何首乌致药物性肝炎2例  

Two cases of drug-induced hepatitis caused by Polygonum multiflorum

作　　者：缪叶军 恽芸蕾[2] 

机构地区：[1]宁波市安康医院医务科,浙江宁波315500 [2]第二军医大学长征医院药材科,上海200003

出　　处：《中国药物应用与监测》2013年第1期61-62,共2页Chinese Journal of Drug Application and Monitoring

摘　　要：病例1:患者,女,52岁,为增强免疫力自服制首乌、核桃、黑芝麻混合物(制首乌250 g、黑芝麻200 g、核桃150 g),每次15 g qd,服用约20 d后全身皮肤、巩膜黄染加重,小便颜色进行性加深,全身乏力、恶心、食欲减退,肝功能示TBIL 116μmol.L-1、ALT 1105 U.L-1、AST 1110 U.L-1,诊断为药物性肝炎。即刻停药,予保肝、利胆、降酶治疗,24 d后,患者肝功能恢复正常。病例2:患者,女,61岁,因血脂偏高而自服山楂、荷叶、生首乌混合物(每次量为各5 g泡水饮用),间断共服用生首乌约500 g,6个月后,患者眼黄,小便颜色加深,呈浓茶色,伴低热、乏力、纳差、腹胀,于外院查肝肾功能示TBIL 123.0μmol.L-1、DBIL 105.0μmol.L-1、AKP 284.0 U.L-1、γ-GT 330 U.L-1,诊断为药物性肝炎。即刻停药,予保肝、退黄、降酶等对症治疗,40 d后,患者肝功能恢复正常。Case one, one 52-year-old female patient took the mixture of Polygonum multiflori radix praeparata, walnut and sesame （including Polygonum multiflori radix praeparata 250 g, walnut 200 g and sesame 150 g, 15 g once a day） for immune enhancement. About twenty days later, the patient developed yellow skin and scleral icterus, lack of power, nausea and anorexia. Results of liver function examination were as follows： TBIL 116 μmol· L^-1, ALT 1105 U· L^-1, AST 1110 U· L^-1. The patient was hospitalized and the labortory test results met the diagnosis criteria for drug-induced hepatitis.After 24-day treatment with tiopronin, compound glycyrrhizin, silymarin and anethol trithione for liver impairment, her hepatic function returned to normal. Case two, one 6 1-year-old female patient took the mixture of hawthorn, lotus leaf and Polygonum multiflori radix for the treatment of hyperlipemia. After about six months, the patient developed fever, malaise, anorexia and abdominal distention. Results of liver function examination were as follows： TBIL123.0 μmol·L^-1, DBIL 105.0 μmol·L^-1, AKP 284.0 U-L^-1, γ-GT 330 U·L^-1. The patient was hospitalized and the labortory test results met the diagnosis criteria for drug-induced hepatitis. After 40-day treatment with tiopronin, compound glycyrrhizin and tanreqing injection for liver impairment, her hepatic function returned to normal.

关 键 词：何首乌 药物性肝炎 肝损害 药品不良反应 

分 类 号：R595.3[医药卫生—内科学]