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Effects of Taking Herbal Medicine of Postpartum Period on Liver Function : A Retrospective Chart Review

산후 한약 복용이 간기능에 미치는 영향 : 후향적 차트 리뷰

  • Mi-Joo Lee (Dept. of Obstetrics & Gynecology, CHA Bundang Medical Center, CHA University) ;
  • Hye-Jung Lee (Dept. of Obstetrics & Gynecology, CHA Bundang Medical Center, CHA University) ;
  • Sung-Se Son (Dept. of Acupuncture & Moxibustion, CHA Bundang Medical Center, CHA University)
  • 이미주 (차의과학대학교 분당차병원 한방부인과) ;
  • 이혜정 (차의과학대학교 분당차병원 한방부인과) ;
  • 손성세 (차의과학대학교 분당차병원 침구과)
  • Received : 2023.10.04
  • Accepted : 2023.11.24
  • Published : 2023.11.24

Abstract

Objectives: The purpose of this study is to investigate safety of postpartum herbal medicine by assessing the effect of taking herbal medicine of postpartum period on liver function. Methods: A retrospective chart review was conducted on 167 mothers who underwent liver function tests (LFT) within 3 months before and after childbirth among mothers who gave birth at ○○ Hospital between January 1, 2016 and May 31, 2018. Mothers with abnormally elevated LFT during pregnancy were excluded. Among 167 women, 6 women are herbal-medicine-group took herbal medicine for 5-6 weeks during postpartum period, and 161 patients are general -group who did not take herbal medicine. LFT Variation of Subjects before and after childbirth were compared between the two groups. And subjects who had elevated liver levels above the normal range after delivery were classified separately, the characteristics and causes of changes in liver levels were analyzed, and the presence or absence of drug-induced liver damage was confirmed. Results: Among a total of 167 subjects, there were 5 women in the herbal-medicine-group and 150 women in the general-group who had changes in liver values within the normal range after childbirth. Aspartate transaminase (AST) change before and after childbirth in the herbal-medicine-group was 3.40±1.82, and AST change in the general-group was 2.92±8.59, showing no significant difference between the two groups (p=0.901). Increase of Alanine transaminase (ALT) before and after childbirth in the herbal-medicine-group was 5.60±3.65, and ALT change in the general-group was 8.01±11.81, showing no significant difference between the two groups (p=0.651). There were 12 subjects who had elevated AST, ALT above the normal range after delivery, including 1 in the herbal-medicine-group and 11 in the normal mothers group. Valuation of 1 Subject of the herbal-medicine-group before and after delivery was 17 IU/L of AST and 52 IU/L of ALT. Because results of AST, ALT is under the standard to diagnose to liver damage, she was observed without any treatment. However the cause of AST, ALT elevation was not found in the chart, she was receiving treatment for diabetes and hyperlipidemia. The general-group had an average increase of AST 35.64±22.67 IU/L and ALT 53.00±26.80 IU/L. As a result of analyzing the cause, there were direct causes such as autoimmune hepatitis, chronic hepatitis B, and acute pyelonephritis. Abnormal elevations in liver levels were also found in mothers with hypothyroidism, diabetes, and fever of unknown cause, although they were not direct causes. Conclusions: To investigate the safety of taking herbal medicines, we assess the variation in AST and ALT within 3 months before and after delivery in the herbal-medicine-group and general-group. There was no significant difference between two groups.

