中成药致肝炎的病例分析

Analysis of hepatitis cases induced by traditional Chinese patent medicines

目的:探讨中成药所致肝损害的相关药物、发病机制及防治。方法:对本院1991-2003年收治的103例中成药所致肝炎进行统计,从发病趋势、相关药物、临床表现、治疗及预后几个方面进行分析。结果:中成药所致药物性肝炎,以治疗骨关节病药物占首位,其次为皮肤病用药。临床表现以肝细胞损害为主,也有表现为胆汁淤积型肝炎者。经西药或中西医结合治疗后,绝大部分痊愈和好转。结论:中成药所致肝损害集中发生于治疗骨关节病与皮肤病两类药物,表明该两类药物可能含有某些肝毒性成分或者与配伍等因素相关,确切机制有待于进一步研究。加强临床监测和信息交流有助于及时发现及预防肝损害的发生。

Objective: To investigate the agents, pathogenesis and management of liver impairment induced by traditional Chinese patent medicines (TCPM). Methods:103 hospitalized cases with TCPM-induced hepatitis in 1991-2003 were retrospectively analysed. Results: TCPM-induced hepatitis was mainly due to drugs for osteoarthropathy, followed by drugs for dermatoses. And clinical presentation was mostly hepatocellular damage and cholestasis. Improvement and recovery were achieved most part of patients treated with drugs for liver disorders. Conclusion: Hepatitis can be induced by TCPM, especially those for osteoarthropathy and dermatoses, which may suggest the hepatotoxicity or prescription incompatibility in the above drugs.