摘要
目的:探讨175例原发性肝癌患者的中医证型与巴塞罗那临床肝癌分期系统(BCLC分期)的相关性。方法:对原发性肝癌(PLC)初治患者175例进行BCLC分期,并将其分为肝气郁结、气滞血瘀、湿热聚毒、肝肾阴虚4组,分析其中医证型与BCLC分期的相关性。结果:1)4种证型PLC患者的BCLC分期情况不一致(P<0.05)。肝气郁结型患者BCLC分期明显早于湿热聚毒型、肝肾阴虚型(P<0.01),且早于气滞血瘀型的可能性大;气滞血瘀型患者BCLC分期明显早于湿热聚毒型(P<0.01)。2)4个证型A期、B期、C期所占比率不一致(P<0.05)。肝气郁结型A期比率明显高于其他证型(P<0.01);湿热聚毒型B期比率明显低于气滞血瘀型(P<0.01),且低于肝肾阴虚型可能性大;湿热聚毒型C期比率明显高于其他证型(P<0.01)。结论:1)BCLC分期中A期是辨证肝气郁结型的临床参考;B期是湿热聚毒型与气滞血瘀型相互鉴别的临床参考,且对于湿热聚毒型与肝肾阴虚型的相互鉴别有一定的指导意义;C期是辨证湿热聚毒型的临床参考。2)PLC患者中医证型与BCLC分期存在一定的相关性。BCLC分期对于中医辨证分型有一定的指导意义。
Objective： To explore the correlation between TCM patterns of 175 patients with primary liver cancer （PLC） and Barcelona clinic liver cancer （BCLC） staging system. Methods： All 175 PLC patients in initial treat- ment were grouped according to BCLC staging, and they were divided into four groups： depression of liver-Qi, Qi stagnation and blood stasis, dampness-heat gathering into the toxin, Yin-deficiency of liver and kidney, to analyze the correlation between TCM patterns and BCLC staging of PLC. Results：l） BCLC staging conditions of the PLC patients with four patterns were not identical （P〈0.05）. BCLC stagings of the patients with depression pattern of liv- er-Qi were earlier remarkably than these of the ones with dampness-heat gathering into the toxin, Yin-deficiency of liver and kidney patterns （P〈0.01）, and the possibility of earlier than Qi stagnation and blood stasis pattern was big- ger; BCLC stagings of the patients with Qi stagnation and blood stasis pattern were earlier than these of the patients with dampness-heat gathering into the toxin pattern notably （P〈0.01）. 2） The ratios of four patterns at stage A, stage B and stage C were different （P〈0.05）. The ratios of depression pattern of liver-Qi at stage A were higher than these of other patterns notably （P〈0.01）; the ratios of dampness-heat gathering into the toxin pattern at stage B were lower than these of Qi stagnation and blood stasis pattern （P〈 0.01）, and the possibility of lower than Yin-deficiency of liv- er and kidney pattern was big; the ratios of dampness-heat gathering into the toxin pattern at stage C were higher than these of other patterns （P〈0.01）. Conclusion： 1） among BCLC staging, stage A is clinical reference for differ- entiating depression of liver-Qi; stage B is clinical reference for differentiating dampness-heat gathering into the tox- in pattern and Qi stagnation and blood stasis pattern mutually, and they are the guidance of differentiating dampness-heat gathering into the toxin pattern and Yin-deficiency of liver and kidney pattern mutually; stage C is clinical reference for differentiating dampness-heat gathering into the toxin pattern. 2） TCM patterns of PLC patients are related to BCLC staging to a certain degree, BCLC staging could guide syndrome differentiation and treatment of TCM to a certain degrees.
作者
欧杰
陈闯
诸佳瑜
林恒红
胡利荣
徐望
OU Jie CHEN Chuan ZHU Jiayu LIN Henghong HU Lirong XU Wang(Cancer Hospital Affiliated to Guangxi Medical University, Nanning 530022, China Graduate School of Guangxi University of Chinese Medicine Yulin Municipality the Second People＇s Hospita Yueyang Municipality TCM Hospital)
出处
《西部中医药》
2017年第7期71-73,共3页
Western Journal of Traditional Chinese Medicine
基金
广西科学研究与技术开发计划项目(编号桂科攻1598012-54)
