原发性肝癌患者高强度聚焦超声治疗前后舌象、脉象参数及中医体质变化

Observation on changes of tongue and pulse parameters and TCM constitution in patients with primary liver cancer before and after high-intensity focused ultrasound treatment

目的:观察原发性肝癌经高强度聚焦超声(HIFU)治疗前后舌象、脉象参数及中医体质的变化情况。方法:应用TDA-1小型舌诊仪和PDA-1型单部脉诊仪采集99例原发性肝癌患者HIFU治疗前后的舌象图片与关部脉图,获得相关舌象、脉象参数:舌质颜色相关指标(TB-R、TB-G、TB-B、TB-H、TB-S、TB-V、TB-L、TB-a、TB-b)、舌苔颜色相关指标(TC-R、TC-G、TC-B、TC-H、TC-S、TC-V、TC-L、TC-a、TC-b)、脉图重要参数(h1、h3、h4、h5、t1、t4、t5、t、w、As、Ad、h3/h1、h4/h1、h5/h1、w/t)。比较治疗前后参数的变化情况。运用《中医体质分类与判定表》评估治疗前后患者体质的变化情况。结果:经HIFU治疗后,舌象参数TB-a、TC-H显著下降,脉图特征参数h4、h4/h1显著下降,w/t显著上升(P<0.05)。与治疗前比较,治疗后体质分类中阴虚质、气虚质的比例显著上升,平和质比例显著下降(P<0.05)。结论:HIFU在消融瘤体的同时,会不可避免地加重原发性肝癌患者"气"和"阴"的亏虚程度,临床遣方用药须重视益气养阴,从而充分发挥中医药抗肿瘤的优势。

Objective: To observe the changes in tongue and pulse parameters and TCM physique of primary liver carcinoma patients which were treated by high intensity focused ultrasound(hereinafter referred to as HIFU). Methods: Tongue images and Guan purse of 99 primary liver carcinoma patients before and after HIFU treatment were collected by TDA-1 small tongue diagnostic instrument and PDA-1 single location pulse diagnostic instrument. Then the related tongue and pulse parameters were obtained included tongue body color-related indicators: TB-R, TB-G, TB-B, TB-H, TB-S, TB-V, TB-L, TB-a, TB-b, tongue coating color-related indicators: TC-R, TC-G, TC-B, TC-H, TC-S, TC-V, TC-L, TC-a, TC-b and important parameters of pulse chart: h1, h3, h4, h5, t1, t4, t5, t, w, As, Ad, h3/h1, h4/h1, h5/h1, w/t. Compare the change of parameters before and after HIFU treatment. The Physique Classification and Judgment Table of TCM was used to evaluate the changes in patients’ physique before and after treatment. Results: After HIFU treatment, the tongue parameters TB-a and TC-H significantly decreased, the pulse chart characteristic h4 and h4/h1 significantly decreased, while w/t significantly increased(P<0.05). Compared with pre-treatment, the proportion of yin deficiency and qi deficiency in the classification of physique increased significantly, while the proportion of mild physique decreased significantly(P<0.05). Conclusion: HIFU will inevitably aggravate the deficiency degree of ‘qi’ and ‘yin’ in patients with primary liver carcinoma while destroying the tumor. Therefore, the clinical prescription should attach importance to ‘qi’ and ‘yin’ supplementation, to give full play to the anti-tumor advantages of TCM.