CAJ | 학술논문

药源性肝损害是临床常见问题，在我国发生率为0．46％～1．08％，其中由中药引起的占30％左右。作者检索了公开发表的有关文献，梳理了中药相关性肝损害的基本情况，以期为中药的安全应用提供参考。易引发肝损害的单味中药主要有黄药子、雷公藤、铅丹等，复方中药主要有青黛丸、克银丸、消核片等，以及中药汤剂小柴胡汤等；造成肝损害的中药有毒成分主要包括生物碱类、萜类、内酯类及毒性植物蛋白类等；肝损害的主要表现为消化道症状、肝区不适、肝大、黄疸、转氨酶升高，损害程度与剂量及疗程密切相关。中药引起的肝损害多为可逆性，但严重者亦可致死。因此，中医临床医生应与时俱进，及时了解中药的现代药理研究，慎用、少用肝毒性中药，必要时定期监测患者肝功能的变化，以提高中药用药的安全性。
약원성간손해시림상상견문제，재아국발생솔위0．46％～1．08％，기중유중약인기적점30％좌우。작자검색료공개발표적유관문헌，소리료중약상관성간손해적기본정황，이기위중약적안전응용제공삼고。역인발간손해적단미중약주요유황약자、뢰공등、연단등，복방중약주요유청대환、극은환、소핵편등，이급중약탕제소시호탕등；조성간손해적중약유독성분주요포괄생물감류、첩류、내지류급독성식물단백류등；간손해적주요표현위소화도증상、간구불괄、간대、황달、전안매승고，손해정도여제량급료정밀절상관。중약인기적간손해다위가역성，단엄중자역가치사。인차，중의림상의생응여시구진，급시료해중약적현대약리연구，신용、소용간독성중약，필요시정기감측환자간공능적변화，이제고중약용약적안전성。
Drug-induced liver injury (DILI) is a common clinical situation.The percentage of DILI cases goes up to about 0.46%— 1.08% in China, in which cases triggered by traditional Chinese medicine accounted for about 30%.To present the basic situation of traditional Chinese medicine-related liver damage and to provide a reference for the safe use in traditional Chinese medi-cine, relevant publications in recent decades are retrieved and searched in this article.According to the data, single Chinese herbs that tend to lead to liver damage mainly include dioscorea bulbifera L., tripchlorolide, minium, whereas compounds contain indignis naturalis pill, keyinwan, xiaohe pian and the traditional Chinese medicine decoction of xiao chaihu decoction.Toxic ingredients in tradi-tional Chinese medicine caused liver damage cover alkaloids, terpenoids, lactones and toxic plant protein elements.Symptoms of liver damage mainly involve digestive tract disturbances, liver dis-comfort, hepatomegaly, jaundice, higher transaminase, and the level of damage is closely related to the dosage.Traditional Chinese medicine-induced liver damage is mostly reversible, but severe cases may lead to death.Therefore, traditional Chinese medicine clinicians should have insights into mo-dern pharmacological research of traditional Chinese medicine and use traditional Chinese medicine with caution.If necessary, clinicians should regularly detect patient’s liver function in order to im-prove drug safety.