105例原发性肝癌患者中医证候分布规律研究
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摘要
目的:观察105例原发性肝癌患者的中医证候分布规律及与AFP的相关性。方法:对105例原发性肝癌患者使用云南省中医医院肿瘤科国家"十一五"重点专科肝癌诊疗方案采集患者四诊信息,将患者分为肝郁脾虚、气滞血瘀、湿热蕴结、瘀湿互结、肝肾阴虚5种基本证候,比较各证型构成比情况,以及各证型在不同临床分期(Ⅰ、Ⅱ、Ⅲ期)的分布情况,统计各中医证型肝癌患者的甲胎蛋白(AFP)水平,分析各中医证型与AFP的相关性。结果:105例原发性肝癌患者中,肝郁脾虚证比肝肾阴虚证、瘀湿互结证、气滞血瘀证多见;湿热蕴结证比瘀湿互结证、气滞血瘀证多见;气滞血瘀证最少;Ⅲ期患者36例,5个证型例数分布,差异有统计学意义(P <0.05);在Ⅲ期最常见的为肝肾阴虚证,其次是湿热蕴结证。在肝郁脾虚证患者中,Ⅰ期、Ⅱ期的患者较多,Ⅲ期患者较少,差异有统计学意义(P <0.01);湿热蕴结证、肝肾阴虚证、瘀湿互结证患者中以Ⅲ期为主,差异均有统计学意义(P <0.01)。5个证型中AFP阳性检出率差异无统计学意义(P> 0.05)。结论:原发性肝癌患者中医证候分布存在一定的规律,总体上肝郁脾虚证多见,Ⅲ期最常见的为肝肾阴虚证,AFP的阳性率与肝癌中医证型无关。
Objective: To observe the distribution rules of Chinese medicine syndrome in 105 cases of patients with primary liver cancer and its correlation with alpha-fetoprotein(AFP). Methods: The information of four examinations of 105 cases of patients with primary liver cancer who were involved in the records of the diagnosis and treatment of liver cancer in the National Eleventh Five-Year Plan for Key Specialty in Oncology Department of Yunnan Provincial Hospital of Traditional Chinese Medicine was collected. The patients were divided into five types according to different basic syndromes,including liver depression and spleen deficiency, blood stasis due to qi stagnation, dampness-heat retention, binding of stasis and dampness as well as liver-kidney yin deficiency. The proportion and the distribution of each syndrome at different clinical stages(stage Ⅰ, Ⅱ and Ⅲ)were compared; the levels of AFP in patients with liver cancer with different Chinese medicine syndromes were observed;the correlation between Chinese medicine syndromes and AFP was analyzed. Results: Among105 cases of patients with primary liver cancer, there were more patients with liver depression and spleen deficiency syndrome than those with liver-kidney yin deficiency syndrome,binding of stasis and dampness syndrome as well as blood stasis due to qi stagnation syndrome; there were more patients with dampness-heat retention syndrome than those with binding of stasis and dampness syndrome as well as blood stasis due to qi stagnation syndrome; there were few patients with blood stasis due to qi stagnation syndrome. Among 36 cases of patients at stage Ⅲ,the proportion of five syndromes showed significant difference(P < 0.05);the most common syndrome at stage Ⅲ was liver-kidney yin deficiency syndrome,followed by dampness-heat retention syndrome. Among the patients with liver depression and spleen deficiency syndrome,the more were at stage Ⅰ and stage Ⅱ,the less were at stage Ⅲ,the difference being significant(P < 0.01);the number of patients with dampness-heat retention syndrome,liver-kidney yin deficency syndrome and binding of stasis and dampness syndrome,the most were at stage Ⅲ,the difference being significant(P < 0.01). There was no significant difference being found in the comparison of the positive rates of AFP in five syndromes(P > 0.05). Conclusion:There are some rules in the distribution of Chinese medicine syndromes in patients with primary liver cancer. Generally, liver depression and spleen deficiency syndrome is common;at stage Ⅲ,liver-kidney yin deficiency syndrome is the most common one;the positive rate of AFP has no correlation with Chinese medicine syndromes of liver cancer.
Objective: To observe the distribution rules of Chinese medicine syndrome in 105 cases of patients with primary liver cancer and its correlation with alpha-fetoprotein(AFP). Methods: The information of four examinations of 105 cases of patients with primary liver cancer who were involved in the records of the diagnosis and treatment of liver cancer in the National Eleventh Five-Year Plan for Key Specialty in Oncology Department of Yunnan Provincial Hospital of Traditional Chinese Medicine was collected. The patients were divided into five types according to different basic syndromes,including liver depression and spleen deficiency, blood stasis due to qi stagnation, dampness-heat retention, binding of stasis and dampness as well as liver-kidney yin deficiency. The proportion and the distribution of each syndrome at different clinical stages(stage Ⅰ, Ⅱ and Ⅲ)were compared; the levels of AFP in patients with liver cancer with different Chinese medicine syndromes were observed;the correlation between Chinese medicine syndromes and AFP was analyzed. Results: Among105 cases of patients with primary liver cancer, there were more patients with liver depression and spleen deficiency syndrome than those with liver-kidney yin deficiency syndrome,binding of stasis and dampness syndrome as well as blood stasis due to qi stagnation syndrome; there were more patients with dampness-heat retention syndrome than those with binding of stasis and dampness syndrome as well as blood stasis due to qi stagnation syndrome; there were few patients with blood stasis due to qi stagnation syndrome. Among 36 cases of patients at stage Ⅲ,the proportion of five syndromes showed significant difference(P < 0.05);the most common syndrome at stage Ⅲ was liver-kidney yin deficiency syndrome,followed by dampness-heat retention syndrome. Among the patients with liver depression and spleen deficiency syndrome,the more were at stage Ⅰ and stage Ⅱ,the less were at stage Ⅲ,the difference being significant(P < 0.01);the number of patients with dampness-heat retention syndrome,liver-kidney yin deficency syndrome and binding of stasis and dampness syndrome,the most were at stage Ⅲ,the difference being significant(P < 0.01). There was no significant difference being found in the comparison of the positive rates of AFP in five syndromes(P > 0.05). Conclusion:There are some rules in the distribution of Chinese medicine syndromes in patients with primary liver cancer. Generally, liver depression and spleen deficiency syndrome is common;at stage Ⅲ,liver-kidney yin deficiency syndrome is the most common one;the positive rate of AFP has no correlation with Chinese medicine syndromes of liver cancer.
引文
[1]董先杰,邵英梅.原发性肝癌的治疗进展[J].现代肿瘤医学,2009,17(9):1814-1817.
[2]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:211.
[2]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:211.