基于相似度算法的痛风病因病机演变规律研究

Evolution Law of Gout Etiology and Pathogenesis Based on Similarity Algorithm

目的:探索利用相似度算法梳理痛风中医病因病机传承发展脉络。方法:采用本体概念相似度比较不同时期医家对痛风病因病机认识的差异,呈现痛风病因病机认识演变过程。结果:病因病机相似度结果显示,晋南北朝与隋唐的病因病机相似度最高(56%),宋元间相似度最低(28.5%)。隋唐以前,医家对痛风病因病机认识较为集中;宋代以后,医家对该病的认识逐步多元。病因相似度结果显示,宋代前病因认识的相似度较高,宋以后呈下降趋势,并逐渐趋于平稳。宋代前医家对痛风病因的认识以外感为主,主要是外感风寒湿邪;宋代后出现包括阳虚、阴虚、内热、内湿、痰饮和血瘀等内伤病因的论述,以及饮食内伤诱因;元代出现气滞记载;至明清时期,医家对痛风的病因认识更深入具体,主要以内热、血虚、气虚为主,气滞、血瘀、阴虚、内生湿邪次之。病位相似度结果显示,明代之前朝代间病位相似度为0,明清间病位相似度48.1%,总体以围绕肝、肾、脾、胃的脏腑辨证为多。结论:痛风总属本虚标实之证,以肝脾肾虚为本,湿热痰瘀、血热气滞为标,常因外感或饮食内伤诱发。本文利用文本相似度算法,串联出痛风中医病因病机理论的演变过程,证明方法在探索中医理论演变规律方面具有可行性。

Objective:To explore the use of similarity algorithm in order to sort out the inheritance and development of traditional Chinese medicine(TCM)etiology and pathogenesis of gout.Methods:Using ontology concept similarity to compare the differences in doctors'understanding of the etiology and pathogenesis of gout in different periods,and present the evolution process of gout etiology and pathogenesis understanding.Results:The results of the similarity of etiology and pathogenesis showed that the similarity of etiology and pathogenesis between the Northern and Southern dynasties and the Sui and Tang dynasties was the highest(56%),and the similarity between the Song and Yuan dynasties was the lowest(28.5%).Before the Sui and Tang dynasties,doctors had a relatively concentrated understanding of the etiology and pathogenesis of gout.After the Song dynasty,doctors gradually diversified their understanding of this disease.The similarity of etiology results showed that the similarity of etiology understanding before the Song dynasty was relatively high.After the Song dynasty,it showed a downward trend and gradually stabilized.Before the Song dynasty,the main stream in the medical field believed that gout was caused by external contraction,mainly wind,cold,and dampness pathogens.After the Song dynasty,some doctors had different ideas and believed that gout was caused by internal damage,resulting in yang deficiency,yin deficiency,internal heat,internal dampness,and phlegm and blood stasis,and dietary internal damage could induce these conditions.There were records of qi stagnation in the Yuan dynasty for the cause of gout.During the Ming and Qing dynasties,doctors had a deeper and more specific understanding of the cause of gout,and believed that internal heat,blood deficiency,and qi deficiency are the main reason,followed by qi stagnation,blood stasis,yin deficiency,and endogenous dampness.The similarity of disease location results showed that the similarity of disease location between dynasties before the Ming dynasty was 0,while between Ming and Qing dynasties was 48.1%,and the disease location generally involved the liver,kidney,spleen and stomach.Conclusion:Gout generally belongs to deficient root and excessive superficiality syndrome,with liver,spleen,and kidney deficiency as the root,dampness,heat,phlegm and stasis,and blood heat and qi stagnation as the superficiality.It is often induced by external factors or diet internal injury.This article uses the text similarity algorithm to concatenate the evolution process of the TCM etiology and pathogenesis theory of gout,proving that this method is feasible in exploring the evolution laws of TCM theory.