| 1 ObjectsTo explore the correlation between TCM syndromes and biochemical indexes,BCLC staging and child-pugh grading in Hepatocellular Carcinoma(HCC)patients.2 MethodsA total of 120 HCC patients were screened out according to the inclusion and exclusion criteria,and the basic information,basic medical history,TCM syndrome and biochemical indicators of the patients were collected.Based on their clinical symptoms and four diagnostic data,120 HCC patients were classified into five different syndromes by two or more associate chief physicians Spss21.0 statistical software was used for data statistics and analysis.General statistical description,chi-square(χ~2)test and rank sum test were adopted to observe the correlation between different TCM syndromes and biochemical indicators,BCLC staging and child-pugh grading.3 Results3.1 Syndrome type distribution of 120 HCC patients:120 HCC patients were collected,including 97 male patients and 23 female patients,with a male to female ratio of about 4.22:1.Males were the common among all syndromes.The mean age of 120 patients was 57.42±11.05 years.Among them,42(42/120)cases were of liver depression and spleen deficiency,accounting for 35%.There were 24(24/120)cases of liver stagnation and qi stagnation,accounting for 20%.There were 21(21/120)cases of damp-heat accumulation type,accounting for 17.5%.There were 19(19/120)cases of qi stagnation and blood stasis,accounting for 15.8%.There were 14(14/120)cases of liver-kidney Yin deficienc y,accounting for 11.7%.3.2 Correlation between TCM syndromes and BCLC stages:Among the 120 patients,there were 58 patients in stage A of BCLC stage,in cluding 24(24/58)patients with liver stagnation and spleen deficiency,18(18/58)patients with liver stagnation and qi stagnation,9(9/58)patients with qi stagnation and blood stasis,6(6/58)patients with damp-heat accumulation,and 1(1/58)patients with liver and kidney Yin deficiency.Among the 120 patients,there were 29patients in stage D of BCLC stage,including 2(2/29)patients with liver stagnation and spleen deficiency,3(3/29)patients with liver stagnation and qi stagnation,8(8/29)patients with damp-heat accumulation,7(7/29)patients with qi stagnation and blood stasis,and 9(9/29)patients with liver and kidney Yin deficiency.BCLC staging was inconsistent among the five groups of HCC patients,with statistically significant differences(P<0.05).BCLC staging in patients with liver stagnation and spleen deficiency was similar to that in patients with liver stagnation and qi stagnation and blood stasis.Moreover,BCLC stage C and stage D in patients with Yin deficiency of liver and kidney and accumulation of dampness and heat were mainly stage C and stage D,with relatively poor condition.3.3.Relationship between TCM syndromes and Child Pugh grading:Among the 120 patients,there were 63 patients with grade A,34 patients with grade B,and 23 patients with grade C.There were 30(30/63)patients with grade A liver depression and spleen deficiency,accounting for 47.6%.There were 19(19/63)cases of liver stagnation and qi stagnation,accounting for 30.2%.Damp-heat accumulation type 6(6/63),accounting for 9.5%;Qi stagnation and blood stasis type6(6/63),accounting for 9.5%;Liver and kidney Yin deficiency type 2(2/63)cases,accounting for 3.2%.There were 10(10/34)cases with grade B liver depressionand spleen deficiency,accounting for 29.4%.Liver stagnation and qi stagnation type3(3/34)cases,accounting for 8.8%;There were 9(9/34)cases of damp-heat accum ulation type,accounting for 26.5%.9 cases(9/34)with qi stagnation and blood stasis syndrome,accounting for 26.5%;Liver and kidney Yin deficiency type 3(3/34)cases,accounting for 8.8%.Grade C,liver depression and spleen deficiency type 2(2/23)cases,accounting for 8.7%;Liver stagnation and qi stagnation type 2(2/23)cases,accounting for 8.7%;Damp-heat accumulation type 6(6/23)cases,accounting for26.1%;Qi stagnation and blood stasis type 4(4/23)cases,accounting for17.4%;There were 9(9/23)cases of liver-kidney Yin deficiency,accounting for 39.1%.According to the statistics,liver function reserve status of liver depression andspleen deficiency type and liver stagnation and qi stagnation type were better in TCM syndromes.And liver kidney Yin deficiency liver function reserve state is poorer.3.4 Relationship between TCM syndromes and alpha-fetoprotein:Statistics showed that there was no significant difference in the three types of liver depression and spleen deficiency,liver depression and qi stagnation,and qi stagnation and blood stasis(P>0.05),indicating that the AFP levels of the three types were not significantly different.The comparison of liver and kidney Yin deficiency with liver stagnation and spleen deficiency,liver stagnation and qi stagnation and blood stasis showed statistical significance(P<0.05),indicating that the AF Plevel of liver and kidney Yin deficiency was significantly higher than the threetypes.However,there was no significant difference between liver and kidney Yin deficiency and damp-heat accumulation type(P>0.05),indicating that the level of AFP in liver and kidney Yin deficiency type was similar to that in damp-heat accumulation type.3.5 Relationship between TCM syndromes and prothrombin:According to the statistics,there were statistical differences in the prothrombin time between the liver depression and spleen deficiency type and the damp-heat accumulation type and the liver-kidney Yin deficiency type(P<0.05),indicating that the coagulation function of the patients with liver depression and spleen deficiency was more likely to be superior to the damp-heat accumulation type and the liver-kidney Yin deficiency type.At the same time,there were statistical differences in the coagulation function state of liver-kidney Yin deficiency type,liver-qi deficiency type and liver-qi stagnation type,which indicated that the coagulation function state of liver-kidney Yin deficiency type was more likely to be worse than other types.There was no significant difference in coagulation function bet ween the damp-heat accumulation type and the liver-kidney Yin deficiency type,indicating that the coagulation function of the two types of patients was similar,and the possibility of the damp-heat accumulation type and the liver-kidney Yin deficiency type were worse than the other three types.4 Conclusions4.1 The 120 HCC patients were mainly middle-aged males,ranging in age from 30 to 78 years.The average age of patients with liver and kidney Yin deficiency was older,while the average age of patients with qi stagnation and blood stasis was younger.4.2 The BCLC stages of liver stagnation and spleen deficiency,liver stagnation and qi stagnation,qi stagnation and blood stasis in 120 HCC patients were mainly stage A and stage B.The stages of liver and kidney Yin deficiency and damp-heat accumulation BCLC were mainly stage C and stage D.4.3 Among the 120 HCC patients,the liver function reserve status of the type ofliver stagnation and spleen deficiency and the type of liver stagnation and qi stagnation in the Child Pugh grade was good.But liver and kidney Yin deficiency type,heat and damp accumulation type liver function reserve state is poor.4.4 Among the 120 HCC patients,prothrombin time prolongation and relatively high AFP levels were mainly characterized by dampness and heat and Yin deficiency of liver and kidney,which may be related to the severity and malignancy of the disease.4.5 Among the 120 HCC patients,most of the patients with liver-kidney Yin deficiency were in stage C and D of BCLC stage,and the liver function reserve state was poor,so the disease was severe,followed by the damp-heat accumulation type and qi stagnation and blood stasis type.Therefore,TCM syndrome differentiation has certain value in guiding the treatment of HCC by TCM. |
PDF Full Text Request