原发性肝癌围血管介入期中医证候演变规律分析

An analysis of evolution of TCM syndrome during transcatheter arterial intervention in primary liver cancer

目的:探讨中医证候在原发性肝癌围血管介入期的演变规律。方法:本次研究通过流行病学抽样调查展开,共收集中医四诊资料400人份,经因子分析及样本聚集,获得构成基本证候的要素,与中医辨证结合,就每例患者所属中医证候进行归纳,对中医证候在血管介入前后分布特点,及证候在不同介入手段下的变化展开总结。结果:5类常见基本证候经血管介入前后整体分布有统计学差异(P<0.05);两两分析,较介入前,湿热蕴结证明显增多,肝郁脾虚证明显减少,有统计学差异(P<0.05),其他变化不明显。结论:介入后应遵循"急则治标"原则,应用清热利湿法、疏肝利胆法,以化解药毒,祛除湿热毒邪后,宜扶正祛邪、标本兼治,灵活运用清热解毒、活血化瘀、补益肝肾、健脾理气,最终对疗效进行控制,最大程度改善预后。

Objective： To investigate evolution of TCM syndrome during transcatheter arterial intervention in primary liver cancer Methods： By epidemiological survey, 400 copies of the diagnostic information were collected. By factor analysis and sample gathering, the basic elements of the syndrome were obtained. Combined with TCM differentiation, patients＇ TCM syndrome was summarized. Distribution characteristics of TCM syndrome before and after vascular intervention, as well as changes in different syndromes in perioperative period are summarized. Results： In perioperative period, the difference among overall distribution of 5 kinds of common basic syndromes were statistically significant （P〈0.05）. After the interventional treatment, patients with the Shi＇re Yunjie syndrome significantly increased; and patients with Ganyu Pixu syndrome significantly reduced; there was a significant difference （P〈0.05）. Conclusion： During treatment, the principle ofStopgap was applied in emergency situation was should be followed; the Qing＇re Lishi therapy and the Shugan Lidan therapy should be applied. After eliminating the TCM medicine, the Qing＇re Jiedu therapy, the Huoxue Huayu therapy, the Buyi Ganshen therapy and the Jianpi Liqi therapy should be applied flexibly to improve the prognosis maximizely and achieve the purpose of tackling the problem.