Liver Damage Associated with Polygonum multiflorum Thunb.: A Systematic Review of Case Reports and Case Series.

Xiang Lei,Jingbo Zhai,Li Zhang,Wenke Zheng,Jingtian Ren,Jing Chen,Yan Li,Wei Mu,Guihua Tian,Hongcai Shang

doi:10.1155/2015/459749

Abstract

Objective. To summarize the characteristics and analysis of relevant factors and to give references for prevention and further study of liver damage associated with Polygonum multiflorum Thunb. (HSW), we provide a systematic review of case reports and case series about liver damage associated with HSW. Methods. An extensive search of 6 medical databases was performed up to June 2014. Case reports and case series involving liver damage associated with HSW were included. Results. This review covers a total of 450 cases in 76 articles. HSW types included raw and processed HSW decoction pieces and many Chinese patent medicines that contain HSW. Symptoms of liver damage occur mostly a month or so after taking the medicine, mainly including jaundice, fatigue, anorexia, and yellow or tawny urine. Of the 450 patients, two cases who received liver transplantation and seven who died, the remaining 441 cases recovered or had liver function improvement after discontinuing HSW products and conservative care. Conclusion. HSW causes liver toxicity and may cause liver damage in different degrees and even lead to death; most of them are much related to long-term and overdose of drugs. Liver damage associated with HSW is reversible, and, after active treatment, the majority can be cured. People should be alert to liver damage when taking HSW preparations.

Highlights

Polygonum multiflorum Thunb. (He Shou Wu in Chinese pinyin, hereinafter referred to as HSW) is the root of Polygonum multiflorum, a member of Polygonaceae
The main reason for using HSW is that patients suffer from gray hair and hair loss; this may be associated with those patients who are more likely to use HSW products, but whether patients suffering from gray hair or hair loss are prone to occurrence of liver damage associated with HSW remains to be further studied
Many studies suggest that processing could reduce the toxicity of HSW [15, 93], all HSW products may lead to liver damage regardless of herbal processing

Summary

Introduction

Polygonum multiflorum Thunb. (He Shou Wu in Chinese pinyin, hereinafter referred to as HSW) is the root of Polygonum multiflorum, a member of Polygonaceae. (He Shou Wu in Chinese pinyin, hereinafter referred to as HSW) is the root of Polygonum multiflorum, a member of Polygonaceae. In the Chinese Pharmacopoeia (2010), there are two forms of HSW decoction pieces: raw state (natural root) (Figure 1) and processed form, that is, radix polygoni multiflori preparata (boiled in black-bean liquid according to a traditional process) (Figure 2). Modern pharmacological studies have shown that HSW have the effect of reducing blood lipid and antiarteriosclerosis [3,4,5], protecting liver [6, 7], enhancing immunologic [8, 9], improving memory, protecting nerve cells, and increasing intelligence [10, 11], antioxidation, antiaging [12, 13], and so forth.

Methods

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Discussion

Conclusion