肝癌血管介入栓塞化疗前后中医证型的变化及其临床意义

目的 探讨肝癌血管介入栓塞治疗前后患者的中医证型变化,发现其内在规律,提高肝癌患者的临床治疗效果.方法 选择行血管介入栓塞治疗的肝癌患者180例.制定肝癌患者介入治疗前后辨证分型回顾性病历调查表,采用多元数据分析方法对症状和体征数据进行样本聚类分析,归纳纳入研究对象的中医证候.结果 血管介入治疗前后比较,患者的中医证候分布差异有统计学意义(P＜0.05),其中,治疗后肝郁脾虚证显著减少,湿热蕴结证显著增加,差异有统计学意义(P＜0.05).进一步对不同介入治疗方法结果分析显示:化疗栓塞治疗前后比较,患者的中医证候分布差异有统计学意义(P＜0.05),其中,治疗后肝郁脾虚证显著减少,湿热蕴结证和脾虚湿困夹瘀证显著增加,差异有统计学意义(P＜0.05);中药联合介入栓塞治疗前后比较,患者的中医证候分布差异无统计学意义(P＞0.05);中药联合化疗栓塞治疗前后比较,患者的中医证候分布差异无统计学意义(P＞0.05),但治疗后气滞血瘀证显著减少,脾虚湿困夹瘀证显著增加,差异有统计学意义(P＜0.05).结论 血管介入治疗中患者的中医证侯处于动态变化之中,对中晚期肝癌进行辨证和辨病相结合,把握住“瘀、毒、虚”互结的病机特点,肝脾同治,提高临床治疗效果.

Changes and Clinical Significance of TCM Syndrome Types of Hepatocellular Carcinoma before and after Transcatheter Arterial Chemoembolization

Objective To explore the changes of TCM syndromes in patients with hepatocellular carcinoma before and after interventional embolization,to find out the inherent laws and improve the clinical effect of patients with liver cancer.Methods 180 patients with hepatocellular carcinoma treated by vascular interventional embolization were selected.To establish a retrospective medical record of patients with hepatocellular carcinoma before and after interventional therapy,to use the data analysis method to analyze the symptoms and signs of the sample clustering analysis,summarized into the study of TCM syndrome.Results There were significant differences in the distribution of TCM syndromes before and after chemotherapy between the 2 groups (P ＜ 0.05).There was significant difference between the 2 groups (P ＜ 0.05).Further analysis of the results of different interventional therapy showed that there was significant difference in the distribution of TCM syndromes between patients before and after interventional embolization chemotherapy (P ＜ 0.05).Among them,the treatment of liver depression and spleen deficiency was significantly reduced,(P ＜ 0.05).There was no significant difference in the distribution of TCM syndromes between the 2 groups (P ＞0.05).Before and after treatment with TCM combined with chemoembolization,the difference was statistically significant (P ＜0.05).However,the blood stasis syndrome was significantly reduced after treatment,and the difference was statistically significant (P ＜ 0.05).The difference was statistically significant (P ＜ 0.05).Conclusion Vascular interventional treatment in patients with syndrome of TCM in the dynamic change.Treatment of advanced hepatocellular carcinoma should be dialectically and disease differentiation combined to hold " blood stasis and toxin,false stasis pathogenesis characteristics and pathogenesis of liver and spleen,improve clinical curative effect.