二、治疗方法
（一）验方观察组；采用自制中药制剂"中肝1号"治疗，"中肝1号"药物与每日剂量为：神仙对坐草、平地木、蛇舌草、半枝莲、羊乳参、虎杖、茵陈各30克，莪术10克。
1．疏肝解郁法：
适应症：两胁间胀满疼痛，胁下有症块，脘腹胀痛，胸闷不舒，纳减呕恶，嗳气泛酸，肢懈乏力，舌红，苔薄，脉弦或涩。
治则：疏肝解郁消症
方药：逍遥散加减（柴胡、当归、徐长卿、杭白芍、茯苓、郁金、藤梨根、炒川芎、平地木、路路通、枳壳、象贝、香附）。治法：疏肝解郁消症。
2．清热解毒法：
适应症：胁下症块坚硬似石，痛如锥刺，面色晦黯，目肤发黄，心烦身热易怒，口干且苦，尿赤便秘，舌红绛苔黄，脉弦或数。
方药：龙胆泻肝汤加减（龙胆草、栀子，柴胡、半枝莲、牛角片、淡芩、川连、蛇舌草、生大黄、虎杖、知母、七叶一支花、犀黄丸、干蟾）。
3．凉血解毒法：
适应症：腹大如鼓、症块膨隆，形体消瘦，肌肤甲错，头晕耳鸣，五心烦热或潮热盗汗，肤烫烦渴，目眩鼻衄，尿赤便秘，舌红少津，苔薄光剥，脉弱细数。
方药：犀角地黄汤加减（羚羊角、生地、白芍、丹皮、炙鳖甲，旱莲草、银柴胡、
4．健脾利水法：
适应症：全腹膨隆，胁下胀痛，身目色黄，头重身困，肢懈无力，胸脘痞满，纳呆尿黄，腹胀便溏，苔厚腻，舌胖红，脉濡。
方药：茵陈五苓散加减（茵陈、茯苓、白术、泽泻、马鞭草、藿佩兰、藤梨根、米仁、半枝莲、大枣、保和丸、炒鸡金）。
5．清热利湿法：
适应症：皮肤、巩膜黄染鲜明，右胁下胀痞疼痛，身热口渴，尿赤便秘，，心中懊恼，恶心欲吐，苔黄腻舌红，脉滑数。
方药；茵陈蒿汤加减（茵陈、大黄、山栀、佩兰、虎杖、泽兰、金钱草、淡芩、半枝莲、半边莲、蛇舌草、牛角片、七叶一枝花、干蟾、犀黄丸）。
适应症：右胁下积块增大，按之坚硬如石，痛而不移，时有寒热，形体膨胀消瘦，体倦乏力，纳少无味，面色灰黑，舌青紫，脉弦细。
方药：膈下逐瘀汤加《金匮》鳖甲煎丸（桃仁、当归、川芎、五灵脂、赤芍、香附、乌药、元胡、炙鳖甲、白芍、蜂房、泽兰、虎杖、地鳖虫，煅牡蛎）。
7．温肾助运法：
适应症：面色萎黄灰黯，面浮肢肿，腹壁静脉怒张，脘闷腹胀，神倦肢冷，小便短少，腰痛背酸，舌质胖，苔白腻，脉沉迟弱。
方药：实脾饮、真武汤加减（白术、茯苓、附子、猪苓、泽泻、芍药、桂枝、赤小豆、米仁、陈皮、生芪、大腹皮）。
8．平肝熄风法：
适应症：面色青黯，形体消瘦，身热，胁下肿块胀痛，头痛眩晕，面红目赤，神昏谵语，烦躁不宁，牙关紧闭，项颈强直，四肢拘急抽搐，舌红绛，苔厚黄糙，脉细弦或弦数。
方药：羚羊钩藤汤合安宫牛黄丸（羚羊角、钩藤、大生地、青龙齿、桑叶、杭白象贝母、地龙、胆南星、安宫牛黄丸或紫雪丹）。
9．泻肝止血法：
适应症：胁下肿块疼痛拒按，鼻衄或齿衄，吐血，便血，头痛目弦，口干且苦，烦躁善怒，便秘，尿短赤，舌红绛，苔黄脉弦数。
治则：凉血泻肝止衄。
方药：丹栀逍遥散合犀角地黄汤（杭白芍、柴胡、茯苓、生军、丹皮、山栀、白茅根、生地、侧柏叶、龙胆草、犀角、仙鹤草、血见愁、参三七）。
10．消痞镇痛法：
