终末期肝病模型与原发性肝癌患者中医证候的相关性研究(1)
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摘 要：目的：探讨终末期肝病模型(MELD)与原发性肝癌患者中医证候的相关性。 方法：回顾性分析278例原发性肝癌患者资料。采用判别分析研究MELD评分与患者中医证候的相关性。 结果：中医辨证为单证、两证、三证和四证相兼(包括四证以上)患者间的MELD评分差异有统计学意义(F8.322，P0.000)；MELD评分按照单证、两证、三证和四证相兼的顺序逐渐递增。MELD评分<6分、6～10分和>10分判别患者的中医证候是单证、两证、三证或四证相兼的符合率分别为48.3%、65.1%和94.3%。结论：MELD评分与原发性肝癌患者中医证候具有一定的相关性；患者的MELD评分越高，患者的中医证候越复杂；当MELD评分>10分时，患者多为复合证。
关键词：肝肿瘤；中医；证候；终末期肝病模型
中图分类号：R735.7 文献标识码：A 文章编号：1673-7717(2011)04-0873-05
Model for End-stage Liver Disease Score and Syndromes of TCM in
Patients with Primary Hepatic Cancer
WEN Jie, ZHU De-zeng
(Department of Traditional Chinese Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China)
Abstract:Objective: To investigate the relationship between model for end-stage liver disease (MELD) score and syndromes of TCM in patients with primary hepatic cancer (PHC). Methods: A total of 278 patients with PHC were enrolled into the study from January 2005 to April 2009. MELD score was calculated for each patient following the original formula on the first day of admission. All patients were followed up at least 1 year. Discriminant analysis was used to estimate the correlation and significance between the syndromes of TCM in patients with PHC and the corresponding MELD score. Results: MELD scores were statistically significant between the single syndrome and complicated syndromes of TCM in patients (F8.322, P0.000). The more complicated syndromes of TCM were, the higher MELD scores were. MELD scores <6, 6～10 and >10, combined with age, tumor size and clinic biochemistry parameters, could discriminate the syndromes of TCM in PHC patients and the coincidence rate of discriminant was 48.3%, 65.1% and 94.3%, respectively. Conclusions: There is a significant correlation between the MELD scores and TCM syndromes in patients with PHC. The more complicated syndromes of TCM were, the higher MELD scores were. MELD scores >10 may accompany complicated syndromes of TCM in patients with PHC.
Key words:liver neoplasmsTCMsyndromeMELD
收稿日期：2010-11-30
作者简介：文洁(1980-)，女，四川成都人，主治医师，博士，研究方向：中西医结合防治肝癌。
通讯作者：朱德增(1955-)，男，上海人，主任医师、教授，博士研究生导师，研究方向：中西医结合防治肝病、糖尿病。
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