原发性肝癌的中医证素特征研究

Study on the TCM syndrome elements of primary hepatocellular carcinoma

目的:探讨福建地区原发性肝癌的中医证素特征,初步揭示本地区原发性肝癌的中医病理特性,为中医的辨证论治提供客观依据。方法:通过观察152例原发性肝癌患者的症状和体征,采用中医证素辨证方法进行研究,运用SPSS 11.5统计软件分析各个证素积分数值之间的相关性、频数分布等。结果:发现肝、气虚、阳虚、阴虚、湿、热6个证素积分数值较高,显著高于其他证素积分数值(P<0.001);积分在70分以上并且居于前几位的证素分别是湿(59.21%)、阴虚(57.24%)、肝(53.95%)、热(51.97%)。通过相关性分析,发现五脏病位证素中,证素肝与胆显著相关(r=0.569),其次是与脾相关(r=0.416),与肺则无明显相关性(r=0.026);肝与病性证素的相关性分析,发现肝与气滞显著相关(r=0.705),其次为血瘀(r=0.635)、阴虚(r=0.511)、血虚(r=0.485)、阳亢(r=0.477)、湿(r=0.455)。结论:原发性肝癌的中医病理特性以肝、湿、热、阴虚为主,本病很容易传至胆和脾,以本虚标实的兼夹证为多见,这很可能与福建当地湿热的气候环境有关。

Objective： To discuss the characteristics of the syndrome elements of TCM of the primary hepatocellular carcinoma in Fujian,initially reveal the pathological characteristics of Chinese medicine,to provide an objective basis for Chinese medicine diagnosis and treatment.Methods： observing the symptoms and signs of 152 patients with primary hepatocellular carcinoma,using the methods of the syndrome elements of TCM to differentiate and statistical software of SPSS11.5 to analyze the correlation and the frequency distribution of each element of the syndromes.Results： It showed that the values of the six syndrome elements of liver,Qi deficiency,Yang deficiency,Yin deficiency,dampness and hotness are in higher levels,significantly higher than the other syndrome elements values（P0.001）.While the values of the six syndrome elements have no significant difference each other;the values more than 70 points of the syndrome elements are dampness（59.21%）,Yin deficiency（57.24%）,liver（53.95%） and hotness（51.97%）.By correlation analysis of the disease location,we found the elements of liver and gallbladder had the most significant correlation（r= 0.569）,followed by the spleen（r=0.416）,with no obvious correlation of lung（r=0.026）.By correlation analysis of the disease nature,we found the elements of liver and Qi Stagnation had obvious correlation（r=0.705）,followed by stasis（r=0.635）,Yin deficiency（r=0.511）,blood deficiency（r=0.485）,hyperactivity of Yang（r=0.477） and dampness（r=0.455）.Conclusion： The main syndrome elements of primary hepatocellular carcinoma are liver,dampness,hotness and Yin deficiency.The disease can easily spread to gallbladder and spleen,which may be related to the hot and humid climate environment of Fujian.