MASKINOVERSÆTTELSE TIL DANSK
MASKINOVERSÆTTELSE FRA KINESISK BROCHURE OM GIFTIGE SVAMPE I KINA (Yunnan-provinsen):

與白色劇毒鵝膏的區別白條蓋鵝膏和黃蓋鵝膏白色變種，淡紅毒鵝膏菌極相似，但白色劇毒鵝膏菌蓋邊緣無明顯棱紋，小菌褶漸狹，菌柄基部多少膨大呈球形。在昆明，大理，麗江，楚雄等地有採食白條蓋鵝膏的習慣，由於一般人難以與白色的劇毒鵝膏分區，建議最好不採食。並且毒性成分檢測時仍能檢測到該菌至少含鵝膏毒肽與鬼筆毒肽各1種。

俗名白羅傘主要鑑別特徵中等至大型，菌蓋白色或稍帶米黃色，中央平坦或稍突起，邊緣具棱紋;菌褶離生，白色，小菌褶平截。膜質，白色，生菌柄上部。菌托白色，深杯狀或袋狀。分佈與生境福貢，思茅，保山，麗江等地有分佈。主要見於闊葉林下。

与白色剧毒鹅膏的区别 白条盖鹅膏 和黄盖鹅膏白色变种、淡红毒鹅膏菌极 相似，但白色剧毒鹅膏菌盖边缘无明显 棱纹、小菌褶渐狭、菌柄基部多少膨大 呈球形。在昆明、大理、丽江、楚雄等 地有采食白条盖鹅膏的习惯，由于一般 人难以与白 色的剧毒鹅 膏区分，建 议最好不采 食。并且毒 性成分检测 时仍能检测 到该菌至少含鹅 膏毒肽与鬼笔毒 肽各 1 种。

俗名 白罗伞 主要鉴别特征 中等 至大型，菌盖白色或稍带 米黄色，中央平坦或稍突起， 边缘具棱纹；菌褶离生，白色， 小菌褶平截。菌柄白色，近基部处不 膨大。菌环膜质，白色，生菌柄上部。 菌托白色，深杯状或袋状。 分布与生境 福贡、思茅、保山、丽 江等地有分布。主要见于阔叶林下。
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Contact: China Center for Disease Prevention and Control of Occupational Health and Poison Control
Address: Xuanwu District, Beijing latitude Road, Room 29318
Phone: 010-83132045; Fax: 010-83132046
Contact: Xie Li Jing, Zhou Jing E-mail: xielijing2003 @ sina.com.cn
Kunming Institute of Botany, Chinese Academy of Sciences Address: 132 Lanhe Road, Kunming, Yunnan
Tel: 0871-5223507; Fax: 0871-5150227
Contact Person: Tang Liping, Yang Zhu Liang Email: tangliping1970@gmail.com; fungiamanita @ gmail.com
Kunming Medical College of Pharmacy Drug resource Department address:
Kunming Chenggong New City Yuhua 1168 spring melt street West
Tel: 0871-5922780; Fax: 0871-5922780 contact: Tang Liping E-mail: tangliping11@qq.com
Chinese Center for Disease Control and Occupation Occupational Health and Poisoning Control Kunming Institute of Botany,

Chinese Academy of Sciences Kunming Medical College
2011.05

Yunnan wild mushroom poisoning prevention and control manual Yunnan wild mushroom poisoning prevention manual Yunnan wild mushroom poisoning prevention and cure manual

Yunnan mushroom poisoning prevention and control manual

It is rich in about 600 species of wild edible mushrooms in the province, accounting for 60% of the total edible fungus species in the country, ranking the highest in all provinces and autonomous regions nationwide.

Wild mushrooms nutritious, delicious, is the treasure of many people's minds. However, people enjoy the delicious wild mushrooms, the tragedy is also staged from time to time.

According to the statistics of Yunnan Provincial Health Bureau, from 1985 to 2000, there were 378 mushroom poisoning cases in China with 2330 people being poisoned and 326 dead, with a case fatality rate of 13.90% and an average annual death toll of 20.4.

In recent years, Incidents caused by poisoning have also been reported from time to time. Therefore, in order to prevent mushroom poisoning and reduce its harm, medical staff and the general public need to popularize the basic knowledge of identifying poisonous mushrooms.

01-appearance of toadstool

-02 Figure 1 Schematic diagram of the main structure of toadstool

Figure 2 Plait on the stipe stalk in the way of Figure 3

Amanita cap edge with or without flocculent small plait shape

Figure 3 -1 shows: the edge of the cap without flocculent, and the small folds flattened truncated (as knife-cut neat)

3-2 shows: the edge of the cap floc there, and the small fungal pleomorphic (arc-like, gradually Stenosis) Stomatal or scales (bacteria curtain residual) Flagella Coriolobus bacteria ring

Yunnan wild mushroom poisoning prevention and control manual

Yunnan wild mushroom poisoning prevention and treatment manual

1. Gastroenteritis-type incubation period of mostly 10 minutes to 2 hours, the performance of Nausea, vomiting, abdominal pain, diarrhea and other gastrointestinal symptoms.

The general prognosis is good, but severe poisoning may be due to dehydration and electrolyte imbalance shock, coma, and even death.

Common species such as yellow powder Boletus, poisonous red mushrooms, Pleurotus eryngii, Cap hair mushrooms, Leopard penguin cream, sulfur bacteria, such as moon light bacteria.

2. Neuropsychiatric latent period of 10 minutes to 6 hours in general, in addition to gastrointestinal symptoms, mental symptoms such as excitement, mania, visual hallucinations, auditory hallucinations can be the main performance, accompanied by miosis, hyperhidrosis, saliva increased , Tears and other symptoms. The prognosis is more good. Representative species such as poison flies Amanita, gorgeous Boletus, Boletus Boletus, Boletus minor, Pleurotus mushroom, mushroom light, naked mushrooms, sulfur bacteria and so on.

In Yunnan, mainly caused by the class of Boletus.

Poisonous mushroom poisoning types and common identification of poisonous mushrooms

Poisonous mushrooms are a type of large fungi that can poison humans or animals (most of them belong to basidiomycetes, a small number belong to ascomycetes, a wide range of different shapes, mainly umbrella- There are also tablets, ears, discoid, saddle, etc.).

