基于矩阵模型的中医临床指南辨证论治疗效评价方法探索

Disscusion on the effectiveness assessment method for pattern differentiation and treatment of clinical practice guideline in traditional Chinese medicine based on analytic hierarchy process

临床实践指南(CPG)是指导临床实践的诊疗技术标准,其核心价值是提高临床疗效,目前我国已颁布并不同程度应用了大量的CPG,但由于缺乏客观的疗效评价方法,很难回答中医CPG的临床疗效,进而评价其临床价值。辨证论治是中医CPG的核心技术,中医CPG疗效评价很大程度就是对CPG中证候-治疗-疗效间非线性关系从多维度层面进行客观的评价。本课题在发现矩阵模型的原理基本符合辨证论治的特征时,拟以慢性萎缩性胃炎(CAG)中医CPG为范例,用矩阵模型研究其辨证论治疗效评价的方法学。首先,鉴于中医CPG的证候、治疗均已明确,通过会议共识法确定疗效、安全等多维度的疗效评价指标;其次,分别构建证候矩阵、治疗矩阵和疗效矩阵,并运用相应的算法计算证候矩阵、治疗矩阵与疗效矩阵的关系数值;然后,前瞻性临床验证CAG中医CPG矩阵疗效评价模型,为进一步研究中医CPG临床疗效评价方法奠定基础。

Clinical practice guidelines（CPGs） in TCM are one of the basic forms of TCM technical standards,and its core value is improving clinical effectiveness.However,their effectiveness could not be proved because of lacking of effectiveness analysis method.The clinical effective assessment of TCM actually is that of pattern differentiation and treatment assessment,but there is not a scientific method for its assessment.The human body is a giant open system with complexity and the thinking process of pattern differentiation and treatment is regulating this system.The matrix model is an integrated assessment method from qualitative to quantitative,which fit for the effectiveness assessment of pattern differentiation and treatment of CPG.The study took CPG with chronic gastritis in TCM as a model,studied the effectiveness analysis method for pattern differentiation and treatment of CPGs in TCM,to make a basis for further research on effectiveness analysis methods for CPGs in TCM.