中草药相关药物性肝损伤的流行特点、主要原因与诊断评估

Epidemic features,major causes,and diagnostic evaluation of herb-induced liver injury

随着中草药在世界范围内的广泛应用及药品不良反应监测体系的不断完善,中草药相关肝损伤(HILI)越来越受关注,但其真正的发病率尚不清楚。根据相关文献报道,其构成比多在20%~30%,且有多种临床分型,以肝细胞损伤型为主。导致HILI的原因复杂多样,主要有药学因素、机体因素、临床前评价缺陷、临床不合理应用等多种因素。目前对HILI的诊断尚较困难,中药溯源在其诊断中具有重要意义。需重视中草药导致的肝损伤,积极诊断,有效防治。

With the wide application of Chinese herbal medicine around the world and the continuous perfection of adverse drug reaction monitoring system, herb -induced liver injury （HILI） has attracted more and more attention, but its actual incidence remains unknown. As is reported in the literature, its constituent ratio ranged from 20% to 30% and there are many clinical types, among which hepatocellular injury is the most common type. There are many causes of HILI, including pharmaceutical factors, factors associated with the human body, lack of preclinical evaluation, and unreasonable clinical application. Currently it is difficult to make a diagnosis of HILI, and tracing the source of Chinese herbal medicine may play an important role in the diagnosis of this disease. Liver injury induced by Chinese herbal medicine should be taken seriously and active diagnosis and effective prevention and treatment should be performed.