原发性肝癌中医诊疗指南(2026年)

原发性肝癌中医诊疗指南（2026年）汇报人李秀惠日期2026年辨证分型·方药施治·疗效评价·中西融合指南导览01指南背景与病机认识疾病负担与标准化必要性url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")02辨证分型体系四大主型与兼夹证辨识url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")03辨证方药推荐分型对应方剂与药物组成url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")04特色疗法与中成药针灸外治与成药应用url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")05疗效评价标准四位一体多维评价体系url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")06中西医融合路径MDT框架下的中医药定位url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")01指南背景与病机认识规范辨证，方能精准施治疾病负担沉重，标准化诊疗势在必行疾病负担与标准化背景原发性肝癌是我国第4位常见恶性肿瘤、第2位肿瘤致死病因疾病负担与中医药价值3项疾病负担沉重严重威胁人民生命健康，疾病负担沉重。中医药疗效显著在改善症状、减少不良反应、延长生存期、改善生活质量等方面临床疗效显著。评价标准缺失目前尚无统一的辨证及疗效评价标准，缺少高水平的循证医学依据。url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")指南标准信息3项标准编号

T/CACM1575—20242024年1月23日由中华中医药学会正式发布。牵头与起草由北京佑安医院李秀惠教授牵头制定，中华中医药学会肝胆病分会承担起草。制定路径文献研究、专家访谈、问卷调查、共识会议，2023年12月26日完成公示征求意见。url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")疾病负担与中医药价值3项疾病负担沉重严重威胁人民生命健康，疾病负担沉重。中医药疗效显著在改善症状、减少不良反应、延长生存期、改善生活质量等方面临床疗效显著。评价标准缺失目前尚无统一的辨证及疗效评价标准，缺少高水平的循证医学依据。url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")病机认识与演变规律早期中期晚期以实为主证候特点多见肝郁脾虚虚实夹杂证候特点多见气滞血瘀兼脾虚毒盛邪盛正虚证候特点多见肝胆湿热或肝肾阴虚病位在肝，与脾、肾三脏功能失调关系密切url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")病机认识中医归属原发性肝癌属积聚、臌胀、黄疸、癥瘕范畴病因情志不遂、饮食失节、湿热内蕴，日久酿生本病病机核心正虚邪实，气滞、血瘀、湿毒相互胶结url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")02辨证分型体系四型为纲，兼夹为目主型定方向，兼夹定细节四大主型总览证型核心病机典型症状舌脉肝郁脾虚肝失疏泄，脾失健运胁痛走窜，食少乏力舌淡红苔薄白，脉弦细气滞血瘀气行不畅，瘀阻肝络肿块刺痛，面色晦暗舌紫暗有瘀斑，脉弦涩湿热蕴结湿热内蕴，聚而成毒身目发黄，发热口苦舌红苔黄腻，脉弦滑数肝肾阴虚久病耗阴，肝络失养隐痛烦热，腰酸消瘦舌红少苔，脉细数指南确立肝郁脾虚、气滞血瘀、湿热蕴结、肝肾阴虚四大主型肝郁脾虚证与气滞血瘀证肝肝郁脾虚证主证胁肋胀痛走窜不定，情志抑郁或烦躁易怒，脘腹胀满，食少纳呆，神疲乏力，大便溏薄舌脉舌质淡红，苔薄白或薄腻，脉弦细病机肝气郁结，横逆犯脾，脾失健运治则疏肝健脾，理气行滞瘀气滞血瘀证主证胁下肿块刺痛或胀痛，痛有定处，入夜尤甚，面色晦暗，或见赤丝血缕，肌肤甲错舌脉舌质紫暗或有瘀斑瘀点，脉弦涩病机肝气郁结日久，血行不畅，瘀血停滞肝络治则活血化瘀，理气散结url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")湿热蕴结证与肝肾阴虚证湿湿热蕴结证主证胁下痞块坚实，痛如锥刺，脘腹胀满，身目发黄鲜明如橘色，发热口苦，小便黄赤，大便秘结舌脉舌质红，苔黄腻，脉弦数或滑数病机外感湿热或饮食不节，湿浊内生，郁而化热，蕴结成毒治则清热利湿，解毒退黄url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")阴肝肾阴虚证主证胁肋隐痛绵绵不休，遇劳加重，头晕目眩，五心烦热，低热盗汗，腰酸膝软，形体消瘦舌脉舌红少苔或光剥有裂纹，脉细数或细涩病机久病耗伤肝肾之阴，或肝郁化火灼伤阴液治则滋补肝肾，养阴柔肝url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")兼夹证型与灵活辨治临床辨治当灵活掌握，不必机械套用单一分型脾虚湿困证纳呆腹胀、便溏肢困舌淡胖有齿痕，脉濡缓肝热血瘀证舌暗红，口干不欲饮肝区剧痛，脉弦涩气阴两虚证神疲乏力兼见口干咽燥正虚瘀结证多见于晚期，正气大伤，瘀血内结肿块坚硬如石痰湿凝结证脘腹胀满，身重便溏舌体胖大灵活辨治原则灵活辨治临证不必拘于某一分型，根据病程长短与具体表现灵活掌握病机演变正虚邪实，早期肝郁脾虚以实为主，晚期邪盛正虚03辨证方药推荐方从法出，法随证立一证一方，随证加减治则治法总纲主要治法疏肝理气健脾化湿活血化瘀清热利湿滋补肝肾软坚散结治法流派各有所宗于尔辛以健脾理气立法，验证可抑制肿瘤增殖、诱导凋亡刘茂甫病位在肝、其本在肾、其标在瘀，主张补肾化瘀吴良村肝癌寒热错杂、虚实共存，多用清热解毒药临床策略：肝癌以虚为本，首当固本，兼以理气、祛瘀、清热解毒治疗核心：扶正祛邪，攻伐与补益结合，中病即止以免伤正url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")肝郁脾虚证方药治法要点疏肝理气，活血化瘀，佐以健脾url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")推荐方剂逍遥散加减，或柴胡疏肝散合参苓白术散加减url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")小柴胡汤加味方药组成药物剂量柴胡、黄芩、郁金、莪术、陈皮、大黄、赤芍各

