Pittler M H, Ernst E
Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, UK.
Aliment Pharmacol Ther. 2003 Sep 1;18(5):451-71. doi: 10.1046/j.1365-2036.2003.01689.x.
Large proportions of patients use herbal medicinal products, and encouraging data in terms of effectiveness exist for some of these. One aspect, however, which is still largely under-investigated is the question of potential harm.
To review the recent evidence on hepatotoxic events associated with the use of herbal medicinal products.
Systematic literature searches were performed on Medline, Embase, The Cochrane Library, Amed and Ciscom. To identify additional data, searches were conducted by hand in relevant medical journals and in our own files. The screening and selection of articles and the extraction of data were performed independently by the two authors. There were no restrictions regarding the language of publication. In order to be included articles were required to report data on hepatotoxic events associated with the therapeutic use of herbal medicinal products.
Single medicinal herbs and combination preparations are associated with hepatotoxic events. Clinically, the spectrum ranges from transient elevations of liver enzyme levels to fulminant liver failure and death. In most instances hepatotoxic herbal constituents are believed to be the cause, while others may be due to herb-drug interactions, contamination and/or adulteration.
A number of herbal medicinal products are associated with serious hepatotoxic events. Incidence figures are largely unknown, and in most cases a causal attribution is not established. The challenge for the future is to systematically research this area, educate all parties involved, and minimize patient risk.
很大比例的患者使用草药产品，其中一些产品在有效性方面有令人鼓舞的数据。然而，一个仍在很大程度上未被充分研究的方面是潜在危害问题。
综述近期关于使用草药产品相关肝毒性事件的证据。
在Medline、Embase、Cochrane图书馆、Amed和Ciscom上进行系统的文献检索。为了识别更多数据，还手工检索了相关医学期刊和我们自己的档案。文章的筛选、选择和数据提取由两位作者独立进行。对发表语言没有限制。为了被纳入，文章需要报告与草药产品治疗用途相关的肝毒性事件的数据。
单一草药和复方制剂都与肝毒性事件有关。临床上，范围从肝酶水平的短暂升高到暴发性肝衰竭和死亡。在大多数情况下，肝毒性草药成分被认为是原因，而其他情况可能是由于草药与药物相互作用、污染和/或掺假。
许多草药产品与严重的肝毒性事件有关。发病率数据大多未知，而且在大多数情况下因果关系尚未确立。未来的挑战是对该领域进行系统研究，教育所有相关方，并将患者风险降至最低。