适应症：肝癌癌块疼痛，中西药难以奏效，本科拟方自制的"阿魏镇痛膏"，贴敷於癌块表面，十有八九在十分钟后，能达到镇痛效果，方药由生大黄、白芷、川草乌、当归 、 细辛、肉桂、穿山甲、全虫、冰片、没药、乳香、麝香、莪术、雄黄、木鳖子、血竭、青黛、公丁香、生南星组成。
三：治疗效果
验方组三个月内存活率为86．7％，超过六个月存活率为3·3％；辨证论治组三个月内存活率为55．3％，超过六个月存活率为18·5％。辨证论治组的存活期明显高于验方组（见附表）
四、讨论
原发性肝癌的晚期病人，大多只能接受药物治疗，中医药治疗经临床验证，可以减轻肝癌病人的痛苦，改善症状，延长存活,少数可获得数年的存活期。我科经验方与辨证论治组进行比较，观察存活期，结果提示辨证论治组的疗效优于验方组。
二、治疗方法
（一）验方观察组：采用自制中药制剂“中肝1号”进行治疗。“中肝1号”的药物组成及每日剂量为：神仙对坐草、平地木、蛇舌草、半枝莲、羊乳参、虎杖、茵陈各30克，莪术10克。
1．疏肝解郁法：
适应症：两胁间胀满疼痛，胁下有症块（积聚），脘腹胀痛，胸闷不舒，食欲减退伴恶心呕吐，嗳气泛酸，肢体懈怠乏力，舌质红，苔薄，脉象弦或涩。
方药：逍遥散加减（柴胡、当归、徐长卿、杭白芍、茯苓、郁金、藤梨根、炒川芎、平地木、路路通、枳壳、象贝、香附）。治法：疏肝解郁，消散症块。
2．清热解毒法：
适应症：胁下症块坚硬如石，疼痛如锥刺，面色晦暗，目肤发黄，心烦身热易怒，口干且苦，尿赤便秘，舌红绛苔黄，脉象弦或数。
方药：龙胆泻肝汤加减（龙胆草、栀子、柴胡、半枝莲、牛角片、淡芩、川连、蛇舌草、生大黄、虎杖、知母、七叶一支花、犀黄丸、干蟾）。
3．凉血解毒法：
适应症：腹部膨大如鼓，症块隆起，形体消瘦，肌肤干燥粗糙如鳞甲，头晕耳鸣，五心烦热或潮热盗汗，皮肤烫手烦渴，目眩鼻衄，尿赤便秘，舌红少津，苔薄光剥，脉弱细数。
方药：犀角地黄汤加减（羚羊角、生地、白芍、丹皮、炙鳖甲、旱莲草、银柴胡、徐长卿、紫草、半边莲、鲜芦根、知母、地骨皮）。
4．健脾利水法：
适应症：全腹膨隆，胁下胀痛，身目色黄，头重身困，肢体懈怠无力，胸脘痞满，食欲不振尿黄，腹胀便溏，苔厚腻，舌胖红，脉濡。
治则：健脾利水，消除肿胀。
方药：茵陈五苓散加减（茵陈、茯苓、白术、泽泻、马鞭草、藿佩兰、藤梨根、米仁、半枝莲、大枣、保和丸、炒鸡金）。
5．清热利湿法：
适应症：皮肤、巩膜黄染鲜明，右胁下胀痞疼痛，身热口渴，尿赤便秘，心中懊恼，恶心欲吐，苔黄腻舌红，脉滑数。
方药：茵陈蒿汤加减（茵陈、大黄、山栀、佩兰、虎杖、泽兰、金钱草、淡芩、半枝莲、半边莲、蛇舌草、牛角片、七叶一枝花、干蟾、犀黄丸）。
适应症：右胁下积块增大，按之坚硬如石，疼痛位置固定不移，时有寒热交替，形体膨胀消瘦，体倦乏力，纳少无味，面色灰黑，舌青紫，脉弦细。
治则：活血化瘀，软化坚块。
方药：膈下逐瘀汤合《金匮》鳖甲煎丸（桃仁、当归、川芎、五灵脂、赤芍、香附、乌药、元胡、炙鳖甲、白芍、蜂房、泽兰、虎杖、地鳖虫、煅牡蛎）。
7．温肾助运法：
适应症：面色萎黄灰黯，面浮肢肿，腹壁静脉怒张，脘闷腹胀，神倦肢冷，小便短少，腰痛背酸，舌质胖，苔白腻，脉沉迟弱。
方药：实脾饮、真武汤加减（白术、茯苓、附子、猪苓、泽泻、芍药、桂枝、赤小豆、米仁、陈皮、生芪、大腹皮）。
8．平肝熄风法：
