294例原发性肝癌初诊患者证候特点初探

Characteristics of 294 Cases of Primary Liver Cancer

目的:观察原发性肝癌初诊患者的证候特点,探讨肝癌的中医病因病机。方法:通过回顾性临床流调,分析294例原发性肝癌初发患者证候情况。结果:原发性肝癌患者多见于中年阶段,男性居多,初发症状以肝胆系统及消化道表现居多。294例原发性肝癌患者中无证可辨69例(23.5%);湿证117例(39.8%);血瘀证81例(27.6%),气滞证69例(23.5%);气虚证69例(23.5%);血虚证34例(11.6%);热证12例(4.1%);阳虚证2例(0.7%);阴虚证1例(0.3%)。不同年龄阶段的原发性肝癌患者基本证候的分布比例基本相同。证候组合形式,无证可辨69例(23.5%),单一证候111例(37.8%),2个证型组合76例(25.9%),3个证型组合31例(10.5%),4个证型组合6例(2%),5个证型组合1例(0.3%)。结论:原发性肝癌初发以实证居多,且不受年龄因素的影响;正虚邪积是肝癌发生后的病理变化和病理属性,并不是肝癌产生的根本原因。

Objective：To explore the Traditional Chinese Medical （TCM）pathogenesis of hepatocarcinoma by study the TCM syndrome characters of preliminary diagnosis patients with primary liver cancer. Methods ：The TCM syndrome of 294 preliminary diagnosis patients with primary liver cancer were analyzed by retrospective clinical epidemical study. Results： Patients with primary liver cancer were more common in the middle-aged and male people. The early symptoms were more observed in liver and biliary system and digestive tract system. In the 294 patients with primary liver cancer, there were 69 cases （23.5%）without any TCM syndrome, 117 cases （39.8%）with dampness-syndrome, 81 cases （27.6%）with blood-stasis syndrome,69 cases（23.5%）qi-stagnation,69 cases（23.5%）with qi-deficieney,34 cases （11.6% ）with blood-deficiency, 12 cases （4.1%）with pyretie-syndrome, 2 cases （0.7%）with yang-asthenia, 1 case （0.3%）with yin-asthenia. The distribution ratio of basic TCM syndrome were similar in different ages. The combination of syndrome,there were 69 cases （23.5%） without any syndrome, 111 cases （37.8%）with single syndrome, 76 cases （25.9%）with two-syndrome combination, 31 cases （10.5%）with three-syndrome combination,6 cases（2%）with four-syndrome combination, 1 ease（0.3%）with five-syndrome combination. Conclusion ：Primary liver cancer was more observed by sthenia-syndrome and was not influenced by age. Asthenia of healthy qi and evil accumulation was the pathological changes and pathological characters, not the fundamental cause of the generation of liver cancer.