10g炒白术、制鳖甲各

15g白花蛇舌草半枝莲石见穿岩柏各

30gurl("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")基础方药8味柴胡佛手川楝子郁金香附太子参茯苓白术url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")气滞血瘀证方药治治法要点活血活血化瘀，理气散结理气活血化瘀，理气散结url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")方推荐方剂主方血府逐瘀汤加减，或膈下逐瘀汤加减其他可选复元活血汤桂枝茯苓丸合柴胡疏肝散加减url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")方血府逐瘀汤加减方药组成药物剂量药物剂量桃仁12g红花9g当归12g生地15g川芎10g赤芍10g牛膝30g柴胡10g随证加减八月札

15g、鳖甲

10g、石见穿

15g、牡蛎

15gurl("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")湿热与阴虚证方药湿热蕴结证清热利湿，肝肾阴虚证滋补肝肾url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")湿热蕴结证清热利湿·化瘀解毒推荐方剂茵陈蒿汤合龙胆泻肝汤加减，或茵陈蒿汤合鳖甲煎丸加减常用药茵陈30g生大黄10g栀子10g龙胆草10g黄连6g生薏仁15g半枝莲30g蛇舌草30gurl("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")肝肾阴虚证滋补肝肾·养阴柔肝推荐方剂一贯煎合六味地黄丸加减，或滋水清肝饮合兰豆枫楮汤加减常用药生熟地

各15g丹皮15g赤白芍

各15g麦冬15g枸杞12g鳖甲10g半枝莲30g蛇舌草30gurl("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")经典经方的循证证据多项临床研究证实，经方与西医方法结合可改善症状、稳定瘤体三组经方联合方案vs单纯对照·循证结果对比url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")18.7%提高小柴胡汤·联合介入治疗6个月生存率较单纯介入组提高18.7%url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")42.5μmol/L茵陈蒿汤·用于黄疸型血清胆红素平均下降42.5μmol/Lurl("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")2.3个月当归龙荟丸·联合索拉非尼无进展生存期延长2.3个月手足皮肤反应发生率降低21.4%url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")04特色疗法与中成药内外兼治，多途增效针药并用，内外协同中成药应用要点介绍常用中成药的功效定位与使用注意，提供内服之外的成药选择使用注意使用前需排除药物过敏史避免与西药抗凝剂联用所有中成药使用均须在执业中医师指导下进行常用中成药3项华蟾素注射液抑制肿瘤细胞增殖，适用于中晚期肝癌辅助治疗金龙胶囊含守宫、金钱白花蛇等成分，缓解肝区疼痛槐耳颗粒扶正固本，改善放化疗后免疫功能url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")槐耳颗粒扶正固本功效定位扶正固本，改善放化疗后免疫功能适用场景放化疗后免疫支持剂型颗粒剂url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")金龙胶囊缓解疼痛主要成分含守宫、金钱白花蛇等主要作用缓解肝区疼痛剂型胶囊剂url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")针灸疗法应用主穴肝俞、期门调节肝脾功能，配穴足三里、三阴交url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")手法与操作手法采用平补平泻手法疼痛明显可电针刺激太冲、阳陵泉，每次留针20分钟操作规范由专业针灸师操作，建议每周3次禁忌提示凝血功能障碍者慎用url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")外治法与饮食调理补充外治技术与饮食调护，构建内服外用并重的综合干预视角外治法肝区外敷消癥散（含乳香、没药等）可缓解胀痛穴位贴敷：吴茱萸粉调醋敷涌泉穴，有助于改善腹水症状中药离子导入：经皮肤渗透给药，减轻口服药物胃肠刺激禁忌：皮肤破损或过敏体质者禁用url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")饮食调理薏苡仁粥健脾利湿，搭配山药、茯苓增强补益效果血瘀体质建议饮用

