因偶然再次服用含黄芩的汉方制剂导致的复发性药物性肝损伤

Shimada Yutaka, Fujimoto Makoto, Nogami Tatsuya, Watari Hidetoshi, Kitahara Hideyuki, Misawa Hiroki, Kimbara Yoshiyuki, Kita Kei-Ichiro

Department of Japanese Oriental Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan.

Department of General Medicine, Toyama University Hospital, University of Toyama, Japan.

Intern Med. 2018 Jun 15;57(12):1733-1740. doi: 10.2169/internalmedicine.0275-17. Epub 2018 Feb 9.

A 67-year-old woman experiencing coughing visited a clinic and was prescribed drugs, including shosaikoto extract, for 4 days. She subsequently suffered from liver injury, but her condition improved after the discontinuation of all medications. Approximately 1 year later, she experienced fatigue, consulted another clinic, and received saikokeishikankyoto extract for 21 days. She subsequently suffered liver injury again. Both shosaikoto and saikokeishikankyoto contain Scutellariae Radix. This case is thought to be one of recurrent drug-induced liver injury caused by the incidental readministration of a Kampo formula containing Scutellariae Radix. An awareness of adverse drug events caused by Kampo formulas, especially those containing Scutellariae Radix, is essential.

一名67岁咳嗽的女性前往诊所就诊，被开了包括小柴胡汤提取物在内的药物，服用了4天。随后她出现肝损伤，但在停用所有药物后病情好转。大约1年后，她感到疲劳，咨询了另一家诊所，并服用了柴胡桂枝干姜汤提取物21天。随后她再次出现肝损伤。小柴胡汤和柴胡桂枝干姜汤都含有黄芩。该病例被认为是因再次偶然服用含黄芩的汉方制剂而导致的复发性药物性肝损伤。认识到汉方制剂尤其是含黄芩的制剂引起的药物不良事件至关重要。