Interpretation on Guideline for Diagnosis and Treatment of Herb-Induced Liver Injury / 中草药

ABSTRACT

With the worldwide extensive application of Chinese herbal medicines and the continuous improvement of the adverse drug reaction (ADR) monitoring system, increasing attentions are focused on herb-induced liver injury (HILI) in recent years. Due to the lack of specific diagnostic indices, the diagnosis of drug-induced liver injury (DILI) is still a great challenge worldwide. Moreover, it is much difficult and often encounters the obstacles to get accurate diagnosis of HILI, since the complexities of constituents and clinical usage of herbal medicines, which includes the misuse of herb origin, improper processing, contamination of hazardous substances, improper drug combination, and improper usage without differentiating patients' syndrome, as well as diversity of patients' organism status. In addition, there are still limitations of knowledge on ADR or toxicity of herbal medicines in public population and sometimes misleading media opinions existance, causing unfavorable effects in development on safety usage of herbal medicines. In order to improve the objectivity and accuracy for diagnosis of HILI, the China Association of Chinese Medicines published the first clinical standard aiming at HILI management-"Guideline for Diagnosis and Treatment of Herb-Induced Liver Injury". In this paper, according to the HILI Guideline, the influencing factors to accurate HILI diagnosis have been discussed. And a brief interpretation has been illustrated to analyze the applicability and advantage of the integrated evidence chain-based causality identification strategy, recommended by the HILI Guideline, so as to provide the practical references for the medical staff and the researchers worked on either Chinese or Western medicine.