Evaluation of diagnostic method for herb-induced liver injury based on the integrated evidence chain: exemplification by Polygonum multiflorum
JING Jing
WANG Rui-lin
ZHU Yun
NIU Ming
SONG Xue-ai
HE Ting-ting
XIAO Xiao-he
WANG Jia-bo
Abstract：Objective To evaluate the applicability and advantage of diagnostic method for herb-induced liver injury (HILI) based on the integrated evidence chain (iEC) with an exemplification by Polygonum multiflorum (PM). Methods A total of 145 HILI patients implicated with PM and its preparation before onset were enrolled from 302 Military Hospital of China from January 2007 to December 2016. The diagnostic efficiency for HILI and the reliability of causality were compared between iEC and Roussel-Uclaf causality assessment method (RUCAM). Results Among 145 HILI patients assessed by RUCAM scale, 74 cases were diagnosed as probable population, which was predominant (51.0%). Among patients diagnosed with probable HILI based on RUCAM score, 5 cases were qualified for confirmed diagnosis, 54 cases for clinical diagnosis and 15 cases for suspected diagnosis after evidence chain was constructed by using iEC method, proportions of cases with confirmed diagnosis, clinical diagnosis and suspected diagnosis were 71.4%, 53.5% and 74.1% assessed by iEC, respectively. Seven patients were diagnosed with confirmed HILI by use of iEC method, whereas those were considered probable (n=5) and possible (n=2) based on RUCAM scale. Chronic liver diseases had no effect on the diagnostic efficiency of iEC method in HILI patients (P > 0.05), but it could obviously reduce the scores of RUCAM scale in HILI patients compared with HILI patients without chronic liver diseases (P<0.001). Conclusions Both iEC method and RUCAM scale have a good consistency. iEC method can be appropriate for the diagnosis and causality assessment of HILI due to clinical complicated factors of herbal medicines, especially in patients with chronic liver diseases.
Keywords：herb-induced liver injuryintegrated evidence chaindiagnosiscausality assessmentPolygonum multiflorum
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 131-134,144 )