In our daily life, we often encounter such conversations: "Recently, our body is not very comfortable, seems to be sub-healthy?" "Why not take some Chinese medicine to recuperate our body, Chinese herbal medicine is non-toxic? What precautions do we have when taking Chinese herbal medicine or Chinese herbal medicine related preparations? How to protect and warn scientifically? As the main metabolic and detoxifying organ of human body, liver is the main target organ of drug toxicity. Liver injury related to Chinese herbal medicine refers to the liver injury caused by the Chinese herbal medicine itself and/or its metabolites or the liver allergic reaction to it when using Chinese herbal medicine, natural medicine and related preparations. The scientific research and clinical team led by Xiao Xiaohe, the director of the Academic Committee of the Department of Hepatology of the Fifth Medical Center of the General Hospital of the People's Liberation Army and the director of the Institute of Traditional Chinese Medicine of the PLA, has been engaged in the research on liver injury of Chinese herbal medicine for a long time. Xiao Xiaohe said that at present, due to the wide application of Chinese herbal medicine in the world, the continuous improvement of the adverse drug reaction monitoring system, and the continuous improvement of people's awareness of safe use of drugs, the reports of liver injury related to Chinese herbal medicine are increasing. Clinically, is liver injury caused by taking Chinese herbal medicine and its related preparations necessarily caused by Chinese herbal medicine? "At present, the diagnosis of liver injury caused by Chinese herbal medicine is relatively difficult." Xiao Xiaohe said, first of all, the effective ingredients contained in Chinese herbal medicine are complex, and the compatibility of the monarch, minister and assistant is more complex when clinicians give the Chinese herbal medicine compound according to the individual's syndrome differentiation. Secondly, when using drugs in daily life, there are often cases such as the combination of traditional Chinese medicine and western medicine. The combination of traditional Chinese medicine and western medicine may have an interaction and increase the risk of liver injury. In this case, it is difficult to clearly distinguish which kind of drugs cause liver toxicity and whether there is liver synergistic injury. "There are also some special cases. For example, although some drugs are traditional Chinese medicine preparations, they are also named after traditional Chinese medicine, but these preparations contain western medicine ingredients. For example, the vitamin C Yinqiao tablets that you often take when you have a cold contain acetaminophen, which is clearly toxic to the liver. However, people tend to ignore this situation and simply think that this kind of liver injury is caused by traditional Chinese medicine." Xiao Xiaohe said. So, how to diagnose the symptoms after taking Chinese herbal medicine or related preparations? Xiao Xiaohe's team pioneered the "integrated evidence chain method" and three-level diagnostic criteria for the causal evaluation of drug-induced liver injury. This diagnostic method does not completely rely on the subjective experience of doctors to exclude the diagnosis of liver injury caused by Chinese herbal medicine, but fundamentally realizes the clear diagnosis supported by the objective evidence chain. "The use of this method in clinical diagnosis can effectively avoid the inertia diagnostic thinking of 'non western medicine, i.e. traditional Chinese medicine', and significantly reduce the misdiagnosis rate of liver injury caused by traditional Chinese medicine." According to Xiao Xiaohe, in view of its good clinical effect, this diagnostic method and standard has been widely recognized, and has been integrated into the guidelines of the Chinese Society of Traditional Chinese Medicine, the guidelines of the State Drug Administration and the guidelines of the Council of International Medical Science Organizations. What precautions should be taken when taking Chinese herbal medicine and related preparations with the risk of liver injury? Xiao Xiaohe told reporters that it is not difficult to find from daily life experience that some Chinese herbs have their own
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