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目的对我院14个月内收治的痔血胶囊单药(主要成分为白鲜皮和苦参)致群发性肝损伤病例进行回顾性分析。方法2007年8月至2008年10月在我院诊断为痔血胶囊相关性药物性肝损伤患者共30例,对其一般资料、临床表现及实验室检查结果进行CIOMS临床分型和回顾性分析。结果本组患者女性(25例)明显多于男性(5例),占83.34%;平均潜伏期为(48.83±26.66)d;平均服药时间为(27.43±12.04)d;27例患者在停药后起病,平均(25.53±20.95)d;生化表现主要为ALT、AST、TBil、ALP及GGT异常。有2例嗜酸性粒细胞>6%。临床分型:肝细胞损伤型16例,胆汁淤积型1例,混合型3例,未分型10例。所有患者均康复。结论痔血胶囊成分复杂,其引起的肝损伤以肝细胞损伤型为主,推测痔血胶囊相关性肝损伤的发病机制与患者对其中成分的特异质性反应有关。
Objective To retrospectively analyze the cases of massive hepatic injury caused by Zhixuexue capsule (the main component is white fresh skin and Sophora flavescens) treated in our hospital within 14 months. Methods From August 2007 to October 2008 in our hospital diagnosed as hemorrhoids capsule-related drug-induced liver injury in patients with a total of 30 cases, its general information, clinical manifestations and laboratory findings CIOMS clinical classification and retrospective analysis . Results The average number of women (25 cases) was significantly higher than that of males (5 cases), accounting for 83.34%. The mean incubation period was (48.83 ± 26.66) days. The mean duration of medication was (27.43 ± 12.04) days. The average age was (25.53 ± 20.95) days. The biochemical findings were mainly ALT, AST, TBil, ALP and GGT. There are 2 cases of eosinophils> 6%. Clinical classification: hepatocellular injury in 16 cases, cholestasis in 1 case, mixed type in 3 cases, not type in 10 cases. All patients recovered. Conclusions The composition of Zhishui Capsule is complex, and the liver injury caused by it is mainly hepatocyte injury. It is speculated that the pathogenesis of Zhiganxue capsule-related liver injury is related to the specific reaction of the patients to the components.