Poisonous mushroom poisonous ingredients are complex, a poisonous mushroom often contains a variety of toxins.

Whether or not poisoning and cooking methods, the amount of consumption, eating habits and other factors, the clinical manifestations are more complex and diverse.

At present, according to the mechanism of poisoning and typical clinical manifestations, can be divided into the following five types:

Pulveroboletus ravenelii
Pulveroboletus ravenelii og Heimioporus retisporus yellow powder Boletus sphaerotheca sea bream common name chanterelles main identification characteristics bright colors, cap and stipe surface dressing Lemon yellow fine powder, picks can contaminate your fingers. Caps hemispherical, yellow to yellowish bacteria, stipe stalk in the real. Distribution and habitat more common in Yunnan, Dali, Chuxiong, Lijiang, Baoshan, Dehong and other places are distributed, was born in the broad-leaved forest or pine forest.Typical cases of poisoning In 2006, there was a case of mushroom poisoning in 77 workers in the canteen of Guizhou Province, with nausea, vomiting, diarrhea and other gastrointestinal symptoms as the main manifestation. Severe patients developed hematochezia and hypovolemic shock .

Heimioporus retisporus
03- -04 Commonly known as red bolete, see hand-green Main features cover cap semi-circular, dark red to gray-red.Tube yellow to light yellow. Stigma dark red to rose red, the surface with small scales, nearly stipe slightly smooth base. Inside the cap and stipe was bright yellow. Distribution and habitat are widely distributed, Dali, Chuxiong, Lijiang, Baoshan, Dehong and other places are distributed. Mainly seen in broad-leaved forest. Typical cases of poisoning Only in the summer of 2007, Kunming, a hospital on the treatment of such bolete poisoning patients 54 cases. Poisoning patients appear dizziness, auditory hallucinations, delirium, mania and other mental symptoms. Toxic ingredients may contain toxoid, toad prime, light umbrella umbrella, isoxazole derivatives and other neurotoxins.

Yunnan wild mushroom poisoning prevention and control manual Yunnan wild mushroom poisoning manual Common name Gypsophila Main identification characteristics of individual medium size. Cover the surface of light yellow brown to yellow, scattered beige to dirty white plaque or granular scales, easy to fall off after the old cap edge with short ribs, bacteria white.

Amanita parvipantherina
Pleurotus pleurotus, free, little pleurodeis more cut. Stigma surface has a small scale, basally swollen nearly spherical or oval. Ring white to beige, usually growing in the upper part of stipe. Distribution and Habitat Dali, Binchuan, Chuxiong, Lijiang, Baoshan, Deqin, Dehong and other places are distributed, was born in the broad-leaved forest or pine forest. Typical cases of poisoning July 2005 Sichuan Province 10 people in the city to eat wild leopard Pica Pica or leopard leopard ointment

Galerina autumnalis
05- -06 A manita parvipantherina Galerina autumnalis Leopard apena 3. Liver injury-type incubation period is usually a few hours to 30 hours, a few onset in half an hour. Early obvious gastrointestinal symptoms may occur, mild organ damage in patients with severe damage directly into the recovery period. Most poisoning patients in the gastrointestinal symptoms 1-2 days after the "false more than", when alanine aminotransferase has been increased, followed by nausea, vomiting, abdominal discomfort, anorexia, liver pain, liver enlargement, jaundice , Bleeding tendency, after aggressive treatment, about 2 to 3 weeks after the recovery gradually. A small number of cases were erupted due to hepatic encephalopathy, respiratory and circulatory failure death. A few cases of arrhythmia, oliguria, urinary closure and other performance.

Representative species such as deadly amanita, yellow capuca cream, gray Amanita cream, autumn helsinki umbrella, brown scales ring handle mushroom (brown scales umbrella) and so on.Poisoning patients 8 to 11 hours after eating frequent nausea, vomiting, abdominal pain, diarrhea, gradually improved after 1 to 2 days, severe cases in 1 to 3 days after the "fake," severe abdominal pain, liver enlargement, jaundice, Extensive systemic hemorrhage and disturbance of consciousness, abnormal liver function, especially prolonged prothrombin time significantly. Autopsy pathology results for the severe acute toxic liver nocturnal Coke Pinus, autumn lily ear identification of one of the main characteristics of the famous germ, fatality rate is extremely high. Individual smaller, nearly flat cover, brown.

1994/12/12/6
Pleurotus yellowish brown. Pedicel slender, hollow, upper yellow, base dark brown, vertical ribbing. Distribution and habitat in Kunming, Dali, Chuxiong, Lijiang and other places are distributed. Born in rotten wood pile. Typical cases of poisoning In 1994, 12 people in Sichuan Province, a place where 12 people ingested poisoned bacteria 6 poisoning, mushroom poisoning, in addition to gastrointestinal symptoms, the clinical manifestations of dizziness, vertigo, salivation, tearing, severe cases of convulsions, coma. Although no cases of poisoning have been reported in Yunnan Province, this type of geese cream is very common in Yunnan Province. Degeneration of cells and extensive hepatic necrosis. Toxic ingredients include amanita toxin and ghost penicillin peptides.

1994/6/5
Common name yellow parachute
Identification of one of the most poisonous mushrooms, highly toxic.Individual small to medium, cap yellowish to dirty yellow, marginal rib is not obvious; flesh yellowish white; follicles from the students, light yellow and white, small bacterial pleat narrowing. Petiole surface with small scales, white cream yellow, nearly spherical at the base of the expansion. Bacterial ring membrane quality, pale yellow or white, was born in the upper stipe, easily broken. Pedicel at the base of the handle to form a neckline or shallow cup-shaped. Distribution and habitats are more common, Xishuangbanna, Kunming, Dali, Lijiang and other places are distributed, was born in the oak forest or oak and pine mixed forest.
Typical cases of poisoning In 1994, 6 people in a county of Hebei province ate yellow gailing cream and killed 5 people.

