Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Academic Teaching Hospital of the Medical Faculty of the Goethe University Frankfurt/Main, Hanau, Germany.
Aliment Pharmacol Ther. 2014 Jul;40(1):32-50. doi: 10.1111/apt.12798. Epub 2014 May 20.
Although evidence for their therapeutic efficacy is limited, herbal traditional Chinese medicine (TCM) preparations increasingly gain popularity. In contrast to other herbal products, adverse effects by herbal TCM including liver toxicity were rarely reported. In recent years, more cases were published, providing new clinical challenges.
To summarise comprehensively the literature on herbal TCM hepatotoxicity since 2011.
PubMed was searched using key words related to TCM, the results were restricted to full English-language publications and abstracts published since 2011. In addition, the database of the National Institutes of Health (NIH) and LiverTox was accessed under the topic 'Drug record: Chinese and other Asian herbal medicines'.
Since 2011, new case reports and case series provided evidence for herbal hepatotoxicity by TCM, focusing on nine TCM herbal mixtures and four individual TCM herbs with potential health hazards. These were the TCM products Ban Tu Wan, Chai Hu, Du Huo, Huang Qin, Jia Wei Xia Yao San, Jiguja, Kamishoyosan, Long Dan Xie Gan Tang, Lu Cha, Polygonum multiflorum products, Shan Chi, 'White flood' containing the herbal TCM Wu Zhu Yu and Qian Ceng Ta, and Xiao Chai Hu Tang. Other developments include the establishment of a new and early diagnostic serum marker for hepatotoxicity caused by pyrrolizidine alkaloids, assessed using ultra performance liquid chromatography-mass spectrometry analysis, and new regulatory details to improve herbal TCM product quality and safety.
Stringent evaluation of the risk/benefit ratio is essential to protect traditional Chinese medicines users from health hazards including liver injury.
尽管草药传统中药（TCM）制剂的治疗效果证据有限，但它们的受欢迎程度却与日俱增。与其他草药产品不同，草药 TCM 引起的不良反应包括肝毒性很少报道。近年来，越来越多的病例被发表，这给临床带来了新的挑战。
全面总结 2011 年以来关于草药 TCM 肝毒性的文献。
使用与 TCM 相关的关键词在 PubMed 上进行搜索，结果仅限于自 2011 年以来发表的全英文出版物和摘要。此外，还在 NIH 数据库和 LiverTox 下以“药物记录：中药和其他亚洲草药”为主题访问数据库。
自 2011 年以来，新的病例报告和病例系列为 TCM 引起的草药肝毒性提供了证据，重点关注了九种 TCM 草药混合物和四种具有潜在健康危害的个别 TCM 草药。这些是 TCM 产品斑蝥丸、柴胡、独活、黄芩、加味逍遥散、鸡骨草、鸡骨草丸、龙胆泻肝汤、露水草、何首乌产品、山慈菇、含草药 TCM 乌珠玉的“白洪”和前参他，以及小柴胡汤。其他进展包括建立一种新的早期诊断肝毒性的血清标志物，使用超高效液相色谱-质谱分析进行评估，以及改善草药 TCM 产品质量和安全性的新监管细节。
为了保护传统中药使用者免受包括肝损伤在内的健康危害，必须严格评估风险/效益比。
