三七伤药片致重度肝损伤  

Severe liver injury caused by Sanqi Shangyao tablets(三七伤药片)

作　　者：陈丽珍[1] 陈秀芬 杨雪妹[1] Chen Lizhen;Chen Xiufen;Yang Xuemei(Department of Pharmacy,the 909th Hospital,Dongnan Hospital of Xiamen University,Fujian Province,Zhangzhou 363000,China)

机构地区：[1]第九〇九医院/厦门大学附属东南医院药剂科,漳州363000

出　　处：《药物不良反应杂志》2024年第7期440-441,共2页Adverse Drug Reactions Journal

摘　　要：1例60岁男性患者因腰椎间盘突出伴坐骨神经痛自行服用三七伤药片(3片、3次/d),6 d后患者出现上腹部闷痛、恶心、呕吐,伴皮肤黄染,实验室检查示血清总胆红素(TBil)155.2μmol/L,直接胆红素(DBil)87.1μmol/L,丙氨酸转氨酶(ALT)817 U/L,天冬氨酸转氨酶(AST)367 U/L,碱性磷酸酶(ALP)136 U/L,γ‑谷氨酰转移酶(GGT)455 U/L。停用三七伤药片并予保肝治疗8 d后,患者上述症状好转;38 d后实验室检查示血清TBil 27.3μmol/L、DBil 9.2μmol/L、ALT 46 U/L、AST 28 U/L、ALP 83 U/L、GGT 55 U/L。患者的肝损伤可能与三七伤药片成分中草乌、雪上一枝蒿所含乌头碱有关。A 60‑year‑old male patient with lumbar disc herniation and sciatica received Sanqi Shangyao 3 tablets thrice daily orally by himself.After 6 days of administration,the patient developed upper abdominal stuffy pain,nausea,vomiting,and yellowish skin.Laboratory tests showed total bilirubin(TBil)155.2μmol/L,direct bilirubin(DBil)87.1μmol/L,alanine aminotransferase(ALT)817 U/L,aspartate aminotransferase(AST)367 U/L,and alkaline phosphatase(ALP)136 U/L.The concentration ofγ‑glutamyltransferase(GGT)was 455 U/L.The drug was stopped,liver protective treatments were given for 8 days,and the above symptoms in the patient were improved;after 38 days of treatments,laboratory tests showed TBil 27.3μmol/L,DBil 9.3μmol/L,ALT 46 U/L,AST 28 U/L,ALP 83 U/L,and GGT 55 U/L.The patient′s liver injury was possibly related to the aconitine contained in the Radix Aconiti Kusnezoffii and Aconitum racemulosum Franch of Sanqi Shangyao tablets.

关 键 词：植物药疗法 药物性肝损伤 乌头碱 三七伤药片 中成药 

分 类 号：R969[医药卫生—药理学]