Epidemiologicaland Clinical Study Of Drug-induced Liver Injury Caused By Boligonum Multiflorum And Its Preparations

Objective By analyzing the reasons for taking the Polygonum multiflorum or its preparations,the source of the drug,the clinical manifestations,the signs of the drug-induced liver injury(DILI),we try to investigate the factors that affected the prognosis of DILI,and reduce or eliminate occurrence of the drug-induced liver injury and improve clinical outcomes.Methods The data of the inpatients were collected at the Second Affiliated Hospital of Chongqing Medical University between January2009 and October 2018.ALL of them had used Polygonum multiflorum or its preparations before the onset of DILI.The materials,such as the cause of taking medication,dosage form,dosage,course of treatment,clinical symptoms and signs,biochemical markers,treatment plan and prognosis,were recorded to find the risk factors of liver injury and prognosis.Results Of the 183 LIDI patients who used Polygonum multiflorum or its preparation,there were 140 cases with relatively detail data,75(53.6%)with single Polygonum multiflorum,29 patients(20.7%)with Traditional Chinese medicine prescription,and 36 cases(25.7%)with Chinese patent medicine.The patients took the medicine from one day up to 150 days,with an average duration of 28 days.Clinical injury patterns were hepatocellular type 132 cases(94.3%),cholestatic and mixed type 4 cases,respectively(2.9%).33 cases(23.6%)were at level 1 DILI severity rating,29 cases(20.7%)at level 2,28 cases(20%)at level 3,47 cases(33.5%)at level 4,and 3 cases(2.1%)at level 5.Among patients with grade 3 or above,the ratio of taking single regime Polygonum multiflorum was higher,and the dose was larger.Mild to moderate DILI cases were mainly in patients taking Chinese patent medicines group,and the severity of patients taking Traditional Chinese medicine prescription were between the two groups.In most patients,the biochemical markers(ALT,AST,LAP)were reduced by more than 50% within 7 days of treatment,and the cure rate was 97.9%.Conclusion The severity of DILI caused by Polygonum multiflorum is closely related to the standardization degree,dosage,course of treatment of drug use.The curative effect of mild and moderate patients were good,but a few patients have serious consequences,even death.Therefore,the level of public awareness should be raised.Attach great importance to the appropriate use of Polygonum multiflorum or its preparations,preferably by a scientifically and standardize way with the guidance of specialists.Liver function changes need to be closely monitored in the course of treatment.We have to make good use of the advantage of Polygonum multiflorum or its preparations.guanrantee safty of drug use,and reduce the occurrence of adverse events.