运用分类学习器探讨肩三针治疗586例卒中后肩手综合征的显效率影响因素

Using Machine Learning to Investigate Factors Influencing the Efficacy of“Shoulder Tri-needles Therapy”in Treatment of Shoulder-hand Syndrome in 586Stroke Patients

目的:采用分类学习器对586例卒中后肩手综合征患者的病历资料进行机器学习,探讨患者的证候体征对显效率的影响,尝试总结提高临床治疗本病显效率的可行方法。方法:从病历系统中提取符合纳入条件的肩三针治疗卒中后肩手综合征患者的病例资料,运用单规则(1R)学习器、RIPPER算法学习器及C 5.0决策树模型对所搜集资料进行机器学习。结果:学习结果显示,疾病分期、面色差异、舌苔差异、血压等级、是否饮酒、体质量指数(BMI)及患者是否吸烟是对本法治疗卒中后肩手综合征的显效率影响较大的因素。结论:面色、舌质、血压、饮酒及吸烟习惯、BMI等是影响肩三针治疗卒中后肩手综合征显效率的主要因素,临床医生可以在治疗或对患者的宣教中加以重视。

Objective To analyze the factors influencing the therapeutic effect of＂Shoulder Tri-needles therapy＂in the treatment of shoulder-hand syndrome of stroke patients by using machine learning approach,so as to provide a feasibility for improving clinical efficacy.Methods A total of 586 stroke patients with shoulder-hand syndrome eligible for this study were involved in our machine learning experiments for classification of the influential factors.Their data including the age,gender,pulse condition,complexion,tongue quality,tongue coating,disease stage,body mass index（BMI）,blood pressure,blood glucose,blood triglyceride,blood total cholesterol,smoking history,drinking history,and final outcomes were extracted from the medical record system（from Oct.of 2014 to Jan.of 2017 in the First Affiliated Hospital and Shenzhen Futian Hospital of Guangzhou University of Chinese Medicine）.The single rule algorithm（1 R）was adopted to learn,followed by optimization with Repeated Incremental Pruning to Produce Error Reduction（RIPPER）algorithm,and C 5.0 decision tree algorithm.Results The accurate classification rates of 1 R,RIPPER and decision tree model were 87.37%（512/586）,95.90%（562/586）,and 97.10%（569/586）,respectively.The final outcomes of machine learning of this study showed that the disease stage（acute or recovery stage）,complexion difference,tongue coating difference,blood pressure level,consumption of alcohol,BMI,and smoking habit were the most important factors influencing the therapeutic effect of＂Shoulder Tri-needles＂in the treatment of shoulder-hand syndrome of stroke patients.Conclusion The disease stage,complexion and tongue identification,blood pressure level,alcohol drinking and smoking habits,and BMI are the principal factors affecting the therapeutic effect of＂Shoulder Tri-needles therapy＂in the treatment of shoulder-hand syndrome of stroke patients.