中药致肝衰竭45例临床分析

目的分析中药致肝衰竭的特点，探讨人工肝治疗药物性肝衰竭的疗效。方法对45例中药致肝衰竭患者的临床资料进行回顾性调查，观察其临床表现、生化指标；根据是否接受人工肝治疗分为治疗组（内科综合治疗＋人工肝支持治疗）与对照组（内科综合治疗），比较其治愈好转率和并发症发生率。结果临床表现无特异性，与病毒性肝炎所致肝衰竭相似；总治愈有效率68．9％（31／45），治疗组80．6％（25／31），对照组42．9％（6／14），P=0．0287，差异具有统计学意义。结论中药引起的肝衰竭，涉及中药种类繁多，预后不良，内科基础治疗联合人工肝治疗可以提高生存率；同时应当加强中药的毒理研究及管理。

Traditional Chinese medicine-induced liver failure: an analysis of 45 cases

Objective To analyze the clinical features of liver failure caused by Traditional Chinese medicine （TCM） and to investigate the effect of artificial liver support system （ALSS） in the treatment of TCM related liver failure. Methods The clinical manifestation, hepatic biochemical parameters of 45 liver failure cases caused by TCM were analyzed, retrospectively. According to receive ALSS or not, these cases were devided into treatment group and control group. The cure rate and incidence of complications were compared between the two groups. Results The clinical manifestations of these cases were similar to liver failure caused by viral hepatitis. Overall clinical cure rate was 68.9% ; the cure rate in treatment group was higher than that in the control group （80.6% vs 42.9% , P =0. 0287）. Conclusion Liver failure caused by TCM with a poor prognosis is not rare. Comprehensive physical treatment combined with ALSS can improve survival rate. The toxicology study and management of TCM should be strengthened.