140例中药肝损伤病例的临床特征分析

肝脏 ›› 2019, Vol. 24 ›› Issue (4): 362-364.

140例中药肝损伤病例的临床特征分析

朱春雾, 王海南, 张亚蕾, 袁继丽, 薛冬英, 张琴, 刘成海

201203 上海中医药大学附属曙光医院肝病研究所上海市中医临床重点实验室(朱春雾,张亚蕾,袁继丽,刘成海);国家食品药品监督管理总局(王海南);上海中医药大学附属普陀医院感染科(薛冬英);上海交通大学医学院附属同仁医院感染科(张琴)

收稿日期:2018-11-18 出版日期:2019-04-30 发布日期:2020-04-07
通讯作者: 刘成海,Email:chenghailiu@hotmail.com
基金资助:
上海市进一步加快中医药事业发展三年行动计划[ZY-(2018-2020)-CCCX-5001]

Analysis of clinical characteristics in 140 patients with herb-induced liver injury

ZHU Chun-wu^1,2, WANG Hai-nan³, ZHANG Ya-lei^1,2, YUAN Ji-li^1,2, XUE Dong-ying⁴, ZHANG Qin⁵, LIU Cheng-hai^1,2

1. Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; 2. Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai 201203, China; 3. China Food and Drug Administration, Beijing100053, China; 4. Department of Infectious Disease, Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; 5. Department of Infectious Disease, Tongren Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200336

Received:2018-11-18 Online:2019-04-30 Published:2020-04-07
Contact: LIU Cheng-hai, Email: chenghailiu@hotmail.com

摘要/Abstract

摘要： 目的了解中药导致肝损伤的临床特征。方法采用回顾性研究的方法,收集患者病史、症状体征、检查结果、治疗与转归等临床资料,分析HILI的临床特征。结果 140例HILI患者中,女性(67.14%)居多,多发年龄段为40～69岁。服用剂型以中药汤剂(58.57%)为主,常见含有何首乌、延胡索、雷公藤。涉及40种中成药,致肝损伤的单一中成药主要有仙灵骨葆胶囊、消瘿合剂、活力苏口服液、精乌胶囊。临床常见症状有乏力、纳差、黄疸等,临床分型以肝细胞损伤型(78.57%)为主。不同分型之间ALT、AST、ALP具有显著差异。根据RUCAM评分,2.86%为非常可能相关,70.71%为很可能相关。结论中药导致的肝损伤,以肝细胞损伤型为主,预后良好。

关键词: 肝损伤, 中药, 临床特征

Abstract: Objective To analyze the clinical characteristics of herb-induced liver injury(HILI). Methods Clinical data of the patients such as medical history, symptoms, signs, examination results, treatment and prognosis were collected and retrospectively analyzed. Results The majority of the 140 HILI patients were female(67.14%), aged from 40 to 69 years old. The herbal medicine was mainly decoction in formulation(58.57%) which mainly contained Polygonum multiflorum, Corydalis ambigua and Tripterygium wilfordii. Xianlinggubao capsules, Xiaoying mixture, Huolisu oral liquid, Jingwu capsules were the commonest to induce liver injure in the involved 40 kinds of Chinese patent medicines. The common clinical symptoms were fatigue, anorexia, jaundice, etc. Hepatocellular injury was the main clinical classification, accounting for 78.57%. There were significantly differences between alanine transaminase, aspartate aminotransferase and alkaline phosphatase among different classifications of HILI. According to Roussel Uclaf Causality Assessment Method, only 2.86% of cases were classified as highly probable and 70.71% as probable. Most patients had a good prognosis. Conclusion Traditional Chinese medicine can lead to liver injury, which is common in middle-aged and elderly women, mainly hepatocyte injury type, the cause of liver injury of traditional Chinese medicine is complex, and the prognosis is good.

Key words: Liver injury, Chinese herbal medicine, Clinical characteristics

朱春雾, 王海南, 张亚蕾, 袁继丽, 薛冬英, 张琴, 刘成海. 140例中药肝损伤病例的临床特征分析[J]. 肝脏, 2019, 24(4): 362-364.

ZHU Chun-wu, WANG Hai-nan, ZHANG Ya-lei, YUAN Ji-li, XUE Dong-ying, ZHANG Qin, LIU Cheng-hai. Analysis of clinical characteristics in 140 patients with herb-induced liver injury[J]. Chinese Hepatolgy, 2019, 24(4): 362-364.

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