中国药物警戒 ›› 2023, Vol. 20 ›› Issue (2): 127-131.
DOI: 10.19803/j.1672-8629.20220661

• 中草药及抗肿瘤治疗相关肝损伤专栏(一) • 上一篇    下一篇

中草药引起肝损伤的临床诊治与用药

李盟1, 李容容1, 刘成海1,2,3*   

  1. 1上海中医药大学附属曙光医院肝病研究所,上海 201203;
    2上海市中医临床重点实验室,上海 201203;
    3肝肾疾病病证教育部重点实验室,上海 201203
  • 收稿日期:2022-11-17 出版日期:2023-02-15 发布日期:2023-02-17
  • 通讯作者: *刘成海,男,博士,教授,中西医结合防治肝病的基础与临床。E-mail: chenghailiu@hotmail.com
  • 作者简介:李盟,男,博士,中西医结合防治慢性肝病。
  • 基金资助:
    国家自然科学基金资助项目(81730109、82274305); 上海市中医药事业发展三年行动计划[ZY(2018-2020)-CCCX-5001]; 上海市科学技术委员会科技计划项目(20Z21900100); 上海市临床重点专科建设项目(shslczdzk01201)

Clinic diagnosis and treatment of herb-induced liver injury

LI Meng1, LI Rongrong1, LIU Chenghai1,2,3*   

  1. 1Institute of Liver Diseases, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China;
    2Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai 201203, China;
    3Key Laboratory of Liver and Kidney Diseases, Ministry of Education, Shanghai 201203, China
  • Received:2022-11-17 Online:2023-02-15 Published:2023-02-17

摘要: 目的 介绍中草药肝损伤(HILI)临床诊治特点,以更好预测与防治HILI。方法 结合国内外最新研究,就HILI的临床流行病学、风险信号与临床诊断、风险因素与发病机制、管理、治疗与用药等几个方面特点做介绍。结果和结论 HILI不仅较药物性肝损伤(DILI)更为凸显,且临床表现多种多样,毒性机制错综复杂,给HILI 临床防治带来极大挑战。临床上应不断提高药物安全性意识,注意发现甄别HILI病例,建立长期随访队列,临床、药学、临床流行病学等多学科相结合,提高HILI的临床预防与诊疗水平,促进中药的临床安全用药水平。

关键词: 中草药肝损伤, 临床流行病学, 临床诊断, 发病机制, 预防, 治疗

Abstract: Objective To introduce the clinical features of herb-induced liver injury (HILI) for better prediction and prevention of HILI. Methods The clinical epidemiology, risk signals and clinical diagnosis, risk factors and pathogenesis, management, treatment and medication of HILI were reviewed based on the latest research at home and abroad. Results and Conclusion The clinical manifestations of HILI are diverse and the toxic mechanism is complex, which is more prominent in drug induced liver injury, so, brings great challenges to the clinical prevention and treatment of HILI. Clinical awareness of drug safety and attention to the detection and screening of HILI cases should be continuously raised. Long-term follow-up cohorts should be established and integrated with clinical, pharmacological and clinical epidemiological disciplines to improve the clinical prevention and treatment of HILI and promote the level of clinical safety in the use of Chinese medicine.

Key words: herb-induced liver injury, epidemiology, diagnosis, pathogenesis, prevention, treatment

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