Review Article

Systematic Review on Chinese Herbal Medicine Induced Liver Injury

Table 2

Clinical information of included cases with highly probable or probable causality grading.

CHMSex/age (y)Usage and dosageExposureALT (IU/L)/AST (IU/L)/
TBIL (mg/dl)/ALP (IU/L)
PatternRUCAM grade (scores)OutcomeReexposureCountries

Sheng-He-Shou-WuM/451 kg soaked in 2.5 kg wine, 25 mL/day7 d2870/2599/2.26/109HepatocellularHighly probable (13)RecoveryNAChina
Sheng-He-Shou-WuM/631 kg soaked in 22 kg wine, 250 mL/day15 d601/1515/2.87/181HepatocellularHighly probable (11)RecoveryNAChina
He-Shou-WuM/29100 g consumed as tea, 100 mL/day29 d1792/899/5.51/138HepatocellularHighly probable (11)RecoveryNAChina
He-Shou-WuM/401 kg soaked in 10 kg wine, 300 mL/day28 d878/853/7.47/112HepatocellularHighly probable (10)RecoveryNAChina
He-Shou-WuM/401 kg soaked in 20 kg alcohol, 50 mL/day43 d4095/2473/1.7/220HepatocellularHighly probable (10)RecoveryNAChina
He-Shou-WuM/551 kg soaked in 15 kg alcohol, 300 mL/day4 d1056/769/10.29/176HepatocellularHighly probable (10)RecoveryNAChina
He-Shou-WuM/61NA1 d818/NA/1.77/109HepatocellularHighly probable (10)RecoveryPositiveKorea
He-Shou-WuM/61NA60 d885/NA/21.2/224MixedHighly probable (10)RecoveryNAKorea
Sheng-He-Shou-WuM/401 kg soaked in 10 kg wine, 200 mL/day1 d3120/1615/16.78/151HepatocellularHighly probable (10)RecoveryNAChina
Move FreeF/78a recommended dose of 1 tablet twice a day21 d1626/1053/7.2/354HepatocellularHighly probable (10)RecoveryNAUSA
He-Shou-WuF/45Not available7 d1196/507/0.88/816HepatocellularHighly probable (9)RecoveryNAChina
He-Shou-WuM/3110 g powder consumed directly, 20 g/day14 d2026/858/2.19/180HepatocellularHighly probable (9)RecoveryNAChina
He-Shou-WuM/561 slice consumed as tea, 100 mL/day120 d2313/1202/5.81/305HepatocellularHighly probable (9)RecoveryNAChina
He-Shou-WuF/371 tablespoon consumed as decoction, 250 mL/day52 d922/319/9.06/116HepatocellularHighly probable (9)RecoveryNAChina
He-Shou-WuF/461 tablespoon consumed as decoction, 250 mL/day50 d1127/297/1.94/203HepatocellularHighly probable (9)RecoveryNAChina
He-Shou-WuF/181 tablespoon consumed as decoction, 100 mL/day67 d1074/348/0.8/89HepatocellularHighly probable (9)RecoveryNAChina
He-Shou-WuM/403 tablespoons consumed as decoction, 100 mL/day23 d1987/872/11/182HepatocellularHighly probable (9)RecoveryNAChina
He-Shou-WuM/34NA30 d1452/NA/25.3/111HepatocellularHighly probable (9)RecoveryNAKorea
He-Shou-WuM/58NA35 d1898/NA/13.4/134HepatocellularHighly probable (9)RecoveryNAKorea
He-Shou-WuM/45NA30 d1400/NA/2.04/125HepatocellularHighly probable (9)RecoveryNAKorea
He-Shou-WuM/49NA90 d1235/NA/32.9/465MixedHighly probable (9)RecoveryNAKorea
He-Shou-WuM/46NA2 d1287/NA/19.7/146HepatocellularHighly probable (9)RecoveryNAKorea
He-Shou-WuM/62NA90 d1174/NA/9.2/175HepatocellularHighly probable (9)RecoveryNAKorea
He-Shou-WuF/63NA30 d943/NA/4.2/137HepatocellularHighly probable (9)RecoveryNAKorea
He-Shou-WuM/44NA7 d1077/NA/15/197HepatocellularHighly probable (9)RecoveryNAKorea
