原发性肝癌中医分型与凝血功能相关性分析

Correlation between syndrome types of primary hepatic carcinoma and coagulation function

目的探讨原发性肝癌(PHC)中医分型与凝血功能的相关性。方法采用回顾性研究方法分析本院2015年1月至2016年5月收治的176例PHC患者中医分型及其与凝血功能之间的关系。结果 176例PHC患者以肝郁脾虚证居多,占34.66%,其次为湿热中阻证(22.73%)和气滞血瘀证(17.05%)。不同分型PHC患者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、D二聚体(D-D)均明显升高,肝郁脾虚组与湿热中阻组、肝肾阴虚组比较差异有统计学意义(P<0.05),纤维蛋白原(FIB)水平明显降低,但不同分型组间比较差异无统计学意义(P>0.05)。结论脾肾阳虚证、湿热中阻证和肝肾阴虚证患者凝血功能相对较差,气滞血瘀证和肝郁脾虚证患者凝血功能相对较好。PT、APTT、TT延长及D-D水平升高程度对鉴别肝郁脾虚证与气滞血瘀证、肝肾阴虚证、湿热中阻证、脾肾阳虚证具有一定意义。

Objective To explore the association between syndrome types of primary hepatic carcinoma(PHC)and coagulation function.Methods From Jan.2015 to May.2016,a total of 176 cases of PHC patients were enrolled to analyze the correlation between syndrome types and coagulation function.Results The liver stagnation and spleen deficiency syndrome(34.66%)was the most common syndrome in all patients,followed by wet and heat resistance syndrome(22.73%)and qi stagnation and blood stasis syndrome(17.05%).Prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)and D-dimer(D-D)levels of patients were significantly increased,with significant differences between liver stagnation and spleen deficiency group and wet and heat resistance syndrome group,liver and kidney Yin deficiency syndrome group(P<0.05).While fibrinogen(FIB)decreased significantly,but without significant differences between each group(P>0.05).Conclusion Coagulation function in PHC patients with spleen and kidney Yang deficiency syndrome,wet and heat resistance syndrome and liver and kidney Yin deficiency syndrome could be poor,but that in patients with qi stagnation and blood stasis syndrome and liver stagnation and spleen deficiency could be relatively good.Increasing of PT,APTT,TT and D-D could be with certain significance to identify liver stagnation and spleen deficiency syndrome with other syndrome types.