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目的探讨土三七致肝小静脉闭塞症(HVOD)的临床特点和危险因素,为临床合理用药提供参考。方法以“土三七”、“菊三七”、“肝小静脉闭塞症”、“肝静脉闭塞病”等为检索词,检索中国期刊全文数据库和万方数据知识服务平台,收集土三七致HVOD的文献进行统计分析。结果共收集到土三七致HVOD患者81例,其中男性50例(61.7%),女性31例(38.3%);年龄17~81(51±1)岁,≥45岁者73例(90.1%)。81例患者中,原发疾病为骨伤科疾病者60例,伴有慢性肝病者11例。所有患者均为自行服药。发病时间为用药后1周至2年。每日服用剂量越大者,发病时间越早;每日服用剂量小但服用时间长者,发病时间相对较晚。慢性起病者36例,亚急性起病者45例。临床表现以消化系统症状和水钠潴留为主。实验室检查以凝血功能和肝功能指标异常为主。46例肝活检显示肝小叶的静脉内皮损害及管腔狭窄。停药并给予对症治疗后,14例治愈;32例好转;15例死亡;20例放弃治疗,转归不详。结论土三七引起的HVOD与服药剂量相关,病死率较高。土三七所致HVOD重在预防,应加强宣传教育,引导患者正确使用中草药。
Objective To investigate the clinical characteristics and risk factors of hepatospedes vein occlusive disease (HVOD) induced by radix pseudostellariae so as to provide reference for clinical rational drug use. Methods The search term was searched for “Chinese medicine”, “Chrysanthemum”, “Hepatic veno-occlusive disease”, “Hepatic veno-occlusive disease” and so on. The full-text databases of Chinese periodicals and Wanfang data Knowledge service platform to collect soil thirty-seven HVOD literature for statistical analysis. Results A total of 81 HVT patients were collected, including 50 males (61.7%) and 31 females (38.3%), and 73 (90.1%) aged 17-81 (51 ± 1) ). Among the 81 patients, 60 were primary traumatic diseases and 11 were chronic liver diseases. All patients take their own medicine. The onset time for 1 week to 2 years after treatment. The higher the daily dose, the earlier the onset of disease; small daily dose but taking the elderly, the onset time is relatively late. 36 cases of chronic onset, 45 cases of subacute onset. Clinical manifestations of digestive symptoms and Shuinazhuliu based. Laboratory tests to coagulation and abnormal liver function based. 46 cases of liver biopsy showed the hepatic lobule of venous endothelial damage and stenosis. After discontinuation and symptomatic treatment, 14 patients were cured; 32 patients improved; 15 patients died; 20 patients gave up treatment and the outcome was unknown. Conclusions The HVOD caused by Sanqi is related to the dose of the drug and the mortality is high. Due to the prevention and treatment of HVOD caused by soil, the publicity and education should be stepped up to guide patients to use Chinese herbal medicine correctly.