玫瑰花山楂茶湿热证型适宜用

溪黄草、鸡骨草煲汤忌食辛辣油腻，合并食管静脉曲张时应避免

粗硬食物url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")05疗效评价标准疗效可量化，评价有标尺多维整合，客观可测四位一体评价体系建立四位一体疗效评价框架，解决传统实体瘤评价标准无法体现中医药综合疗效的难题影像学评价中医证候评价生存质量评价生物学标志物评价url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")核心指标与动态权重核心指标权重说明总生存期延长双重核心指标之一症状缓解率双重核心指标之一中医证候积分晚期姑息治疗时权重可提升至

30%西医客观指标与中医主观指标并重，强调临床实际获益而非单纯瘤体缩小。url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")证候积分量化标准证候评价以

0-3级

症状分级为基础，主证占

60%

、兼证占

40%

，总分

≥15分

判定显著改善评价要素量化规则症状分级按频率与严重程度划分0-3级舌脉权重舌象、脉象各占10%权重评估规范两名副主任中医师独立评估，差异≥2分启动第三方复核复合计分主证占60%，兼证占40%，总分≥15分判定显著改善疗效判定治疗4周后积分下降≥30%为有效，≥50%为显效复评机制每8周复评一次，关注证型转化与AFP趋势生存期相关指标辨证施治方案随访显示，短期生存率较高，随随访时间延长递减，其中3至6个月降幅最大url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")各随访节点生存率3个月76.67%6个月46.67%1年25.59%2年16.56%3年11.04%5年7.36%递减趋势3至6个月降幅最大url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")06中西医融合路径中西协同，共谋长生存中医药是MDT不可或缺的一环MDT框架下的中医药定位《中国肝癌多学科综合治疗专家共识（2025年版）》由中国抗癌协会肝癌专业委员会修订发布，明确“中西医结合”为肝癌MDT六大原则之一，MDT团队含肝胆外科、介入科、肿瘤内科等7大核心科室。url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")中医药的独特优势改善患者症状缓解其他治疗的不良反应提高患者生活质量url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")中药应作为肝癌MDT的重要组成部分，充分发挥传统医学的积极作用。url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")系统治疗与中医药协同系统抗肿瘤治疗方案分一线、二线两组，中医药协同减毒增效url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'fill='%23D4AF37'opacity='0.15'/%3E%3C/pattern%3E%3C/defs%3E%3Crectwidth='100%25'height='100%25'fill='url(%23gold-dust)'/%3E%3C/svg%3E")一线方案8项阿替利珠单抗联合贝伐珠单抗信迪利单抗联合贝伐珠单抗类似物阿帕替尼联合卡瑞利珠单抗多纳非尼仑伐替尼替雷利珠单抗索拉非尼FOLFOX4url("data:image/svg+xml,%3Csvgxmlns='/2000/svg'width='100%25'height='100%25'%3E%3Cdefs%3E%3Cpatternid='gold-dust'width='10'height='10'patternUnits='userSpaceOnUse'%3E%3Ccirclecx='2'cy='3'r='0.8'fill='%23D4AF37'opacity='0.12'/%3E%3Ccirclecx='7'cy='8'r='0.5'fill='%23D4AF37'opacity='0.08'/%3E%3Ccirclecx='5'cy='2'r='0.3'