中草药相关肝损伤的研究进展与挑战

Research advances and challenges in herb-induced liver injury

中草药相关肝损伤发生众多,对中药临床安全用药与产业健康发展等有重要影响,近年来中草药肝损伤研究受到广泛重视并取得显著进展,我国与国际学术组织均制订并更新了相关临床诊疗指南。本文比较分析了近期有关中草药相关肝损伤诊疗指南的特点,继而从毒性机制、临床诊断与病情评估、风险因素与临床防治等方面简述主要进展,提出部分尚未满足的需求、需要重视的研究难点与可能的防治措施。

Herb-induced liver injury(HILI)shows a high incidence rate and has great impacts on the clinical medication safety of traditional Chinese medicine and the healthy development of the industry.In recent years,the research on HILI has attracted wide attention and made remarkable progress,and related clinical diagnosis and treatment guidelines have been formulated and updated by the academic organizations in China and globally.This article compares the recent guidelines on HILI formulated by different organizations and elaborates on the main achievements in terms of mechanism of toxicity,clinical diagnosis and disease assessment,risk factors,and clinical prevention and treatment,and it also proposes the unmet needs,the research difficulties that need to be taken seriously,and possible prevention and treatment strategies.