Primary Liver Cancer Of Tcm Syndrome Types And Blood Coagulation Function Correlation Studies

1.The purpose of the researchMake a deep research on the classifying principle of traditional chinese medicine in the Primary hepatic carcinoma (PHC),then explore the correlation of the principle and the coa-gulation function test,provide the basis to the diagnosis、dialectical treatment of the PHC, and estimate the metastasis of tumor and evaluate the future of the disease.2.Research methodDivide the99PHC patients who meet the standard into two parts,one part is simplify pattern of syndrome,it includes qi deficiency,blood deficiency,yin and yang deficiency,spleen deficiency,dampness-heat and cold-dampness,qi stagnation,blood stasis.the other part is compound pattern of syndrome,it consists of qi-stagnation and blood stasis,hot and humid poison together,water retention due to spleen deficiency,deficiency of liver-yin and kidney-yin,stagnation of liver qi and spleen deficiency.Register the number of patients in some special subjects,such as history of smoke and alcohol, basic hepatic disease,volume of the ascitic fluid and hydrothorax,condition of metastasis,child-pugh liver function,Karnofsky performance scale,upper gastrointestinal hemorrhage,hepatic encephalopathy and test of coagulation function(TT,APTT,PT,PTR,INR,FIB).Compare the TCM syndrome with the test of coagulation function,and explore the corrlation of the two subjects,Make the statistic for the data with the SPSS17.0statistical software,using the chi-square test for the enumeration data,and rank sum test for the measurement data,make P<0.05as a test level.3.Result3.1Analysis of the clinical manifestationsAverage age of PHC patients is61.56,the onset of rush hour is centralized to the age of50-59and70-79,and more male patients found in the research with history of basic hepatic diseases (B hepatitis and cirrhosis are more likely occur).For the patients having bad addiction,they are more likely to have the cancer(the highest rate of morbidity in the patients with10-20years history).Most of the PHC patients have the middle weight ascitic fluid,few have the hydrothorax,most of the patients have Karnofsky performance scoring40-70.3.2Distribution rule of TCM syndromeFollowing simplify pattern of syndromes are more seen,it includes qi deficiency, yin deficiency,spleen deficiency,dampness-heat,qi stagnation,blood stasis.Qi-stagnation and blood stasis,hot and humid poison together,water retention due to spleen deficiency,deficiency of liver-yin and kidney-yin,stagnation of liver qi and spleen deficiency are dominated the com-pound pattern of syndrome,we found the diversity between the results of the test of coagulation function(in items of FIB,TT,PT),through the test between the groups,there are the evident diversity between the groups of yin-deficiency and blood stasis,spleen-deficiency,qi-deficiency,qi-stagation in the term of FIB,so we can say the patients of yin deficiency are more likely to occur the abnormal condition in item of FIB, there are diversity in item of PT in the groups between blood stasis and qi stagnation,spleen deficiency and qi deficiency,spleen deficiency and qi stagnation,qi stagnation and yin deficiency.There is obvious diversity between yin-deficiency and other5groups in the items of FIB and TT,and the diversity have the meaning of statistic.there is no evident diversity between the5compound patterns of syndrome in the test of coagulation function.3.3Correlation between the clinical evaluation index of PHC and coagulation functionThere is statistical diversity between different genders in item of PT(%),no obvious diversity between the other items.There is some age diversity in the items of PT(s)、PT(%) and APTT(s), with the change of the age,three items above change simultaeously. Meanwhile, number of PT(s) at age of30-39is the highest in comparison with the other groups,and have evident diversity in comparison with other age groups,There is statistical diversity in the items of PT (S)、PT (%)、APTT (S) at age of the40-49.For patients with basical hepatic diseases,there is no obvious diversity between the B hepatisis and cirrhosis,there is little diversity between the cirrhosis and hepatic cyst in the item of APTT,or it having the lowest number.Smoke and alcohol can make the diversity in coagulation function.First,with the increase of the time of smoke,item of FIB presents a decrease tendency,then,number of the item PTR is generally high in the patients without history of smoke and alcohol.There is obvious diversity between the metastasized patients and no-metastasized patients in the items of PT(%) and FIB in coagulation function.The metastasized patients have high level of numerical value in item of FIB.Patients with upper gastrointestinal hemorrhage have high level of numerical value in items of PT (S)、PT(%)、APTT (S)、PTR、INR,and have diversity with no hemorrhage patients.Patients with hepatic encephalopathy have diversity in the item of APTT,and this comparison have the statistical meaning.Patients with portal vein tumor thrombus have diversity in the item of TT,the diversity have the statistical meaning.Patients with different level of the volume of the seroperitoneum have obvious diversity in the coagulation function.The more seroperitoneum,the worse the coagulation function,Patients without seroperitoneum usually have the better coagulation function,there is the obvious diversity between the two kinds of the patients,and the comparison have the statistical meaning.There is no diversity in the patients with pleural effusion or no pleural efiusion,so there is no correlation between the pleural effusion and the coagulation function.Patients of Karnofskys performance scoring0-30have obvious diversity in the coagulation function with the other groups,the diversity mainly centralized in the items of PT (S)、PT (%)、APTT,and the comparison have the statistical meaning.there is no obvious diversity between the other groups.There is obvious correlation between the different Child-pugh liver function and the coagulation function.The obvious diversity exists in the patients with the different level of the liver function.Patients with level C of liver function have the bad coagulation,with the decrease of the liver function,the level of the coagulation function reduce too.