Department of Cardiovascular & Neurologic Diseases, College of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea.
Phytomedicine. 2011 Nov 15;18(14):1208-13. doi: 10.1016/j.phymed.2011.06.026. Epub 2011 Jul 30.
Concurrent use of herbal medicine (HM) and conventional medicine (CM) is increasing. However, little is known about the prevalence of drug-induced liver injury (DILI) related to this concurrent use. In order to investigate changes in liver enzymes during concurrent use of HM and CM and to assess the prevalence of DILI related to their concurrent use, we screened for liver injury among inpatients at our institution who were administered both HM and CM for at least 14 days while hospitalized between 2006 and 2010. We used the Council for International Organization of Medical Science (CIOMS) laboratory criteria to define liver injury. Of the 892 patients included in the study, 34 (3.81%) had liver injury on admission and 21 (2.35%) had liver injury at discharge. Of the 48 cases that fulfilled the CIOMS laboratory criteria for liver injury, 34 had preexisting liver injury. The remaining 14 were analyzed, and five were concluded to have DILI, resulting in a prevalence of 5/892 (0.56%, with a 95% confidence interval of 0.07-1.05%). Overall, clinical symptoms of liver injury were mild. We thus contend that concurrent use of HM and CM is relatively safe.
同时使用草药（HM）和常规药物（CM）的情况正在增加。然而，对于这种同时使用导致的药物性肝损伤（DILI）的流行程度知之甚少。为了研究同时使用 HM 和 CM 期间肝酶的变化，并评估与它们同时使用相关的 DILI 的流行程度，我们对 2006 年至 2010 年间在我们机构住院期间同时使用 HM 和 CM 至少 14 天的住院患者进行了肝损伤筛查。我们使用国际医学科学组织理事会（CIOMS）实验室标准来定义肝损伤。在纳入研究的 892 名患者中，34 名（3.81%）入院时存在肝损伤，21 名（2.35%）出院时存在肝损伤。在符合 CIOMS 实验室肝损伤标准的 48 例中，有 34 例存在预先存在的肝损伤。对其余 14 例进行了分析，其中 5 例被诊断为 DILI，导致发病率为 5/892（0.56%，95%置信区间为 0.07-1.05%）。总体而言，肝损伤的临床症状较轻。因此，我们认为同时使用 HM 和 CM 相对安全。