适应症：面色青黯，形体消瘦，身热，胁下肿块胀痛，头痛眩晕，面红目赤，神昏谵语，烦躁不宁，牙关紧闭，项颈强直，四肢拘急抽搐，舌红绛，苔厚黄糙，脉细弦或弦数。
方药：羚羊钩藤汤合安宫牛黄丸（羚羊角、钩藤、大生地、青龙齿、桑叶、杭白象贝母、地龙、胆南星、安宫牛黄丸或紫雪丹）。
9．泻肝止血法：
适应症：胁下肿块疼痛拒按，鼻衄或齿衄，吐血，便血，头痛目弦，口干且苦，烦躁善怒，便秘，尿短赤，舌红绛，苔黄脉弦数。
治则：凉血泻肝，止衄血。
方药：丹栀逍遥散合犀角地黄汤（杭白芍、柴胡、茯苓、生军、丹皮、山栀、白茅根、生地、侧柏叶、龙胆草、犀角、仙鹤草、血见愁、参三七）。
10．消痞镇痛法：
适应症：肝癌癌块疼痛，中西药难以奏效，本科拟方自制的“阿魏镇痛膏”，贴敷于癌块表面，十有八九在十分钟后，能达到镇痛效果。方药由生大黄、白芷、川草乌、当归、细辛、肉桂、穿山甲、全虫、冰片、没药、乳香、麝香、莪术、雄黄、木鳖子、血竭、青黛、公丁香、生南星组成。
三、治疗效果
验方组三个月内存活率为86.7％，超过六个月存活率为3.3％；辨证论治组三个月内存活率为55.3％，超过六个月存活率为18.5％。辨证论治组的存活期明显高于验方组（见附表）。
四、讨论
原发性肝癌的晚期病人，大多只能接受药物治疗。中医药治疗经临床验证，可以减轻肝癌病人的痛苦，改善症状，延长存活期，少数患者可获得数年的存活期。我科经验方与辨证论治组进行比较，观察存活期，结果提示辨证论治组的疗效优于验方组。
II. Treatment Methods
(1) Empirical Formula Observation Group: Treated with the self-prepared traditional Chinese medicine preparation "Zhonggan No. 1". The composition and daily dosage of "Zhonggan No. 1" are as follows: *Houttuynia cordata* (Shenxian Duizuo Cao, 神仙对坐草), *Ardisia japonica* (Pingdimu, 平地木), *Hedyotis diffusa* (Shezhecao, 蛇舌草), *Scutellaria barbata* (Banzhilian, 半枝莲), *Ampelopsis glandulosa* (Yangrushen, 羊乳参), *Polygonum cuspidatum* (Huzhang, 虎杖), and *Artemisia capillaris* (Yinchen), each 30g; *Curcuma zedoaria* (Ezhu, 莪术) 10g.
(2) Syndrome Differentiation and Treatment Group: Treated using ten methods based on syndrome differentiation and treatment (Bianzheng Lunzhi, 辨证论治).