Herbal extracts containing Hu-Ji-Sheng and Ye-GeM/55NA30 d1528/1108/6.3/160HepatocellularHighly probable (9)RecoveryNAKorea
He-Shou-WuM/382 slices consumed as tea, 500 mL/day1 d1815/1351/5.3/108HepatocellularProbable (8)RecoveryNAChina
He-Shou-WuM/48100 g mixed with 150 g bee honey, 8 g/day10 d1891/798/7.9/159HepatocellularProbable (8)RecoveryNAChina
He-Shou-WuF/6110–20 g/d60 d56/61/28.07/601CholestaticProbable (8)RecoveryNAChina
He-Shou-WuM/57NA30 d853/NA/28.1/173MixedProbable (8)DeathNAKorea
He-Shou-WuF/47NA60 d1947/NA/30.4/218HepatocellularProbable (8)RecoveryNAKorea
He-Shou-WuM/59NA30 d1245/NA/1.6/155HepatocellularProbable (8)RecoveryNAKorea
He-Shou-WuF/46NA30 d1804/NA/6.2/81HepatocellularProbable (8)RecoveryNAKorea
He-Shou-WuM/45NA20 d271/NA/2.9/164MixedProbable (8)RecoveryNAKorea
He-Shou-WuM/65NA10 d1107/NA/21.9/197HepatocellularProbable (8)RecoveryNAKorea
He-Shou-WuF/42NA10 d500/NA/1.6/181MixedProbable (8)RecoveryNAKorea
He-Shou-WuM/42NA60 d1706/NA/26.3/147HepatocellularProbable (8)RecoveryNAKorea
He-Shou-WuF/48NA3 d1142/NA/15.9/145HepatocellularProbable (8)RecoveryNAKorea
Sheng-He-Shou-WuM/501 kg soaked in 5 kg wine, 500 mL/day20 d1992/1155/6.73/185HepatocellularProbable (8)RecoveryNAChina
Qi Bao Mei Ran Wan M/26Taken at the recommended dosages30 d1674/617/3.2/normalHepatocellularProbable (8)RecoveryNAChina
He-Shou-WuF/4115 tablets per day21 d104/85/21.7/947CholestaticProbable (7)RecoveryNAChina
He-Shou-WuM/371 tablespoon consumed as decoction, 1500 mL/day7 d1613/835/2.26/177HepatocellularProbable (7)RecoveryNAChina
He-Shou-WuF/54NA4 d1752/NA/8.4/286HepatocellularProbable (7)RecoveryNAKorea
He-Shou-WuM/24NA60 d1652/NA/31.9/140HepatocellularProbable (7)Liver transplantationNAKorea
He-Shou-WuM/42NA120 d1677/NA/15.8/93HepatocellularProbable (7)RecoveryNAKorea
He-Shou-WuM/41NA30 d520/NA/9.9/143MixedProbable (7)RecoveryNAKorea
Huang-Yao-ZiF/6630 g decocted in water for oral dose per day21 d1042/1006/16.44/normalHepatocellularProbable (7)RecoveryNAChina
He-Shou-Wu YanShouPianM/1715 tablets per day45 d1501/545/18.63/155HepatocellularProbable (6)RecoveryNAChina
He-Shou-WuF/54NA180 d1519/NA/11.7/187HepatocellularProbable (6)RecoveryNAKorea
He-Shou-Wu/1M/53NA180 d1227/NA/33.2/370MixedProbable (6)RecoveryNAKorea
Herbal tea containing KelpF/403 cups per day60 d435/219/9.2/435MixedProbable (6)RecoveryNAUSA
KamishoyosanF/48NA60 d972/900/12.8/420HepatocellularProbable (6)RecoveryNAJapan
Move FreeF/624 tablets/d for two and a half weeks tapered down to 2 tablets/d for four days21 d1247/893/6.9/297HepatocellularProbable (6)RecoveryNAUSA
Decoction [30]F/51Brewed with water, two times a day23 d758/1262/9.92/normalHepatocellularProbable (6)RecoveryNAChina

NA = not available, ALT = alanine aminotransferase, AST = aspartate aminotransferase, TB = total bilirubin, and ALP = alkaline phosphatase. The article did not provide an outcome of RUCAM scale but detailed information based on which a score was given.