摘要
目的探讨肝癌血管介入栓塞化疗前后中医证型的变化,为临床治疗提供思路。方法采用回顾性研究方法,调查行血管介入栓塞化疗的原发性肝癌患者312例,应用"肝癌介入前后辨证分型回顾性病历调查表"收集患者介入前后的中医四诊资料,包括症状、体征、舌脉55个变量,对所有症状、体征、舌脉象等四诊信息进行样本频数统计分析,删除各证候指标中出现率<2%的变量,其余变量应用分层变量聚类分析确定每类的证候要素,归纳出每类的中医证型,比较介入前后中医证型变化特点。结果介入前后原发性肝癌中医证型均以肝郁气滞证、血瘀证、湿热证、脾虚证、阴虚证为主。介入前后基本证候整体分布差异具有统计学意义(P<0.01);介入后肝郁气滞证、湿热证较介入前明显增多,脾虚证、阴虚证较介入前显著减少(P<0.05)。结论肝癌血管介入栓塞化疗后患者中医病机更倾向于肝气郁滞证、湿热证,临床应重视疏肝利胆、清热利湿的治疗策略。
Objective To investigate the changes of TCM Syndrome Types in patients with liver cancer before and after interventional embolization, chemotherapy and to provide ideas for clinical treatment. Methods A retro- spective study was performed in 312 patients with primary liver cancer who underwent interventional embolization chemotherapy, the ＂Retrospective chart review of patients with liver cancer before and after intervention＂ were used to collect the patients＇ TCM diagnostic data, including 55 variables, such as symptoms, signs, tongue pulse and so on, Analysis of sample frequency statistics for all symptoms, signs, tongue and pulse and other diagnostic information were taken, if the occurrence rate of the variables of the syndrome indicators is less than 2%, they would be deleted, the remaining variables are analysed by hierarchical variable clustering analysis to determine the syndrome elements of each class, to sum up each type of TCM syndrome type, and to compare the characteristics of TCM syndrome types before and after intervention. Results Before and after interventional therapy of primary liver cancer, the TCM syndromes were mainly Liver Qi stagnation syndrome, blood stasis syndrome, damp heat syndrome, spleen deficiency syndrome and yin deficiency syndrome. The difference in the overall distribution of basic syndromes before and after intervention was statistically significant （P 〈 0.01 ） ; After the intervention, Liver Qi stagnation syndrome and damp heat syndrome were significantly increased, spleen deficiency syndrome and yin deficiency syndrome were significantly reduced （P 〈 0. 05 ）. Conclusion TCM Pathogenesis of Liver cancer after interventional embolization chemothera- py tends to be Liver Qi stagnation syndrome and damp heat syndrome, in clinical work attention should be paid to the clinical treatment strategy of soothing-liver cholaneresis and eliminating dampness and heat.
出处
《中医杂志》
CSCD
北大核心
2015年第19期1678-1681,共4页
Journal of Traditional Chinese Medicine
基金
广西壮族自治区中医药管理局中医药民族医药自筹经费科研课题(GZZC1152)
柳州市应用技术研究与开发计划课题(2011J0302010)
关键词
原发性肝癌
介入栓塞化疗
中医证候
肝郁气滞
湿热蕴结
primary liver cancer
interventional embolization chemotherapy
TCM syndrome
liver Qi stagnation
stagnation of damp-heat