1. Method of Soothing the Liver and Resolving Depression:
Indications: Distending pain in both hypochondriac regions, masses under the hypochondrium (Zhengkuai, 症块), distending and painful epigastrium and abdomen, chest tightness and discomfort, reduced appetite with nausea and vomiting, belching with acid regurgitation, limb fatigue and weakness, red tongue with thin coating, wiry or choppy pulse.
Treatment Principle: Soothe the liver, resolve depression, and dissipate masses.
Prescription: Xiaoyao San (Xiaoyao Powder) modified (Chaihu, Danggui, Xuchangqing, Hangbaishao, Fuling, Yujin, Tengligen, Chao Chuanxiong, Pingdimu, Lulutong, Zhike, Xiangbei, Xiangfu). Therapeutic Method: Soothe the liver, resolve depression, and dissipate masses.
2. Method of Clearing Heat and Detoxifying:
Indications: Hard mass under the hypochondrium like stone, stabbing pain like a needle, dull complexion, jaundice of eyes and skin, irritability with restlessness and heat sensation, dry mouth with bitter taste, dark urine with constipation, crimson tongue with yellow coating, wiry or rapid pulse.
Treatment Principle: Clear heat, detoxify, and purge the liver.
Prescription: Longdan Xiegan Tang (Gentiana Decoction for Draining the Liver) modified (Longdancao, Zhizi, Chaihu, Banzhilian, Niujiaopian, Danqin, Chuanlian, Shezhecao, Sheng Dahuang, Huzhang, Zhimu, Qiyeyizhihua, Xihuang Wan, Ganchan).
3. Method of Cooling Blood and Detoxifying:
Indications: Abdominal distension like a drum, protruding masses, emaciation, rough and scaly skin (Jifujiacuo, 肌肤甲错), dizziness and tinnitus, five-palm heat or tidal fever with night sweats, hot skin with thirst, vertigo and epistaxis, dark urine with constipation, red tongue with little fluid, peeled and thin coating, weak, fine, and rapid pulse.
Treatment Principle: Cool blood, detoxify, and nourish yin.
Prescription: Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) modified (Lingyangjiao, Shengdi, Baishao, Danpi, Zhiejiia, Hanliancao, Yinchaihu, Xuchangqing, Zicao, Banbianlian, Xian Lugen, Zhimu, Digupi).
4. Method of Strengthening Spleen and Promoting Water Metabolism:
Indications: General abdominal distension, distending and painful hypochondrium, jaundice of body and eyes, heavy head and lethargic body, limb weakness, chest and epigastric fullness, poor appetite with dark urine, abdominal distension with loose stools, thick and greasy coating, fat and red tongue, soggy pulse.
Treatment Principle: Strengthen spleen, promote water metabolism, and reduce swelling.
Prescription: Yinchen Wuling San (Artemisia Capillaris and Five-Ingredient Poria Pill) modified (Yinchen, Fuling, Baizhu, Zexie, Biancao, Huopeilan, Tengligen, Miren, Banzhilian, Dazao, Baohe Wan, Chao Jijin).
5. Method of Clearing Heat and Promoting Dampness Drainage:
Indications: Bright yellow staining of skin and sclera, distending and painful right hypochondrium, fever and thirst, dark urine with constipation, mental restlessness (Aonao, 懊恼), nausea and urge to vomit, yellow greasy coating with red tongue, slippery and rapid pulse.
Treatment Principle: Clear heat, promote dampness drainage, and resolve jaundice.
Prescription: Yinchen Hao Tang (Artemisia Scoparia Decoction) modified (Yinchen, Dahuang, Shanzhi, Peilan, Huzhang, Zelan, Jinqianncao, Danqin, Banzhilian, Banbianlian, Shezhecao, Niujiaopian, Qiyeyizhihua, Ganchan, Xihuang Wan).
6. Method of Invigorating Blood and Softening Hardness:
Indications: Enlargement of mass in the right hypochondrium, hard like stone upon palpation, fixed pain, intermittent chills and fever, abdominal distension with emaciation, fatigue and weakness, poor appetite with loss of taste, gray-black complexion, bluish-purple tongue, wiry and fine pulse.
Treatment Principle: Invigorate blood, remove stasis, and soften hardness.