Keywords

References

  1. Song BG, Korean Medicine Obstetrics & Gynecology. Seoul:Haenglim Publishing. 1994:105-10. 
  2. Lee TK, Lee JH. Literature analysis with the postpartum depression. J Korean Obstet Gynecol. 2000;13(1):518-30. 
  3. Hwang YS, et al. Analysis on Outpatients with Postpartum Disease at the Korean Gynecology Clinic of Traditional Korean Medicine Hospital. J Korean Obstet Gynecol. 2018;31(3):61-78. 
  4. Jang SR, Kim DC. A Case Report of Postpartum Disease with Hyperhidrosis and Finger Pain. J Korean Obstet Gynecol. 2015;28(3):128-35.  https://doi.org/10.15204/jkobgy.2015.28.3.128
  5. Kim NH, et al. A Clinical Study of Rheumatoid Arthritis after Parturition. J Korean Obstet Gynecol. 2012;25(4):105-12. 
  6. Lee JE, et al. A Clinical case report about the postpartum depression patient with goiter. J Korean Obstet Gynecol. 2001;14(2):274-84. 
  7. Yang JI, et al. A Report on Liver Function of 82 Psoriasis Patients Taking Herbal Medication over 3 months. J Korean Oriental Med. 2012;33(3):95-104. 
  8. Kim GY, et al. A Case Report of Liver and Renal Function Changes in Stroke Patients Taking Long-term Herbal Medicine. J Int Korean Med. 2017;38(5):555-63.  https://doi.org/10.22246/jikm.2017.38.5.555
  9. Yoon SH, Lew JH, Jang MS. Response of Kagamseanggantang on the Live Fenction in Alcoholic Liver Disease. J Korean Oriental Med. 1993;14(2):348-54. 
  10. Lim JE, et al. A Clinical Study of the Effects of Acupuncture, Moxibustion and Whuallak-tang (Huoluo-tang) in Acute Back Pain and Liver Function. J Korean Acupuncture & Moxibustion Society. 2001;18(5):43-9. 
  11. Lee JH, Jeon WH. Effects of the Obesity Therapy with Korean Herbal Medicine on Liver Function: Case Series. J Korean Med Obes Res. 2017;17(1):54-60.  https://doi.org/10.15429/jkomor.2017.17.1.54
  12. Paeck EK, et al. Influence of Taking Medicine for a Period of Time on th Liver Function and Improvement of the Developmental Disordered Children. Korean J Oriental Physiology & Pathology. 2006;20(2):494-7. 
  13. Lee WJ, et al. Systematic review on herb-induced liver injury in Korea. Food Chem Toxicol. 2015;84:47-54.  https://doi.org/10.1016/j.fct.2015.06.004
  14. Kim DJ. A multicenter study for the detection and the development of nationwide reporting system of toxic liver injury. The Annual Report of KFDA. 2006;10:402-5. 
  15. Uom ES, Lee DN, Lim EM. Clinical Investigation for Various Postpartum Symptoms. J Korean Oriental Med. 2001;14(1):365-79. 
  16. Cho JH, et al. A nationwide study of the incidence rate of herb-induced liver injury in Korea. Arch Toxicol. 2017;91(12):4009-15.  https://doi.org/10.1007/s00204-017-2007-9
  17. David AL, Kotecha M, Girling JC. Factors influencing postnatal liver function tests. BJOG. 2000;107(11):1421-6.  https://doi.org/10.1111/j.1471-0528.2000.tb11659.x
  18. Izumi Y, et al. Development of liver dysfunction after delivery is possibly due to postpartum autoimmune hepatitis. A report of three cases. J Intern Med. 2002;252(4):361-7.  https://doi.org/10.1046/j.1365-2796.2002.01047.x
  19. Yun YJ, et al. Korean Herbal Medicine on Liver Function : A Systematic Review in Korean Literature. Korean J Orient Int Med. 2009;30(1):153-72. 
  20. Lee TK, Oh SS, Kim DI. A study of SaingHwa-Tang in Bucheungjueukwa. J Korean Obstet Gynecol. 1999;12(2):327-48. 
  21. Roh YB. Literature analysis of Ojeok-san. The Korean Medicine Society for Herbal Formula Study. 1990;1(1):72-86. 
  22. Nadir A, et al. Acute hepatitis with the use of a Chinese herbal product, ma-huang. Am J Gastroenterol. 1996;91(7):1436-8. 
  23. An BM. Herbal Preparation-induced Liver Injury. Korean Journal of Gastroenterology. 2004;44(3):113-25.