基于中国分期的原发性肝癌中医证候演变规律探析

Analysis of Syndrome Changing Regularities of Primary Liver Cancer Based on China Liver Cancer Staging

目的:探讨基于1977年中国分期的原发性肝癌中医证候演变规律。方法:以"肝癌"与"证候"为检索主题词,对中国知网1979年1月至2016年6月的相关文献进行检索。结果:纳入7篇以1977年中国分期为分期标准的原发性肝癌中医证候临床研究文献,并对文献内容进行分析。结论:血瘀证与脾虚证是原发性肝癌的两大基本证候;从Ⅰ期到Ⅲ期,呈现出从单纯气滞→气滞与血瘀相兼→以血瘀为主,从脾虚→湿热蕴结的演变趋势;Ⅲ期(晚期)表现为虚实夹杂,实证以血瘀证、湿热证为主,虚证则特异性地出现肝肾阴虚证、脾肾阳虚证;毒邪内蕴作为兼证,贯穿始终。

Objective:To investigate the evolution regularities of TCM syndromes of primary liver cancer based on Chinese staging made in 1977.Methods :The relevant documents of Chinese Knowledge Network from January 1979 to June 2016 were searched for by "Hepatocarcinoma"and "Certificate of Syndrome".Results:Seven clinical research literatures on TCM syndromes of primary liver cancer with 1977 Chinese staging were included,and the contents of the literature were analyzed.Conclusion:Blood Stasis Syndrome and Spleen Deficiency Syndrome are the two basic syndromes of primary liver cancer.Namely,from stage Ⅰ to stage Ⅲ, evolution trend is from simple Qi stagnation→Qi stagnation and blood stasis→blood stasis and from Spleen deficiency→Spleen Damp and Heat Accumulation.In the third stage (late stage),it is characterized by mixed syndromes of excessive and deficiency combination,in which Blood Stasis Syndrome and Damp Heat Syndrome are the main excessive cases,and the deficiency syndrome is specifically performed as liver and Kidney Yin Deficiency Syndrome.Toxin evil exists as accompanied symptom throughout the whole process.