Amanita subjunquillea
yellow capucine 07- -08 and the virulent species – the difference between yellow capitatum Both cap color is very similar, but the individual yellow-amanita smaller, slightly slender, cap edge ribbing Obviously, small bacterial pleat narrow, base stigma globose. Although Dali, Lijiang, Chuxiong and other places eat red and yellow goose ointment brown habit, but according to local residents after eating more dizziness, nausea and other symptoms, it is recommended that the most toxic ingredients mainly include amanitaine and ghost Penicillin peptide is good to eat. Wait. These toxins are extremely toxic, stable in nature, resistant to high temperatures, dry and resistant to general cooking.

Amanita hemibapha var. ochracea
yellow and yellow goose ointment brown varieties easily confused species common name yellow parachute, goose egg bacteria, egg bacteria main identification characteristics of individual medium to large, thick stout bacteria. Caps dark yellow to dark brown, with obvious long edges on the edges. Bacteria yellow-white. Pleurotus light white, free, small fold flattened bacteria. Petiole light yellow, hollow after internal maturity, near the base is not swollen. Bacterial ring membrane quality, light yellow to yellow-white, was born in the upper handle. Stool form a pocket or deep cup at the base of the handle. Distribution and Habitat Dali, Chuxiong, Lijiang and other places are distributed, mainly seen in the spruce, fir forest, pine forest visible.

5% KOH giver gul farve
Common name poisonous white umbrella Main identification characteristics The toxin content and yellow galena similar to one of the most poisonous mushrooms. Characteristics similar to the yellow galea, the difference is that the bacteria cover white, only the central light beige. When the kind of fresh, all parts of 5% potassium hydroxide drops into a bright yellow immediately. (See right) distribution and habitat Kunming, Simao, Dali, Chuxiong, Lijiang and other places are distributed, found in the pine or oak forest. Difference with the white draconic amanita white gland amanita and yellow galea white varieties, light red amanita bacteria very similar, but the white draconical amanita cap edge no obvious ribs, small bacteria pleat narrow, bacteria Shank basal enlargement of the number of spherical. In Kunming, Dali, Lijiang, Chuxiong and other places have the habit of eating white strips covered with amanita, because most people are difficult to distinguish with the white highly toxic amanita, it is recommended not to eat the best. And the toxic components can still detect the detection of the bacteria at least amanitin and phalloidin each one.

09- -10
Amanita subjunquillea var. alba
Amanita pallidorosea
Amanita chepangiana
yellow capitatum white variant light red poisonous goose cream white strip amanita common white umbrella main identification characteristics of medium to large, cap white or slightly beige , Central flat or slightly raised, margin with ribs; follicles free, white, small fold pleurodesis. Petiole white, near the base is not swollen. Ring bacteria membranous, white, upper stems stipe. Bacteria support white, deep cup or bag. Distribution and habitat Fugong, Simao, Baoshan, Lijiang and other places are distributed. Mainly seen in broad-leaved forest. Easily confused species Popular white poison umbrella main identification of one of the most poisonous mushrooms, medium size, slim cell body. Cap white, central slightly protruding, with a few pink, no rib edge. Pleurotus away from the white, small bacterial pleat narrowing. Petiole white, near the base near the ball inflated. Membranous membranous, white or beige, was born in stipe the upper part. Bacteria support white, shallow cup. Distribution and habitat Fugong, Simao, Baoshan and other places are distributed, found in oak trees.

11- -12

1996/7 alle døde/10g dødelig
Amanita fuliginea (dødelig)
Amanita manginiana (spiselig)

Amanita fuliginea
Gray pattern Amanita Crypto alba distribution and habitat Dali, Chuxiong, Lijiang, Zhaotong and other places are distributed mainly in the oak Under the woods. Typical cases of poisoning In 1996, a county in Hunan Province, 7 were mistakenly infected with the bacteria, all died.

Toxic ingredients to amanitaine and phalloidin peptide-based. The color of the cap is very similar, but the virulent yellow galea individual smaller, light gray to gray-black stipe, the base is enlarged and spherical. In Kunming, Dali, Lijiang, Chuxiong and other places have the habit of eating cryptocystin cream, because most people are difficult to distinguish with the gray pattern of goose cream, it is recommended not to eat the best. Easily confused species Popular name of the poisonous umbrella Main identification of one of the most poisonous mushrooms, highly toxic. An individual weighing about 10g fresh may cause one adult to die. The individual bacteria smaller, cap dark gray or dark brown to near black, with dark filament filiform pattern or markings, no rib edge. Pleurotus away from the living, nearly white, small bacterial pleat narrowing. Stipe stalk is light grayish brown scales, near the base of spherical bulge. Mycoplasma membrane quality, light gray, was born in the upper handle. Bacteria support white, shallow cup. Common name grass chicken brown main identification characteristics of medium to large, thick stout cells. Caps dark gray or dark brown to almost black, with dark filamentous impressions or stripes, edges without ribs. Pleurotus away from the white, small bacterial pleat narrowing. Stems white, white ciliate to powdery scales, slightly swollen near the base. Bacterial ring membranous, white, fragile, top or near terminal. Bacteria support white, shallow cup. Distribution and habitats Kunming, Simao, Baoshan, Dali, Chuxiong, Lijiang and other places are distributed mainly in broad-leaved trees or coniferous and broad-leaved mixed forest. And the poisonous species – gray pattern Amanita two

SIDE 13
4/6-12/5/24-48/porphyrin-fotosensitiv/3000 meters højde/15%-35%/1-2/MMH methylamin hydrolysat
Gyromitra infula
Melanogaster
Ionomidotis frondosa [opløser blod, hvilket kan give skade på lever, milt, nyresvigt, påvirke hjernen og endog medføre døden]
leaf-like ear fungus

LATENSTID-GRUPPE 4 (SIDE 13 ØVERST). Hemolysis latent period 6 ~ 12 hours, in addition to gastrointestinal symptoms, but also waist and abdomen pain, weakness, dark brown urine, anemia, hepatosplenomegaly and other acute hemolytic symptoms, severe hemolysis can cause acute renal failure, and even death. This type can also be accompanied by central nervous system manifestations. Representative species such as deer and ocher flowers.

