Construction and application of knowledge graph of Treatise on Febrile Diseases

Objective To establish the knowledge graph of“disease-syndrome-symptom-method-formula”in Treatise on Febrile Diseases(Shang Han Lun,《伤寒论》)for reducing the fuzziness and uncertainty of data,and for laying a foundation for later knowledge reasoning and its application.Methods Under the guidance of experts in the classical formula of traditional Chinese medicine(TCM),the method of“top-down as the main,bottom-up as the auxiliary”was adopted to carry out knowledge extraction,knowledge fusion,and knowledge storage from the five aspects of the disease,syndrome,symptom,method,and formula for the original text of Treatise on Febrile Diseases,and so the knowledge graph of Treatise on Febrile Diseases was constructed.On this basis,the knowledge structure query and the knowledge relevance query were realized in a visual manner.Results The knowledge graph of“disease-syndrome-symptom-method-formula”in the Treatise on Febrile Diseases was constructed,containing 6469 entities and 10911 relational triples,on which the query of entities and their relationships can be carried out and the query result can be visualized.Conclusion The knowledge graph of Treatise on Febrile Diseases systematically realizes its digitization of the knowledge system,and improves the completeness and accuracy of the knowledge representation,and the connection between“disease-syndrome-symptom-treatment-formula”,which is conducive to the sharing and reuse of knowledge can be obtained in a clear and efficient way.

Pang Anshi, a famous great master of school of cold-induced diseases

Pang Anshi (courtesy name:Pan Anchang,styled himself Qishui Taoist,1042-1099) was from Qizhou Prefecture (present Hubei Province).He was a famous scholar of the school of cold-induced diseases in the Northern Song Dynasty (960-1127).His works Supplement to the Herbals (Ben Cao Bu Yi),Pulse Study (Mai Fa),Zhu Dui Ji,etc.are all lost.His only remaining one is the General Treatise on Cold-induced Diseases (Shang Han Zong Bing Lun).

Ye Gui and Treatise on Warm-heat Diseases

Ye Gui (courtesy name:Ye Tianshi,assumed name:Ye Xiangyan 1667-1746),a celebrated physician of the Qing Dynasty was from Wu County,Jiangsu province.Born into a TCM family and nurtured by his family tradition,he read many medical classics like Huangdi's Canon of Medicine (Huang Di Nei Jing),Classic of Difficulties (Nan Jing),etc.,which laid a solid foundation for his future medical career.He was naturally bright and talented so he was good at drawing analogies.Although his medical attainments outdid his teachers,he did not become complacent.He was modest and eager to learn,so when he met any medical expert he would listen to advice with an open mind.He chose to learn from 17 super physicians,which became a favorite topic among the medical cycles.1 Since he discovered and made use of the strong points of all others and gained a thorough understanding,he advanced by leaps and bounds and his fame skyrocketed.Eventually he became a very influential medical expert.

Heterogeneous graph construction and node representation learning method of Treatise on Febrile Diseases based on graph convolutional network

Objective To construct symptom-formula-herb heterogeneous graphs structured Treatise on Febrile Diseases(Shang Han Lun,《伤寒论》)dataset and explore an optimal learning method represented with node attributes based on graph convolutional network(GCN).Methods Clauses that contain symptoms,formulas,and herbs were abstracted from Treatise on Febrile Diseases to construct symptom-formula-herb heterogeneous graphs,which were used to propose a node representation learning method based on GCN−the Traditional Chinese Medicine Graph Convolution Network(TCM-GCN).The symptom-formula,symptom-herb,and formula-herb heterogeneous graphs were processed with the TCM-GCN to realize high-order propagating message passing and neighbor aggregation to obtain new node representation attributes,and thus acquiring the nodes’sum-aggregations of symptoms,formulas,and herbs to lay a foundation for the downstream tasks of the prediction models.Results Comparisons among the node representations with multi-hot encoding,non-fusion encoding,and fusion encoding showed that the Precision@10,Recall@10,and F1-score@10 of the fusion encoding were 9.77%,6.65%,and 8.30%,respectively,higher than those of the non-fusion encoding in the prediction studies of the model.Conclusion Node representations by fusion encoding achieved comparatively ideal results,indicating the TCM-GCN is effective in realizing node-level representations of heterogeneous graph structured Treatise on Febrile Diseases dataset and is able to elevate the performance of the downstream tasks of the diagnosis model.

