临床应用黄连饮片对患者转氨酶的影响——85例回顾性分析

A Retrospective Analysis on Changes of Aminotransferase in 85 Patients Taking Huanglian(Coptis Chinensis Franch.)

目的 分析临床应用黄连饮片对血清转氨酶的影响。方法 对85例门诊应用黄连饮片的患者病案进行回顾性分析,提取患者年龄、性别、病史、中药处方用药情况、合并用药情况、疗程及患者应用黄连片后丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）水平的变化。结果 85例患者中,男65例,女20例;糖尿病患者81例（95.29%）,多囊卵巢综合征、肥胖症、精神分裂症及慢性肾功能衰竭各1例（4.71%）;黄连日用量为1.2~30 g,平均（19.78±7.95）g;全疗程黄连平均日用量符合《中华人民共和国药典》规定的2~5 g者3例;黄连饮片累计用量165~6850 g,平均（2008.25±1766.75）g。观察期内ALT、AST均无明显变化者63例（74.12%）;ALT、AST均升高者3例（3.53%）,分别有肝病史、酗酒史、超量应用有毒中药史;ALT、AST均降低者4例（4.71%）,中药处方中多配伍了茵陈、五味子或应用了西药降酶保肝药。结论 临床应用黄连饮片导致ALT、AST均升高的可能性较低,既往病史、过敏史、联合用药等因素可能影响患者服用黄连饮片期间ALT、AST水平的变化。

Objective To analyze clinical effect of Huanglian（ Coptis Chinensis Franch.） on aminotransferase changes. Methods A retrospective analysis was carried out on 85 patients taking Huanglian in clinic. Patient＇ s age,gender,disease history,traditional Chinese medicine（ TCM） prescribtion,combined prescribtion,course of disease and changes of alanine aminotransferase（ ALT） and aspartate aminotransferase（ AST） levels were extracted from case files. Results There were 65 males and 20 females in all 85 patients,in which 81 patients were with diabetes（ 95. 29%）,while one with polycystic ovary syndrome,one with obesity,one with schizophrenia and one with chronic renal failure（ 4. 71%）. Dosage of Huanglian per day was among 1. 2 g to 30 g with an average of（ 19. 78 ± 7. 95） g. Only 3 cases＇ average dose was in accordance with the 2- 5 g provided by Pharmacopeia of the People＇s Republic of China during full course. Total amount of Huanglian usage was 165 g to 6850 g with an average of（ 2008. 25 ± 1766. 75） g. There were 63 cases showing no change in ALT and AST; 3 cases（ 3. 53%） showed an increase of ALT and AST with histories of liver diseases,alcohol abuse and excessive use of toxic Chinese medicine;4 cases（ 4. 71%） showed a decline of ALT and AST with additional compatibility of Yinchen（ Artemisiacapillaris Thunb）,Wuweizi（ Schisandra chinensis） or aminotransferase-reducing and liver-protecting drugs. Conclusion Huanglian would unlikely to cause the rising of ALT and AST. Past medical history,allergic history,compatibility of drugs and other factors may have an impact on the levels of ALT and AST during treatments with Huanglian.