原发性肝癌常见中医基本证候定性诊断规范的研究

Study of a qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer

目的:初步建立原发性肝癌常见中医基本证候定性诊断规范。方法:应用文献整理、临床调查、专家 研讨等方法,初步建立原发性肝癌常见中医基本证候定性诊断规范,将诊断规范的辨证结果与专家经验辨证 进行对照验证,根据临床验证结果对诊断规范进行反复修订,逐步完善。结果:初步建立的原发性肝癌常见 中医基本证候定性诊断规范包括实证与虚证两部分,实证包括气滞证、血瘀证、热证、湿证,虚证包括气虚证、 血虚证、阴虚证、阳虚证,并设立了每个基本证候的诊断条件。临床验证结果显示:诊断规范辨证与专家辨证 结果对照,基本证候的总体符合率为73.92%。结论:原发性肝癌中医基本证候定性诊断规范基本符合中医 临床实际,值得在临床上进一步验证和修订,并在此基础上进一步开展肝癌复合证候的研究。

Objective： To work out a qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer. Methods： Based on the collection and analysis of related medical literature, clinical investigation, and experts＇ discussion, a preliminary qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer was formulated. Then it was used in clinic to be verified and revised repeatedly till it was improved to be a satisfied formal criterion. Results： The basic syndromes listed in the qualitative diagnostic criterion for basic syndromes in patients with primary liver cancer consisted of two parts： excessive syndromes, including the syndromes of stagnation of qi, blood stasis, excess-heat and dampness, and deficient syndromes, including the syndromes of deficiency of qi, deficiency of blood, deficiency of yin and deficiency of yang. Each of the above syndromes could be diagnosed according to specific combination of its corresponding symptoms or signs. The clinical verification results showed that the total matching ratio was 73. 92% between the diagnoses made according to the criterion and the diagnoses acquired from the experts＇ experience.Conclusions： The qualitative diagnostic criterion for basic syndromes of traditional Chinese medicine in patients with primary liver cancer is coincident with the experts＇ clinical practice. However, it needs to be further studied.