Exploration and Research on Translation Strategies of Terminologies in Treatise on Warm Heat Disease

Cultural Translation Theory,originated in the 20 th century,states that the study of translation is the study of cultural in-teraction.It aims to explain that translation should not merely be constrained at traditional linguistic level,but should go to a muchbroader area,that is to say,the cultural and historical frame to direct our translation.Wen Re Lun(Treatise on Warm Heat Disease)is a representative classic of Warm Disease Theory in Traditional Chinese Medicine(TCM),with considerable cultural tradition.From the perspective of Cultural Translation Theory,this thesis discussed the translation strategy of terminologies in Wen Re Lun.The principle,"mainly based on foreignization and domestication as minor",could be preferable to transmit the TCM essence byits own language.

Epidemic Diseases and Chinese Medicine: Example of SARS and COVID-19: Part Two

Along with the legends about epidemic demons,China has developed over the centuries a medical approach to epidemic diseases based on the teachings of Hucng Di Nei Jing(《黄帝内经》Huangdi s Intermnal Classic),Nan Jing(《难经》Classic of Difficult Issues),and Shang Han Lun(《伤寒论》Treatise on Cold Damage).Other doctors and scientists participated in this evolution of knowledge,like Wang Shuhe(王叔和),Ge Hong(葛洪),Chao Yuanfang(巢元方),Sun Simiao(孙思邈),and Liu Wansu(刘完素).However,it was in the 17^th century,after the great break of the Song,Jin,and Yuan eras that an innovative spirit,Wu Youke(吴又可1582-1652)first foresaw the existence of microorganisms as we know them now.His Wen Yi Lun(《瘟疫论》Treatise on Pestilence)foreshadows an original approach to epidemic diseases,particularly emerging infectious diseases of the 21^st century.After them,traditional Chinese medicine developed a comprehensive method of diagnosing and treating of these diseases(Epidemic Diseases Theory瘟疫学说)within the School ofHeat Diseases(温病学派).In a third article,we will examine some applications in the treatment of the SARS 2003-2004 epidemic(非典型肺炎)and the current COVID-19(新型冠状病毒肺炎)pandemic.

Epidemic Diseases and Chinese Medicine:Example of SARS and COVID‑19:Part Two

Along with the legends about epidemic demons,China has developed over the centuries a medical approach to epidemic diseases based on the teachings of Huang Di Nei Jing(《黄帝内经》Huangdi’s Internal Classic),Nan Jing(《难经》Classic of Difficult Issues),and Shang Han Lun(《伤寒论》Treatise on Cold Damage).Other doctors and scientists participated in this evolution of knowledge,like Wang Shuhe(王叔和),Ge Hong(葛洪),Chao Yuanfang(巢元方),Sun Simiao(孙思邈),and Liu Wansu(刘完素).However,it was in the 17th century,after the great break of the Song,Jin,and Yuan eras that an innovative spirit,Wu Youke(吴又可1582–1652)first foresaw the existence of microorganisms as we know them now.His Wen Yi Lun(《瘟疫论》Treatise on Pestilence)foreshadows an original approach to epidemic diseases,particularly emerging infectious diseases of the 21st century.After them,traditional Chinese medicine developed a comprehensive method of diagnosing and treating of these diseases(Epidemic Diseases Theory瘟疫学说)within the School of Heat Diseases(温病学派).In a third article,we will examine some applications in the treatment of the SARS 2003–2004 epidemic(非典型肺炎)and the current COVID-19(新型冠状病毒肺炎)pandemic.

译介学视域下中医典籍中文化负载词的英译策略研究

由于中医典籍成书年代久远,其在翻译过程中往往存在着大量的文化对应空缺词汇,因此,中医典籍中的文化负载词翻译成了一个重要的环节,也是一个难点。为了使中医文化更好、更广泛、更有效地传播,译者必须针对现实情况采取相应的对策。基于译介学理论,从文化负载词的定义出发,立足文化视角,通过对《黄帝内经》《伤寒杂病论》和《金匮要略》等中医典籍中的文化负载词的识别和解读,提出了中医文化负载词在翻译过程中需要熟练运用语言维转换、文化维转换、交际维转换等转换方法,总结了中医典籍文化负载词可以使用直译、音译/音译和注释相结合、省译或意译的方法。目的是通过中医典籍文化负载词的界定和提出的翻译策略的同时,有助于为中医文化负载词英译研究提供新的翻译视角、拓宽研究思维,旨在为解读文化差异、探寻更加合理有效的文化交流路径和方法提供新的启发和切入点,对推动中医文化负载词英译研究及中医药文化对外传播进程的加快提供有价值的参考。

