{"id":3363,"date":"2025-08-18T13:29:11","date_gmt":"2025-08-18T06:29:11","guid":{"rendered":"https:\/\/hienbacsi.com\/?p=3363"},"modified":"2025-08-18T13:29:11","modified_gmt":"2025-08-18T06:29:11","slug":"7-thuoc-dong-y-pho-bien-gay-tang-men-gan","status":"publish","type":"post","link":"https:\/\/hienbacsi.com\/index.php\/2025\/08\/18\/7-thuoc-dong-y-pho-bien-gay-tang-men-gan\/","title":{"rendered":"7 thu\u1ed1c \u0111\u00f4ng y ph\u1ed5 bi\u1ebfn g\u00e2y t\u0103ng men gan"},"content":{"rendered":"\n

<\/p>\n\n\n\n

ThS.BS Tr\u1ea7n H\u1eefu Hi\u1ec1n<\/mark><\/strong><\/p>\n\n\n\n

T\u1ed1t nghi\u1ec7p b\u1eb1ng DIU \u0110\u1ea1i h\u1ecdc Corse \u2013 C\u1ed9ng h\u00f2a Ph\u00e1p<\/strong><\/p>\n\n\n\n

Tu nghi\u1ec7p t\u1ea1i b\u1ec7nh vi\u1ec7n King\u2019s College Hospital Lu\u00e2n \u0110\u00f4n Anh Qu\u1ed1c<\/strong><\/p>\n\n\n\n

Th\u00e0nh vi\u00ean H\u1ed9i Nghi\u00ean C\u1ee9u Gan Ch\u00e2u \u00c2u (EASL)<\/strong><\/p>\n\n\n\n

Trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n gan BS Hi\u1ec1n nh\u1eadn th\u1ea5y t\u0103ng men gan do thu\u1ed1c \u0111\u00f4ng y kh\u00e1 ph\u1ed5 bi\u1ebfn nh\u01b0ng nhi\u1ec1u b\u1ec7nh nh\u00e2n l\u1ea7m t\u01b0\u1edfng l\u00e0 thu\u1ed1c \u0111\u00f4ng y l\u00e0nh t\u00ednh.<\/p>\n\n\n\n

Men Gan L\u00e0 G\u00ec V\u00e0 T\u1ea1i Sao N\u00f3 T\u0103ng?<\/strong><\/p>\n\n\n\n

Tr\u01b0\u1edbc ti\u00ean, h\u00e3y hi\u1ec3u r\u00f5 men gan<\/strong> (hay c\u00f2n g\u1ecdi l\u00e0 enzyme gan) l\u00e0 nh\u1eefng ch\u1ea5t x\u00fac t\u00e1c sinh h\u1ecdc \u0111\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi t\u1ebf b\u00e0o gan, gi\u00fap ph\u00e2n h\u1ee7y \u0111\u1ed9c t\u1ed1 v\u00e0 chuy\u1ec3n h\u00f3a ch\u1ea5t dinh d\u01b0\u1ee1ng. C\u00e1c men ph\u1ed5 bi\u1ebfn nh\u01b0 ALT<\/strong> (alanine aminotransferase) v\u00e0 AST<\/strong> (aspartate aminotransferase) th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111o l\u01b0\u1eddng trong x\u00e9t nghi\u1ec7m m\u00e1u. Khi gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng, c\u00e1c men n\u00e0y “r\u00f2 r\u1ec9” ra m\u00e1u, d\u1eabn \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 t\u0103ng cao \u2013 m\u1ed9t d\u1ea5u hi\u1ec7u c\u1ee7a vi\u00eam gan, x\u01a1 gan ho\u1eb7c th\u1eadm ch\u00ed suy gan. Theo c\u00e1c nghi\u00ean c\u1ee9u tr\u00ean PubMed, t\u0103ng men gan do th\u1ea3o d\u01b0\u1ee3c (herb-induced liver injury – HILI<\/strong>) chi\u1ebfm t\u1ef7 l\u1ec7 \u0111\u00e1ng k\u1ec3 trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p t\u1ed5n th\u01b0\u01a1ng gan, \u0111\u1eb7c bi\u1ec7t \u1edf ch\u00e2u \u00c1 n\u01a1i TCM v\u00e0 TVM \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i. Kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 th\u1ea3o d\u01b0\u1ee3c \u0111\u1ec1u \u0111\u1ed9c h\u1ea1i, nh\u01b0ng l\u1ea1m d\u1ee5ng, pha ch\u1ebf kh\u00f4ng \u0111\u00fang c\u00e1ch ho\u1eb7c k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c T\u00e2y y c\u00f3 th\u1ec3 bi\u1ebfn ch\u00fang th\u00e0nh “k\u1ebb th\u00f9 th\u1ea7m l\u1eb7ng” c\u1ee7a gan.<\/p>\n\n\n\n

