网络辨证的理论方法与应用评价

The Theoretical Method and Application Evaluation of Network Differentiation

病机是中医辨证的核心概念,反映了疾病发生发展过程中正邪斗争的本质。从信息学角度讲,病机可具象为人体正气对应的基本病态与/或邪气对应的基本病因组成的复杂网络。以系统科学为指导,结合图论理论建立病机的数学定义即病机网络,其中基本病态或基本病因代表网络的节点(亦称为病机元),基本病态或基本病因的关系代表网络的边(亦称为病机链)。提出病机网络的整体性定义,将中医辨证的整体观(念)数学化为整体性(质),并基于病机网络定义与网络整体性定义,初步探索并构建辨病机智能推理方法——网络辨证。针对网络辨证的辨证性能评价提出一致性评价策略,并通过真实临床病例开展网络辨证的仿真应用,仿真辨证结果显示网络辨证能够充分拟合中医实践者的推理思维。

Pathogenesis is the core of syndrome differentiation in traditional Chinese medicine(TCM),reflecting the essence of struggle between healthy qi and pathogenic qi in the disease occurrence and development.From the perspective of informatics,the pathogenesis can be embodied as a complex network composed of the basic pathology corresponding to the healthy qi of the human body and/or the basic etiology corresponding to the pathogenic qi.Guided by system science,a mathematical definition of pathogenesis is established based on graph theory,namely pathogenesis network,where the basic pathology or basic etiology represents the nodes of the network(also called pathogenesis element),and the relationship between the basic pathology or basic etiology represents the edge of the network(also called pathogenesis chain).The holistic definition of the pathogenesis network is proposed,which transform the concept of holism of TCM syndrome differentiation into the mathematical nature of holistics(essence);based on the definition of the pathogenesis network and the holistic definition of the network,preliminary exploration and construction of an intelligent reasoning method for differentiating the pathogenesis was explored and preliminarily constructed,namely the network differentiation.A consistency evaluation strategy was proposed for evaluating the performance of the network differentiation,and the simulation application of network differentiation was carried out in real clinical cases.The simulation results shows that differentiation based on network fully reflect the reasoning thinking of TCM practitioners.