中文摘要
漫长的中医临床诊疗实践,是形成“理法方药”体系稳定的必由之路,然而碎片化的个体诊疗经验如何上升为诊疗规律,是提高中医辨证论治水平的关键问题之一。前期研究表明:同一患者依次接受三位知名中医诊治,治疗有效前提下,辨证与方药存在较大差异。本研究提出“中医医师个体辨证论治及其理法方药是一种自洽的知识体系,可以运用知识图谱可视化建模技术表达出来”的工作假说,通过结构化设计、前瞻性采集3位高年资中医师门诊病例连续数据1500例;针对辨证论治诊疗数据的多尺度、非完整特点,拟采用结构组稀疏算法、随机森林等模式识别方法,建立有效患者群特征和核心处方等子网络;整合“病-证-治-效”信息构建医师个体知识图谱,形成其更新与临床应用机制,发现并可视化个体诊疗规律。本研究为知识图谱建模技术在辨证论治个体诊疗规律方面的研究与应用提供更为有效的统计模型及数据分析方法的同时,为名老中医经验传承与创新研究奠定方法学基础。
英文摘要
The long clinical practice of diagnosis and therapy was the essential way to form the stable system of “theory, principle, formula and herb” in traditional Chinese medicine (TCM). While, how could the pieces of personal experience accumulated into practice guideline, it is one of the key points to enhance the level of treatment variation based on syndrome differentiation. Early study has shown that the discrimination of syndrome types and herbs given to a same patient successively by three experienced doctor have a big difference, while they are all effective. Hypothesis was proposed that the personal treatment based on syndrome differentiation and the TCM doctor’s “theory, principle, formula and herb” could be taken into a self-consistency knowledge system, which could be expressed by the information visualization techniques of Knowledge Graphs. Structured design was chosen in the prospective data collection of 1500 outpatients treated continuously by three senior TCM doctors in two years. Realized the feature of the multi-scale nonholomic data in the treatment variation based on syndrome differentiation, method like Group structure thinning algorithm, random forest and other pattern recognition approach would be applied to construct the sub-net of the effective patient population, core herb formula and others. Information about the “diseases-syndrome patterns-treatment-effect” would be integrated to build up the personal knowledge graph. In the process, the management system of the update and clinical application could be formulated, and the personal experience in diagnosis and treatment would be explored and visualized. The study would provide more effective Statistical models and data analysis methods for the study and application of the individual regulation of the therapy based on syndrome differentiation by the construction technology of Knowledge Graph. Meanwhile, the study would lay the methodology foundation for researches about the inheritance and innovation of the distinguished veteran doctors of TCM.
