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Combination of medicine and pharmacy assists for precise prevention and control of drug-induced liver injury
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摘要: 当今药物性肝损伤(DILI)不仅是国际肝病领域关注的热点,也是全球安全用药关注的热点问题。由于缺少特异性检测指标,DILI误诊率高,也容易造成用药安全的误导,中草药所致DILI成因更复杂,临床诊断更棘手,防控难度更大。为此,呼吁临床专家与药学专家携手合作,医药结合,临床科研结合,构建DILI客观辨识策略和方法,科学厘清DILI与药物之间的因果关系,实现DILI精准诊断;科学阐明DILI成因和机制,从易感人群、易感物质和合理使用等方面实现DILI精准防控。同时建议,要进一步重视和加强中草药肝损伤研究,保证中药临床用药安全,促进中医药事业健康发展。Abstract: Drug-induced liver injury( DILI) is not only a hot topic in the field of liver diseases around the world,but also a major concern in the field of global drug safety at present. Due to a lack of specific indices,the misdiagnosis rate of DILI is high and there may be important issues in drug safety. DILI caused by Chinese herbal medicine has complex etiologies,with difficulties in clinical diagnosis,prevention,and control. Therefore,clinicians should cooperate with pharmaceutical experts to establish the strategies and methods for objective identification of DILI,clarify the causal relationship between drug and liver injury in order to realize the precise diagnosis of DILI. The etiology and pathogenesis about susceptible population,risk substance of drugs and rational usage of DILI should be clarified to manage DILI. Also,the research on liver injury induced by Chinese herbal medicine should be further emphasized and strengthened to guarantee the drug safety in clinical practice,and to promote the healthy development of traditional Chinese medicine.
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