中国药物应用与监测
中國藥物應用與鑑測
중국약물응용여감측
CHINESE JOURNAL OF DRUG APPLICATION AND MONITORING
2014年
3期
191-192,193
,共3页
茵栀黄颗粒%药物性肝炎%肝损害%药品不良反应
茵梔黃顆粒%藥物性肝炎%肝損害%藥品不良反應
인치황과립%약물성간염%간손해%약품불량반응
Yinzhihuang granules%Drug-induced hepatitis%Liver impairment%Adverse drug reaction
病例1：患者，男性，46岁，因肝功能异常服用茵栀黄颗粒降酶退黄治疗，后出现呕吐、乏力，小便颜色进行性加深，并伴有畏寒、发热，体温最高达39.0℃。自行停药后体温降至正常，症状缓解。2个月后再次服用茵栀黄颗粒，畏寒、发热、乏力、尿黄症状再次出现。于外院查肝功能示：TBIL 65.7μmol·L-1，DBIL 34.8μmol·L-1，ALT 939.2 IU·L-1，AST 489.9 IU·L-1，γ-GT 785.0 IU·L-1，诊断为药物性肝炎。即刻停药，予保肝、利胆、降酶治疗，45 d后，患者肝功能恢复正常。病例2：患者，女性，51岁，因急性戊型肝炎在我院住院治疗，治疗2个月病情好转后出院，出院后服用茵栀黄颗粒降酶退黄治疗10余天，服药期间出现发热、呕吐、腹胀、纳差，肝功能示：TBIL 22.8μmol·L-1，DBIL 16.0μmol·L-1，ALT 308.0 IU·L-1，AST 309.0 IU·L-1，γ-GT 237.0 IU·L-1，AKP 258.0 IU·L-1，诊断为药物性肝炎。即刻停药，予保肝、退黄、降酶等对症治疗，35 d后，患者肝功能恢复正常。
病例1：患者，男性，46歲，因肝功能異常服用茵梔黃顆粒降酶退黃治療，後齣現嘔吐、乏力，小便顏色進行性加深，併伴有畏寒、髮熱，體溫最高達39.0℃。自行停藥後體溫降至正常，癥狀緩解。2箇月後再次服用茵梔黃顆粒，畏寒、髮熱、乏力、尿黃癥狀再次齣現。于外院查肝功能示：TBIL 65.7μmol·L-1，DBIL 34.8μmol·L-1，ALT 939.2 IU·L-1，AST 489.9 IU·L-1，γ-GT 785.0 IU·L-1，診斷為藥物性肝炎。即刻停藥，予保肝、利膽、降酶治療，45 d後，患者肝功能恢複正常。病例2：患者，女性，51歲，因急性戊型肝炎在我院住院治療，治療2箇月病情好轉後齣院，齣院後服用茵梔黃顆粒降酶退黃治療10餘天，服藥期間齣現髮熱、嘔吐、腹脹、納差，肝功能示：TBIL 22.8μmol·L-1，DBIL 16.0μmol·L-1，ALT 308.0 IU·L-1，AST 309.0 IU·L-1，γ-GT 237.0 IU·L-1，AKP 258.0 IU·L-1，診斷為藥物性肝炎。即刻停藥，予保肝、退黃、降酶等對癥治療，35 d後，患者肝功能恢複正常。
병례1：환자，남성，46세，인간공능이상복용인치황과립강매퇴황치료，후출현구토、핍력，소편안색진행성가심，병반유외한、발열，체온최고체39.0℃。자행정약후체온강지정상，증상완해。2개월후재차복용인치황과립，외한、발열、핍력、뇨황증상재차출현。우외원사간공능시：TBIL 65.7μmol·L-1，DBIL 34.8μmol·L-1，ALT 939.2 IU·L-1，AST 489.9 IU·L-1，γ-GT 785.0 IU·L-1，진단위약물성간염。즉각정약，여보간、리담、강매치료，45 d후，환자간공능회복정상。병례2：환자，녀성，51세，인급성무형간염재아원주원치료，치료2개월병정호전후출원，출원후복용인치황과립강매퇴황치료10여천，복약기간출현발열、구토、복창、납차，간공능시：TBIL 22.8μmol·L-1，DBIL 16.0μmol·L-1，ALT 308.0 IU·L-1，AST 309.0 IU·L-1，γ-GT 237.0 IU·L-1，AKP 258.0 IU·L-1，진단위약물성간염。즉각정약，여보간、퇴황、강매등대증치료，35 d후，환자간공능회복정상。
Case 1:one 46-year-old male patient developed vomiting, lack of power, yellow urine with chill and fever after receiving Yinzhihuang granules for the treatment of abnormal liver function. The highest body temperature was 39.0℃. All the above symptoms alleviated after discontinuation of the drug. Two months later, Yinzhihuang granules were taken again and the symptoms of chill, fever, lack of power and yellow urine reappeared. Laboratory examinations were as follows:TBIL 65.7 μmol·L-1, DBIL 34.8 μmol·L-1, ALT 939.2 IU·L-1, AST 489.9 IU·L-1,γ-GT 785.0 IU·L-1. Drug-induced hepatitis was diagnosed and Yinzhihuang granules were stopped. Treatments of protecting liver function, depressing transaminase and abating jaundice were given to the patient. After 45 days, the patient discharged with normal liver function. Case 2:one 51-year-old female patient was admitted to hospital because of acute hepatitis E. The liver function of the patient recovered after 2-month treatment, and then the patient discharged with Yinzhihuang granules. Ten days later, the patient developed fever, vomiting, abdominal distention and anorexia. Laboratory ifndings were:TBIL 22.8 μmol·L-1, DBIL 16.0 μmol·L-1, ALT 308.0 IU·L-1, AST 309.0 IU·L-1,γ-GT 237.0 IU·L-1, AKP 258.0 IU·L-1. The patient was hospitalized again and the clinical diagnosis was drug-induced hepatitis. Yinzhihuang granules were stopped, and the symptomatic treatments of protecting liver function, depressing transaminase and abating jaundice were given immediately. About 35 days later, hepatic function of the patient recovered to normal.
