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目的分析中草药引起药物性肝损伤的药物因素、患者因素、临床表现,总结导致肝损伤的中草药品种,为药物性肝损伤的预防诊断治疗提供参考。方法检索万方数据库(Wanfangdata)、中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)和中国生物医学文献数据库(CBM)中1964年1月至2016年7月有关药物性肝损伤的病例报告,并对文献资料进行整理、汇总、分析。结果药物性肝损伤病例报道呈逐年上升趋势。共确定中草药肝损伤文献132篇,病例数为169例,男性79例,女性90例,并明确有14种中草药具有潜在的肝毒性,以何首乌、土三七引起的肝损伤多见。高发年龄段41~50岁(26.6%)及51~60岁(23.1%)。中草药导致药物性肝损伤的发生时间在服药后7天内、2周至3个月内最常见。临床表现以厌食厌油、乏力,腹胀腹痛,恶心呕吐、尿黄、皮肤巩膜黄染多见。169例患者中好转16例,无好转7例,死亡11例,肝移植2例,痊愈133例。结论 14种中草药可引起药物性肝损伤,临床用药过程中应注意。
OBJECTIVE: To analyze the drug factors, patient factors and clinical manifestations caused by drug-induced liver injury in Chinese herbal medicine, and to summarize the types of Chinese herbal medicines that cause liver damage, so as to provide references for the prevention and treatment of drug-induced liver injury. Methods The data of Wanfangdata, CNKI, VIP and Chinese CBM were collected from January 1964 to July 2016 for drug-induced liver injury Case reports, and collated the literature, summary, analysis. Results Drug-induced liver injury cases reported a rising trend year by year. A total of 132 articles on liver injury in Chinese herbal medicine were identified. The number of cases was 169, including 79 males and 90 females. It was clarified that 14 kinds of Chinese herbs had potential hepatotoxicity, and liver injury caused by Radix Polygoni Multiflori and Radix Notoginseng was more common. High age group of 41 to 50 years (26.6%) and 51 to 60 years (23.1%). Chinese medicine lead to drug-induced liver injury occurred within 7 days after taking the medication, 2 weeks to 3 months the most common. Clinical manifestations to anorexia tired of oil, fatigue, abdominal pain abdominal distension, nausea and vomiting, urinary yellow, scleral skin yellow see more common. Of the 169 patients, 16 improved, 7 improved without improvement, 11 died, 2 received liver transplantation and 133 recovered. Conclusion 14 kinds of Chinese herbal medicine can cause drug-induced liver injury, should pay attention to the clinical medication.