Dictamni Cortex powder-induced liver injury based on integrated evidence chain.
10.19540/j.cnki.cjcmm.2017.0015
- Author:
Yi-Xue HUANG
1
;
Yu-Ming GUO
2
;
Yong-Feng ZHOU
2
;
Cong-En ZHANG
2
;
Jing JING
3
;
Shi-Jing LIU
3
;
Na-Na ZHANG
4
;
Jing-Yuan SONG
4
;
Xiao-He XIAO
3
;
Jia-Bo WANG
2
Author Information
1. Chengde Medical College, Chengde 067000, China.
2. China Military Institute of Chinese Materia Medica, 302 Military Hospital, Beijing 100039, China.
3. Integrated Traditional Chinese and Western Medicines Diagnosis, Treatment and Research Center, 302 Military Hospital, Beijing 100039, China.
4. Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100193, China.
- Publication Type:Journal Article
- Keywords:
Chinese herbal medicine;
Dictamni Cortex;
integrated evidence chain;
liver injury;
pharmacognostical identification
- From:
China Journal of Chinese Materia Medica
2017;42(3):600-606
- CountryChina
- Language:Chinese
-
Abstract:
A typical clinical case of taking Dictamni Cortex(Baixianpi) powder was analyzed to study liver damage caused by Dictamni Cortex. Liver damage was diagnosed according to the integrated evidence chain method recommended by the Guideline for Diagnosis and Treatment of Herb-Induced Liver Injury. By analyzing clinical history and biochemistry and imaging examinations, underlying diseases, such as viral hepatitis, autoimmune liver disease and alcoholic liver disease, were excluded. Through the investigation of medication history, we made it clear that the patient only took Dictamni Cortex powder during the period, and thus suspected that the liver injury was induced by Dictamni Cortex. Furthermore, the quality of the drug was tested, and the results showed it was consistent with the quality standard of Chinese Pharmacopoeia. DNA barcoding showed that the drug was 100% similar with Dictamnus dasycarpus. Moreover, exogenous harmful substances and chemical drug additions were tested, and the results showed that the content of heavy metal, pesticide residues and microbial toxin were consistent with the required standards, and no chemical drug additions were found in Agilent Fake TCM-Drugs database. In summary, we confirmed that the clinical case of drug-induced liver injury was induced by D. dasycarpus with the dose of 15 g•d⁻¹, which exceeded the prescribed amount of Chinese Pharmacopoeia. According to the Guideline for Diagnosis and Treatment of Herb-Induced Liver Injury, the case of drug-induced liver injury induced by D. dasycarpus was confirmed, which provided a direct and reliable evidence for the study of risk of liver injury induced by D. dasycarpus and its relevant preparations.