LATENSTID-GRUPPE 5 (SIDE 14 ØVERST). Photosensitive dermatitis type incubation period generally 24 to 48 hours, there may be skin irritation or herpes, after sun exposure symptoms increase, the toxic components may be porphyrin photosensitive material, the general prognosis of this type is good. Representative species such as leaf-shaped ear fungus, plastic gyro and so on.

Gyromitra infula
Common name ocher saddle main identification characteristics of individual medium size, brown to ocher brown.The upper part of the saddle-shaped, hollow, light color, stipe cylindrical nearly cylindrical or flat, smooth or wrinkled surface, hollow.Distribution and habitat distribution in Dali, Chuxiong, Lijiang and other places higher elevation (about 3000 meters) under the forest, was born on the ground. Typical cases of poisoning Sienna deer and its approximate species are edible mushrooms in Europe and the United States, in Europe, the mortality rate of poisoning is 15% to 35%.

Most of the initial symptoms of headache, nausea, vomiting, diarrhea, 1 to 2 days after chills, fever, abdominal pain, splenomegaly, hemoglobinuria, severe cases of acute renal failure may lead to death.Although Yunnan has not yet been reported cases of poisoning, but this type of toxins in Yunnan Province is more common, should be careful not to eat such germs. Toxic components deer hormones (also known as saddle-sour) and its hydrolyzate methyl amine (MMH) can dissolve the red blood cells, so that a large number of red blood cells destroyed, acute hemolysis. Methyl amine on the liver, stomach, bladder, etc. are damaged. Common name of dark brown fungus, fungus fungus main identification characteristics of bacteria was flaky, dark ink, dull, dull, wrinkle-free, opaque, inelastic; taste bitter, with numbness. Water immersion was black. (See above) Distribution and habitat Dali, Chuxiong, Lijiang and other places are distributed, born in rotten wood.

Juli 1992/6/
porphyrin

Typical cases of poisoning July 1992, a county in Yunnan Province, 6 people ingested the bacteria, numbness of the exposed parts of the skin, swelling and pain, eyelid edema, photophobia and other performance, sun exposure after the skin blisters of varying sizes. The toxic components may be porphyrins photosensitive substances.

The difference between the fungus and black fungus The fungus and black fungus very similar, but the Auricularia auricular, more regular shape, brown, surface folds, more shiny, translucent, flexible; no bitter, hemp flavor. Aqueous solution was light yellow. (
Auricularia auricular – indsat billede
See below)

Common name Egg fungus
Main identification characteristics Individual medium size. Caps white to beige, the surface of the powder, cover the outer layer often covered with large tracts of light yellow or He color bacteria curtain residual edge of the lid without ribs; bacteria white; folds white, dried shallow soil yellow Brown, free, dense, small bacterial pleat. Petiole basal enlargement was spindle-shaped or white radish, white to dirty white, the surface of the powder or cotton-wool scales, the lower part of the bacteria ring is not complete or belt distribution. When the rainfall is plentiful, flowers like flowers are born rotten wood, easy to pick.Typical Cases Since 1975, a series of sudden and unexplained death diseases have emerged in remote mountainous areas and semi-mountainous areas in Yunnan Province. Most of the cases have symptoms of dizziness, nausea, palpitations, syncope and coma before they die. According to the results of the present study shows that the bacteria may be related to the disease.

SIDE15- Russula subnigricans
Others According to the literature, some clinical manifestations of poisonous mushroom poisoning are the same as those of the above types of Pleurotus ostreatus, including acute kidney damage, rhabdomyolysis and other clinical manifestations as the evidence is not yet Full, yet to be further studied. Popular name Mycophenolate fake mushrooms, the main identification of one of the most virulent mushrooms, mortality is extremely high. Caps flat, gray-black surface. Gill folds white, sparse and thick, folds with transverse veins. Stipe stalk is short, dirty white, hollow. Bacterial injuries darken red. Distribution and habitat Dali, Chuxiong, Baoshan and other places are distributed under the forest. Typical cases of poisoning In August 1998, 9 people in Taiwan Province mistakenly consumed the bacteria, except 2 cases of rhabdomyolysis, except nausea and vomiting.

SIDE 16
Amanita neoovoidea
curled, nearly white. Ring bacteria white, easily broken off.Distribution and Habitat Dali, Jianchuan, Chuxiong, Xundian and other places are distributed mainly in the coniferous or mixed coniferous forest. Typical poisoning cases from 1999 to 2000, 15 people in Hunan Province, the incidence of eating the bacteria poisoning, in addition to gastrointestinal symptoms, some patients with acute renal damage as the main performance, accompanied by mild liver damage. The main toxic components are amanita peptide components.

Ditch pleurotus Common name white fungi, cockscomb bacteria, fingernail bacteria, Butterfly bacteria, eight large main features of the main identification of semi-circular to fan-shaped, petal-like, with a short handle; texture slightly tough, thin leathery, translucent, To rice soup color, a little light purple when young; the upper surface is more shiny, the lower surface of the obvious radial veins. Dry light brown. Distribution and habitat in Yunnan is widely distributed, Yunnan, Xishuangbanna, Dali, Chuxiong, Lijiang, Baoshan, Dehong and other

1. Bright mushroom poisonous, color ordinary mushrooms non-toxic.wrong! According to the color and shape can not simply distinguish whether the mushroom poisonous.

Chanterelle, Pleurotus bovis and Rhodococcus are brightly colored and deliciously edible; while gray-tufted goose anger, deadly goose angels and other highly poisonous mushrooms are gray or white in color.

2. Mushrooms that grow on wet or livestock excrement are poisonous, and mushrooms that grow in clean areas such as pine trees are non-toxic. wrong! Most mushrooms grow in dark and humid environment, some poisonous and some edible.

Some poisonous mushrooms do grow on the droppings, such as Helicobacter pylori and some poisonous species in the flowering umbrella; however, some of the poisonous species in goose creams, mushrooms, and red mushrooms also grow in the pine forests.

3. Mushrooms with silverware, ginger, rice, raw onions cooked together, the liquid dark toxic, the same color is non-toxic. wrong
Mushroom toxins can not react with silverware, etc., can not produce color change. Such as amanita toxin can not occur color reaction.

