175例原发性肝癌中医证型与Child-Pugh分级相关性的研究

Research on the Relationship Between Traditional Chinese Medicine Syndrome Patternsz of 175 Primary Liver Cancer Patients and Child-Pugh Classification

目的:探讨175例原发性肝癌患者的中医证型与肝功能Child-Pugh分级的相关性。方法:以2013年3月至2013年12月广西医科大学附属肿瘤医院住院收治原发性肝癌(PLC)初治患者175例为研究对象。对PLC患者的肝功能进行Child-Pugh分级,并将其分为肝气郁结、气滞血瘀、湿热聚毒、肝肾阴虚四组,分析中医证型与Child-Pugh分级的相关性。结果:(1)四种证型PLC患者的Child-Pugh分级情况不一致(P<0.05)。肝肾阴虚型患者Child-Pugh分级明显晚于其它证型(P多重比较<0.01)。(2)四个证型A级、C级所占比率均不一致(P<0.05)。肝气郁结、气滞血瘀型A级比率明显高于肝肾阴虚型(P多重比较<0.01)。肝肾阴虚型C级比率明显高于其它证型(P多重比较<0.01)。结论:(1)肝肾阴虚型患者的肝功能最差,且气滞血瘀型优于湿热聚毒型的可能性大。(2)Child-Pugh分级中A级可以被认为是肝气郁结、气滞血瘀型鉴别肝肾阴虚的临床参考,且对于湿热聚毒型与气滞血瘀型、肝肾阴虚相互鉴别仍有一定的指导意义;C级可以被认为是辨证肝肾阴虚型的临床参考。(3)PLC患者中医证型与Child-Pugh分级存在一定的相关性。Child-Pugh分级对于中医辨证分型有一定的指导意义。

Objective： To investigate the relationship between TCM syndrome pattern and Child-Pugh classification in liver function from the information of 175 primary liver cancer（ PLC） patients. Methods： 175 PLC patients in initial treatment who hospitalized in Affiliated Tumor Hospital of Guangxi Medical University from March to December in 2013 were divided into four groups such as depression of liver-Qi,stagnation of vital energy and blood stasis,moist heat and poly poison and hepatic and renal Yin-deficiency,and then were staged by Child-Pugh classification in liver function. To analyze the relationship between PLC patients TCM syndrome pattern and Child-Pugh classification. Results：（ 1） Four TCM syndrome pattern patients were not coincident in Child-Pugh classification（ P〈0. 05）. Hepatic and renal Yin-deficiency was obvious weaker than the others（ Pmultiple comparison〈0. 01）.（ 2） Four TCM syndrome pattern patients were not coincident in probability ratio of A and C classification.Depression of liver-Qi,stagnation of vital energy and blood stasis were obvious higher than hepatic and renal Yin-deficiency in probability ratio of a classification（ Pmultiple comparison〈0. 01）. Hepatic and renal Yin-deficiency was obvious higher than the others in probability ratio of C classification（ Pmultiple comparison〈0. 01）. Conclusion：（ 1） Hepatic and renal Yin-deficiency is the worst in liver function. The possibility is large that stagnation of vital energy and blood stasis is better than moist heat and poly poison and hepatic in liver function.（ 2） A classification in Child-Pugh can be considered as clinic reference to distinguish between depression of liver-Qi,stagnation of vital energy and blood stasis and hepatic and renal Yin-deficiency,to discriminate between moist heat and poly poison and stagnation of vital energy and blood stasis,hepatic and renal Yin-deficiency. C classification in Child-Pugh can be considered as clinic reference to confirm hepatic and renal Yin-deficiency.（ 3） There are some relationships between PLC patients TCM syndrome pattern and Child-Pugh classification. And the latter has the value of guidance to confirm the former.