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中药药源性肝损伤的文献评价研究

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  • NETL
  • NSTL
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目的:中药的使用主要分为3种方式:单味药材或饮片、复方汤剂、单味或复方制剂.本研究制定这三类中药相关风险分类表,以指导合理临床用药.方法:研究在7个电子数据库中检索有关中药药源性肝损伤的临床报告,收集文章的基本信息、用药,并进行风险程度分类:第一类药物(单个中心的个案报道);第二类药物(单个中心的多人报道);第三类药物(多中心报道).结果:第一类包括65种单味药材或饮片和145种单味或复方制剂,第二类包括62种单味药材或饮片和120种单味或复方制剂,第三类包括51种单味药材或饮片和92种单味或复方制剂.分类类别越高,循证级别越强,可疑肝毒性就越大.结论:评价其肝毒性风险时应根据其分类区别对待.新发现的肝毒性中药制剂,其相关毒理机制有待进一步探索.
Literature evaluation study on herb-induced liver injury
Objective:The use of Chinese medicines is categorized into three main methods:Single herbs or tablets,compound decoctions,and single and compound preparations.This study develops a classification table of the risks associated with these three Chinese medicines to guide rational clinical use.Methods:In this study,we searched seven electronic databases for clinical reports on drug-induced liver injury from Chinese medicines,collected basic information about the articles,and medications used,and classified the risk into three categories:class Ⅰ(case reports from a single center),class Ⅱ(multiple reports from a single center),and class Ⅲ(reports from multiple centers).Results:Class Ⅰ comprised 65 single herbs or tablets and 145 of both single and compound preparations,class Ⅱ included 62 single herbs or tablets and 120 of both single and compound preparations,and class Ⅲ consisted of 51 Single herbs or tablets and 92 of both single and compound preparations.The higher the classification,the stronger the level of evidence and the greater the suspected hepatotoxicity.Conclusion:Hepatotoxicity risk should be assessed differently based on their classification.The toxicological mechanisms of newly identified hepatotoxic Chinese medicine preparations await further investigation.

Drug-induced liver injuryHerb-induced liver injuryAdverse effectEvidence-based medicineRational therapy

霍光远、付丽红、高月求

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上海中医药大学附属曙光医院肝病科,上海 201203

药物性肝损伤 中药药源性肝损伤 不良反应 循证医学 合理用药

上海市临床重点专科建设项目上海市2020年度"科技创新行动计划"医学创新研究专项项目上海市进一步加快中医药传承创新发展三年行动计划(2021-2023年)上海市进一步加快中医药传承创新发展三年行动计划(2021-2023年)上海炎癌转化病证生物学前沿研究基地

shslczdzk0120120Z21900100ZY2021-2023-0103ZY2021-2023-03022021KJ03-12

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子：1.135
ISSN：1673-1727
年,卷(期)：2024.39(9)