原发性肝癌中医证型分布及生存期差异研究

The Distribution of Chinese Medicine Syndrome Types in Primary Liver Cancer and Their Differences of the Survival Time: a Clinical Study

目的探讨原发性肝癌(primary liver cancer,PLC)中医证型分布以及各证型生存期差异。方法选择151例2007年5月—2009年3月在广东省中医院肿瘤科住院的PLC患者,进行中医辨证分型,统计患者生存期,采用Kaplan-Meier法计算患者的平均生存期及中位生存期,比较各证型生存期差异。结果 PLC患者中医证型比例由高至低分别为湿瘀互结证(43.0%,65/151)、肝郁脾虚证(34.4%,52/151)、气滞血瘀证(9.3%,14/151)、湿热蕴结证(8.6%,13/151)及肝肾阴虚证(4.6%,7/151)。PLC患者各证型中位生存期由长至短分别为:肝郁脾虚证(14.77个月)、气滞血瘀证(6.13个月)、湿热蕴结证(5.27个月)、湿瘀互结证(4.78个月)、肝肾阴虚证(0.80个月);各证型平均生存期由长至短分别为:肝郁脾虚证(12.40个月)、气滞血瘀证(8.84个月)、湿瘀互结证(6.99个月)、湿热蕴结证(7.08个月)、肝肾阴虚证(0.72个月),不同证型间的生存期差异有统计学意义(P<0.05)。结论肝郁脾虚证及湿瘀互结证是PLC最常见的证型;肝郁脾虚证与湿瘀互结证、湿热蕴结证及肝肾阴虚证的生存期有差异,湿瘀互结证与肝肾阴虚证亦有差异;肝郁脾虚证是预后最好的证型,而肝肾阴虚证预后最差。

Objective To explore the distribution of Chinese medicine （CM） syndrome types in primary liver cancer （PLC） and their differences of the survival time. Methods From May 2007 to March 2009, recruited were 151 PLC inpatients at Department of Tumor, Guangdong Provincial Hospital of Traditional Chinese Medicine. Their survival time were statistically calculated. Patients＇ average survival time and median survival time were calculated using Kaplan-Meier method. The Log-rank test was used to ana- lyze their differences of survival time among different CM syndrome types. Results The proportion of CM syndrome types in PLC patients were ranked from high to low as follows： mutual accumulation of damp- ness and blood stasis syndrome [ MADBSS, 43.0% （65/151）], Gan-stagnation Pi-deficiency syndrome [GSPDS, 34.4% （52/151） ], qi stagnation blood stasis syndrome [QSBSS, 9.3% （14/151） ], retention of damp-heat syndrome [ RDHS, 8.6% （13/151） ], and Gan-Shen yin deficiency syndrome [ GSYDS, 4.6% （7/ 151 ） ]. The median survival time of different CM syndrome types were ranked from longer to shorter as fol- lows： GSPDS （14.77 months）, QSBSS （6.13 months）, RDHS （5.27 months）, MADBSS （4.78 months）, and GSYDS （0.80 months）. The mean survival times were ranked from longer to shorter as follows ： GSP- DS （12.40 months）, QSBSS （8.84 months）, MADBSS （6.99 months）, RDHS （7.08 months）, and GSYDS （0.72 months）. There was statistical difference in the difference of the survival time among different CM syndrome types （P 〈0.05）. Conclusions GSPDS and MADBSS were the most common CM syndrome types in PLC patients. There was difference in the survival time between GSPDS and MADBSS/between RDHS and GSYDS. There was difference in the survival time between MADBSS and GSYDS. Patients of GSPDS might get the best prognosis, while patients of GSYDS might get the poorest prognosis.