Name of herbal ingredient | No. of cases, n (%) | Types of hepatotoxicity implicated (n) | Mean TDD (g) (SD) | Mechanisms of action (based on TCM system of therapeutics) a | Recommended daily doses (g) a |
---|---|---|---|---|---|
Fu Ling (Sclerotium poriaecocos) | 18 (31.6) | Acute hepatic necrosis (3), Acute hepatitis (11), Cholestatic hepatitis (1), Mixed hepatocellular-cholestatic hepatitis (1), Enzyme elevations without jaundice (2) | 8.3 (13.4) | Promotes urination in order to drain dampness, strengthens the spleen and calms the heart. | 10–15 |
Huang Qin (Radix scutellaria baicalensis) | 15 (26.3) | Acute hepatic necrosis (3), Acute hepatitis (10), Mixed hepatocellular-cholestatic hepatitis (1), Enzyme elevations without jaundice (1) | 6.3 (12.1) | Clears heat and dries dampness, purges fire to remove toxin, stops bleeding and prevents miscarriage. | 3–10 |
Gan Cao (Radix glycyrrhizae) | 15 (26.3) | Acute hepatic necrosis (3), Acute hepatitis (8), Mixed hepatocellular-cholestatic hepatitis (1), Enzyme elevations without jaundice (3) | 8.9 (10.6) | Strengthens spleen and improves 'qi', clears heat and removes toxin, dispels phlegm in order to relieve cough, relax spasm and relieves pain and moderate drug actions. | 2–10 |
Ze Xie (Alisma orientalis) | 14 (24.6) | Acute hepatic necrosis (2), Acute hepatitis (11), Mixed hepatocellular-cholestatic hepatitis (1) | 5.9 (14.4) | Promotes urination to drain dampness, discharge heat, revolves turbidity, and lowers lipid | 6–10 |
Chuan Xiong (Rhizoma ligustici) | 14 (24.6) | Acute hepatic necrosis (1), Acute hepatitis (10), Mixed hepatocellular-cholestatic hepatitis (1), Enzyme elevations without jaundice (2) | 6.3 (8.3) | Activates blood and moves 'qi', and dispels wind in order to relief pain. | 3–10 |