藿香正气散，随着制药技术的发展，发现采用乙醇（酒精）提取法能更好地发挥它的药效，因而有了现在的藿香正气水。”
近期，福州一男子就因为服用含有酒精的藿香正气水进了抢救室。据媒体报道，陈先生因发热、咳嗽、咳痰等，前往医院就诊，并挂了一瓶头孢西丁钠。回家的途中，他判断自己出现中暑症状，便购买藿香正气水并口服了一支。约15分钟后，他突然昏厥，被送医抢救。经诊断，男子因“酒精+头孢”同时服用，出现了双硫仑样“中毒”反应。
何主任指出，由于头孢类抗生素药物会抑制代谢酶活性，导致酒精代谢产物乙醛的蓄积，就可能发生双硫仑样反应，患者会出现心慌头晕、心跳加速，严重者甚至会休克。除了头孢类药物，还有不少药物如甲硝唑片，与酒精同服也会导致此类反应的出现。她提醒，服用藿香正气水的同时，应避免使用可能导致“双硫仑样反应”的药物。
“此外，藿香正气水因酒精浓度高，服用后应避免开车；服药期间少食或禁食生冷油腻及甜食。” 何主任强调，对于儿童老人和孕妇来说，酒精对肠道刺激大，建议选择更温和的藿香正气口服液。她提醒，除了藿香正气水外，其他型别的制剂均不含有酒精，但在选购胶囊或者颗粒时，还需注意辅料是否含糖，对于血糖高的患者，需要仔细甄别。
藿香正气功效相差不大，但起效有所不同
据了解，藿香正气的经典配方由十三味药材组成，包括藿香、大腹皮、白芷、紫苏、茯苓、半夏、白术、陈皮、厚朴、桔梗、炙甘草、生姜和大枣。目前市面上常见的藿香正气制剂经过演变，多采用十味药材，保留了经典方剂的主要成分，并结合现代人的生理特点等进行了调整。
“作为中医里的祛湿‘神器’，不同品牌藿香正气制剂，配方可能略有不同，但主要功效、适应证其实都差不多。”何主任介绍说，“藿香正气主要用于解表化湿、理气和中，适用于夏季的热感冒、身体湿重以及拉肚子等胃肠道不适症状。”她还提醒，藿香正气并非解暑良药，不适用于高温中暑。
专家指出，藿香正气制剂的不同点，更大程度上，体现在服用的方便程度以及药效起效的快慢。“如果症状比较急，藿香正气滴丸是起效最快的，可以优先选择；如果只是常规不适或是调理，浓缩丸起效较慢，但也更加温和。” 在她看来，藿香正气水、藿香正气口服液以及其他一些片剂或颗粒，治疗效果差异性并没有很大，“可在医生和药师的专业指导下进行使用。如果要自行购买，还是要根据自身情况，结合药品说明书进行选择，不能盲目跟风。”
扬子晚报/紫牛新闻记者 王梦航
校对 盛媛媛
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