肝硬化或肝癌之脈象

The Pulse Phenomenon of Liver Cirrhosis and Hepatoma

本文係從肝硬化與肝癌的臨床實踐，透過中醫脈診與成代醫學檢查互相對照診斷，所體驗出的一套「未治療前肝硬化與肝癌的脈象」指標。本研究病患組是以30個尚未治療前，由現代醫學確診為肝硬化或肝癌為對象；正常對照組分成兒童、成人兩組：經脈診統計結果發現病患組左手寸、尺虛脈為多，尤以左寸虛脈占絕大多數，而正常對照組左手寸、關、尺（注1）三部有虛脈者甚少。故左寸、尺脈虛，特別是左寸脈虛，可作為肝硬化與肝癌的脈象指標。肝硬化與肝癌何以表現為左寸脈蠓的機轉，本文從兩方面加入探討：（一）從本症之病因病機方面探討：(1)外因：寒氣（註2）、濕熱（註3）、邪毒（註4）、化學致病因子（註5）侵入人體；(2)內因：飲食不節、勞慾過度或情志抑鬱，導致肝脾受損、氣血凝滯、脈絡瘀阻（註6）而漸成本症。故正氣（註7）虛虧（註8）、脾腎損傷（註9）為本廷發病的主導地位。（二）從「六脈臟象」五行相生的規律探討：肝木濕熱之邪久滯，木剋脾土，脾氣虛衰，土不生金，肺金氣處，腎臟血流無力，津液失布，導致腎精虧損，腎水不生肝木，肝失濡養，不能生血、藏血以養心，心血不足，故心脈（左寸脈）虛象顯現（註10）。

In traditional Chinese medicine cirrhosis and hepatoma patients will lead to jaundice, mass or lump in the abdomen and distension of abdomen with gas or fluid. ... ..etc. , many symptoms. The main etiology is that human body is attacked by cold. wet, viral. chemical, disease factors, unusual food and drink, overstrain or anxiety, so lead to the impairment of liver and kidney, stagnation of vital energy and stasis of blood, deficiency of Yang of the kidney, disturbance in metabolic function, impairment of Yang would impede generation of Yin... ... etc. In view of modem medicine, that's because of the malfunction of internal organs, disorder of the nervous system and metabolism, and maladjustment of immune system. With many symptoms and complications, different disease stages have different signs, so the differential diagnosis is not completely the same. This paper just offer the pulse condition of untreated cirrhosis or hepatoma as reference. After examining 30 untreated patients (patient group), who have confirmed as cirrhosis or hepatoma by western medicine diagnosis. We find the most patients are weak pulse on left Ts'un pulse and left Ch'ih pulse by chinese medicine. especially on left Ts'un pulse. Besides, there're 2 normal controlled groups: one group is consisted of 30 healthy children aged 12, and the other one is consisted of 30 healthy adults aged 35-55. The result indicates that few patients are weak pulse on left Ts'un pulse, left Kuan pulse and left Ch'ih pulse. According to our study, we find left Ts'un weak pulse has highly significant difference in liver cirrhosis and hepatoma patients. It's certainly valuable for clinical practice doctors when they examine patient's condition.