Liver injury induced by Mugua pills(木瓜丸) combined with Zhuifeng Tougu pills (追风透骨丸)
10.3760/cma.j.cn114015-20211203-01221
- VernacularTitle:木瓜丸与追风透骨丸联用致肝损伤
- Author:
Zhiyu XU
1
;
Aiwu ZHANG
1
Author Information
1. 内蒙古医科大学附属医院药剂部,呼和浩特 010050
- Publication Type:Journal Article
- Keywords:
Drugs, Chinese herbal;
Chemical and drug induced liver injury;
Aconitum
- From:
Adverse Drug Reactions Journal
2022;24(4):223-224
- CountryChina
- Language:Chinese
-
Abstract:
A 63-year-old female patient was treated with 30 Mugua pills and Zhuifeng Tougu pills 6 g twice daily for tenosynovitis. After taking the medicine for 10 days, the patient developed nausea and vomiting, which were aggravated gradually; after taking the medicine for 22 days, the patient had fever, nausea, retching, slight pain in the upper abdomen, systemic edema, skin pruritus, and poor spirit, appetite, and sleep. Laboratory tests showed alanine aminotransferase (ALT) 454 U/L, aspartate aminotransferase (AST) 946 U/L, alkaline phosphatase (ALP) 133 U/L, gamma glutamyltransferase (γ-GT) 170 U/L, direct bilirubin (DBil) 12.8 μmol/L, and glutamate dehydrogenase 17.3 U/L. Viral hepatitis and biliary obstruction were excluded by laboratory tests and imaging examination. Drug-induced liver injury was diagnosed, Mugua pills and Zhuifeng Tougu pills were stopped, and diisopropylamine dichloroacetate injection and compound glycyrrhizin tablets were given. Liver function was gradually improved in the patient and laboratory tests showed ALT 62 U/L, AST 49 U/L, γ-GT 38 U/L, and DBil 7.2 μmol/L 12 days later. The medication was adjusted to 3 compound glycyrrhizin tablets thrice daily for 2 weeks. After 4 weeks, laboratory tests showed ALT 31 U/L, AST 26 U/L, γ-GT 30 U/L, and DBil 5.0 μmol/L.