2060例原发性肝癌患者证候特点分析

Analysis on Characteristics of Syndromes in 2060 Cases of Primary Hepatic Cancer

目的:观察肝癌患者证的演变及兼证特点。方法:采用大样本临床流行病学调研方案,临床调查原发性肝癌2060例。结果:原发性肝癌的病机是随病程的发展不断变化的,Ⅰ～Ⅲ期证候以肝郁气滞、脾气虚为主,Ⅱ期以肝血瘀阻、气滞、气虚、湿热等为主,Ⅲ期以气虚、阴虚、血瘀、气滞、水湿内停等为主。各期中证型出现率居前4位的是气滞、血瘀、气虚、阴虚。还显示,肝癌无证可辨者仅占1.07％,而3个证型组合者占23.06％,4个证型组合者占24.37％,5个证型组合者占18.11％,平均每个患者出现3.75个证型。其中Ⅰ期平均2.03证次,Ⅱ期平均3.47证次,Ⅲ期平均4.99证次。结论:随着病程的发展,证的相兼愈加显著,病机愈加复杂,而气滞血瘀与气阴两虚是根本病机,贯穿于该病的始终。

Objective: To observe the development of syndromes and characteristics of coexistant syndromes in the patient of hepatic cancer. Methods: 2060 cases of primary hepatic cancer were clinically researched by a large sample number clinical epidemiological survey program. Results: The pathogenesis of primary hepatic cancer is continuously changing with development of course of disease. From stage I to I , syndrome of stagnation of the liv-er-Qi and syndrome of deficiency of spleen-Qi are main. At stage I , stasis of blood in the liver, Qi-stagnation, Qi-deficiency and damp-heat are main. At stage III, Qi-deficierncy, Yin deficiency, blood stasis, Qi-stagnation and retention of water in the body are main. The occurrence rate of syndromes at various stages in the first fourth positions are Qi-stagnation, blood stasis, Qi-deficiency and Yin-deficiency. The patients with no syndrome able to differentiated only accounted for 1. 07%, with 3 syndrome groups for 23. 06%, 4 syndromes for 24. 37%, 5 syndromes for 18. 11%, averaging 3. 75 syndromes in each patient, and averaging 2. 03 syndrome-times at stage I , 3. 47 at stage II , and 4. 99 at stage III . Conclusion: Coexistent syndromes were more obvious and pathogeneses were more complicated with development of condition of illness. Stagnation of Qi and stasis of blood , and deficiency of both Qi and Yin are basic pathogenesis, running through the course of the disease.