含何首乌的中成药致肝损伤的临床分析

doi:10.5246/jcps.2022.04.026

中国药学(英文版) ›› 2022, Vol. 31 ›› Issue (4): 289-297.DOI: 10.5246/jcps.2022.04.026

• 【药事管理与临床药学专栏】 • 上一篇下一篇

含何首乌的中成药致肝损伤的临床分析

沈洁¹^,², 杨凯⁴, 孙彩华², 蒋程³^,^*(), 郑敏霞²^,^*()

1. 浙江大学出版社浙江大学学报(医学版)编辑部, 浙江杭州 310028
2. 浙江中医药大学附属第一医院, 浙江杭州 310006
3. 浙江省立同德医院, 浙江杭州 310012
4. 浙江大学附属第一医院, 浙江杭州 310003

收稿日期:2021-12-08 修回日期:2022-01-23 接受日期:2022-02-16 出版日期:2022-04-30 发布日期:2022-04-30
通讯作者: 蒋程, 郑敏霞
作者简介:
+ Tel.: +86-571-87073482, E-mail: jiangcheng0818@126.com
+ E-mail: zmxyxx@126.com
基金资助:
Traditional Chinese Medical Science and Technology Projects of Zhejiang Province (Grant No. 2016ZQ017 and 2015ZB044); Clinical pharmacy of TCM in the 13th five years plan of Zhejiang Administration of traditional Chinese Medicine (Zhejiang health office TCM (2019) No. 1); and the Clinical Pharmacy Research Fund of Chinese Integrative Medicine Association of Zhejiang Province (Grant No. 2013LYSX018).

Clinical analysis of liver injury caused by Chinese patent medicines containing Polygonum multiflorum

Jie Shen¹^,², Kai Yang⁴, Caihua Sun², Cheng Jiang³^,^*(), Minxia Zheng²^,^*()

1 Editorial Office of Journal of Zhejiang University (Medical Sciences), Zhejiang University Press, Hangzhou 310028, Zhejiang, China
2 The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang, China
3 Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China
4 The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou 310003, Zhejiang, China

Received:2021-12-08 Revised:2022-01-23 Accepted:2022-02-16 Online:2022-04-30 Published:2022-04-30
Contact: Cheng Jiang, Minxia Zheng

摘要/Abstract

摘要：

本文对含何首乌的中成药引起的药物性肝损伤进行了探讨, 以期为临床合理使用何首乌及其制剂提供参考。本文报告了2例长期服用含何首乌的中成药所致的药物性肝损伤的案例, 如: 精乌胶囊、活力苏口服液、润燥止痒胶囊均含有何首乌或制何首乌, 长期服用可导致肝损伤, 探讨何首乌致肝损伤的临床特点及毒性机理。肝损害患者血清转氨酶明显升高, 且ALT升高率高于AST, 黄疸明显。肝损伤机制涉及药物代谢、免疫应答和体质等诸多种因素。最后还对何首乌及其制剂的临床合理用药提出了相应的建议, 对剂量和周期应加以界定, 用药期间应监测肝功能指标, 患者的肝病史或过敏史应谨慎使用。

关键词: 药物性肝损伤, 何首乌, 精乌胶囊, 活力苏口服液, 润燥止痒胶囊

Abstract:

In the present study, we discussed the drug-induced liver injury caused by Chinese patent medicines containing Polygonum multiflorum to provide a reference for clinical rational drug use of Polygonum multiflorum and its preparations. One case of long-term taking Jingwu capsule and Huolisu oral liquid, which led to the drug-induced liver injury, was reported. The other case took Runzaozhiyang capsule for a long time, which also led to drug-induced liver injury. Jingwu capsule, Huolisu oral liquid, and Runzaozhiyang capsule all contained Polygonum multiflorum, which could result in liver injury when used long-term. Moreover, we explored the clinical features and toxicity of liver damage induced by Polygonum multiflorum. Liver damage in serum transaminase was significantly increased, and the increasing rate of ALT was more than that of AST. Jaundice appeared obviously. The liver damage mechanisms included drug metabolism, immune response, physical fitness, and many other reasons. Corresponding suggestions on rational use of Polygonum multiflorum and its preparations were presented. The dosage and period should be regulated. The index of liver function should be monitored during the medication periods. Collectively, patients with a history of liver disease or a history of allergies should pay more attention when using the above-mentioned drugs.

Key words: Drug-induced liver injury, Polygonum multiflorum, Jingwu capsule, Huolisu oral liquid, Runzaozhiyang capsule

Supporting:

沈洁, 杨凯, 孙彩华, 蒋程, 郑敏霞. 含何首乌的中成药致肝损伤的临床分析[J]. 中国药学(英文版), 2022, 31(4): 289-297.

Jie Shen, Kai Yang, Caihua Sun, Cheng Jiang, Minxia Zheng. Clinical analysis of liver injury caused by Chinese patent medicines containing Polygonum multiflorum[J]. Journal of Chinese Pharmaceutical Sciences, 2022, 31(4): 289-297.

图/表 5

Table 1. The drug combination of the patient who took Jingwu capsule and Huolisu oral liquid (Case 1).

Table 2. Liver and kidney function biochemical immune test of patient who took Jingwu capsule and Huolisu oral liquid (Case 1).

Table 3. The drug combination of the patient who took Runzaozhiyang capsules (Case 2).

Table 4. Liver and kidney function biochemical immune test of patient who took Runzaozhiyang capsule after forty days (Case 2).

Table 5. Liver and kidney function biochemical immune test of patient who took Runzaozhiyang capsule after seventy days (Case 2).

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含何首乌的中成药致肝损伤的临床分析

Clinical analysis of liver injury caused by Chinese patent medicines containing Polygonum multiflorum

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