4. Secretion or injury discoloration of mushroom poisoning. wrong! Some poisonous mushrooms do have secretions or discoloration, but some succulent mushrooms have milk secretions and color changes when they are injured. They are not only poisonous, but also tasty mushrooms, such as juicy mushrooms Milk syrup).

5 raw maggots, parasites mushrooms are not poisonous. wrong! Many highly toxic amanita maggots, worms. 1. Emetic: Should promptly induce vomiting as conditions permit.

2. Immediately to the regular hospital for treatment, it is best to carry the remaining mushroom samples for further diagnosis and treatment.

1. Contact the relevant professionals to identify mushrooms.

2. As soon as possible to carry out toxicant removal techniques, such as gastric lavage.

3. Mushroom poisoning no specific antidote to symptomatic supportive treatment.

SIDE 17- -18 poison mushrooms misunderstanding mushroom poisoning how to save yourself? Hospital poisoning after poisoning: Conclusion Yunnan a wide range of toxic mushrooms, the above mentioned only some of the common poisonous mushrooms. As the mushroom identification often requires professional knowledge and certain equipment, equipment, medical personnel in the admissions to patients suspected of poisonous mushroom poisoning, it is best to ask the professional bodies of mushroom specimens for professional identification. Due to limited research data, this information is for medical advice only.

