84例中成药致药物性肝损伤患者临床特点分析

肝脏 ›› 2026, Vol. 31 ›› Issue (4): 545-548.

84例中成药致药物性肝损伤患者临床特点分析

聂虹, 宋洁, 张慧, 王瑞, 娄婷婷, 武建军

010010 呼和浩特内蒙古自治区人民医院消化内科(聂虹,张慧,王瑞,娄婷婷,武建军),干部保健所(宋洁)

收稿日期:2025-07-12 出版日期:2026-04-30 发布日期:2026-06-04
通讯作者: 武建军,Email:nmyywjj@163.com
基金资助:
内蒙古自治区自然科学基金项目(2020MS08153)

Clinical characteristics of 84 cases of drug-induced liver injury caused by Chinese patent medicines

NIE Hong¹, SONG Jie², ZHANG Hui¹, WANG Rui¹, LOU Ting-ting¹, WU Jian-jun¹

1. Department of Gastroenterology, Inner Mongolia Autonomous Region People′s Hospital, Hohhot 010010, China;
2. Department of Cadre Health Care Institute, Inner Mongolia Autonomous Region People′s Hospital, Hohhot 010010, China

Received:2025-07-12 Online:2026-04-30 Published:2026-06-04
Contact: WU Jian-jun,Email:nmyywjj@163.com

摘要/Abstract

摘要： 目的对中成药致药物性肝损伤(DILI)患者用药情况、实验室检查结果、肝损伤类型及临床转归等资料进行分析。方法筛选2022年1月至2024年12月期间内蒙古自治区人民医院主要或次要诊断为“药物性肝损害”及“药物性肝炎”的病历资料,共纳入84例由中成药引发DILI的患者,包括肝细胞损伤型41例、胆汁淤积型29例和混合型14例。分析可疑中成药成分、预后情况,比较不同临床分型DILI症状、血生化指标。结果 DILI患者可疑中成药成分以何首乌及相关制剂、雷公藤多苷片及壮骨关节丸最为常见。纳入患者常见临床症状包括乏力、食欲减退及黄疸。经比较,3种临床分型的主要临床症状差异不具有统计学意义(P>0.05)。胆汁淤积型、混合型DILI患者皮肤瘙痒例数显著高于肝细胞损伤型(P<0.05);治疗前,肝细胞损伤型及混合型患者ALT、AST显著高于胆汁淤积型(P<0.05),而胆汁淤积型与混合型患者ALP及TBil明显高于肝细胞损伤型(P<0.05),治疗后各分型患者肝功能指标均较基线显著改善(P<0.05)。经停用可疑致病药物和常规护肝治疗后,所有患者均治愈出院,无病例发生肝衰竭或死亡。结论中成药引发的DILI以肝细胞型和胆汁淤积型为主,临床表现不典型,诊断需结合详细的用药史和肝功能指标动态监测。通过规范停药与护肝治疗,患者预后良好。

关键词: 药物性肝损伤, 中成药, 肝细胞损伤型

Abstract: Objective To analyze the medication usage, laboratory test results, types of liver injury, and clinical outcomes in patients with drug-induced liver injury (DILI) caused by Chinese patent medicines, and to provide robust data support for safe clinical medication practices and pharmaceutical supervision. Methods Patients diagnosed with primarily or secondarily as “drug-induced liver injury” or “drug-induced hepatitis” between January 2022 and December 2024 were sellected. A total of 84 DILI cases caused by Chinese patent medicines were included, comprising 41 cases of hepatocellular injury type, 29 cases of cholestatic type, and 14 cases of mixed type. The suspected ingredients of the Chinese patent medicines and patient prognoses were analyzed. Clinical symptoms and biochemical parameters were compared across different clinical types of DILI. Results The most common suspected ingredients in Chinese patent medicines associated with DILI were Polygonum multiflorum (He Shou Wu) and its related preparations, tripterygium glycosides tablets, and Zhuanggu Guanjie Pills. Among the 84 cases, there were 41 cases of hepatocellular injury type, 29 cases of cholestatic type, and 14 cases of mixed type. The most common clinical symptoms included fatigue, loss of appetite, and jaundice. Comparisons showed no statistically significant differences in the main clinical symptoms among the three types of DILI (P>0.05). However, the incidence of pruritus was significantly higher in patients with cholestatic and mixed types than in those with hepatocellular injury type (P<0.05). Before treatment, ALT and AST levels were significantly higher in the hepatocellular and mixed types compared to the cholestatic type (P<0.05), while ALP and TBil levels were significantly elevated in the cholestatic and mixed types compared to the hepatocellular type (P<0.05). After treatment, liver function indices in all types significantly improved from baseline (P<0.05). All patients recovered and were discharged following the withdrawal of suspected causative agents and standard hepatoprotective therapy. No cases of liver failure or death occurred. Conclusion DILI caused by Chinese patent medicines primarily manifests as hepatocellular and cholestatic types. Clinical symptoms are often non-specific, and diagnosis relies on detailed medication history and dynamic monitoring of liver function indicators. With timely withdrawal of the offending drug and proper hepatoprotective treatment, patients generally have favorable outcomes.

Key words: Drug-induced liver injury, Chinese patent medicine, Hepatocellular injury type

聂虹, 宋洁, 张慧, 王瑞, 娄婷婷, 武建军. 84例中成药致药物性肝损伤患者临床特点分析[J]. 肝脏, 2026, 31(4): 545-548.

NIE Hong, SONG Jie, ZHANG Hui, WANG Rui, LOU Ting-ting, WU Jian-jun. Clinical characteristics of 84 cases of drug-induced liver injury caused by Chinese patent medicines[J]. Chinese Hepatolgy, 2026, 31(4): 545-548.

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