Diagnostic value of traditional Chinese medical dialectical classification in hashimoto's thyroiditis complicated with suspicious nodules

Objective:To explore the diagnostic value of traditional Chinese medical(TCM)dialectical classification in Hashimoto's thyroiditis complicated with suspicious nodules.Methods:The clinical data of patients with Hashimoto's thyroiditis complicated with thyroid nodules in the Department of Breast and thyroid surgery of Weifang Hospital of traditional Chinese Medicine from January 2018 to December 2019 were collected.The patients were examined by 2 or more experienced TCM doctors,and the four diagnostic data were obtained,and then the relevant syndrome types of the patients were judged according to the data.According to the color Doppler ultrasonographic features of thyroid nodules,the patients who met the indication of fine needle aspiration biopsy of thyroid nodules were selected and underwent fine needle aspiration biopsy of thyroid nodules before operation.To analyze the clinical diagnostic value of that the ultrasonic mode used in this study and thyroid cytopathology Bethesda report system combine dialectical classification of traditional Chinese medicine in Hashimoto's thyroiditis complicated with suspected thyroid nodules.Result:A total of 89 patients with Hashimoto's thyroiditis complicated with thyroid nodules were collected.according to the ultrasonic mode,the difference between different modes was statistically significant(P<0.05).The mode of color ultrasound is also related to the dialectical classification of traditional Chinese medicine.The patients with high malignant risk score are mainly qi depression and phlegm stagnation,phlegm and blood stasis,while those with low score are exuberant liver fire and heart liver yin deficiency.According to the study of different The Bethesda System for Reporting Thyroid Cytopathology(TBSRTC)classification,the dialectical classification of patients with higher TBSRTC classification was more inclined to qi depression and phlegm stagnation,phlegm and blood stasis,and there was significant difference between different classification(P<0.05).Conclusion:Qi depression and phlegm obstruction,phlegm and blood stasis have high ultrasound malignant risk score and high TBSRTC classification grade in patients with Hashimoto's thyroiditis complicated with suspected thyroid nodules,which has important clinical diagnostic value.

Effects of traditional Chinese medicine nursing combined with conventional nursing in patients with chronic obstructive pulmonary disease:a meta-analysis

Objective: This meta-analysis aims to evaluate the effects of traditional Chinese medicine(TCM) nursing combined with conventional nursing in patients with chronic obstructive pulmonary disease(COPD).Methods: Data were collected from the databases of PubMed, Embase, the Cochrane Library, Web of Science, Google Scholar,China National Knowledge Infrastructure(CNKI), WanFang Data(WF) and VIP Database, including literature regarding the effects of TCM nursing combined with conventional nursing in patients with COPD published before January 2017. The Jadad scale was used to assess the quality of the eligible literature. The weighted mean differences and odds ratios were used to analyze St. George's Respiratory Questionnaire(SGRQ) scores, pulmonary function, hospital stay, and clinical efficacy.Results: Twenty-three randomized controlled trials comprising 3116 cases(TCM nursing combined with the conventional nursing group: 1559; conventional nursing group: 1557) met the inclusion criteria. TCM nursing combined with conventional nursing was associated with a lower SGRQ score, higher forced expiratory volume in 1 second(FEV1) value, higher FEV1/forced vital capacity(FVC) value, higher FEV1% value, higher FEV1 predicted value, shorter hospital stay, and preferable clinical efficacy.Conclusions: TCM nursing combined with conventional nursing emphasized that dialectical nursing can be performed preferably in patients with COPD.

Detection of consensuses and treatment principles of diabetic nephropathy in traditional Chinese medicine: A new approach

Objective:To propose and test a new approach based on community detection in the field of social computing for uncovering consensuses and treatment principles in traditional Chinese medicine(TCM).Methods:Three Chinese databases(CNKI,VIP,andWan Fang Data)were searched for published articles on TCM treatment of diabetic nephropathy(DN)from their inception until September 31,2014.Zheng classification and herbdatawereextractedfromincluded articlesand usedto construct a Zheng classification and treatment of diabetic nephropathy(DNZCT)network with nodes denoting Zhengs and herbs and edges denoting corresponding treating relationshipsamong them.Community detection was applied to the DNZCT and detected community structures were analyzed.Results:A network of 201 nodes and 743 edges were constructed and six communities were detected.Nodes clustered in the samecommunity captured the samesemantic topic;different communities had unique characteristics,and indicated different treatment principles.Large communities usually represented similar points of view or consensuses on common Zheng diagnoses and herb prescriptions;small communities might help to indicate unusual Zhengs and herbs.Conclusion:The results suggest that the community detection-based approach is useful and feasible for uncovering consensuses and treatment principles of DN treatment in TCM,and could be used to address other similar problems in TCM.

