湿毒清胶囊致肝损伤  

Liver injury caused by Shiduqing capsules(湿毒清胶囊)

作　　者：郝利亚 李正川 王丽华 Hao Liya;Li Zhengchuan;Wang Lihua(Department of Pharmacy,Xingtai Third Hospital,Hebei Province,Xingtai 054000,China)

机构地区：[1]河北省邢台市第三医院药剂科,054000

出　　处：《药物不良反应杂志》2020年第7期420-421,共2页Adverse Drug Reactions Journal

摘　　要：1例56岁男性患者因皮肤瘙痒、皮疹,自购湿毒清胶囊1.5 g、3次/d口服。7 d后患者出现尿黄、腹胀及皮肤黄染。实验室检查:丙氨酸转氨酶(ALT)1871 U/L,天冬氨酸转氨酶(AST)1502 U/L,碱性磷酸酶(ALP)222 U/L,总胆红素(TBil)260.6μmol/L,直接胆红素(DBil)187.7μmol/L。经肝炎病毒学检测、自身抗体检查和影像学检查,排除病毒性肝炎、自身免疫性肝病和肝内外占位性病变,考虑为湿毒清胶囊导致的肝损伤。停用该药,给予异甘草酸镁注射液和舒肝宁注射液静脉滴注治疗。28 d后,患者症状明显好转,ALT 56 U/L,AST 65 U/L,TBil 68.9μmol/L,DBil 51.5μmol/L。考虑肝损伤的发生与湿毒清胶囊中的白鲜皮成分有关。A 56-year-old male patient purchased Shiduqing capsules by himself and took the drug orally 1.5 g thrice daily for pruritus and rash.After 7 days of administration,the patient developed yellow urine,abdominal distension,and yellowish skin.Laboratory tests showed alanine aminotransferase(ALT)1871 U/L,aspartate aminotransferase(AST)1502 U/L,alkaline phosphatase(ALP)222 U/L,total bilirubin(TBil)260.6μmol/L,and direct bilirubin(DBil)187.7μmol/L.Viral hepatitis,autoimmune liver disease,and intra and extrahepatic space-occupying lesions were excluded by virological detection of hepatitis,autoantibody examination,and imaging examination.Liver injury caused by Shiduqing capsules was considered.Then Shiduqing capsules were discontinued and magnesium isoglycyrrhizinate injection and Shuganning injection(舒肝宁注射液)were given by intravenous infusion.Twenty-eight days later,the patient′s symptoms were improved significantly,and laboratory tests showed ALT 56 U/L,AST 65 U/L,TBil 68.9μmol/L,and DBil 51.5μmol/L.It was considered that the liver injury was related to the component of densefruit pittany root-bark(Cortex Dictamni)in Shiduqing capsules.

关 键 词：化学性和药物性肝损伤 中草药 白鲜属 湿毒清胶囊 

分 类 号：R285.6[医药卫生—中药学]