中草药相关肝损伤的管理与治疗

Management and treatment of herb-induced liver injury

由于我国中草药产品应用形式多样,使用人群广泛,用药情况复杂,近年来中草药相关肝损伤等不良反应事件频发,为进一步科学认识中草药相关肝损伤,规范其风险管理与防治措施,本文结合近年的临床研究进展与相关经验,对中草药相关肝损伤的风险管理、临床评价、预防及治疗展开论述。在中药研发生产、上市后的临床应用等多环节,建立涉及中药产品质量控制、患者安全教育、临床医师合理用药、定期监测、分级分型治疗等全方位的中草药相关肝损伤的管控体系,对于预防和处理肝损伤等不良反应事件非常重要,为中草药临床安全合理用药提供参考和借鉴。

Due to the diverse application forms of Chinese herbal medicine products,the wide range of users,and the complex conditions of medication in China,adverse events including herb-induced liver injury(HILI)occur frequently in recent years.In order to further understand HILI and standardize its risk management and prevention and treatment measures,this article discusses the risk management,clinical evaluation,prevention,and treatment of HILI based on related clinical research advances and experience in recent years.In the multiple links of traditional Chinese medicine including production and clinical application after marketing,the establishment of a comprehensive control system is of great importance for the prevention and treatment of HILI and other adverse events,involving product quality control,patient safety education,rational drug use by clinicians,regular monitoring,and graded and classified treatment,which provides a reference for the rational and safe clinical use of Chinese herbal medicine in the future.