茵栀黄颗粒致药物性肝炎2例-论文.pdf

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1、中国药物应用与监测2014年6Y]第11卷第3期ChineseJournalofDrugApplicationandMonitoring,Vo1．11，No．3，June2014茵栀黄颗粒致药物性肝炎2例蒋杰，劳国琴，张谊芳(绍兴市第六人民医院药剂科，浙江绍兴312000)I摘要1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：TBIL65．7~tmol·L，DBIL34．8~tmo

2、l·L-，_一T939．2IU·L『，AST489．9IU·L-。y-GT785．0IU-L～，诊断为药物性肝炎。即刻停药，予保肝、利胆、降酶治疗，45d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：TBIL22．8nJ0l·L。，DBIL16．0pmol-L，ALT308．0IU·L-，AST309．0IU·L。，丫．GT237．0Iu，L。。，AKP258．0IU·L。。，诊断为药物性肝炎。即刻停药，予保肝、退黄、降酶等对症治疗，35d后，患

3、者肝功能恢复正常。I关键词l茵栀黄颗粒；药物性肝炎；肝损害；药品不良反应I中图分类号】11969．3I文献标识码】Bl文章编号】1672—8157(2014)03—0191—03Twocasesofdrug-inducedhepatitiscausedbyHnzhihuanggranulesJIANGJie，LAOGuo—qin，ZHANGYi—fang(DepartmentofPharmacy,theSixthPeople'sHospitalofShaoxing,Shaoxing312000,China)【ABSTRACTJCase1：one46一year-oldmalepatientdev

4、elopedvomiting，lackofpower,yellowurinewithchillandfeverafterreceivingYinzhihuanggranulesforthetreatmentofabnormalliverfunction．Thehighestbodytemperaturewas39．0oC．Alltheabovesymptomsalleviatedafterdiscontinuationofthedrug．Twomonthslater,Yinzhihuanggranulesweretakenagainandthesymptomsofchill，fever,lac

5、kofpowerandyellowurinereappeared．Laboratoryexaminationswereasfollows：TBIL65．7~tmol·L～，DBIL34．8I．tmol‘L。。，ALT939．2IU‘L。。，AST489．9IUL。。，y-GT785．0IU‘L。。．Drug—inducedhepatitiswasdiagnosedandYinzhihuanggranuleswerestopped．Treatmentsofprotectingliverfunction，depressingtransaminaseandabatingjaundiceweregiv

6、entothepatient．After45days，thepatientdischargedwithnormalliverfunction．Case2：one51-year-oldfemalepatientwasadmittedtohospitalbecauseofacutehepatitisE．Theliverfimctionofthepatientrecoveredafter2-monthtreatment，andthenthepatientdischargedwithYinzhihuanggranules．Tendayslater,thepatientdevelopedfever,vo

7、miting，abdominaldistentionandanorexia．Laboratoryfindingswere：TBIL22．8~tmol·L～，DBIL16．0~tmol·L～，ALT308．0IU·L～，AST309．0IU·L～，y-GT237．0IU·L一，AKP258．0IU·L。。．Thepatientwashospitalizedagainandtheclinicaldia