原发性肝癌高强度聚焦超声治疗前后中医证型变化的研究

Study on changes of TCM syndrome in patients with primary liver cancer before and after high intensity focus ultrasound treatment

目的探讨原发性肝癌患者高强度聚焦超声治疗前后中医证型变化的规律及高强度聚焦超声治疗对中医证型的影响。方法对64例原发性肝癌患者行高强度聚焦超声治疗前后进行中医证候分型,常见有气虚、血虚、阴虚、气滞、血瘀、湿阻等证型。按治疗前2d、治疗后3d、治疗后1周3个时间段进行统计分析。结果气滞证和血瘀证在高强度聚焦超声治疗3d及治疗后1周与治疗前比较,差异有统计学意义(P<0.01);气虚证在高强度聚焦超声治疗后3d及治疗后1周与治疗前比较,差异有统计学意义(P<0.05);阴虚证在治疗后1周与治疗前及治疗后3d比较,差异均有统计学意义(P<0.05)。结论高强度聚焦超声治疗可有效改善原发性肝癌患者气滞证和血瘀证,但可能加重气虚证和阴虚证,故其无法改变原发性肝癌本虚标实的基本病理特点。

Objective To observe TCM syndrome types in patients（pts） with primary liver cancer（PLC） before and after high intensity focus ultrasound（HIFU） treatment,and to explore the influence of HIFU treatment on TCM syndrome types.Methods Based on the data of 64 PLC pts with HIFU treatment,TCM Syndrome types were analyzed before and after HIFU treatment.Principal TCM Syndrome was qi-deficiency syndrome,blood-deficiency syndrome,yin-deficiency syndrome,qi-stagnation syndrome,blood stasis syndrome,damp-blocking syndrome,etc.Results There were significantly differences in qi-stagnation syndrome,blood stasis syndrome and qi-deficiency syndrome in pts who received HIFU treatment 3 days and one week later compared to themselves when had not had before（P0.01 or P0.05）.There were significantly differences in yin-deficiency syndrome in pts who received HIFU treatment one week later compared to themselves when received HIFU treatment 3 days later or had not had before（P0.05）.Conclusion HIFU treatment could significantly relieve symptoms of qi-stagnation syndrome and blood stasis syndrome.But it could also aggravate symptoms of qi-deficiency syndrome and yin-deficiency syndrome.The result suggested that HIFU treatment could not radically change the pathogenesis of PLC.