ORIGINAL KINESISK TEKST:
联系方式： 中国疾病预防控制中心职业卫生与中毒控制所 地址：北京市宣武区南纬路 29 号 318 房间 电话：010-83132045；传真：010-83132046 联系人：谢立璟、周静 电子邮箱：xielijing2003@sina.com.cn 中国科学院昆明植物研究所 地址：云南省昆明市蓝黑路 132 号 电话： 0871-5223507；传真：0871-5150227 联系人：唐丽萍、杨祝良 电子邮箱：tangliping1970@gmail.com；fungiamanita@gmail.com 昆明医学院药学院药物资源系 地址：昆明市呈贡新城雨花街道春融西路 1168 号 电话： 0871-5922780；传真： 0871-5922780 联系人：唐丽萍 电子邮箱：tangliping11@qq.com 中国疾病预防控制中心职业卫生与中毒控制所 中国科学院昆明植物研究所 昆明医学院 2011.05 云南 野生蘑菇 中毒防治 手册 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 云南食用菌资源极其丰富， 全省境内已知野生食用菌约 600 种， 占全国食用菌种类的 60%，居全国各省区之冠。 野生蘑菇营养 丰 富， 味 道 鲜 美， 是不少人心目中的 山珍。然而人们在 享用美味的野生蘑 菇时，悲剧也在不 时上演。据云南省 卫 生 机 构 统 计， 1985 年 ~2000 年之 间，全省共发生蘑菇 中 毒 378 起， 中 毒 2330 人，死亡 326 人， 病 死 率 13.90 ％， 平 均每年死亡人数 20.4 人；近年来，媒体对 蘑菇中毒引发的事件 亦时有报道。因此， 为预防蘑菇中毒，减 少其危害，医务人员 及普通群众亟待普及 鉴别有毒蘑菇的基本 知识。 01- 伞菌外观特征示意图 -02 图 1 伞菌主要结构示意图 图 2 菌褶在菌柄上的着生方式示意图 图 3 鹅膏菌盖边缘有无絮状物与小菌褶形状示意图 图中 3-1 示：菌盖边缘无絮状物，且小菌褶平截（如刀切般整齐） 3-2 示：菌盖边缘有絮状物，且小菌褶渐狭（圆弧状，逐渐变狭窄） 菌托或鳞片 （菌幕残余） 鳞片 菌盖 菌褶 菌柄 菌环 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 1. 胃肠炎型 潜伏期多为 10 分钟 ~2 小时，表现为恶心、呕吐、 腹痛、腹泻等消化道症状。一般预后较好，但严重中毒者可因脱水及电 解质紊乱出现休克、昏迷，甚至死亡。常见种类如黄粉末牛肝菌、毒红菇、 密褶红菇、毛头乳菇、小豹斑鹅膏、硫磺菌、月光菌等。 2. 神经精神型 潜伏期一般 10 分钟 ~6 小时，除出现消化道症 状外，精神症状如兴奋、狂躁、幻视、幻听等可为主要表现，同时可伴 有瞳孔缩小、多汗、唾液增多、流泪等症状。预后多良好。代表种如毒 蝇鹅膏、华丽牛肝菌、中华牛肝菌、小美牛肝菌、斑褶菇、光盖菇、裸 盖菇、硫磺菌等。在云南地区主要由牛肝菌类引起。 毒蘑菇中毒类型与常见毒蘑菇鉴别特征 毒蘑菇是一类可使人或动物中毒的大型真菌（大多数隶属于担子菌， 少数属于子囊菌，种类繁多，形状各异，以伞状为主，也有片状、耳状、盘状、 马鞍状等）。 毒蘑菇毒性成分复杂，一种毒蘑菇常含有多种毒素。中毒与否与烹调 方法、食用量的多少、饮食习惯等多种因素有关，临床表现较为复杂多样。 目前根据中毒作用机制和典型临床表现，主要分为以下五型 : Pulveroboletus ravenelii H eimioporus retisporus 黄 粉 末 牛 肝 菌 网 孢 海 氏 牛 肝 菌 俗名 黄蘑菇 主要鉴别特征 颜色鲜艳，菌盖与菌柄 表面敷有柠檬黄色细粉末，采摘时可沾 染手指。菌盖半球形，菌肉黄色至黄白 色，菌柄中实。 分布与生境 在云南较多见，大理、楚 雄、丽江、保山、德宏等地均有分布， 生于阔叶林或松树林下。 典型中毒案例 2006 年贵州省某职工 食堂曾发生一起 77 人食入混有该菌的 蘑菇中毒事件，以恶心、呕吐、腹泻 等消化道症状为主要表现，严重患者 发生便血、低血容量性休克。 03- -04 俗名 红牛肝菌、见手青 主要鉴别特征 菌盖半圆形，暗红色至 灰红色。菌管鲜黄至浅黄色。菌柄暗红 至玫红色，表面具细小鳞片，近菌柄基 部稍光滑。菌盖与菌柄的内部呈鲜黄色。 分布与生境 分布广泛，大理、楚雄、 丽江、保山、德宏等地均有分布。主要 见于阔叶林下。 典型中毒案例 仅 2007 年夏季，昆明 市某医院就收治该类牛肝菌中毒患者 54 例。中毒患者出现头晕、幻听、谵妄、 狂躁等精神症状。 毒性成分 可能含有毒蝇碱、蟾蜍素、 光盖伞素、异噁唑衍生物等神经毒素。 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 俗名 满天星 主要鉴别特征 个体中等大小。菌 盖表面浅黄褐色至黄色，散布米色 至污白色的细小斑块或颗粒状鳞 片，老后易脱落，菌盖边缘有短棱 纹，菌肉白色。菌褶白色，离生， 小菌褶多平截。菌柄表面有小鳞片， 基部膨大呈近球形或卵圆形。菌环 白色至米色，一般生长在菌柄上部。 分布与生境 大理、宾川、楚雄、 丽江、保山、德钦、德宏等地 均有分布，生于阔叶林或松 林下。 典 型 中 毒 案 例 2005 年 7 月四川省某市 10 人误食野外采 摘的小豹斑鹅膏或假豹斑鹅膏类蘑 05- -06 A manita parvipantherina G alerina autumnalis 小 豹 斑 鹅 膏 秋 生 盔 孢 伞 3. 肝脏损伤型 潜伏期一般为数小时 ~30 小时，少数在半小时内 发病。早期可出现明显的消化道症状，轻度中毒患者脏器损害不严重， 直接进入恢复期。多数中毒患者在消化道症状后呈 1~2 天的“假愈期”， 此时谷丙转氨酶已经升高，之后出现恶心、呕吐、腹部不适、纳差、肝 区疼痛、肝脏肿大、黄疸、有出血倾向，经积极治疗，约 2~3 周后渐趋 恢复。少数病例呈爆发性经过，因肝性脑病、呼吸和循环衰竭死亡。少 数病例有心律失常、少尿、尿闭等表现。代表种如致命鹅膏、黄盖鹅膏、 灰花纹鹅膏、秋生盔孢伞、褐鳞环柄菇（褐鳞小伞）等。 中毒患者食后 8 ～ 11 小时出现频繁恶 心、呕吐、腹痛、腹泻，1 ～ 2 天后逐 渐好转，重症病例于 1 ～ 3 天的“假愈 期”后， 出现剧烈腹痛、肝脏肿大、黄 疸、全身广泛出血和意识障碍，肝功能 明显异常，特别是凝血酶原时间显著延 长。