摘要
目的探讨原发性肝癌的中医证候分布规律。方法对559例原发性肝癌患者使用"中医肝癌证候调查表"采集患者四诊信息,将患者分为气滞证、血瘀证、实热证、水湿证、气虚证、血虚证、阴虚证、阳虚证8种基本证候,比较各证型患者在不同临床分期(Ⅰ、Ⅱ、Ⅲ期)的分布及证候量化积分,并结合聚类分析初步探讨其证候组合规律。结果 559例原发性肝癌患者的证候按出现频次由高到低依次为血瘀证380例、气虚证330例、水湿证264例、气滞证250例、实热证236例、阴虚证136例、血虚证与阳虚证各57例。气滞证在Ⅱ、Ⅲ期中分布较Ⅰ期明显减少,水湿证、阴虚证和阳虚证则在Ⅲ期的分布较Ⅰ、Ⅱ期明显增高(P<0.01);血瘀证、气虚证、实热证和血虚证在各期分布的差异无统计学意义(P>0.05)。气滞证、水湿证、气虚证和阳虚证的证候量化积分在各临床分期的差异具有统计学意义(P<0.01),血瘀证、实热证、血虚证和阴虚证的证候量化积分差异无统计学意义(P>0.05)。聚类分析结果显示,血瘀证和气虚证一类,气滞证、水湿证和实热证一类,阳虚证、阴虚证和血虚证一类。结论原发性肝癌的基本证候以血瘀证和气虚证最常见,随着分期进展,气滞证减少,而水湿证、阴虚证和阳虚证明显增多。
Objective To explore regularities of Chinese medical syndrome distribution in patients with primary liver cancer. Methods Questionnaire of Chinese Medical Syndrome about Liver Cancer was used to gather messages about the four methods of diagnosis in 559 patients with primary liver cancer. Patients were divided into 8 kinds of basic syndrome including Qi stagnation,blood stasis,excess heat,wet with water,Qi deficiency,blood deficiency,Yin deficiency,and Yang deficiency. Distribution and scores of syndrome quantification of the patients with the different syndrome in different clinical stages（ Ⅰ,Ⅱ and Ⅲ stage） were also compared,and the syndrome combination rule according to clustering analysis was preliminarily discussed. Results According to occurred frequency from high to low,the sequence about syndromes in 559 patients with primary liver cancer was that blood stasis（ 380cases）,Qi deficiency（ 330 cases）,water with wet（ 264 cases）,Qi stagnation（ 250 cases）,excess heat（ 236cases）,Yin deficiency（ 136 cases）,blood deficiency（ 57 cases）,and Yang deficiency syndrome（ 57 cases）. The distributions of Qi stagnation syndrome in Ⅱ and Ⅲ stages were much fewer than that in Ⅰ stage,but the distributions of water with wet,Yin deficiency,and Yang deficiency syndrome in Ⅲ stage were much more than that in Ⅰand Ⅱ stages.（ P〈0. 01）; there were no significant differences in distributions of blood stasis,Qi deficiency,excess heat,and blood deficiency syndrome in each different stage（ P〉0. 05）. There were significant differences in scores of syndrome quantification of Qi stagnation,water with wet,Qi deficiency,and Yang deficiency syndrome in various clinical stages（ P〈0. 01）,but no significant differences in those of blood stasis,excess heat,blood deficiency and Yin deficiency syndrome（ P〉0. 05）. Result of clustering analysis showed that blood stasis and Qi deficiency syndrome were in the same category,Qi stagnation,water with wet and excess heat syndrome
出处
《中医杂志》
CSCD
北大核心
2016年第12期1053-1056,共4页
Journal of Traditional Chinese Medicine
基金
国家高技术研究发展计划("863"计划)(2012AA02A609)
上海市卫计委中医药事业发展三年行动计划(ZYSNXD-CC-ZDYJ023
ZY3-CCCX-3-3038
ZY3-LCPT-2-1004)
关键词
原发性肝癌
证候分布
临床分期
primary liver cancer
syndrome distribution
clinical stages