“胃家实”及三承气汤运用辨析

“胃家实”作为阳明病提纲,意义重大的同时也颇具争议。本文基于阳明胃肠的生理机制揭示“胃家实”本质,并进一步分析“胃家实”病机治法,又据此探讨三承气汤之鉴别运用、“燥屎”与大小承气汤辨证关系及“胃家实”与“脾家实”的内在联系。从而提出“胃家实”属于正阳阳明病提纲,是阳明胃肠“更虚更满”机制紊乱而形成的一种病理状态。

外感热病共性病机及传变机制探讨

探讨外感热病共性病机及传变机制。指出外邪侵袭,导致卫气抗邪,正邪相争,阳气壅郁,从而表现出一系列的热病证候,病机特点为“郁-虚”。以“气血-体用”论概括热病证候传变规律,将热病病程概括为气、血两个阶段,其中气分阶段包括卫分等,以功能失调为主;血分统营分,以实质损害为主,兼有更加严重的功能失调。外感热病重症转化病机包括热盛动血、热闭心包、热盛动风、化源欲绝、少阴寒化及正气外脱等。

浅谈仲景胃食管反流病诊治思路

通过对《伤寒论》《金匮要略》中关于胃食管反流病相关条文的研读,归纳出胃食管反流病的临床证型,为肝胃不和证、寒热错杂证、痰气交阻证、肝郁化火证、水饮内停证、脾虚痰壅证、胃虚有热证、脾胃虚寒证、阴虚内热证。对每种证型的方药结合的临床体会进行分析,最后通过典型临床医案举隅,浅析经方治疗胃食管病的思路。

基于六经辨病浅析柴胡桂枝干姜汤证及验案举隅

“六经辨病”指的是一种中医临床诊疗思维。即先诊断疾病,分属六经病范畴,再辨别方证,寻找方证对应线索,一一对号入座,精准用药。柴胡桂枝干姜汤证属《伤寒论》六经病中少阳病范畴,临证首先把握少阳病特点,再结合其方证要点(往来寒热、胸胁苦满、心烦、但头汗出、周身无汗、口渴而不呕、小便不利、大便溏泄等),适证选方,则药随方出。如此,病证方药,环环相扣,病下是证,证下是方,药出方下,呈无缝对接,具有精准性及可重复性,更有助提高临证有效率。

《伤寒论》《金匮要略》问诊研究

问诊是医者重要诊病技能。善问者,有条不紊并处处直指要害;不善问者,天马行空且杂乱无序。文章试结合《伤寒论》《金匮要略》来探讨问诊在临床中的应用,分别从问以获知发病诱因、问以知治疗史、问以知既往史、问以获知现症、问以指导辨证、问以知药后情况这六方面展开。在此基础上,挖掘问诊背后的思维,归纳出整体观、联系观、主次观、恒动观、除外观等思维观念。最后,介绍自拟问诊思维歌诀以助记忆,并提醒临床问诊应主动运用。希望文章所做出的工作成果能有益于中医临床。

民国时期吉林地域《伤寒论》的研究与应用——基于《医林》杂志研究的探讨

民国时期,吉林地域中医的发展受到了西医盛行的强烈的冲击,在中西医并存的发展的背景下,吉林地区的中医们传承并研究中医经典,在当时吉林地区出版发行的中医学杂志《医林》杂志中发表了大量的中医经典研究内容,其中以《伤寒论》研究的内容最为广泛,本文通过考证《医林》杂志中发表的《伤寒论》研究文献,认为当时的《伤寒论》研究文献具有篇目连载较多,内容连续强的特点,在研究内容上推崇原文,注重经典,并在一定程度上反映了中西医汇通的特点,研究形式多样,代表了当时中医的学术发展水平,对于研究中医药的发展具有重要意义。

小陷胸汤古今文献考证

目的:分析小陷胸汤的方名方源、组成、剂量、煎服方法、主治病证、功效方义以及现代疾病谱,为其现代临床应用及制剂研发提供依据。方法:古代文献检索基于湖南中医药大学图书馆馆藏资料、读秀数据库、博览医书中医古籍库等,以“小陷胸汤”,或以“陷胸”二字为关键词进行检索,同时查阅影印版古籍进行内容审校。现代临床研究以中国知网为检索数据库,以“小陷胸汤”为主题词进行检索。结果:小陷胸汤首载于东汉张仲景《伤寒论》,组成包括黄连、半夏、瓜蒌实,后世医书多有记载,方名有“仲景小陷胸汤”“古小陷胸汤”“半夏黄连瓜蒌汤”等,异名同方,煎服法大多遵守仲景“先煮瓜蒌,去滓,后纳诸药,续煎”的方法,主治病证广,包括呼吸系统疾病、心血管系统疾病、消化系统疾病、内分泌系统疾病等,尤以循环系统疾病、呼吸系统疾病、消化系统疾病为多。结论:小陷胸汤证病机为痰热互结,小陷胸汤功效为清热化痰,通痹止痛。