尸检病理结果为重度急性中毒性肝 俗名 焦脚菌、秋生鳞耳 主要鉴别特征 著名毒菌之一，致死率 极高。个体较小，菌盖近平展，黄褐色。 菌褶黄褐色。菌柄细长，中空，上部黄色， 基部黑褐色，有纵棱纹。 分布与生境 在昆明、大理、楚雄、 丽江等地有分布。群生于腐木桩上。 典型中毒案例 1993 年四川省某地发 生 12 人误食该菌 6 人死亡的中毒事件， 菇 中 毒， 除 消 化 道 症 状 外， 临 床 表现 以 头 晕、 眼 花、 流 涎、流泪为主， 严 重 患者 出 现 抽 搐、 昏 迷。 虽 然 云南 未 见 中毒案例报道， 但 该 类鹅 膏 在 云 南 境内 十 分 常见。 细胞空泡变性及广泛肝坏死。 毒性成分 主要包括鹅膏毒 肽和鬼笔毒肽等。 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 俗名 黄罗伞 主要鉴别特征 最毒的蘑菇之一，毒 性极强。个体小至中等，菌盖浅 黄色至污黄色，边缘棱纹不 明显；菌肉浅黄白色；菌褶 离生，浅黄白色，小菌褶渐 狭。菌柄表面有细小的鳞片， 白色带奶油黄色，近基部处 膨大呈球形。菌环膜质，浅 黄白色或近污白色，生于菌 柄上部，易破碎。菌托在柄 基部形成领口状或浅杯状。 分布与生境 较为常见，西 双版纳、昆明、大理、丽江 等地均有分布，生于栎树林 下或栎与松的混交林下。 典型中毒案例 1994 年， 河北省某县 6 人误食黄盖鹅 膏，死亡 5 人。 A manita subjunquillea 黄 盖 鹅 膏 07- -08 与剧毒种 – 黄盖鹅膏的区别 两者 的菌盖颜色极相似，但黄盖鹅膏的个体 较小、稍纤细，菌盖边缘棱纹不明显， 小菌褶渐狭，菌柄基部膨大呈球形。尽 管在大理、丽江、楚雄等地有采食红黄 鹅膏黄褐变种的习惯，但据当地居民反 映多食后有头昏、恶心等症状，建议最 毒性成分 主要含鹅膏毒肽和鬼笔毒肽 好不采食。 等。这些毒肽毒性极大，性质稳定，耐 高温、耐干燥，一般烹调不能破坏。 A manita hemibapha var. ochracea 红 黄 鹅 膏 黄 褐 变 种 易 混 淆 种 俗名 黄罗 伞、鹅蛋菌、 鸡蛋菌 主 要 鉴 别 特 征 个 体 中 等 至 较 大， 菌 体 粗 壮。 菌 盖 暗 黄色至暗黄 褐 色， 边 缘 具明显长棱 纹。 菌 肉 黄 白色。菌褶浅白色，离生，小菌褶平截。 菌柄浅黄色，内部成熟后中空，近基部 处不膨大。菌环膜质，浅黄至黄白色， 生于柄上部。菌托在柄基部形成口袋状 或深杯状。 分布与生境 大理、楚雄、丽江等地均 有 分 布， 主 要 见 于 云 杉、 冷 杉 林 下， 松 树 林可见。 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 俗名 白毒伞 主要鉴别特征 毒素含量与黄盖 鹅膏相似，也是最毒的蘑菇之 一。 特征与黄盖鹅膏相似，不 同之处，该种菌盖白色，仅中 央呈浅米黄色。该种新鲜时， 各部位滴加 5% 氢氧化钾立刻 变为鲜黄色。（见右图） 分布与生境 昆明、思茅、大理、楚雄、 丽江等地有分布，见于松林或栎树林下。 与白色剧毒鹅膏的区别 白条盖鹅膏 和黄盖鹅膏白色变种、淡红毒鹅膏菌极 相似，但白色剧毒鹅膏菌盖边缘无明显 棱纹、小菌褶渐狭、菌柄基部多少膨大 呈球形。在昆明、大理、丽江、楚雄等 地有采食白条盖鹅膏的习惯，由于一般 人难以与白 色的剧毒鹅 膏区分，建 议最好不采 食。并且毒 性成分检测 时仍能检测 到该菌至少含鹅 膏毒肽与鬼笔毒 肽各 1 种。 09- -10 A manita subjunquillea var. alba A manita pallidorosea A manita chepangiana 黄 盖 鹅 膏 白 色 变 种 淡 红 毒 鹅 膏 白 条 盖 鹅 膏 俗名 白罗伞 主要鉴别特征 中等 至大型，菌盖白色或稍带 米黄色，中央平坦或稍突起， 边缘具棱纹；菌褶离生，白色， 小菌褶平截。菌柄白色，近基部处不 膨大。菌环膜质，白色，生菌柄上部。 菌托白色，深杯状或袋状。 分布与生境 福贡、思茅、保山、丽 江等地有分布。主要见于阔叶林下。 易 混 淆 种 俗名 白毒伞 主要鉴别特征 最毒的蘑菇之一，个体中等 大小，菌体纤细。菌盖白色，中央稍突起，多 少带浅粉红色，边缘无棱纹。菌褶离生，白色， 小菌褶渐狭。菌柄白色，近基部处近球形膨大。 菌环膜质，白色或米黄色，生于菌柄上部。菌 托白色，浅杯状。 分布与生境 福贡、思茅、保山等地 有分布，见于栎树林下。 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 11- -12 A manita fuliginea A manita manginiana 灰 花 纹 鹅 膏 隐 花 青 鹅 膏 分布与生境 大理、楚雄、丽江、昭通 等地均有分布，主要见于 栎树林下。 典型中毒案例 1996 年湖 南省某县一家 7 口误服该 菌中毒，全部死亡。 毒性成分 以鹅膏毒肽和 鬼笔毒肽为主。 者 的 菌 盖 颜 色 极 相似，但剧毒的黄 盖鹅膏个体较小、 菌 柄 浅 灰 色 至 灰 黑色，基部膨大呈球形。在昆明、大理、 丽江、楚雄等地有采食隐花青鹅膏的 习惯，由于一般人难以与灰花纹鹅 膏区分，建议最好不采食。 易 混 淆 种 俗名 麻毒伞 主要鉴别特征 最毒的 蘑菇之一，毒性极强。一 只 鲜 重 10g 左 右 的 个 体 足可导致一个成人死亡。 该菌个体稍小，菌盖深灰 色 或 暗 褐 色 至 近 黑 色， 具深色纤丝状隐花纹或 斑纹，边缘无棱纹。菌褶 离生，近白色，小菌褶渐 狭。菌柄被浅灰褐色细小 鳞片，近基部处呈球形膨 大。菌环膜质，浅灰色， 生于柄的上部。菌托白色， 浅杯状。 俗名 草鸡棕 主要鉴别特征 中等至 较大，菌体粗壮。菌盖深灰 色或暗褐色至近黑色，具深色 纤丝状隐花纹或斑纹，边缘无 棱纹。菌褶离生，白色，小菌 褶渐狭。菌柄白色，具白色纤 毛状至粉末状鳞片，近基部处 稍膨大。菌环膜质，白色，易碎， 顶生或近顶生。菌托白色，浅杯状。 分布与生境 昆明、思茅、保山、大理、 楚雄、丽江等地均有分布，主要见于阔 叶树或针阔混交林下。 与剧毒种 – 灰花纹鹅膏的区别 两 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 13- -14 G yromitra infula 赭 鹿 花 菌 I onomidotis frondosa 叶 状 耳 盘 菌 4. 