系统综述已发表的草药诱导肝损伤数据。

Systematic review of published data on herb induced liver injury.

机构信息

Korean Medical College of Daejeon University, 62, Daehak-ro Dong-gu, Daejeon 301-716, Republic of Korea.

Department of Health Service Management, Daejeon University, 62, Daehak-ro Dong-gu, Daejeon 301-716, Republic of Korea.

出版信息

J Ethnopharmacol. 2019 Apr 6;233:190-196. doi: 10.1016/j.jep.2019.01.006. Epub 2019 Jan 11.

DOI:10.1016/j.jep.2019.01.006

PMID:30639232

Abstract

ETHNOPHARMACOLOGICAL RELEVANCE

Herbal products have been widely used as a means of ethnomedicine worldwide. Recently, the potential hepatotoxicity of herbs has become a medical issue but comprehensive studies are limited.

AIM OF THE STUDY

This study aims to determine the clinical features of herb induced liver injury (HILI) including its constituent ratio among liver injury case cohorts that included both HILI and drug induced liver injury (DILI).

MATERIALS AND METHODS

A systematic review was conducted using a literature search for DILI/HILI in seven electric databases including PubMed, Cochrane and Embase. We analyzed the DILI/HILI cases and clinical characteristics in terms of herbs, conventional drugs, concomitant, or others.

RESULTS

Thirty-one studies met the necessary criteria and included 9 prospective and 22 retrospective studies. Among total number of overall DILI/HILI cases (7511, male 2819, female 3669 and unknown 1023), 25.0% (1874 cases) were implicated in herbs. HILI was relatively higher in females (69.8% vs. 30.2% male), compared to conventional drugs (57.3% female vs. 42.7% male, p < 0.01), while it was prone to induce hepatocellular injury (hepatocellular 78.8%, cholestatic 8.9%, mixed type 12.3%), contrary to conventional drugs (hepatocellular 56.7% vs. cholestatic 22.1% vs. mixed 21.2%), respectively (p < 0.01). The main herbs causing HILI included Polygonum multiflorum, Psoralea corylifolia, Corydalis yanhusuo, and Rheum officinale.

CONCLUSIONS

This review created the comparative and comprehensive feature of hepatotoxicity by herbal products, which provides reference data for the clinical applications and establishing pharmacovigilance system of herbs.

摘要

民族药理学相关性

草药产品已被广泛用作世界各地民族医学的手段。最近，草药的潜在肝毒性已成为一个医学问题，但综合研究有限。

研究目的

本研究旨在确定草药引起的肝损伤（HILI）的临床特征，包括其在包括 HILI 和药物性肝损伤（DILI）在内的肝损伤病例队列中的构成比。

材料和方法

使用文献检索对七个电子数据库（包括 PubMed、Cochrane 和 Embase）中的 DILI/HILI 进行系统评价。我们根据草药、常规药物、伴随用药或其他药物分析了 DILI/HILI 病例和临床特征。

结果

符合必要标准的研究有 31 项，包括 9 项前瞻性研究和 22 项回顾性研究。在总共的 7511 例整体 DILI/HILI 病例中（男性 2819 例，女性 3669 例，未知 1023 例），25.0%（1874 例）与草药有关。与常规药物（女性 57.3%，男性 42.7%，p<0.01）相比，HILI 在女性中相对较高（女性 69.8%，男性 30.2%），而与常规药物（肝损伤 56.7%，胆汁淤积 22.1%，混合性 21.2%）相比，HILI 更倾向于引起肝细胞损伤（肝细胞损伤 78.8%，胆汁淤积 8.9%，混合性 12.3%）（p<0.01）。引起 HILI 的主要草药包括何首乌、补骨脂、延胡索和大黄。