中国药物警戒 ›› 2023, Vol. 20 ›› Issue (5): 511-513.
DOI: 10.19803/j.1672-8629.20220672

• 中草药及抗肿瘤治疗相关肝损伤专栏（二） • 上一篇    下一篇

雷公藤多苷片致急性肝损伤1例分析

刘宝生1, 王冠杰1, 王振华1,*, 刘丽红2, 朱彦2, 周秀丽3#   

  1. 1潍坊市中医院临床药学科,山东 潍坊 261000;
    2中国中医科学院中医药信息研究所,北京 100700;
    3阳光融和医院药学部,山东 潍坊 261000
  • 收稿日期:2022-06-02 出版日期:2023-05-15 发布日期:2023-05-16
  • 通讯作者: *王振华,女,本科,主任药师,临床药学。E-mail: wzh6606@126.com;#为共同通信作者。
  • 作者简介:刘宝生,男,硕士,主管药师。
  • 基金资助:
    国家自然科学基金资助项目（82174534、82274684）; 中国毒理学会临床毒理专项研究课题(CST2019CT307); 潍坊高新区科技惠民计划项目（2021KJHM75）; 潍坊市卫生健康委员会科技项目（WFWSJK2022279）

One case of acute liver injury caused by tripterygium glycosides tablets

LIU Baosheng1, WANG Guanjie1, WANG Zhenhua1,*, LIU Lihong2, ZHU Yan2, ZHOU Xiuli3#   

  1. 1Department of Clinical Pharmacy, Weifang Hospital of TCM, Weifang Shandong 261000, China;
    2Institute of Information on Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China;
    3Department of Pharmacy, Sunshine Union Hospital, Weifang Shandong 261000, China
  • Received:2022-06-02 Online:2023-05-15 Published:2023-05-16

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摘要： 目的 以病例为基础探讨雷公藤多苷片致急性肝损伤的临床特点、高危因素及治疗方案。方法 基于1例应用雷公藤多苷片治疗慢性肾小球肾炎致中药药源性肝损伤的案例进行分析,并结合相关文献进行归纳和讨论。结果 1例34岁女性患者因慢性肾小球肾炎,给予雷公藤多苷片20 mg每日3次口服。患者出现谷丙转氨酶（ALT）、谷草转氨酶（AST）、碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（GGT）升高,停用雷公藤多苷片后给予还原型谷胱甘肽联合异甘草酸镁治疗,患者肝功能指标恢复正常。结论 雷公藤多苷片治疗过程中应加强监护患者的临床症状及肝功能生化指标,鉴别可能导致的中药药源性肝损伤,发生肝损伤应及时根据病情给予对应治疗。

关键词: 雷公藤多苷片, 药源性肝损伤, 药品不良反应, 病例分析

Abstract: Objective To investigate the clinical characteristics, high-risk factors and treatment options of acute liver injury caused by tripterygium glycosides tablets on a case-by-case basis. Methods The clinical data on one case of pharmacogenic liver injury caused by tripterygium glycosides tablets used for chronic glomerulonephritis was analyzed based on related literature. Results A 34-year-old female patient with chronic glomerulonephritis was treated with tripterygium glycosides tablets 20 mg orally three times daily. She developed elevated ALT, AST, ALP and GGT before being given reduced glutathione combined with magnesium isoglycyrrhizate after discontinuation of tripterygium glycosides tablets. Her liver function indexes returned to normal after symptomatic treatment. Conclusion The clinical symptoms and biochemical indexes of liver function of patients should be monitored during treatment with tripterygium glycosides tablets to identify the possible pharmacogenic liver injury caused by traditional Chinese medicine. Patients with adverse reactions of liver injury should be given quick and corresponding treatment according to their conditions.

Key words: tripterygium glycosides tablets, drug induced liver injury, adverse drug reaction, case analysis

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