溶血型 潜伏期一般 6~12 小时，除消化道症状外，还可出现腰 腹部疼痛、无力、深褐色尿、贫血、肝脾肿大等急性溶血症状，严重溶 血者可致急性肾功能衰竭，甚至死亡。此型还可伴有中枢神经系统表现。 代表种类如鹿花菌和赭鹿花菌。 5. 光敏性皮炎型 潜伏期一般 24~48 小时，可出现皮肤红肿或 疱疹，日光照射后症状加重，毒性成分可能为卟啉类光敏性物质，该型 一般预后良好。 代表种类如叶状耳盘菌、胶陀螺等。 俗名 赭马鞍菌 主要鉴别特征 个体中等大小，黄褐色 至赭褐色。上部近似马鞍形，中空、色浅， 菌柄近圆柱形或扁平、表面平滑或有皱 沟，中空。 分布与生境 分布于大理、楚雄、丽江 等地海拔较高（3000 米左右）林下， 生于地上。 典型中毒案例 赭鹿花菌及其近似种 是欧美地区的食用菌，在欧洲中毒 死亡率为 15％～ 35％。多数患 者最初症状为头痛、恶心、 呕吐、腹泻，1 ～ 2 天后可 出现寒颤、发热、腹痛、脾 肿大、血红蛋白尿，严重患 者可因急性肾功能衰竭导致 死亡。尽管云南尚未见中毒 病例报道，但该类毒菌在云 南地区较常见，应注意勿采 食该类毒菌。 毒性成分 鹿花菌素 ( 又称马鞍酸 ) 及 其水解产物甲基联胺（MMH）能溶解 红细胞，使大量红细胞被破坏，出现急 性溶血。甲基联胺对肝、胃、膀胱等均 有损害。 俗名 暗皮皿菌、毒木耳 主要鉴别特征 菌体呈片状，墨黑色， 表面暗淡、无光泽，无皱褶， 不透明，无弹性；味微苦、有 麻味。水浸液呈黑色。（见上图） 分布与生境 大理、楚雄、丽江 等地均有分布，生于腐 木上。 典型中毒案例 1992 年 7 月云南省某县 6 人误 食该菌，出现皮肤暴露 部位麻木、红肿疼痛、眼睑浮肿、 畏光等表现，日光照晒后皮肤出 现大小不等的水泡。 毒性成分 可能为卟啉类光敏性物 质。 与黑木耳的区别 该菌与黑木耳 极相似，但黑木耳呈耳状，形状 较规则，黄褐色，表面具皱褶， 较有光泽，半透明，有弹性；无苦、 麻味。水浸液呈浅黄色。（见下图） 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 俗名 鸡蛋菌 主要鉴别特征 个体中等大小。菌盖白 色至米黄色，表面具粉末状物，菌盖外 层常覆盖着大片浅土黄色或赫色菌幕残 余，菌盖边缘无棱纹；菌肉白色；菌褶 白色，干后浅土黄褐色，离生，密，小 菌褶渐狭。菌柄基部膨大呈纺锤状或白 萝卜状，白色至污白色，表面有粉状或 棉毛状鳞片，下部菌托不完整环带状或 地均有分布。雨量充沛时如花朵般成片 生于腐木上，极易采摘。 典型案例 自 1975 年以来，云南省一 些偏远山区及半山区陆续出 现一种不明原因猝死疾病， 多数病例死前有头晕、恶心、 心悸、晕厥、昏迷等症状。 根据目前研究结果显示本菌 可能与该病有关。 15- R ussula subnigricans 其他 根据文献报道，有一些毒蘑菇中毒的临床表现与以上各型不 亚 稀 褶 黑 菇 尽相同，包括以急性肾脏损害、横纹肌溶解等为主要临床表现者，由于 证据尚不充分，还有待于进一步研究。 俗名 火炭菌、假炭菇 主要鉴 别特征 剧 毒 的 蘑 菇 之 一， 致 死 率 极 高。菌盖平展，表面灰黑色。菌褶污白色， 疏而厚，菌褶具横脉。菌柄短，污白色， 中空。菌肉受伤变暗红色。 分布与生境 大理、楚雄、保山等地有 分布，生林下。 典型中毒案例 1998 年 8 月台湾省 9 人误食该菌，除恶心、呕吐等消化道症 状 外， 其 中 2 例 患 者 出 现 横 纹肌溶解。 -16 卷边状，近白色。菌环白色，易破碎脱落。 分布与生境 大理、剑川、楚雄、寻甸 等地均有分布，主要见于针叶林或针阔 混交林下。 典型中毒案例 1999 年～ 2000 年， 湖南省发生 15 人误食该菌中毒，除消 化道症状外，部分患者以急性肾损害为 主要表现，伴有轻度肝损害。 毒性成分 主要为鹅膏毒肽类成分。 沟褶菌 俗名 小白菌、鸡冠菌、 指 甲 菌、 蝴 蝶 菌、 八 大肠 主要鉴别特征 半圆 形 至 扇 形， 花 瓣 状， 具一短柄；质地稍韧， 薄 革 质， 半 透 明 状， 近白色至米汤色，幼 时稍带浅紫色；上表 面较有光泽，下表面 具明显的放射状脉纹。干后呈浅褐色。 分布与生境 在云南分布较广，西双版 纳、大理、楚雄、丽江、保山、德宏等 云南野生蘑菇中毒防治手册 云南野生蘑菇中毒防治手册 1. 鲜艳的蘑菇有毒，颜色普通的蘑菇没毒。 错！根据颜色与形状不能简单区别蘑菇是否有毒。鸡油 菌、褶孔牛肝菌和大红菌等颜色鲜艳，美味可食；而灰花纹 鹅膏、致命鹅膏等剧毒蘑菇，其颜色则为灰色或白色。 2. 长在潮湿处或家畜粪便上的蘑菇有毒，长在松树下等清洁 地方的蘑菇无毒。 错！大部分蘑菇生长在阴暗潮湿的环境中，有的有毒， 有的可食。有一些毒蘑菇的确喜生长在粪便上，如盔孢伞和 花褶伞中一些有毒种类；但是鹅膏、口蘑、红菇中一些有毒 种类也生长在松林中。 3. 蘑菇跟银器、生姜、大米、生葱一起煮，液体变黑有毒， 颜色不变则无毒。 错！蘑菇毒素不能与银器等发生化学反应，也就不能产生 颜色变化。如鹅膏毒素就不能发生颜色反应。 4. 有分泌物或受伤变色的蘑菇有 毒。 错！有 的 毒 蘑 菇 的 确 具 有 分 泌 物 或 受 伤 变 色，但是有一些多汁蘑菇 受伤后，有乳汁分泌，同 时颜色也会发生变化，它 们不仅没有毒，而且还是 美味食用菌，如多汁乳菇 （俗称奶浆菌）。 5. 生蛆、生虫的蘑菇没有 毒。 错！许 多 剧 毒 的 鹅 膏成熟后同样会生蛆、生 虫。 1. 催吐：应在条件允许的情况下尽快催吐。 2. 立即到正规医院救治，最好携带剩余蘑菇样品，以 备进一步诊断治疗。 1. 联系相关专业人员对蘑菇进行鉴定。 2. 尽快开展毒物清除技术，如洗胃等。 3. 蘑菇中毒无明确特效解毒剂，以对症支持治疗为主。 17- -18 毒蘑菇认识 误区 之 蘑 菇 中 毒 如 何 自 救 ？ 蘑 菇 中 毒 后 的 医 院 内 救 治 : 结 语 云南有毒蘑菇种类繁多，上述仅提及部分常见有毒蘑菇。由于蘑菇鉴别 时往往需要具备专业知识和一定的仪器、设备，因此医务人员在接诊到疑似 有毒蘑菇中毒患者时，最好请专业机构对蘑菇标本进行专业鉴定。由于供研 究资料有限，本资料仅供广大医务人员参考。

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