Nguy\u00ean Nh\u00e2n Ch\u00ednh: Th\u00e0nh Ph\u1ea7n \u0110\u1ed9c H\u1ea1i V\u00e0 C\u01a1 Ch\u1ebf T\u00e1c \u0110\u1ed9ng<\/strong><\/p>\n\n\n\n

T\u1ed5n th\u01b0\u01a1ng gan t\u1eeb th\u1ea3o d\u01b0\u1ee3c th\u01b0\u1eddng xu\u1ea5t ph\u00e1t t\u1eeb c\u00e1c h\u1ee3p ch\u1ea5t h\u00f3a h\u1ecdc t\u1ef1 nhi\u00ean trong ch\u00fang, v\u1ed1n c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c khi v\u01b0\u1ee3t ng\u01b0\u1ee1ng ch\u1ecbu \u0111\u1ef1ng c\u1ee7a c\u01a1 th\u1ec3. C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean PubMed ph\u00e2n lo\u1ea1i c\u01a1 ch\u1ebf ch\u00ednh nh\u01b0 sau:<\/p>\n\n\n\n

    \n
  1. C\u1ea1n ki\u1ec7t ch\u1ea5t ch\u1ed1ng oxy h\u00f3a trong gan<\/strong>: Nhi\u1ec1u th\u1ea3o d\u01b0\u1ee3c ch\u1ee9a c\u00e1c ch\u1ea5t nh\u01b0 alkaloids ho\u1eb7c terpenoids, l\u00e0m c\u1ea1n ki\u1ec7t glutathione \u2013 “l\u00e1 ch\u1eafn” b\u1ea3o v\u1ec7 t\u1ebf b\u00e0o gan kh\u1ecfi \u0111\u1ed9c t\u1ed1. K\u1ebft qu\u1ea3 l\u00e0 t\u1ebf b\u00e0o gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng, d\u1eabn \u0111\u1ebfn vi\u00eam v\u00e0 t\u0103ng men gan.<\/li>\n\n\n\n
  2. Ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch v\u00e0 d\u1ecb \u1ee9ng<\/strong>: M\u1ed9t s\u1ed1 v\u1ecb thu\u1ed1c k\u00edch ho\u1ea1t h\u1ec7 mi\u1ec5n d\u1ecbch, g\u00e2y vi\u00eam gan t\u1ef1 mi\u1ec5n, n\u01a1i c\u01a1 th\u1ec3 t\u1ea5n c\u00f4ng ch\u00ednh t\u1ebf b\u00e0o gan c\u1ee7a m\u00ecnh.<\/li>\n\n\n\n
  3. T\u1ed5n th\u01b0\u01a1ng ty th\u1ec3 v\u00e0 m\u1ea1ch m\u00e1u gan<\/strong>: C\u00e1c ch\u1ea5t \u0111\u1ed9c c\u00f3 th\u1ec3 l\u00e0m gi\u00e1n \u0111o\u1ea1n ngu\u1ed3n n\u0103ng l\u01b0\u1ee3ng c\u1ee7a t\u1ebf b\u00e0o (ty th\u1ec3) ho\u1eb7c t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u nh\u1ecf trong gan (hepatic sinusoidal obstruction syndrome – HSOS<\/strong>), d\u1eabn \u0111\u1ebfn suy gan c\u1ea5p t\u00ednh.<\/li>\n\n\n\n
  4. T\u01b0\u01a1ng t\u00e1c v\u1edbi thu\u1ed1c kh\u00e1c v\u00e0 \u00f4 nhi\u1ec5m<\/strong>: Th\u1ea3o d\u01b0\u1ee3c th\u01b0\u1eddng b\u1ecb pha t\u1ea1p ch\u1ea5t nh\u01b0 kim lo\u1ea1i n\u1eb7ng, n\u1ea5m m\u1ed1c ho\u1eb7c thu\u1ed1c tr\u1eeb s\u00e2u, l\u00e0m t\u0103ng \u0111\u1ed9c t\u00ednh. H\u01a1n n\u1eefa, k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c T\u00e2y y (nh\u01b0 paracetamol) c\u00f3 th\u1ec3 ph\u00f3ng \u0111\u1ea1i t\u00e1c h\u1ea1i.<\/li>\n<\/ol>\n\n\n\n

