肝癌并发上消化道出血的危险舌象分析

目的:以望舌为主了解原发性肝癌并发上消化道出血的危险因素,为临床预防提供依据。方法:收集737例原发性肝癌患者的临床资料,并使用标准化舌象采集环境获取其临床舌象,由医学专家给出舌象诊断,使用条件Logistic回归对肝癌并发上消化道出血的危险因素进行筛选。结果:舌色按由淡白、淡红到红进行分类,结果显示上消化道出血的主要危险因素主要与肝癌临床分期(OR=3.607,P=0.000)、舌形异常(OR=3.295,P=0.005)、舌下脉形状(OR=1.558,P=0.008)和血清总胆红素水平(OR=1.008,P=0.015)有关;而舌色按紫与不紫进行分类,结果显示舌色也与肝癌并发上消化道出血密切相关(OR=1.989,P=0.047)。结论:舌体胖大、舌下脉增粗或迂曲、舌色见紫、肝癌临床分期进展和血清胆红素水平过高均为上消化道出血的危险因素,以舌象观察为主可望作为一种预测肝癌并发上消化道出血的简捷方法。

Analysis on Risk Tongue Demonstrations in Patients with Primary Liver Cancer Complicated with Upper Gastrointestinal Bleeding

Objective:To study risk factors of tongue in patients with primary liver cancer complicated with upper gastrointestinal bleeding,and supply a reliable basis for preventing this disease.Method: Seven hundred and thirty-seven patients with primary liver cancer were collected,and their tongue demonstrations were obtained under standardized circumstances,and diagnosed by ten experts based on Delphi evaluation.A conditional logistic regression analysis was employed for screening risk factors of upper gastrointestinal bleeding in patients with liver cancer.Result: Primary liver cancer complicated with upper gastrointestinal bleeding was significantly correlated with such factors as clinical stage(OR=3.607,P=0.000),abnormal shape of tongue(OR=3.295,P=(0.005)),abnormal shape of sublingual veins(OR=1.558,P=0.008)and serum total bilirubin(OR=1.008,P=0.015)when the classification of tongue color was based on pale white,damask and red.Irregular tongue color was also correlated with primary liver cancer complicated with upper gastrointestinal bleeding(OR=1.989,(P=0.047)) if the classification of tongue color was based on purple or not.Conclusion: Fat tongue in shape,wide or tortile sublingual veins,purple tongue,advanced clinical stage and abnormal level of serum total bilirubin are the risk factors of primary liver cancer complicated with upper gastrointestinal bleeding,and the observation of tongue demonstration is hoped to be a helpful and easy method for the prediction of upper gastrointestinal bleeding in patients with primary liver cancer.