| 引用本文:惠梦雨1，苏式兵2，周汶君2，杨梦蝶2，陈晓乐2，季青2，3，王文海4，王鹏5，孟志强5，张华1.414例原发性肝癌患者证候分布特征及其与理化指标相关性观察[J].世界中医药,2025,(03):. |
|
| 414例原发性肝癌患者证候分布特征及其与理化指标相关性观察 |
| Syndrome Distribution Characteristics and Correlation with Clinical Laboratory Indicators of 414 Primary Hepatocellular Carcinoma Patients |
| 投稿时间：2024-01-21 |
| DOI：10.3969/j.issn.1673-7202.2025.03.015 |
| 中文关键词: 原发性肝癌 证候分布特征 复发转移 中医药 手术治疗 介入治疗 理化指标 相关性 |
| English Keywords:Primary hepatocellular carcinoma Syndrome distribution characteristics Relapse and metastasis Traditional Chinese medicine Surgical treatment Interventional therapy Clinical laboratory indicators Correlation |
| 基金项目:国家自然科学基金重点项目（81330084）；国家自然科学基金面上项目（81673849） |
|
| 摘要点击次数: 8 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的：探讨原发性肝癌中医证候分布特征及其与理化检查指标间的相关性。方法：收集肝癌患者的四诊信息、诊疗过程记录及理化检查指标结果，由专人辨证，分析各证候分布规律及其与治疗方法、理化检查指标间的关系。结果：414例患者中发生转移75例；总体证候分布以脾虚证最多，占42%，其余为隐证、肝肾阴虚证、湿热证和肝郁脾虚证。复发转移者中，脾虚证最多，占41%，与总体证候分布相比较，差异无统计学意义（P>0.05）。对比是否采用手术、放化疗及介入患者的证候分布，差异有统计学意义（P<0.05）；脾虚证、肝肾阴虚证、湿热证3种证候间的总胆红素（TBIL）、碱性磷酸酶（ALP）、凝血酶原时间（PT）、糖类抗原125及199（CA125、199）差异均有统计学意义（均P<0.05）。3组间两两比较，脾虚及肝肾阴虚证的TBIL、PT降低，胆碱酯酶（CHE）升高，脾虚证ALP、CA125、CA199降低（均P<0.05）。结论：原发性肝癌证候分布以虚证为主，尤以脾虚证为多，其次为无症状或无证可辨者（隐证）。不同治法的患者证候分布特征不同。不同证候的理化检查指标存在一定差异，可为辨证提供一定客观依据。 |
| English Summary: |
| To investigate the distribution characteristics of traditional Chinese medicine(TCM) syndromes in primary hepatocellular carcinoma and their correlation with laboratory test indicators.Methods:Clinical information，diagnostic records，and laboratory test results of hepatocellular carcinoma patients were collected.Syndromes were identified by trained TCM practitioners，and their distribution patterns and correlations with treatment methods and laboratory indicators were analyzed.Results:Among 414 patients，75 had metastases.The most common syndrome was spleen deficiency(42%)，followed by latent syndrome，liver-kidney yin deficiency，dampness-heat syndrome，and liver stagnation with spleen deficiency.In metastatic cases，spleen deficiency remained the most frequent syndrome(41%)，with no statistically significant difference from the overall distribution(P>0.05).However，syndrome distribution varied significantly among patients receiving surgery，chemotherapy，or interventional therapy(P<0.05).Significant differences were found in total bilirubin(TBIL)，alkaline phosphatase(ALP)，prothrombin time(PT)，and carbohydrate antigens CA125 and CA199 among spleen deficiency，liver-kidney yin deficiency，and dampness-heat syndromes(all P<0.05).Pairwise comparisons revealed lower TBIL and PT and higher cholinesterase(CHE) in spleen deficiency and liver-kidney yin deficiency syndromes，while ALP，CA125，and CA199 were lower in spleen deficiency syndrome(all P<0.05).Conclusion:Primary hepatocellular carcinoma is predominantly characterized by deficiency syndromes，especially spleen deficiency，followed by asymptomatic or unidentifiable syndrome(latent syndrome).Syndrome distribution differs across treatment methods.Certain laboratory test indicators vary among syndromes，providing objective references for TCM syndrome differentiation. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
