Analysis Of The Characteristics Of 128 Cases Of Traditional Chinese Medicine Syndrome Of Primary Liver Cancer And The Correlation Analysis Of The Time Of Recurrence After Ablation

Objective:By observing the distribution of TCM syndromes in untreated patients with primary liver cancer and the correlation analysis of the recurrence time after primary ablation of liver cancer(including radiofrequency ablation and microwave ablation),the TCM syndromes of primary hepatocellular carcinoma Distribution and the factors influencing the recurrence time after ablation.It provides the basis for TCM syndrome differentiation and primary liver cancer,and provides the basis for predicting and preventing early recurrence of liver cancer ablation.Methods:Selected from January 2014 to November 2016 Henan University of Traditional Chinese Medicine First Affiliated Hospital outpatient and ward treatment,untreated primary liver cancer cases 128 cases,which meet the inclusion,excluding standard cases.Data were collected from patients with basic information,history,tongue pulse and clinical indicators and other data;by the Chinese medicine chief physicianandChinesemedicineattendingphysicianintheprincipleof nonintervention on the syndrome analysis;statistical analysis software using SPSS20.0,to take the general statistical description,Χ~2)test,Wilcoxon rank sum test,Kruskal-wallis rank sum test.A total of 36 cases of primary liver cancer treated by ablation were collected,including 2 cases,13 of them were selected,including sex,age,TCM syndrome,jaundice,ascites,bclc stage,preoperative AFP,liver cancer,liver function Child-Pugh classification,the number of hepatic lesions,hepatitis b history and history of liver cirrhosis.The survival analysis among the factors was single factor analysis,and the survival(log rank test)method was used to test the survival distribution among the factors,and Cox regression model was introduced for multi-factor analysis.Results:1untreated primary liver cancer TCM syndrome distribution is as follows:In this study,128 patients with primary liver cancer were collected,accounting for29.7%(38/128),39.5%(48/128)of qi stagnation and blood stasis syndrome,14.8%(19.8%)/128);liver and kidney yin deficiency accounted for 17.9%of the total(23/128);which the highest proportion of qi stagnation of blood stasis,dampness and blood stasis at least.Among them,there were 101 males and 27 females with male to female ratio of 4.1:1.There was no difference between males and females(P>0.05).The age of primary hepatocellular carcinoma was 57.72±11.84 years old.The age distribution was the highest and the age of liver and kidney was the highest.The age difference between the two groups was statistically significant(P>0.05).There were98 patients with HBV infection in primary hepatocellular carcinoma,the overall infection rate was 76.56%;HBV infection rate was the highest,accounting for 94.73%.The HBV infection rate of liver depression and spleen deficiency syndrome and qi stagnation and blood stasis syndrome were 71.05%And 72.92%respectively.The infection rate of HBV was 78.26%.The infection rate of HBV was significantly higher than that of liver and spleen deficiency syndrome and qi stagnation and blood stasis syndrome(P<0.05).In this study,the liver function Child-pugh grade A grade 77 cases,B grade 33 cases,C grade 18 cases;which liver depression spleen deficiency syndrome,qi stagnation blood stasis syndrome,the best liver function,A group accounted for 86.8%and64.6%(P<0.05).The liver function reserve was the worst and the liver function of grade C was 39.1%.The liver function reserve was related to TCM syndromes(P<0.05).Liver and kidney yin deficiency syndrome and liver qi and spleen deficiency syndrome,qi stagnation blood stasis syndrome,damp heat poisoning liver function reserve status are different.In this study,the stage of BCLC staging was the highest,accounting for 57.3%,and the stage of liver and kidney yin deficiency was the highest in stage D,accounting for47.8%.There was significant difference between the four groups(P<0.05).Liver stagnation and spleen deficiency tumor staging and qi stagnation of blood stasis,damp-heat stasis and liver and kidney yin deficiency between the differences,liver and kidney yin deficiency syndrome and qi stagnation blood stasis tumor staging are different.In this study,the size of tumor lesions in less than 5cm in 24 cases,accounting for63.16%of liver and spleen deficiency syndrome,liver and kidney yin deficiency in the tumor size of 5-10cm in 15 cases,accounting for liver and kidney Card of 65.21%,by statistical analysis,tumor size and TCM syndromes related.Liver and spleen deficiency syndrome and liver and kidney yin deficiency of the tumor size of the difference,the other groups were no significant difference.In this study,there were no portal vein tumor thrombus in 87 cases,there were 41cases of portal vein thrombosis,of which the formation of portal vein thrombosis of liver depression and spleen deficiency was the least,only 4 cases,accounting for10.52%of the group,followed by qi stagnation and blood stasis,Accounting for 27%,liver and kidney yin deficiency portal vein thrombosis up to 16 cases,accounting for69.6%of the group,with the progress of TCM syndromes,portal thrombosis rate group increased,statistical analysis,Chinese medicine The formation rate of different portal vein thrombosis was different(P<0.05).Liver and kidney yin deficiency,damp-heat poisoning portal vein thrombosis is higher than the incidence of liver depression and spleen deficiency,liver and kidney yin deficiency portal vein thrombosis is higher than qi stagnation of blood stasis.In this study,there were 34 cases of extrahepatic metastasis of primary hepatocellular carcinoma,and no extrahepatic metastasis was found in 94 cases.The liver metastasis rate of liver depression and spleen deficiency was the lowest,which was only 7.9%of the group,followed by qi stagnation and blood stasis,accounting for 20.83%,Liver and kidney yin deficiency of the extrahepatic metastasis rate of the highest,accounting for 52.2%of the group;for statistical analysis,different TCM syndrome extrahepatic metastasis may be different(P<0.05).Liver and kidney yin deficiency of liver metastases than liver depression and spleen deficiency syndrome,qi stagnation blood stasis syndrome,dampness and heat poisoning of the extrahepatic metastasis rate is higher than liver and spleen deficiency syndrome.2factors of recurrence after primary liver cancer ablation were as follows:Single factor analysis showed that preoperative AFP value,and the size of the lesions in the liver and TCM syndrome types,number of intrahepatic lesions,5 factors such as history of hepatitis b and recurrence was statistically significant(P<0.05),while sex,age,jaundice,ascites Child grading,BCLC tumour stage,liver cirrhosis,liver function between recurrence and the influence factors,such as history of no statistical significance(P>0.05).For element analysis will have significant factors in the single factor analysis and jaundice,history of BCLC,cirrhosis of the liver cancer stage introduction of COX model analysis of many factors,according to the size of the regression coefficient absolute value can be concluded that the biggest effect after ablation of liver cancer lesion size,followed by the second liver disease history,and at last the preoperative AFP value;Conclusion:This study found that the incidence of male patients with primary liver cancer than women,hot and humid poison stasis HBV infection rate was significantly higher liver spleen deficiency and qi and blood stasis.2 In this study,liver function reserve,tumor staging,tumor embolus,extrahepatic metastasis,tumor size and TCM syndrome type has a certain relation with TCM syndrome evolution,hepatic reserve variation,tumor clinical stage D increased,portal vein tumor thrombus and extrahepatic metastasis patients increased and the tumor increased,treatment to provide clinical basis for TCM Syndrome differentiation.3 the study found that the traditional Chinese medicine syndrome type,preoperative AFP value,intrahepatic disease focal size,number of intrahepatic lesions,preoperative AFP value is a risk factor for primary liver cancer ablation in the treatment of postoperative recurrence.4 liver lesion size of this study is primary liver cancer recurrence independent risk factors after ablation,merge the hepatitis b virus are risk factors for recurrence of liver cancer,preoperative AFP negative to extend the time of primary liver cancer recurrence.