中药相关性肝损害研究——从理论到临床  

Study on traditional Chinese medicine-induced liver injury: from theory to clinical analysis

作　　者：李秀玉[1] 李超群[1] 张志敏[1] 王晓静[1] 腰向颖[1] 

机构地区：[1]海军总医院中医科,北京100048

出　　处：《转化医学杂志》2015年第4期244-249,共6页Translational Medicine Journal

摘　　要：药源性肝损害是临床常见问题，在我国发生率为0．46％～1．08％，其中由中药引起的占30％左右。作者检索了公开发表的有关文献，梳理了中药相关性肝损害的基本情况，以期为中药的安全应用提供参考。易引发肝损害的单味中药主要有黄药子、雷公藤、铅丹等，复方中药主要有青黛丸、克银丸、消核片等．以及中药汤剂小柴胡汤等；造成肝损害的中药有毒成分主要包括生物碱类、萜类、内酯类及毒性植物蛋白类等：肝损害的主要表现为消化道症状、肝区不适、肝大、黄疸、转氨酶升高，损害程度与剂量及疗程密切相关。中药引起的肝损害多为可逆性，但严重者亦可致死。因此，中医临床医生应与时俱进，及时了解中药的现代药理研究，慎用、少用肝毒性中药，必要时定期监测患者肝功能的变化，以提高中药用药的安全性．Drug-induced liver injury (DILI) is a common clinical situation.The percentage of DILI cases goes up to about 0.46%- 1.08% in China, in which cases triggered by traditional Chinese medicine accounted for about 30%.To present the basic situation of traditional Chinese medicine-related liver damage and to provide a reference for the safe use in traditional Chinese medi-cine, relevant publications in recent decades are retrieved and searched in this article.According to the data, single Chinese herbs that tend to lead to liver damage mainly include dioscorea bulbifera L., tripchlorolide, minium, whereas compounds contain indignis naturalis pill, keyinwan, xiaohe pian and the traditional Chinese medicine decoction of xiao chaihu decoction.Toxic ingredients in tradi-tional Chinese medicine caused liver damage cover alkaloids, terpenoids, lactones and toxic plant protein elements.Symptoms of liver damage mainly involve digestive tract disturbances, liver dis-comfort, hepatomegaly, jaundice, higher transaminase, and the level of damage is closely related to the dosage.Traditional Chinese medicine-induced liver damage is mostly reversible, but severe cases may lead to death.Therefore, traditional Chinese medicine clinicians should have insights into mo-dern pharmacological research of traditional Chinese medicine and use traditional Chinese medicine with caution.If necessary, clinicians should regularly detect patient’s liver function in order to im-prove drug safety.

关 键 词：药源性肝损害 中药 

分 类 号：R28[医药卫生—中药学]