通天口服液与养血清脑丸联用致重度肝损伤  

Severe liver injury induced by Tongtian oral solution(通天口服液)combined with Yangxue Qingnao pills(养血清脑丸)

作　　者：牛晓强[1] Niu Xiaoqiang(Department of Pharmacy,Heping Hospital Affiliated to Changzhi Medical College,Shanxi Province,Changzhi 046000,China)

机构地区：[1]长治医学院附属和平医院药剂科,长治046000

出　　处：《药物不良反应杂志》2025年第1期50-52,共3页Adverse Drug Reactions Journal

摘　　要：1例46岁女性患者因偏头痛给予通天口服液10 ml口服、3次/d和养血清脑丸2.5 g口服、3次/d。服药10 d后出现尿黄,12 d后自行停用通天口服液。继续服用养血清脑丸5 d后发现皮肤及巩膜黄染,10 d后自行停用养血清脑丸。停用养血清脑丸次日患者出现腹胀。实验室检查示丙氨酸转氨酶(ALT)1454 U/L,天冬氨酸转氨酶(AST)1429 U/L,γ-谷氨酰转移酶(GGT)290 U/L,碱性磷酸酶(ALP)176 U/L,总胆红素(TBil)94.2μmol/L,总胆汁酸(TBA)365.9μmol/L。根据患者病史、实验室检查结果和辅助检查结果,诊断为药物性肝损伤,考虑可能与通天口服液和养血清脑丸相关。患者停用养血清脑丸1周后,皮肤及巩膜黄染症状减轻,尿液颜色变浅,ALT 495 U/L、AST 202 U/L、GGT 181 U/L、ALP 120 U/L、TBil 24.6μmol/L、TBA 15.6μmol/L。予异甘草酸镁、促肝细胞生长素、腺苷蛋氨酸等药物治疗7 d后,患者病情明显好转。停用上述药物,予双环醇(25 mg口服、3次/d)治疗8 d后,患者肝功能各项指标基本恢复正常。A 46-year-old female patient received Tongtian oral solution 10 ml thrice daily combined with Yangxue Qingnao pills 2.5 g thrice daily for migraine.After 10 days of treatments,the patient developed yellow urine.After 12 days of treatments,the patient stopped using Tongtian oral solution by herself.After continuing to take Yangxue Qingnao pills for 5 days,the patient developed symptoms of yellowish skin and sclera,and 10 days later,Yangxue Qingnao pills were discontinued by herself.The next day of discontinuing the Yangxue Qingnao pills,the patient experienced abdominal distension.The laboratory tests showed alanine aminotransferase(ALT)1454 U/L,aspartate aminotransferase(AST)1429 U/L,gamma glutamyltransferase(GGT)290 U/L,alkaline phosphatase(ALP)176 U/L,total bilirubin(TBil)94.2μmol/L,and total bile acid(TBA)365.9μmol/L.Based on the patient′s medical history,laboratory test results,and auxiliary examinations,drug-induced liver injury was diagnosed,which might be related to Tongtian oral solution and Yangxue Qingnao pills.After one week of Yangxue Qingnao pills withdrawal,the patient′s symptoms of yellowish skin and sclera were improved and urine color became lighter,with ALT 495 U/L,AST 202 U/L,GGT 181 U/L,ALP 120 U/L,TBil 24.6μmol/L,and TBA 15.6μmol/L.After 7 days of treatments such as magnesium isoglycyrrhizinate,hepatocyte growth-promoting factor,and ademetionine,the patient′s condition was significantly improved.The above-mentioned drugs were discontinued and switched to bicyclol 25 mg thrice daily orally.Eight days later,the patient′s liver function indicators had basically returned to normal.

关 键 词：植物药疗法 药物性肝损伤 通天口服液 养血清脑丸 中成药 

分 类 号：R285.6[医药卫生—中药学]