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Evidence-Based Complementary and Alternative Medicine
Volume 2016, Article ID 3560812, 15 pages
Review Article

Systematic Review on Chinese Herbal Medicine Induced Liver Injury

1The First Clinical Medical School, Beijing University of Chinese Medicine, Beijing, China
2Department of Gastroenterology and Hepatology, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China
3Department of Infectious Disease, Beijing University of Chinese Medicine Affiliated Dongzhimen Hospital, Beijing, China

Received 10 June 2016; Revised 22 July 2016; Accepted 1 August 2016

Academic Editor: Victor Kuete

Copyright © 2016 Peng Zhang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. In recent years, with the popularity of CHM, its hepatotoxicity has also been increasingly noticed. However, there are still veils on causative herbs and clinical characteristics. Aim. To systematically review data on CHM induced liver injury with particular focus on causative herbs and clinical characteristics. Methods. Using terms related to CHM and liver injury, PubMed and three Chinese electronic databases were searched, which was limited to the past 5 years. Publications meeting our eligibility criteria were included and further analyzed. Results. In total, 4 single herbs, 21 patent drugs, and 4 decoctions were reported to be of hepatotoxicity, with He-Shou-Wu being the most common one (65/114). Dang-Gui and other 5 herbs were the most common ingredients of patent drugs and decoctions. All patients were assessed using the RUCAM scale, with 26 being highly probable and 28 being probable. For these 54 cases, the latent period was 30 (47) days, and 81.48% were labeled as hepatocellular injuries. Most patients (96.3%) recovered, apart from the fact that one died and one is receiving liver transplantation. Conclusions. CHM should be used carefully for hepatotoxicity. Liver injury from CHM is similar to that from conventional medicines in clinical characteristics. Details about causative herbs should be illustrated, and more RUCAM should be used in future.