摘要
目的分析因服用中草药或含草药成分的保健食品引起肝损害的情况。方法收集1982年至2005年诊断为"药物性肝病"患者82例。诊断根据为病史、药物史、临床表现、肝功能及其他实验室检查。最后回顾诊断,按药物性肝损伤评分进行评估。结果24年中诊断的82例"药物性肝病"患者占同期因肝功能异常住院患者的2.2%。其中男性28例,女性54例.年龄16～81岁.平均(50.1±16.9)岁。服用的与肝损伤有关药物中,减肥保健品占30.5%、皮肤科用药占12.2%、抗风湿病用药占8.5%、心血管用药占8.5%、妇科疾病用药占7.3%、肝病药占6.1%、调节血脂药占6.1%、乳房小叶增生药占3.7%、甲状腺肿块用药占3.7%、其他用药占13.4%。用药疗程6 d～6个月不等,潜伏期6 d～3个月。临床表现中.肝细胞损伤型占36.59%、胆汁淤积型占39.02%,其他为混合型,尚有10%的患者同时伴有变态反应表现。所有患者在停药后一般病情恢复较快.预后良好。结论中药和草药是引起药物性肝病的重要原因.应提高临床医师对药物引起肝损伤的认知及在治疗过程中加强监测。
Objective To investigate the drug induced liver injure（DILI） associated with Chinese herbal medicine and herbal related food supplements. Methods From 1982 to 2005, 82 consecutive patients were diagnosed as DILl based on their medication history, clinical manifestation,liver function and other laboratory tests. The final retrospection confirmatory diagnosis was made according to the interna tional scoring system for DILI. Results The 82 DILI patients（28 men, 54 females, age ranging from 16 to 81 years old） accounted for 2.2% of hospitalized patients with liver dysfunction. Among those patients with DILI, 30.5 % was caused by weight reducing drugs or food supplements, 12.2 % by drugs of dermatology, 8.5% by drugs for cardiovascular disease, 8. 5% by drugs of rheumatology, 7. 3% by drugs of gynecology, 6.1% by drugs for liver disease, 6.1% by blood-lipids modulators, 3.7% by drugs for thyroid disease, 3.7% by drugs for hyperplasia of mammary glands and 13.4% by the others. The duration of medication was from 6 days to 6 months and the incubation period was from 6 days to 3 months. DILI could be classified as acute hepatocellular injury（36. 59%）, acute cholestasis（39. 02%） and mixtures （24.39 %）. About 10 % patients were accompanied by allergic manifestations. All patients recovered rap idly after stopping the relevant medicine. Conclusion Chinese herbal medicine and herbal related food supplements are a common cause of DILI in China. The awareness and monitoring improving DILI during herbs treatment is a critical issue in daily practice.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2007年第7期435-438,共4页
Chinese Journal of Digestion
关键词
肝脏疾病
中草药
保健食品
Liver disease
Drug, Chinese herbal
Dietary supplements
