中藥藥源性肝毒性和中藥組分、個(gè)體差異及配伍等方面關(guān)系密切。從化學(xué)成分、作用機(jī)制、臨床與動(dòng)物實(shí)驗(yàn)的比較3個(gè)方面對(duì)中藥引起的肝毒性進(jìn)行分析、歸納和總結(jié)。結(jié)果發(fā)現(xiàn)生物堿、萜類、蒽醌類化合物是引起中藥肝毒性的主要化學(xué)成分，肝毒性作用機(jī)制包括藥物代謝酶基因表達(dá)異常、肝細(xì)胞凋亡失調(diào)、脂質(zhì)過(guò)氧化損傷、線粒體損傷、炎癥反應(yīng)等。中藥化學(xué)成分復(fù)雜，在關(guān)注其臨床療效的同時(shí)也應(yīng)重視其所引起的肝毒性，才能進(jìn)一步確保臨床合理用藥。

Drug-induced liver toxicity of Chinese herbs is closely related to chemical components in drugs, individual difference and compatibility. Hepatotoxicity caused by Chinese materia medica was analyzed, generalized and summarized from three perspectives including chemical composition, mechanism of action and comparison of clinical application with animal experiments in this paper. Alkaloids, terpenoids and anthraquinones are the main chemical components that cause liver toxicity of traditional Chinese herbs. The mechanisms of hepatotoxicity include abnormal drug metabolism enzyme gene expression, apoptosis disorder of hepatocytes, lipid peroxidation damage, mitochondrial damage and inflammatory response. The chemical ingredients of traditional Chinese medicine are complex. With clinical efficacy of Chinese drugs paid attention to, the problem of hepatotoxicity should also be taken seriously in order to further ensure rational medication clinically.

國(guó)家“重大新藥創(chuàng)制”科技重大專項(xiàng)（2017ZX09304002）；上海市2020年度“科技創(chuàng)新行動(dòng)計(jì)劃”生物醫(yī)藥科技支撐專項(xiàng)（20S21902100）；上海申康醫(yī)院發(fā)展中心《市級(jí)醫(yī)院醫(yī)企協(xié)同臨床試驗(yàn)管理項(xiàng)目》（20CR4003B）