The theory development of traditional Chinese medicine constitution: a review

Traditional Chinese medicine constitution (TCMC),as one of the most important parts of Chinese medicine theory,attracted the attention of more and more researchers and many research projects were conducted during past several decades in China's Mainland.This review provided a historic overview of TCMC theory and research progress in its classification,evaluation criteria and epidemiology,so as to give people through a different lens to understand human health.

Relationship between symptoms of traditional Chinese medicine and indicator of western medicine about liver cirrhosis

Traditional Chinese medicine (TCM) is one of the safe and effective methods to treat liver cir-rhosis. The practitioners of TCM assess hepatic function in term of syndrome. But the course of syndrome differentiation is subjectivity. At pre-sent most of all the researches are focused on the relationship between the syndrome and the Western medicine objective indicators such as child-pugh grade. In fact syndrome is the syn-thesis of signs and symptoms and collecting signs, symptoms is easy than syndrome differ-entiation. We try to explore the relationship be-tween the objective Western medicine standard such as child-pugh grade, decompensation or compensation stage, active or inactive period and the signs and symptoms of TCM by using the data mining method. We use the information gain method to assess the attributes and use five typical classifiers such as logistic, Bayes-Net, NaiveBayes, RBF and C4.5 to obtain the classification accuracy. After attribute selection, we obtain the main symptoms and signs of TCM relating to the stage, period and child-pugh grade about liver cirrhosis. The experiment re-sults show the classification accuracy is im-proved after filtering some symptoms and signs.

Research Progress of Treating Diabetic Nephropathy with Traditional Chinese Medicine

By collecting and sorting out the literature and journals on the clinical use of Chinese medicine in the treatment of diabetic nephropathy in recent years,it is concluded that Chinese medicine is effective in the treatment of DKD.Chinese medicine therapy has a unique role in the treatment of diabetic nephropathy.How to correct syndrome differentiation and treatment?Improving clinical effects is the research direction that all medical staff will work together in the future.

Traditional Chinese Herbal Medicine for Epilepsy Treatment Should Be Administered According to the Seizure Type and Epileptic Syndrome

Traditional Chinese herbal medicine (TCHM) has long been used to treat epilepsy. Although many clinical trials and animal studies have seemingly demonstrated its effect, the question of whether TCHM is efficacious in epileptic patients has not been certified because of insufficient supportive evidence. This insufficient supportive evidence stems from the fact that most of the current studies regarding TCHM for epilepsy treatment are not designed according to the different seizure types and epileptic syndromes (STESs). Here, we explore the reasons why many studies have not considered the various STESs and explain how to treat epilepsy according to the pharmacological mechanism for different STESs and exploit the advantage of TCHM for epilepsy treatment. Then, we explain how we treat epilepsy using TCHM according to the different STESs and Bian Zheng Lun Zi.

老年初治肺结核中医证型与细胞因子及免疫表达的相关性分析

目的 观察老年初治肺结核患者血清中细胞因子及TB淋巴细胞亚群的表达水平,探究中医证型与细胞因子、TB淋巴细胞表达之间的关系。方法 纳入2016年5月至2021年12月解放军总医院第八医学中心结核医学部收治的初治老年肺结核病患者322例作为研究对象,根据辨证分型分为肺阴亏虚组78例、阴虚火旺组83例、气阴两虚组79例、阴阳两虚组82例。采用酶联免疫吸附试验检测血清中γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、IL-5、IL-2、IL-6、IL-8、IL-17、IL-4、IL-10等细胞因子的表达水平,流式细胞仪测定TB淋巴细胞亚群中CD3^(+)、CD4^(+)、CD8^(+)、B细胞、NK细胞的绝对数及CD4^(+)/CD8^(+)T细胞比值,并将测定结果进行统计学分析。结果 四组肺结核患者IL-β、IL-5、IL-2、IL-17、IL-4、IL-10水平差异无统计学意义(P>0.05)。气阴两虚组IFN-γ水平显著高于其他三组(P<0.05);阴阳两虚组TNF-α水平显著高于其他三组(P<0.05);阴阳两虚组、气阴两虚组、阴虚火旺组、肺阴亏虚组的IL-6水平依次降低(P<0.05);阴阳两虚组IL-8水平显著高于其他三组,气阴两虚组高于肺阴亏虚组、阴虚火旺组(P<0.05)。CD3^(+)、CD4^(+)、CD8^(+)、B细胞、NK细胞绝对数在阴阳两虚组、气阴两虚组、阴虚火旺组、肺阴亏虚组依次降低,差异均有统计学意义(P<0.05)。阴阳两虚组CD4^(+)/CD8^(+)T细胞比值显著高于其他三组,肺阴亏虚组、阴虚火旺组、气阴两虚组组间比较差异无统计学意义(P>0.05)。结论 不同证型的老年肺结核病患者细胞因子及免疫细胞表达存在差异性,可作为中医辨证论治的客观参考标准之一,为临床辨证治疗提供一定参考。

