Introduction:

Traditional Chinese medicine (TCM) is a traditional treatment based on herbal medicines and holistic healing. It has resulted in both favorable and unfavorable patient outcomes when used to treat cancer. Cancer patients frequently depend on second opinions and folk remedies. In this case, we report the case of TCM inducing repeated moderate liver injury and delay for chemotherapy.

Case presentation:

A 59-year-old woman was diagnosed with lung cancer and conducted surgery a month ago. She went to a TCM specialty clinic expecting a complete cure for the lung cancer, to improve her physical condition, and to enhance her immunity. She received the TCM formulas hanshirento, zenshikunshito, and ninjin’yoeito. After starting these medicines, she felt severe fatigue but continued them for approximately 2 weeks, After discontinuing the medicine, her fatigue was improved. She was admitted to our hospital for adjuvant chemotherapy. On admission, laboratory tests revealed moderate liver injury (AST: 705 U/L, ALT: 1091 U/L). In view of her medication history, the laboratory tests, and her lifestyle history, we thought that moderate liver injury was caused by TCM, employing the Roussel Uclaf Causality Assessment Method (RUCAM).

Discussion:

TCM are known to be metabolized by the resident bacteria in the small intestine, but the specific metabolic processes are not well understood. Cancer patients sometimes try TCM from their own research to stay healthy. However, as with our case, TCM rarely induces liver injury, which is not well known to TCM users. Medical staffs need to be vigilant with their drug histories, including TCM, if patients have liver injuries.

中文翻译：

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中医药 Hanshirento、Zenshikunshito 和 Ninjin'yoeito 对肺癌患者的肝损伤：采用更新的 Roussel Uclaf 因果关系评估方法评估的可能因果关系

介绍：

传统中医（TCM）是一种基于草药和整体治疗的传统治疗方法。当用于治疗癌症时，它导致了有利和不利的患者结果。癌症患者经常依赖第二意见和民间疗法。在这种情况下，我们报告了中医引起反复中度肝损伤和延迟化疗的病例。

案例介绍：

一个月前，一名 59 岁的妇女被诊断出患有肺癌并进行了手术。她去中医专科诊所期待肺癌彻底治愈，改善身体状况，增强免疫力。她接受了中医配方 hanshirento、zenshikunshito 和 ninjin'yoeito。服用这些药物后，她感到严重疲劳，但持续服用约 2 周，停药后，她的疲劳得到改善。入我院接受辅助化疗。入院时，实验室检查显示中度肝损伤（AST：705 U/L，ALT：1091 U/L）。结合她的用药史、实验室检查和她的生活方式史，我们认为中度肝损伤是由中医引起的，采用鲁塞尔乌克拉夫因果关系评估法（RUCAM）。

讨论：

众所周知，中药是由小肠中的常驻细菌代谢的，但具体的代谢过程尚不清楚。癌症患者有时会根据自己的研究尝试中医以保持健康。然而，与我们的案例一样，中医很少引起肝损伤，这对于中医使用者来说并不为人所知。如果患者有肝损伤，医务人员需要警惕他们的用药史，包括中医。