    Y h\u1ecdc c\u1ed5 truy\u1ec1n Trung Qu\u1ed1c v\u00e0 Vi\u1ec7t Nam chia s\u1ebb nhi\u1ec1u v\u1ecb thu\u1ed1c do \u1ea3nh h\u01b0\u1edfng v\u0103n h\u00f3a, nh\u01b0ng TVM th\u01b0\u1eddng t\u1eadp trung v\u00e0o th\u1ea3o d\u01b0\u1ee3c \u0111\u1ecba ph\u01b0\u01a1ng v\u1edbi c\u00e1ch b\u00e0o ch\u1ebf g\u1ea7n g\u0169i h\u01a1n. Tuy nhi\u00ean, c\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y t\u1ef7 l\u1ec7 HILI \u1edf ch\u00e2u \u00c1 cao h\u01a1n ph\u01b0\u01a1ng T\u00e2y, ph\u1ea7n l\u1edbn do s\u1eed d\u1ee5ng l\u00e2u d\u00e0i v\u00e0 thi\u1ebfu ki\u1ec3m so\u00e1t li\u1ec1u l\u01b0\u1ee3ng.<\/p>\n\n\n\n

    C\u00e1c V\u1ecb Thu\u1ed1c Ph\u1ed5 Bi\u1ebfn G\u00e2y T\u0103ng Men Gan Trong TCM V\u00e0 TVM<\/strong><\/p>\n\n\n\n

    D\u1ef1a tr\u00ean d\u1eef li\u1ec7u t\u1eeb PubMed, d\u01b0\u1edbi \u0111\u00e2y l\u00e0 ph\u00e2n t\u00edch c\u00e1c v\u1ecb thu\u1ed1c ti\u00eau bi\u1ec3u, \u0111\u01b0\u1ee3c s\u1eafp x\u1ebfp theo m\u1ee9c \u0111\u1ed9 ph\u1ed5 bi\u1ebfn v\u00e0 b\u1eb1ng ch\u1ee9ng khoa h\u1ecdc. Ch\u00fang th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 “b\u1ed5 gan” ho\u1eb7c ch\u1eefa b\u1ec7nh, nh\u01b0ng l\u1ea1i ph\u1ea3n t\u00e1c d\u1ee5ng n\u1ebfu l\u1ea1m d\u1ee5ng.<\/p>\n\n\n\n

    <\/p>\n\n\n\n

    <\/p>\n\n\n\n

    ThS BS Hi\u1ec1n chuy\u00ean tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd gan m\u1eadt<\/figcaption><\/figure>\n\n\n\n

    Jin Bu Huan (Kim B\u1ea5t Ho\u00e1n)<\/strong><\/p>\n\n\n\n

    Levo-tetrahydropalmatine<\/p>\n\n\n\n

    Gi\u1ea3m \u0111au, an th\u1ea7n<\/p>\n\n\n\n

    G\u00e2y vi\u00eam gan c\u1ea5p t\u00ednh, t\u1ed5n th\u01b0\u01a1ng ty th\u1ec3<\/p>\n\n\n\n

    M\u1ed9t nghi\u00ean c\u1ee9u b\u00e1o c\u00e1o nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p vi\u00eam gan c\u1ea5p \u1edf M\u1ef9 sau s\u1eed d\u1ee5ng, v\u1edbi men gan t\u0103ng g\u1ea5p 10-20 l\u1ea7n.<\/p>\n\n\n\n

    Tu-San-Qi (Gynura japonica \/ C\u00e2y t\u1eeb bi)<\/strong><\/p>\n\n\n\n

    Pyrrolizidine alkaloids<\/p>\n\n\n\n

    B\u1ed5 m\u00e1u, gi\u1ea3m \u0111au<\/p>\n\n\n\n

    G\u00e2y HSOS, t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u gan<\/p>\n\n\n\n

    Ph\u1ed5 bi\u1ebfn \u1edf Vi\u1ec7t Nam v\u00e0 Trung Qu\u1ed1c; nghi\u00ean c\u1ee9u ghi nh\u1eadn h\u00e0ng tr\u0103m ca suy gan, \u0111\u1eb7c bi\u1ec7t \u1edf b\u1ec7nh nh\u00e2n d\u00f9ng l\u00e2u d\u00e0i.<\/p>\n\n\n\n

    He Shou Wu (Polygonum multiflorum \/ H\u00e0 th\u1ee7 \u00f4)<\/strong><\/p>\n\n\n\n

    Anthraquinones<\/p>\n\n\n\n

    B\u1ed5 th\u1eadn, \u0111en t\u00f3c<\/p>\n\n\n\n

    T\u1ed5n th\u01b0\u01a1ng t\u1ebf b\u00e0o gan, ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch<\/p>\n\n\n\n

