中药饮片致药物性肝损的原因及防范

Causes and Prevention of Liver Injury Induced by TCM Decoction Pieces

目的:提升医师临床使用中药饮片的注意义务,有效防范中药饮片药物性肝损。方法:对2010年至2018年某三级甲等中医医院发生的37起中药饮片药物性肝损医疗纠纷进行案例分析,总结医方担责的主要原因。结果:此类医疗纠纷医方担责的主要原因为医方未监测肝功能、诊疗行为不规范、饮片与成药同用等。结论:医方在使用中药饮片时应尽到必要的注意义务,采取提高思想认识、注意定期监测、认真问诊查体等措施来防范此类医疗纠纷的发生。

Objective:To improve the duty of the doctors in caring the adverse effects of traditional Chinese medicine decoction pieces,and to prevent the occurrence of the liver injury caused by Chinese medicine. Methods:Thirty-seven cases of medical disputes about drug-induced liver injury caused by traditional Chinese medicine decoction pieces in a grade A tertiary hospital of traditional Chinese medicinefrom 2010 to 2018 were analyzed,and the main reasons for the doctors’ responsibility were summarized. Results:The main resons for the medical disputes were the failure to monitor liver function,the careless writing of medical records,and the use of decoction pieces with proprietary drugs. Conclusions:The necessary duty of taking care of the adverse effects is the key factor to prevent the occurrence of medical disputes,and the measures such as raising the ideological awareness,paying attention to the regular monitoring,and earnest inquiryand physical examination are important to prevent the occurrence of this kind of medical disputes.