元胡止痛滴丸致肝损伤

Liver injury induced by Yuanhu Zhitong dropping pills(元胡止痛滴丸)

1例54岁女性患者因盆腔炎致腹痛口服元胡止痛滴丸30粒/次、3次/d , 6个月后出现食欲不振、恶心、尿液呈浓茶色伴皮肤瘙痒。口服护肝片2周后无改善,自行停用元胡止痛滴丸。停药7 d后,实验室检查显示丙氨酸转氨酶(ALT) 679 U/L,天冬氨酸转氨酶(AST) 698 U/L,总胆红素(TBil) 66.5 μmol/L,直接胆红素(DBil) 51.8 μmol/L,考虑为元胡止痛滴丸所致肝损伤。给予保肝治疗,7 d后肝功能ALT 278 U/L,AST 317 U/L,TBil 150.8 μmol/L,DBil 115.4 μmol/L;25 d后患者未诉不适,前述症状消失,ALT 54 U/L,AST 49 U/L,TBil 44.5 μmol/L,DBil 39.0 μmol/L。随访4个月,患者肝功能正常。

A 54-year-old female patient received Yuanhu Zhitong dropping pills 30 pills thrice daily for pelvic inflammatory-related abdominal pain. Six months after medication, the patient developed anorexia, nausea, dark brown urine, and skin pruritus.After taking Hugan tablets(护肝片) orally for 2 weeks, the symptoms did not improve. The patient stopped using Yuanhu Zhitong dropping pills by himself. On day 7 of drug withdrawal, the laboratory tests showed alanine aminotransferase(ALT) 679 U/L, aspartate aminotransferase (AST) 698 U/L, total bilirubin (TBil) 66.5 μmol/L, and direct bilirubin (DBil) 51.8 μmol/L. Liver injury induced by Yuanhu Zhitong dropping pills was considered. Hepatoprotection treatments were given. Seven days later, the laboratory tests showed ALT 278 U/L, AST 317 U/L, TBil 150.8 μmol/L, and DBil 115.4 μmol/L. Twenty-five days later, the patient did not complain of discomfort, above symptoms disappeared, and the laboratory tests showed ALT 54 U/L, AST 49 U/L, TBil 44.5 μmol/L, and DBil 39.0 μmol/L. At 4 months of follow-up, the patient had normal liver function.