原发性肝癌中医证型与组织学分型及形态学分型的相关性研究

Study on the Correlation between TCM Patterns,Histological and Morphological Types of Primary Liver Cancer

目的:探究原发性肝癌(primary liver cancer,PLC)常见中医证型与组织学分型、形态学分型之间存在的相关性。方法:选择确诊为原发性肝癌的372名患者,按照中医病证分型,将患者分为肝郁脾虚证、肝热血瘀证、肝胆湿热证、肝肾阴虚证4型。分析不同组织学分型、形态学分型肝癌患者的中医证候分布情况,探求其中的相关性。结果:肝郁脾虚证152例(40.86%);肝胆湿热证69例(18.55%),肝热血瘀证72例(19.35%),肝肾阴虚证79例(21.24%)。肝细胞癌284例,以肝郁脾虚证最为常见;胆管细胞癌45例,以肝胆湿热证最为常见;混合型肝癌24例,以肝热血瘀证最为常见;其他组织学分型14例,以肝肾阴虚最为常见。弥散型肝癌97例,以肝郁脾虚证最为常见;结节型肝癌123例,以肝郁脾虚证最为常见;块状型肝癌84例,以肝热血瘀证最为常见;小癌型68例,以肝肾阴虚最为常见。结论:原发性肝癌患者的不同组织学分型、形态学分型与中医证型存在一定的相关性,对PLC的辨证分型存在一定的指导意义,也对PLC的流行病学调查研究提供一定的参考意义。

Objective:To discuss the connections between common TCM patterns,histological and morphological patterns of PLC.Methods:All 372 patients diagnosed as PLC were chosen and divided into liver depression and spleen deficiency pattern,liver heat blood stasis pattern,liver-gallbladder damp-heat pattern,liverkidney Yin deficienciy pattern according to the classifications of TCM patterns.To analyze the distribution conditions of TCM patterns of the patients of different morphological and histological patterns,and survey their connections.Results:There were 152 cases of liver depression and spleen deficiency pattern(40.86%);69 cases of liver-gallbladder damp-heat pattern(18.55%);72 cases of liver heat blood stasis pattern(19.35%);and 79 cases of liver-kidney Yin deficienciy pattern(21.24%).Mostly 284 cases of hepatocellular carcinoma were of liver depression and spleen deficiency pattern;45 cases of cholangiocarcinoma of liver-gallbladder damp-heat pattern;24 cases of mixed hepatocellular carcinoma of liver heat blood stasis pattern;14 cases of other histological patterns of liver-kidney Yin deficienciy pattern.Liver depression and spleen deficiency pattern is the most common type among 97 cases of diffuse liver cancer;liver depression and spleen deficiency pattern is the most common type among 123 cases of nodular liver cancer;liver heat blood stasis pattern is the most common type among 84 cases of massive hepatocellular carcinoma;liver-kidney Yin deficienciy pattern is the most common type among 68 cases of small cancer type.Conclusion:There is a certain correlation between different histological and morphological patterns,TCM patterns of PLC,which could guide syndrome differentiation and patterns of TCM,and provide the reference for the study on epidemiological investigation of PLC.