基于《中草药相关肝损伤临床诊疗指南》的中药肝损伤诊断实例

Guidelines for clinical diagnosis and treatment of herb-induced liver injury

近年,中草药相关肝损伤(herb-induced liver injury,HILI)问题备受关注,HILI因具有联合用药复杂、组成成分多样及体质、遗传、基础疾病等特点,导致其临床诊断比西药肝损伤诊断更加困难。中华中医药学会在2016年发布国内外首个专门针对HILI的诊疗技术标准——《中草药相关肝损伤临床诊断指南》(以下简称《指南》)。为便于广大临床医师特别是肝病专科医师在诊断HILI时对《指南》的操作应用,该文将不同诊断结果的病例诊断流程予以解析。

In recent years, the issues related to herb-induced liver injury （HILI） have received much concern. Its clinical diagnosis is much difficult than that of Western medicine-induced liver injury due to its complicated drug combination and multiple constituents. Moreover, it is also correlated with physiques, inheritance and basic diseases. China Association of Chinese Medicine has released the first standards for HILI diagnosis and treatment technology in 2016, namely Guidelines for clinical diagnosis of herb-induced liver injury （hereinafter referred to as the Guidelines）. The diagnostic processes with different diagnostic results were explained in this paper to help clinicians, particularly liver specialists, in diagnosing liver diseases by applying the operation of the Guidelines.