土三七致肝小静脉闭塞病2例报告

Report on Two Cases of Hepatic Veno-occlusive Disease induced by Sedum Aizoom

目的探讨中药土三七导致肝小静脉闭塞病(HVOD)的临床特点,提高对HVOD的认识,为临床早期诊断治疗提供依据。方法回顾性分析2例(夫妻)HVOD患者的发病情况、临床特点、诊治经过、预后等相关情况。结果 2例患者均服用土三七长达3年,以腹胀、乏力、纳差为主要临床表现,均有肝功能异常、腹水及脾大,及时停用土三七后,采用中西医综合疗法治疗,最终取得较好疗效。结论不当使用土三七可导致HVOD;如有服用土三七史,出现肝功能异常、腹胀、腹水、黄疸,要高度怀疑HVOD;临床上遇到不能明确病因的肝脏疾病时,应及早进行肝穿刺活检。

Objective To investigate clinical characteristics of hepatic veno-occlusive disease（HVOD） induced by Chinese medicine sedum aizoom, and to provide evidence for early diagnosis and treatment of HVOD. Methods Retrospective analysis of the incidence,clinical characteristics, diagnosis, treatment, prognosis and the relevant situation of two HVOD cases（husband and wife） were car-ried out. Results Two cases all took sedum aizoom orally for 3 years, had main clinical manifestations of abdominal distension, fa-tigue, poor appetite, had dysfunction of liver, ascites and splenomegaly, after discontinuation of sedum aizoom in time, treated them with integrated traditional Chinese and Western medicine therapy, finally achieved good curative effect. Conclusion Taking sedum aizoom inappropriately can induce HVOD. If there is a history of taking sedum aizoom, appears dysfunction of liver, abdominal dis-tension, ascites, jaundice, HVOD should be highly suspected. When the liver disease can not be clearly defined in clinical, liver biopsy should be taken as soon as possible.