关键词: 药物性肝损伤, 中草药, 临床特征, 病理学

Abstract: Objectve To explore the clinical and pathological features of patients with Chinese herbal drug-induced liver injury（DILI） in recent years. Methods 305 patients with Chinese herbal drug-induced liver injury between Jan 2010 and Jan 2015 were enrolled in this study. The serology for exclusion of viral infection were done by ELISA,and liver biopsies were performed routinely. The clinical symptoms,findings of laboratory examinations were analyzed retrospectively. Results Major symptoms and signs in these patients included fatigue （64.3%）,anorexia （46.6%） and splenomegaly （78.0%）;Hepatocellular type （40.0%） was the major clinical type, and 87.9% of the patients had taken Chinese herbal medicine for more than 2 weeks before the occurrence of liver injury;The main pathological changes in the liver tissues were moderate inflammation and fibrosis （G2-3S2-3 accounted for 59.0%）;Liver injury-induced by administration of polygonum multiflorum accounted for 11.8%, thunder god vine for 10.8%,airpotato yam rhizome for 9.2% and compounded herbal medicine for the treatment of psoriasis for 13.8%,and osteoarthrosis for 5.6%;the three above-mentioned herbal medicine took shorter times to induce liver injury;After 24-week management by withdrawal of suspected medicines and supporting treatment, 284 patients（93.1%） recovered. Conclusion Chinese herbal drug-induced liver injury has slow onset,and it could take long before being noticed. More attentions must be paid in clinical practice.

Key words: Drug-induced liver injury, Chinese herbal medicine, Clinical features, Pathology