Correlation Between The Syndrome Classified By Traditional Chinese Medicine And Blood Clotting Disorder In Patients With Medium Or Late Stage Primary Liver Cancer

Primary hepatic carcinoma (PHC)is a kind of malignant neoplasm, Whichoccurs in the hepatocyte or in the epithelial cell of bile duct. In TraditionalChinese Medicine(TCM), it is described under such headings as "distentionof abdomen", accumulation of the liver "abdominal mass", "mass in theabdomen", "jaundice" and "hypochondriac pain". The TCM treatment in PHChas good curative effect. TCM can relieve symptom,raise quality of life,improve liver function,control tumor growth and prolong life span.Determination of treatment based in pathogenesis obtained throu-ghdifferentiation of symptoms and signs is the essence of the treatment in livercancer with TCM. It is also the basic clinical method of modern TCM and hassignificant sense to improve the clinical curative effect. But now there isno unified standard in PHC differentiation of symptoms and signs forclassification of syndrome, so there is important to make unified standardand carry out objective research and supply theory for determine the treatmentbased on differentiation of symptoms and signs.Objective: perfecting the quantitative index relevant to specificsyndrome of PHC, establishing assessing the association between the two inorder to provide objective basis for clinical treatment scheme of hepaticcancer and predicting prognosis.Methods: 163 eligible cases were collected and allocated three groups.They were respectively syndrome of stagnation of liver-QI with deficiency ofthe spleen and qi-stagnancy and.blood stasis; stagnation of vital energy andblood stasis and humid heat congestion and hepatic and renal yin deficiency.Then objective indexes were examined in all cases, 1. Monfactor analysis:comparison of four groups on all indexes including background of the disease,portal vein cancer emblolus, aversion condition, bleeding condition, tumor size, function classification, liver functional parameter, blood clottingfour item, hemanalysis, fecal occult blood, AFP,ESR, Karnofsky by one-wayanalysis. 2. A multivariate analysis of significantly different indexesrelevant to differential syndrome of TCM and blood clotting four items andliver function markers by multiple stepwise regressions.Results: 1. One-way analysis revealed that blood clotting disorder PT,APTT,FIB exist in significant difference among four groups. PT,APTT werefound significant difference between syndrome of stagnation of liver-QI withdeficiency of the spleen,qi-stagnancy and blood stasis and hepatic and renalyin deficiency. The rank order was stagnation of liver-QI with deficiency ofthe spleen,qi-stagnancy and blood stasis,humid heat congestion,hepatic andrenal yin deficiency on the prolong time. FIB was found significant differencein all the four syndromes except syndrome of stagnation of liver-QI withdeficiency of the spleen and humid heat congestion. And the time ofqi-stagnancy and blood stasis was the longest in the four syndromes, hepaticand renal yin deficiency was the shortest. 2. Multiple regression suggestedPT,APTT,FIB,TB,TBA,ESR,Karnofsky were significantly correlated withthe differential syndrome of PHC. PT,APTT,GGT,TB,ESR,TBA were positivecorrelated with it. However, FIB,Karnofsky were negative. 3. AST,ALP,GGTwere significantly correlated with blood clotting function: AST,ALP werepositive correlated with PT; APTT was positive correlated with GGT; GGT wasnegative correlated with FIB.Vonclusions: 1. PT,APTT,FIB were objective indexes that can differentsymptoms and signs for classification of syndrome and predict prognosis ofPHC. 2. From the blood clotting and liver function indexes, we can analyze thatsyndrome of stagnation of liver-QI with deficiency of the spleen andqi-stagnancy and blood stasis is the early or middle stage of PHC, andpatients' general state of health is better relatively, have less bleedingand death; humid heat congestion and hepatic and renal yin deficiency is theadvanced or terminal stage of PHC, patients have bad liver function and bloodclotting function, and serious bleeding and death, and the prognosis is verybad. So the result could reflect a definite pathological course of PHCdeveloping in TCM.