基于复杂算法的中医证候研究

Study on syndrome manifestations of Chinese medicine based on complicated algorithm

目的将中医诊断方法与复杂算法结合,以期通过复杂算法研究证候诊断的新思路。方法通过多中心流行病学调查,收集包括5种病的696例病例,采用信息熵的关联度和多元对应分析对中医证候中的血瘀证及亚型进行研究。结果基于信息熵的关联度提取出气虚血瘀、气滞血瘀、阴虚血瘀、痰浊血瘀4种血瘀亚型的症状体征,得出4种亚型的共同症状体征共12项作为总体血瘀证的症状体征。说明血瘀兼证=血瘀证+兼证;同时得出气虚血瘀患者的总体血瘀证贡献度远大于其他3类亚型。利用对应分析得出5种疾病与血瘀兼证的相关距离表。结果显示气虚证位于5种不同部位血瘀证的中央。类风湿关节炎与阴虚血瘀证的关系最密切;肝硬化与气滞的关系最密切;月经不调与气虚、气滞的关系最密切;脑梗死与气滞痰浊的关系密切;心绞痛与痰浊的关系最密切。结论综合以上2种算法,说明复杂算法适合中医证候规范化研究。同时得出气虚证是伴随血瘀证的主要证候,不同兼证的血瘀证除有共同的症状和体征外,还各有自己的特点。即使是公共症状,它们各自在不同部位所占的权重也不同。

Objective To combine diagnosis of Chinese medicine with complicated algorithm to study a new way for syndrome diagnosis by complicated algorithm. Methods Through multicentre epidemiologic survey 696 cases including 5 kinds of diseases were colected. Correlation rate of information entropy andcorrespondence analysis were used to investigate syndrome of blood stasis and its subtypes. Results The symptoms and signs of 4 subtypes of syndrome of blood stasis, deficiency of qi and blood stasis, qistagnancy and blood stasis, yin asthenia and blood stasis and phlegm-turbid and blood stasis, were got out based on correlation rate of information entropy, and 12 common symptoms and signs shared by 4 subtypes were taken as symptoms and signs of total syndrome of blood stasis. The patients with syndrome of qi-stagnancy and blood stasis contributed more to total syndrome of blood stasis than those with other 3 subtypes. Correspondence analysis was applied to get the table of correlated distance between disease and subtype of syndrome of blood stasis. The results showed that syndrome of deficiency of qi was located at the centre of 5 syndromes of blood stasis with different situs. Rheumatoid arthritis （ RA ） , hepatic cirrhosis, irregular menses, cerbral infarction and angina pectoris had most close relationship with yin asthenia and blood stasis, qi-stagnancy and blood stasis, qi-stagnancy and blood stasis and deficiency of qi and blood stasis, phlegm-turbid and blood stasis and qi-stagnancy and blood stasis, respectively. Conclusion Complicated algorithm is applicable to study the normalization of syndrome of Chinese medicine. Syndrome of deficiency of qi is the main syndrome accompanied with blood stasis and different subtypes of syndrome of blood stasis have their special symptoms and signs apart from common symptoms and signs.