Prescription: Gexia Zhuyu Tang (Decoction for Expelling Stasis Below the Diaphragm) combined with Biejia Jian Wan (Mantis Egg Case Pill) from *Jinkui Yaolue* (Taoren, Danggui, Chuanxiong, Wulingzhi, Chishao, Xiangfu, Wuyao, Yuanhu, Zhiejiia, Baishao, Fengfang, Zelan, Huzhang, Dibiechong, Duan Muli).
7. Method of Warming Kidney and Assisting Transportation:
Indications: Sallow and gray-dull complexion, facial and limb edema, distended abdominal wall veins, epigastric stuffiness and abdominal distension, mental fatigue and cold limbs, scanty urination, lower back soreness and spinal ache, fat tongue with white greasy coating, deep, slow, and weak pulse.
Treatment Principle: Warm kidney, strengthen spleen, and assist transportation.
Prescription: Shipin Yin (Solidify the Root Decoction) and Zhenwu Tang (True Warrior Decoction) modified (Baizhu, Fuling, Fuzi, Zhuling, Zexie, Shaoyao, Guizhi, Chixiaodou, Miren, Chenpi, Sheng Qi, Dafupi).
8. Method of Calming Liver and Extinguishing Wind:
Indications: Cyan and dull complexion, emaciation, fever, distending and painful hypochondrial mass, headache and vertigo, red face and eyes, coma with delirious speech, restlessness, locked jaw, stiff neck, limb spasms and convulsions, crimson tongue with thick, yellow, and rough coating, fine wiry or wiry-rapid pulse.
Treatment Principle: Calm liver, extinguish wind, and open orifices.
Prescription: Lingyang Gouteng Tang (Antelope Horn and Uncaria Decoction) combined with Angong Niuhuang Wan (Calomine and Musk Pill for Opening Orifices) (Lingyangjiao, Gouteng, Da Shengdi, Qinglongchi, Sangye, Hang Bai Xiangbeimu, Dilong, Dannanxing, Angong Niuhuang Wan or Zixue Dan).
9. Method of Purging Liver and Stopping Bleeding:
Indications: Painful mass under hypochondrium refusing pressure, epistaxis or gingival bleeding, hematemesis, hematochezia, headache and visual disturbance, dry mouth with bitter taste, irritability and anger, constipation, short dark urine, crimson tongue with yellow coating and wiry-rapid pulse.
Treatment Principle: Cool blood, purge liver, and stop bleeding.
Prescription: Danzi Xiaoyao San combined with Xijiao Dihuang Tang (Hang Baishao, Chaihu, Fuling, Sheng Jun, Danpi, Shanzhi, Baimaogen, Shengdi, Cebaiye, Longdancao, Xijiao, Xianhecao, Xuejianchou, Shen Sanqi).
10. Method of Dissipating Fullness and Relieving Pain:
Indications: Pain from liver cancer masses where Chinese and Western medicines are ineffective. The department formulated a self-made "Awei Analgesic Plaster" applied to the surface of the mass. In most cases, analgesic effects were achieved within ten minutes. The prescription consists of Sheng Dahuang, Baizhi, Chuan Caowu, Danggui, Xixin, Rougui, Shanshanjia, Quanchong, Bingpian, Moyao, Ruxiang, Shexiang, Ezhu, Xionghuang, Muguaizi, Xuexie, Qingdai, Gong Dingxiang, and Sheng Nanxing.
III. Treatment Effects
The three-month survival rate of the empirical formula group was 86.7%, and the six-month survival rate was 3.3%. The three-month survival rate of the syndrome differentiation group was 55.3%, and the six-month survival rate was 18.5%. The survival period of the syndrome differentiation group was significantly longer than that of the empirical formula group (see attached table).
IV. Discussion
Patients with advanced primary liver cancer can mostly only receive drug therapy. Clinical verification has shown that traditional Chinese medicine treatment can alleviate the suffering of liver cancer patients, improve symptoms, and prolong survival, with a minority achieving survival for several years. A comparison between our department's empirical formula and the syndrome differentiation group regarding survival periods indicates that the efficacy of the syndrome differentiation group is superior to that of the empirical formula group.