130例原发性肝癌患者舌象的临床分析

通过对130例肝癌和111例其它肝胆疾病患者舌象的对照观察,初步总结认为:肝癌患者主要表现以舌边两侧(即中医舌诊属肝胆区)青紫和绛紫舌居多,并结合舌之瘀斑瘀点、条纹线隆起物及静脉迂曲色变的多少和轻重,一定程度上可反映肝癌的病变程度。青紫舌或绛紫舌患者,肝脏肿瘤多数>5cm,且易在肝内播散,手术切除率和切除后的甲胎蛋白(AFP)转阴率低,易在短期内再发或常致死亡;舌色淡红或仅舌边红赤的肝癌患者,肿瘤多数<5cm,一般无肝内播散,手术切除率及术后甲胎蛋白转阴率高,术后再发时间较长,且二次或三次手术机会亦多。

英文摘要:

By observing changes of the tongue picture during pre-and post-operative period and before and after treatment with Chinese herbal medicine and chemotherapeutic agents in 130 patients with diagnoses of primary liver carcinoma confirmed,the author found that the tongue picture is of great significance in making diagnosis and predicting prognosis of the disease.Color changes mainly appeared at both sides of the tongue,i.e.,at the hepato- biliary zone.Discoloration was chiefly of bluish purple and deep reddish purple type.Various manifestations,such as the presence or absence of color changes,the appearance of petechiae and striae,the number of papillae,the degree of discoloration and the extent of the venule varicosity,all of which may reflect the severity of the underlying disease.Bluish purple or deep reddish purple tongue indicates that the tumor is most likely to be greater than 5 cm or about half the total size of the liver and there is more intrahepatic dissemination.A red tongue or a tongue whose sides are of red color indicates that the tumor is most probably less than 5 cm and there is generally no intrahepatic dissemination.In the presence of a bluish purple or deep reddish purple tongue,the possibility of tumor resection is low,whereas in the presence of a pinkish tongue or a tongue with reddish sides,the possibility of tumor resection is high.Furthermore,in the former cases,even if the tumor can be resected,the post-operative incidence for α- fetoprotein to be converted to negative is low;and even though it is converted to negative,the tumor is liable to recurrence within a short period and leads to death rapidly.In the latter cases,the incidence for α-fetoprotein to be converted to negative is higher,time for recurrence is longer,and even with recurrence,chances for second or third time resection are higher and prognoses are better.

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