| Objective:Through a retrospective investigation and analysis of the medical record data of 96 patients with primary liver cancer, especially repeatedly hospitalized patients condition data, recorded four diagnostic data and laboratory test results, complications, related factors, counted and analysed distribution and evolvement rule of TCM syndrome type of primary liver cancer, provided reference for the Chinese medicine treatment of the disease. Methods:Collected liver cancer cases included in standard of traditional Chinese medicine department of the first affiliated hospital of Nanchang university from January 2015 and December 2015, recorded patients' gender, age, symptoms, signs, diagnosis of traditional Chinese medicine or TCM four diagnostic data, laboratory test results, the onset time, complications, such as the cause of death data, then we used SPSS21.0 statistical software to analyze data. Specific methods: 1, the enumeration data is analyzed by the method of frequency and composition, and graphics were exported. Compared differences between groups by chi-square test.2, Describe the characteristics measurement data by the mean and standard deviation(X ±S),the difference between groups were dealt by LSD test(equal variance),or by GamesHowell test(heterogeneity of variance). 3, Ranked data was dealt by Kruskal-Wallis or Mann-Whitney test. Results:112 medical records were collected, of which 96 were valid, 33 repeated, and the actual number was 76. The number of women patients was 14, while the men 82.All of the patients the youngest was 38 y,the oldest was 83 y.The average age was 58.61±58.61 y, the median age was 58.00 y, age of the onset peaks was 46-50 y. Clinical stage : ? A 4 cases, ? A 19 cases, ? B 26 cases, ? A 27 cases, ? B20 cases.The characteristics of TCM syndrome type distribution: 28 cases was liver stagnation and spleen deficiency syndrome, 17 cases was qi stagnancy and blood stasis syndrome, 24 cases was Heat-Damp Syndrome, 27 cases was. All ? stage patients 24 liver stagnation and spleen deficiency syndrome accounted for the major proportion, All ? stage patients 23 deficiency of liver-yin and kidney-yin syndrome accounted for the major proportion.All TCM syndrome type distribution and changes of the repeated patients, there were 6 cases of liver stagnation and spleen deficiency syndrome when the first time. When the second time, 1 cases of qi stagnancy and blood stasis syndrome and 2 cases of Heat-Damp Syndrome changed into deficiency of liver-yin and kidney-yin syndrome, and 1 cases of qi stagnancy and blood stasis syndrome changed into liver stagnation and spleen deficiency syndrome, 1 case of liver stagnation and spleen deficiency syndrome changed into qi stagnancy and blood stasis syndrome. When the third time,1 cases of live stagnation and spleen deficiency syndrome changed into qi stagnancy and blood stasis syndrome. When the forth time,1 cases of qi stagnancy and blood stasis syndrome were the only 1 inpatients.The mean value of Albumin was 32.8469 ± 3.90330 g/l, total bilirubin( TBL) 45.74±74.32 umol/ml, direct bilirubin31.76±59.45umol/ml, prothrombin time(TP) 12.64±2.9 S, activated partial thromboplastin time(APTT) 34.51±6.87 S, compared every two groups, P values are less than 0.05, the difference has significant meaning.During observation period 1 year, 11 patients died, of which 10 people belonged to deficiency of liver-yin and kidney-yin syndrome, 1 patient belonged to Heat-Damp Syndrome.All of the 11 patients,4patients died from hepatorrhexis, 3 cases died from hepatic encephalopathy, 2 patients died from metabolic disturbance,1 patient died from respiratory failure, 1 case died of gastrointestinal bleeding. The average survival time was 17.27±10.13 months. Conclusions:?In the retrospective study, primary liver cancer incidence peak was 46-50 years old, male-female sex ratio was 5.86:1, similar to clinical reports. Actually 67 cases,67.79% of the patients, infection with hepatitis b. As hepatitis b was significantly correlated with liver cancer.?The middle-late primary liver cancer patients was more current, a total of 92 patients were stage?, ?, accounted for 95.83% of 96 cases of primary liver cancer,?Deficiency of liver-yin and kidney-yin syndrome and liver stagnation and spleen deficiency syndrome were more than others. The former was 28 cases(29.17%),and the latter was 27 cases(28.13%).All of the liver function, blood coagulation function of the deficiency of liver-yin and kidney-yin syndrome, are generally poor, while Qi stagnancy and blood stasis syndrome, liver stagnation and spleen deficiency syndrome and Heat-Damp Syndrome were better, and more stable.?Evolution regular pattern of TCM syndrome: Qi stagnancy and blood stasis syndrome and liver stagnation and spleen deficiency syndrome can be mutual transformed in a certain period, belong to reversible changes. the illness is stable in that time.Qi stagnancy and blood stasis syndrome, liver stagnation and spleen deficiency syndrome and Heat-Damp Syndrome changed into the deficiency of liveryin and kidney-yin syndrome when liver cancer progressing. it was irreversible, most of them died in a short term after the exacerbate.?According to the evolvement rule of syndrome, we found that as the disease progresses, Healthy qi was decreasing, while pathogenic factor was increasing. The tender pointed out direction of traditional Chinese medicine in the prevention and treatment of primary liver cancer.The loss and weak of Healthy qi was continuous, so the thought of Strengthening Body Resistance must be throughout the treatment, we should paid attention to eliminate pathogenic factors also.In advanced stages, More attention should be paid to increase the strength the Body Resistance when the pathogenic factor rised as the main contradiction.?Traditional Chinese medicine participated inadequate in treatment of primary hepatocellular carcinoma. To exert the advantages of Chinese medicine as a holistic dialectical treatment of tumor better,we should pay more attation in the surgery, targeted drug patient selection,precancerous lesions to the whole course of the syndrome differentiation and treatment start and full clinical trials,. |
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