中药药物性肝损害的临床特征及预防  

Analysis on Clinical Features of Liver Injuries Induced by Chinese Traditional Medicines

作　　者：臧红[1] 游绍莉[1] 柳芳芳[1] 申力军[1] 刘鸿凌[1] 荣义辉[1] 朱冰[1] 辛绍杰[1] 

机构地区：[1]中国人民解放军第302医院全军肝衰竭诊疗与研究中心,北京100039

出　　处：《实用预防医学》2013年第9期1025-1027,共3页Practical Preventive Medicine

基　　金：国家"十二五"科技重大专项(2012ZX10002004-005)

摘　　要：目的研究中药药物性肝损害的临床特征,探讨中药药物性肝损害的防治策略。方法对本院住院行肝脏活检穿刺病理与临床诊断药物性肝损害的患者回顾分析,以西药组161例患者为对照,研究157例中药药物性肝损害临床特征及影响因素。结果中药组药物性肝损害临床类型和西药组构成差异无统计学意义(P>0.05);临床表现中药组和西药组相似,但乏力和消化道症状更为常见(P<0.05)。实验室检查结果显示,中药组ALT、AST、GGT、ALP分别为(437.10±416.13)、(300.10±278.73)、(205.30±178.82)、(151.65±84.93)U/L,西药组(617.29±422.19)、(502.94±290.28)、(280.10±229.25)、(187.67±153.78)U/L,升高水平较西药组为低(P<0.01)。用药原因分析本组中药药物性肝损害的首要用药原因是保健与美体美容,占21.02%,其次是皮肤科用药占15.29%,妇科用药占12.10%。用药持续时间分析显示,43.31%的患者持续用药超过2个月。结论中药药物性肝损害乏力和消化道症状更为常见,但肝组织损伤的程度并不比西药组重,避免疗程过长和不恰当用药对预防中药药物性肝损害极为重要。Objective To study the clinical features of liver injuries induced by Chinese traditional medicines and explore their preventions and treatments. Methods Data of patients with drug- induced liver injuries diagnosed by the liver biopsy were retrospectively analyzed. 161 cases with liver injuries induced by western drugs were determined as the control group, and 157 cases with liver injuries induced by Chinese traditional medicines were the study group. The clinical features of the liver injury and the influence factors were explored. Results The constitutions o{ the clinical types of the liver injuries of the two groups were not statistically significant （P 〉 0.05）. The clinical manifestations of the two groups were similar, except that fatigue and gastrointestinal symptoms were more common in the study group （P 〈 0.05）. Laboratory tests showed that serum ALT, AST, GGT and ALP levels in the study group were respectively 437.10 ± 416.13 U/L, 300.10 ± 278.73 U/L, 205.30 ± 178.82 U/L and 151.65 ± 84.93 U/L, whereas those in the control group were 617.29 ± 422.19U/L,502.94 ± 290.28 U/L, 280.10 ± 229.25 U/L and 187.67 ± 153.78 U/L, respectively. The elevation of the biochemical markers in the study group was signifi- cantly lower than that in the control group （P 〈 0.01）. The main medicines inducing the liver injuries in the study group were those used for health care and body beauty （21.02%）, dermatological medicines （15.29%） and gynecological medicines （ 12.10 % ）. Regarding the duration time, 43.31% of the patients used drugs for more than 2 months. Conclusions Fatigue and gastrointestinal symptoms are more corranon in the liver injuries induced by Chinese traditional medicines. However, the inju- ries are not severer than those induced by western drugs. It is important to avoid long drug duration and inappropriate usage. Key words： Drug- induced liver injury; Chinese traditional medicine; Clinical feature

关 键 词：药物性肝损害 中药 临床特征 

分 类 号：R575.1[医药卫生—消化系统]