基于方证分析下中医妇科常见证候的Ⅲ级分类与规律研究

Class Ⅲ Classification and Laws of Common Gynecological Syndromes in Traditional Chinese Medicine Based on Formula and Syndrome Analysis

目的:随着人工智能在医学领域的应用,了解中医治疗妇科疾病的内在规律愈发迫切与重要。中医妇科是在中医辨证论治理论指导下诊治妇女特有疾病的临床学科,因其包含妇人“经带胎产”的诊治特点而从中医内科中分立,但仍需遵循辨证论治的一般规律,基于此,该研究为证候结构化采集提供参考依据,为证候关联性研究提供探索方向。方法:通过对《中医妇科学》中收录的数据进行挖掘,纳入了58个中医妇科常见疾病、106首常用方剂,整理相关证候共320个。所得数据用于建立妇科常见疾病、方证、证候数据集,并进行相应标准化处理。其后通过Ⅲ级分类模式建立证候分类分级表,进行证候频次、关联性、差异性的一般描述性分析,分析结果使用统计软件R 4.0可视化处理。结果:证候可被分类分级管理,其分布具有差异性,其组成具有关联性。结论:由此提出3个有关辨证论治内在规律的观点:客观性是辨方证的起点;差异性是辨方证的基础;关联性是辨方证的依据,这对方证分析基础逻辑的阐明有重要的促进意义。

Objective:With the increasing application of artificial intelligence in the field of medicine,understanding the inherent laws of traditional Chinese medicine(TCM) in the treatment of gynecological diseases has become increasingly urgent and important.TCM gynecology is a clinical discipline that diagnoses and treats specific diseases of women under the guidance of TCM syndrome differentiation and treatment theory.Due to its unique characteristics in diagnosing and treating women′s diseases related to menstruation,leukorrhea,pregnancy,and childbirth,it is separated from internal medicine in TCM.However,it still needs to follow the general rules of syndrome differentiation and treatment.Based on this,this study provided a reference basis for structured collection of syndromes and explored the direction of syndrome correlation research.Methods:By mining the data collected in Chinese Medicine Gynecology,58 common gynecological diseases and 106 commonly used formulas were included,and 320 relevant syndromes were organized.The obtained data were used to establish a dataset of common gynecological diseases,formula-syndrome correlations,and syndromes,and underwent corresponding standardization.Subsequently,a classification and grading table of syndromes was established using a tertiary classification model,and a general descriptive analysis of syndrome frequency,correlation,and differences was conducted.The analysis results were visualized using statistical software R 4.0.Results:Syndromes can be classified and graded for management,with differential distribution and interrelated composition.Conclusion:Three points regarding the inherent laws of syndrome differentiation and treatment were proposed as follows:objectivity is the starting point of syndrome differentiation;differences are the basis of syndrome differentiation;correlation is the basis of syndrome differentiation,which has important promoting significance for clarifying the basic logic of syndrome analysis.