卞嵩京论经方汤液派六经提纲

《伤寒论》六经提纲千百年来观点林立,众说纷纭。经方汤液派,肇始于廖季平,奠基于刘民叔,发展于卞嵩京,于六经提纲有其独到见解,即“太阳病以脉浮为提纲,阳明病以腹满为提纲,少阳病以胸胁苦满为提纲,太阴病以吐利腹痛为提纲,少阴病以下利脉微细为提纲,厥阴病无提纲可言”。

基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方结果的Kappa一致性分析

目的分析基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方结果的一致性。方法纳入门诊患者共747例,医生通过四诊的采集得出治疗处方,再以手机终端录入采集的相关症状、体征后得到系统推荐处方。利用Kappa一致性检验来评价基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方结果的一致性。结果基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方的结果具有高度一致性,差异具有统计学意义(Kappa=0.71,P<0.001)。结论基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方结果具有一致性,可辅助临床医生处方。

“精诚合一”理念下《伤寒琢》辅助伤寒学课程的实践研究

目的:明晰《伤寒琢》在中医学生伤寒学课程中的教学效果。方法:在2020~2021学年第一学期,选择南京中医药大学两个同年级相同专业中医本科大三班级,分别设为对照组(n=53)及试验组(n=51),每组总课时皆为72学时,其中对照组采用传统伤寒论教学,而试验组则在传统教学基础上,适当压缩教材教学时间,在平时教学过程中融入《伤寒琢》相关教学内容。学期末课程结束后,两组分别进行考核,考核内容分为两大部分,临床标准化病人(standardized patients,SP)考核及统一试卷考试,具体为中医临床诊疗操作、医德考核及SP打分,各占总成绩20%,而试卷考试占总成绩40%;最后将2大考核部分、4个项目成绩按比例计算总成绩。结果:对照组缓考3人,试验组缓考2人。SP考核中,中医临床诊疗操作、医德考核及SP打分成绩两组差异皆有统计学意义(P<0.05),而卷面成绩无统计学差异(P>0.05)。最后两组总成绩有统计学差异(P<0.05)。结论:将《伤寒琢》内容融入中医学生伤寒学教学实践中,并不影响学生卷面成绩,且对学生的医德修养、临床诊疗水平及总体学习成绩皆有促进作用。

《伤寒论》治疗反应病机观探微

目的提炼《伤寒论》中通过分析治疗后的反应而得出病机认知的思辨方法的规律与精华。方法通过对《伤寒论》体现治疗反应病机观的原文进行客观全面的探析,对《伤寒论》中治疗反应病机观理论进行精准提炼和详细阐释。结果《伤寒论》中治疗反应病机观包括:根据药物治疗之后药效反应进行病机分析、根据药物试探的药效反应分析病机,以及根据误治后治疗反应分析病机(包括误汗、吐、下、火疗或针刺)等内容。结论对《伤寒论》中治疗反应病机观理论进行详细阐释,对于《伤寒论》病机理论和中医学辨证理论的研用,以及临床疗效的提高均具有重要的启发意义和指导价值,值得深入研究。

基于太阳病误下变证论“膈病”

太阳病涵盖了伤寒由表到里的整个演变过程,由于患者禀赋强弱、感邪轻重、就诊是否及时等原因,在此阶段可能出现表里证,所以太阳病可用到下法,但由于对表里先后顺序及整体病势把握不准确而误下产生变证者不少。太阳病下之后结局有两种:(1)下之愈。(2)下之不愈,而不愈者又可分为三种情况:一是误治后邪气仍在表者,当以汗解之;二是有表里证者,表解乃可攻里,否则引邪入里,为逆;三是误下影响了太阳病自然发展轨迹,导致表证几无,而邪气入膈,从而产生变证。无论太阳病正常转归还是误下发为变证,“膈”均是邪气入里之“首站”。膈病主要是邪气侵扰使其失去阻隔、分界作用,导致清浊易位,上下隔拒,典型特点为清浊不分,“上逆”与“下趋”症状并见,治疗首当察其在膈上、膈下,遵循“病在膈上必吐,在膈下必利”的治疗原则,观其脉证,随证治之。