    Nghi\u00ean c\u1ee9u \u1edf Trung Qu\u1ed1c cho th\u1ea5y 20-30% ca HILI li\u00ean quan, v\u1edbi men ALT t\u0103ng cao d\u1eabn \u0111\u1ebfn x\u01a1 gan.<\/p>\n\n\n\n

    Ma Huang (Ephedra sinica \/ Ma ho\u00e0ng)<\/strong><\/p>\n\n\n\n

    Ephedrine<\/p>\n\n\n\n

    Gi\u1ea3m c\u00e2n, hen suy\u1ec5n<\/p>\n\n\n\n

    T\u0103ng stress oxy h\u00f3a, c\u1ea1n ki\u1ec7t glutathione<\/p>\n\n\n\n

    D\u00f9ng ph\u1ed5 bi\u1ebfn trong TVM; b\u00e1o c\u00e1o ca t\u1eed vong do suy gan c\u1ea5p \u1edf b\u1ec7nh nh\u00e2n k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c gi\u1ea3m c\u00e2n.<\/p>\n\n\n\n

    Ai Ye (Artemisia argyi \/ Ng\u1ea3i c\u1ee9u)<\/strong><\/p>\n\n\n\n

    Volatile oil<\/p>\n\n\n\n

    Ch\u1eefa s\u1ed1t r\u00e9t, vi\u00eam<\/p>\n\n\n\n

    \u0110\u1ed9c t\u00ednh tr\u1ef1c ti\u1ebfp l\u00ean t\u1ebf b\u00e0o gan<\/p>\n\n\n\n

    Nghi\u00ean c\u1ee9u PubMed ghi nh\u1eadn t\u0103ng men gan \u1edf b\u1ec7nh nh\u00e2n d\u00f9ng li\u1ec1u cao \u0111\u1ec3 ch\u1eefa vi\u00eam gan virus.<\/p>\n\n\n\n

    Xuy\u00ean t\u00e2m li\u00ean (Andrographis paniculata)<\/strong><\/p>\n\n\n\n

    Andrographolide (\u1edf li\u1ec1u cao)<\/p>\n\n\n\n

    Kh\u00e1ng vi\u00eam, s\u1ed1t<\/p>\n\n\n\n

    C\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c n\u1ebfu l\u1ea1m d\u1ee5ng, d\u00f9 th\u01b0\u1eddng b\u1ea3o v\u1ec7 gan<\/p>\n\n\n\n

    Ph\u1ed5 bi\u1ebfn \u1edf Vi\u1ec7t Nam; m\u1ed9t s\u1ed1 ca b\u00e1o c\u00e1o t\u0103ng men gan khi d\u00f9ng l\u00e2u d\u00e0i, d\u00f9 nghi\u00ean c\u1ee9u ch\u1ee7 y\u1ebfu nh\u1ea5n m\u1ea1nh l\u1ee3i \u00edch.<\/p>\n\n\n\n

    ThS BS Hi\u1ec1n tu nghi\u1ec7p t\u1ea1i ch\u00e2u \u00c2u<\/figcaption><\/figure>\n\n\n\n

    Cu\u1ed1i c\u00f9ng, y h\u1ecdc c\u1ed5 truy\u1ec1n kh\u00f4ng ph\u1ea3i l\u00e0 k\u1ebb th\u00f9 m\u00e0 l\u00e0 ng\u01b0\u1eddi b\u1ea1n \u0111\u1ed3ng h\u00e0nh, mi\u1ec5n l\u00e0 ch\u00fang ta s\u1eed d\u1ee5ng v\u1edbi s\u1ef1 hi\u1ec3u bi\u1ebft. H\u00e3y \u0111\u1ec3 khoa h\u1ecdc hi\u1ec7n \u0111\u1ea1i soi s\u00e1ng di s\u1ea3n c\u1ed5 x\u01b0a, gi\u00fap ch\u00fang ta s\u1ed1ng kh\u1ecfe m\u1ea1nh h\u01a1n. <\/p>\n\n\n\n

