Hepatotoxizität in der chinesischen Arzneitherapie – Fiktion und Fakten

ZUSAMMENFASSUNG

Leberreaktionen sind für die chinesische Arzneitherapie (CAT) ein relevantes Thema. Aus Sicht der Arzneimittelsicherheit ist es von Bedeutung, die tatsächlich hepatotoxischen Arzneidrogen zu identifizieren und falsche Zuweisungen zu vermeiden. Bei pflanzlichen Produkten stellen sich für Kausalitätsbestimmungen besondere Anforderungen, vor allem ist eine ausreichende Charakterisierung des verdächtigten Mittels einschließlich Authentifizierung der Pflanzenspezies und Ausschluss von Kontaminanten und Verfälschungen erforderlich. Bei der Interpretation vorliegender Daten werden nicht selten wissenschaftliche Grundsätze missachtet, die zu unbegründeten Verdachtszuweisungen führen. Eine kürzlich veröffentlichte Studie aus der TCM-Klinik Kötzting stellt umfangreiches neues Datenmaterial zur Verfügung, dessen Interpretation jedoch korrekturbedürftig ist. Klinisch relevante Leberschädigungen unter CAT sind selten und nur für wenige chinesische Arzneidrogen ausreichend belegt.

ABSTRACT

Hepatotoxicity in Chinese herbal therapy. Fiction and facts

Liver injury is a relevant subject in Chinese herbal therapy. From a safety point of view, identification of the actual hepatotoxic drugs and avoiding of flawed assignments is crucial. Relating to herbal medicinal products, for a causality assessment special requirements are to be met, especially sufficient characterising of the suspected drug, including the authentication of the herbal species and the exclusion of contamination and adulteration. As to interpretation of the existing data, scientific principles are often disregarded and there are unsubstantiated assignments of suspicion. A recent published study from the Kötzting TCM hospital provides comprehensive new data, however its interpretation deserves some revision. Clinical relevant liver injuries induced by Chinese herbal therapy are rare and substantiated for a few drugs only.

Schlüsselwörter

Hepatotoxizität - Leberreaktionen - chinesische Arzneitherapie - chinesische Arzneidrogen - herb-induced liver injury (HILI)

Keywords

Herb-induced liver injury (HILI) - hepatotoxicity - Chinese herbal therapy - Chinese herbs

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