基于机器学习探讨经脑深部电刺激术治疗后帕金森病围手术期中医证候变化

Research on changes of traditional Chinese medicine syndromes in perioperative period of Parkinson's disease after deep brain stimulation based on machine learning

目的:初步探讨经脑深部电刺激术(DBS)治疗后帕金森病(PD)围手术期中医证候变化。方法:按照临床流行病学的原则和方法收集80例PD患者经DBS治疗前1周与治疗后2周四诊信息,采用Excel2019对常见症状进行频次、频数统计,对频率超过10%的69个中医症状,运用无监督学习中K均值聚类算法进行系统聚类分析。结果:DBS术前患者以运动障碍症状多见,术后以非运动症状多见;DBS术前后中医证型各聚为6类,符合统计学要求及临床实际情况;DBS手术前后均见均见肾阳亏虚、阴阳两虚、肾虚髓减、气虚、阴虚、肝郁、脾虚、风动证;术后肝郁火旺、湿热内蕴实证之象较术前减少,术后瘀血阻络、阴虚内热、气血亏虚虚实夹杂之象较术前增加。结论:本研究首次初步探讨PDDBS围手术期的中医证候变化,尤体现在DBS术对PD非运动症状的影响。

Objective:Preliminary study on changes of traditional Chinese medicine(TCM)syndromes in perioperative period of Parkinson's disease(PD)after deep brain stimulation(DBS).Methods:According to the principles and methods of clinical epidemiology,the clinical information of 80 PD patients one week before and two weeks after DBS treatment was collected.Excel 2019 was used to calculate the frequency and frequency of common symptoms,and K-means clustering algorithm in unsupervised learning was used for systematic cluster analysis of 69 TCM symptoms with frequency more than 10%.Results:Before DBS,most patients had motor disorders as the main symptoms,while most patients had non-motor symptoms after DBS.The TCM syndromes before and after DBS were grouped into six categories,which met the statistical requirements and clinical conditions.Before and after DBS,the syndrome of kidney yang deficiency,yin and yang deficiency,kidney deficiency and marrow reduction,qi deficiency,yin deficiency,liver depression,spleen deficiency,wind movement were observed.After the operation,the symptoms of liver depression,fire and dampness and heat accumulation were relieved,while the symptoms of blood stasis,yin deficiency and internal heat,qi and blood deficiency and excess were aggravated.Conclusion:This study is the first to preliminarily explore the changes of TCM syndromes in the perioperative period of PD DBS,especially the effect of DBS on nonmotor symptoms of PD.