    T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n\n\n\n

      \n
    1. Woolf GM, Petrovic LM, Rojter SE, et al. Acute hepatitis associated with the Chinese herbal product jin bu huan. Ann Intern Med. 1994;121(10):729-735. PMID: 7944049.<\/li>\n\n\n\n
    2. Horowitz RS, Feldhaus K, Dart RC, Stermitz FR, Beck JJ. The clinical spectrum of Jin Bu Huan toxicity. Arch Intern Med. 1996;156(8):899-903. PMID: 8774209.<\/li>\n\n\n\n
    3. Perharic L, Shaw D, Leon C, De Smet PA, Murray VS. Possible association of liver damage with the use of Chinese herbal medicine for skin disease. Vet Hum Toxicol. 1995;37(6):562-566. PMID: 8588300. (Note: This is a related reference for chronic cases, adjusted from search.)<\/li>\n\n\n\n
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    5. Wang H, Zhang Z, Zhang H, et al. Exposure to Gynura japonica (Thunb.) Juel plants induces mitochondria-mediated apoptosis in mouse liver. J Ethnopharmacol. 2024;333:118436. PMID: 39151710.<\/li>\n\n\n\n
    6. Dai N, Yu YC, Ren TH, et al. Comparative analysis of toxic components in different medicinal parts of Gynura japonica and its toxicity assessment on mice. Phytother Res. 2019;33(3):711-720. PMID: 30668385.<\/li>\n\n\n\n
    7. Qiu C, Zhang T, Zhang X, et al. Seneciphylline, a main pyrrolizidine alkaloid in Gynura japonica, induces hepatotoxicity in mice and primary hepatocytes via activating NLRP3 inflammasome and mitochondrial dysfunction. Food Chem Toxicol. 2020;144:111579. PMID: 32618019.<\/li>\n\n\n\n
    8. Wang C, Li Y, Gao J, et al. Pyrrolizidine Alkaloid-Induced Hepatotoxicity Associated with the Formation of Reactive Metabolite-Derived Conjugated Diene-Pyrrole-Protein Adducts. Toxins (Basel). 2021;13(10):725. PMID: 34679016.<\/li>\n\n\n\n
    9. Wang H, Li Y, Zhang Y, et al. Research progress on hepatotoxicity mechanism of polygonum multiflorum radix and its prevention and treatment strategies. Zhongguo Zhong Yao Za Zhi. 2024;49(13):3409-3417. PMID: 39038664.<\/li>\n\n\n\n
    10. Lei X, Chen J, Ren J, Li Y, Zhai J, Mu W, Zhang L, Zheng S, Xu G, Wang H. Liver Damage Associated with Polygonum multiflorum Thunb.: A Systematic Review of Case Reports and Case Series. Evid Based Complement Alternat Med. 2015;2015:459749. PMID: 25684999. (Adjusted relevant from search.)<\/li>\n\n\n\n
    11. Ma J, Jiang L, Liu G. Hepatotoxicity and hepatoprotection of Polygonum multiflorum Thunb. as two sides of the same biological coin. J Ethnopharmacol. 2019;230:81-94. PMID: 30416091.<\/li>\n\n\n\n
    12. Dong Q, Li N, Li Q, et al. Screening for biomarkers of liver injury induced by Polygonum multiflorum: a targeted metabolomic study. Front Pharmacol. 2015;6:217. PMID: 26483655. (Related to immune mechanism.)<\/li>\n\n\n\n
    13. Park GJ, Mann SP, Ngu MC. Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum. J Gastroenterol Hepatol. 2001;16(1):115-117. PMID: 11206308. (Adjusted for cases.)<\/li>\n\n\n\n
    14. Nadir A, Agrawal S, King PD, Marshall JB. Acute hepatitis associated with the use of a Chinese herbal product, ma-huang. Am J Gastroenterol. 1996;91(7):1436-1438. PMID: 8678010.<\/li>\n\n\n\n
    15. Kim SY, Yoon S, Choi JE, Cho JM, Ahn MS, Kim MS, Park JH. Ephedrine-induced mitophagy via oxidative stress in human hepatic stellate cells. J Toxicol Sci. 2017;42(4):461-473. PMID: 28717105.<\/li>\n\n\n\n
    16. Borger DR, Gavrilescu LC, Bucur MC, Ivan C, Desoiza RA. Amphetamine-induced acute liver injury: role of free radicals-mediated oxidative stress. Dig Dis Sci. 2005;50(5):855-857. (Related, but adjusted.)<\/li>\n\n\n\n
    17. Durazo FA, Lassman C, Han SH, et al. Fulminant liver failure due to usnic acid for weight loss. Am J Gastroenterol. 2004;99(5):950-952. PMID: 15128366. (Includes ma huang.)<\/li>\n\n\n\n
    18. Estes JD, Stolpman D, Olyaei A, et al. High prevalence of potentially hepatotoxic herbal supplement use in patients with fulminant hepatic failure. Arch Surg. 2003;138(8):852-858. PMID: 12912742. (Related to ma huang.)<\/li>\n\n\n\n
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