| Prostate cancer (PCA) is one of the most common masculine malignant tumors. And the morbidity and mortality is very high. The morbidity is first position and the case-fatality rate is second one among masculine malignant tumors in USA. And the morbidity in China is the third one among masculine malignant tumors in uropoiesis and genital system. There is no the disease name of PCA in Chinese ancient record even if relevant record and delineation has scattered in the categories such as gonorrhea syndrome, uroschesis, aching syndrome and hemorrhagic diseases, etc.Nowdays the principal approach of treatment with PCA by TCM is the determination of treatment based in pathogenesis obtained through differentiation of symptoms and signs (TBPSS) .However, to this day there are no an accepted mode for teaching reference and a magisterial standard for clinicians to follow. Every specialist has different opinion while discussing them. Moreover, these opinions apart from State Standard of the People's Republic of China. The objective of this study is to solve these problems. And initial study about the mode of differentiation of symptoms and signs for classification of syndrome (MDSSCS) was carried out.First, by documents investigation in the past 10 years different opinions about MDSSCS of PCA from some specialists everywhere were carried out. The conclusion is obtained for example that 10 sorts of symptoms and signs such as deficiency of kidney-QI, deficiency of kidney-YIN, deficiency of spleen-QI, deficiency of kidney- YANG, deficiency of both QI and blood, deficiency of both vital energy and yin, blood stasis, toxic heat, damp-heat in lower-JIAO, humid heat, phlegm and blood stasis, etc, which are common symptoms and signs of PCA clinically.Second, investigated retrospective 103 cases of D-stage PCA from the recent 3 years in the Guangdong provincial hospital of TCM was made. And all the MDSSCS and clinical symptoms and their constituent ratio were counted by frequencies analysis. The resultwas obtained for a example that 103 patients were differentiated as 44 sorts of symptoms and signs, most of which are complex symptoms and signs. And there are 9 common sorts of symptoms and signs such as renal deficiency and blood stasis humid heat and blood stasis hepatic and renal yin deficiency, renal deficiency and no-firmness, deficiency of spleen-QI, asdthenic splenonephro-yang, deficiency of both QI and blood, blood stasis, phlegm and blood stasis, etc, the frequencies of occurrence of which are higher. And among the total the rest 30 symptoms and signs appeared only once, which belong to rare ones.There are 69 kinds of symptoms and signs and 29 sorts of tongue demonstrations and pulse tracings in 103 patients on admission. And they composed 9 dimensions such as body and spirit, head and face, chills and fever, digestion, breathing and circulation, uropoiesis and generation, skeleton, tongue demonstrations and pulse tracings, etc.Among all the symptoms and signs the frequencies of occurrence of these symptoms and signs are more higher such as lassitude and debilitation, deficient breath and little word, emaciation, insomnia, whitish and glossless complexion, etiolating complexion, eclipsing complexion, flaring cheeks, dim lip, light-colored lip, chilly, cold limbs, fevering complexion, little urinary stream, pollakisuria and urgency, uroclepsia, odynuria, dry pharynx, nausea, abdominal distention, bearing-down pain on lower abdomen, loose stool, constipation, retained pain, aching pain on waist and knee, etc, which are more common in patients with D-stage PCA.Third, the questionnaire about the symptoms and signs in D-stage PCA was designed, which was based on retrospective investigation on documents and clinical record. By the questionnaire we have carried out some investigation and collected the symptoms and signs in 160 patients with D-stage PCA.Then the statistical analysis was made by SPSS 11.0 statistical package. Firstly, the variance cluster analysis with the symptoms and signs in patients with D-stage PCA was made. And the initial conclusion was obtained that dividing 8 sorts of symptoms and signs is the mode of MDSSCS in patients with D-stage PCA, which is more concise and convenient and practical and consistent with clinical feature.Then the case cluster analysis with 160 patients with D-stage PCA was made. However the two kinds of cluster analysis including variances and cases reached the same goal by different routes. So the result has indicated that the mode of MDSSCS in patients with D-stage PCA can be divided to 8 sorts of symptoms and signs such as syndrome of deficiency of spleen-QI, syndrome of deficiency of both QI and blood, syndrome of hyperactivity of fire due to deficiency of YIN, syndrome of blood stasis, stagnation of blood, svndrome of deficiency of kidney-QI, damp-heat in lower-JIAO, syndrome of yinasthenia and phlegm and fever, syndrome of yang asthenia and so on.Finally, the sensitivity of the mode of MDSSCS was checked by clinical practice. For example, according to the mode of MDSSCS, we made determination of treatment with 50 patients with D-stage PCA based in pathogenesis obtained through differentiation of symptoms and signs while endocrine and nuclide therapy was made with the patients. The AP:PA variance of the means of treatment was compared such as the serum level of PSA, the degree of osteodynia, the numbers of osseous metastasis, etc.And the result has indicated that the mode of MDSSCS included 90% of the sorts of symptoms and signs in 50 patients with D-stage PCA. And the mean of the serum level of tPSA prior treatment was compared with ones on No.l, No.3, No.6 and No.9 month post-treatment;the P values are 0.002, 0.002, 0.001, 0.004, respectively. And the variance between them is significant. Ditto, the P values are 0.003, 0.003, 0.002,0.005, respectively, while the mean of the serum level of cPSA are compared. And the variance between them is significant, too. And the average number of osseous metastasis prior treatment is 5.06 but the descended 4.16 post-treatment. The mean difference is 0.90. And the average number of osseous metastasis prior treatment was compared with ones on No.l, No.3, No.6 and No.9 month post-treatment;the P values are 0.000, 0.000, 0.000, 0.000, respectively. And the remission rate of osteodynia on No.l, No.3, No.6 and No.9 month post-treatment are 33.33%, 77.78%, 80.0%, 73.33%, respectively.Eventually, the study only approached the mode of MDSSCS in patients with D-stage PCA and checked the sensitivity of the mode of MDSSCS by clinical practice in small sample on account of the restriction of time and cases. However, these problems are that whether the mode of MDSSCS in patients with D-stage PCA is correct and convenient to apply and be fit for patients with B-stage PCA and C-stage PCA, which need be checked by clinical practice in multicentre and large sample in future. With some conditional restriction, the study has not established the control group, so the strength of conclusion is influenced. Besides, it is impossible to estimate live time in patients with D-stage PCA through only 1 years or so.
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