中医药数据资源目录体系构建与研究

目的/意义规范中医药数据资源的有效管理和应用。方法/过程以中医药数据资源为主要研究对象,以目录学为研究方法,参考相关行业领域数据资源分类体系、中医药相关法律法规、中医药领域业务职能和学科分类等资料,提出中医药数据资源目录分类模型及主要内容。结果/结论初步建立中医药数据资源目录分类体系,为中医药数据资源目录数据库构建提供参考。

基于双阶段元学习的小样本中医舌色域自适应分类方法

舌色是中医(TCM)望诊最关注的诊察特征之一。在实际应用中,通过一台设备采集到的舌象数据训练得到的舌色分类模型应用于另一台设备时,由于舌象数据分布特性不一致,分类性能往往急剧下降。为此,该文提出一种基于双阶段元学习的小样本中医舌色域自适应分类方法。首先,设计了一种双阶段元学习训练策略,从源域有标注样本中提取域不变特征,并利用目标域的少量有标注数据对网络模型进行微调,使得模型可以快速适应目标域的新样本特性,提高舌色分类模型的泛化能力并克服过拟合。接下来,提出了一种渐进高质量伪标签生成方法,利用训练好的模型对目标域的未标注样本进行预测,从中挑选出置信度高的预测结果作为伪标签,逐步生成高质量的伪标签。最后,利用这些高质量的伪标签,结合目标域的有标注数据对模型进行训练,得到舌色分类模型。考虑到伪标签中含有噪声问题,采用了对比正则化函数,可以有效抑制噪声样本在训练过程中产生的负面影响,提升目标域舌色分类准确率。在两个自建中医舌色分类数据集上的实验结果表明,在目标域仅提供20张有标注样本的情况下,舌色分类准确率达到了91.3%,与目标域有监督的分类性能仅差2.05%。

上海浦东某地脑卒中患者的中医分型特点及治疗情况分析

目的分析上海浦东某地脑卒中患者的中医分型特点及治疗情况,为该地区中医药防治脑卒中提供参考依据。方法收集2020年10月至2021年9月我院中医科的284例脑卒中患者为研究对象。对研究对象脑卒中进行中医辨证诊断,并依据证型给予辨证论治。分析脑卒中患者的中医证型及治疗效果。结果浦东某地男性脑卒中患者多于女性(P<0.05);不同性别患者的年龄比较,差异具有统计学意义(P<0.05);不同性别患者的偏瘫部位比较,差异无统计学意义(P>0.05)。284例患者的中医证型由多到少依次为风痰阻络证、阴虚风动证、气虚血瘀证、痰湿蒙窍证、痰火闭窍证、肝阳暴亢证及痰热腑实证。治疗后,风痰阻络证、阴虚风动证的美国国立卫生院卒中量表(NIHSS)评分低于治疗前(P<0.05);治疗后,风痰阻络证的Barthel指数(BI)评分高于治疗前(P<0.05)。脑卒中患者的治疗总有效率为91.55%。结论浦东某地脑卒中男性患者多于女性,患病年龄小于女性,偏瘫部位与性别无关,中医证型诊断风痰阻络证型最多。现代医学规范化治疗方案结合中医药辨证论治对卒中预后有明显干预作用,中医治疗使用祛风化痰通络之法最多。

背部痧象特征要素数显划分方法

目的通过对痧象图片数据的研究,提出一种数显的客观方法来对背部痧象特征要素进行准确辨识,以避免主观认知不同带来的偏差,帮助人们快速辨识痧象的相关特征,为中医医师的诊断提供一定的客观依据,减少主观化成分。方法首先,采用深度语义分割算法模型对采集的背部痧象图片进行分割,以获取只包含痧象的部分区域,去除图片中其他无关部分,尽可能减少对后续实验所带来的影响。然后针对分割得到的图像,结合中医五脏六腑在背部的映射区,采用关键区域检测的方法对痧象颜色特征进行3种区间的识别;根据中医主观上对于痧象形状的划分,采用像素统计方法将痧象形状划分为片状和点状两种。最后,通过准确度、精确度、召回率、F1值对客观识别的结果进行数据上的评价。结果本文提出的客观数显方法在痧象颜色特征划分上的准确率达到了80.56%,在痧象形状特征的划分上准确率达到了89.60%,能够较为准确地对痧象特征要素进行划分,具有一定的可行性。结论本文提出的数显方法能够对痧象的颜色和形状特征进行较为准确的辨识,可以在很大程度上避免主观认知所造成的辨识不同问题,在辅助医师诊断以及用于中医痧象特征的识别教学方面具有较大的应用前景,可为正确了解痧象特征信息提供帮助。

Consensus on the integrated traditional Chinese and Western medicine criteria of diagnostic classification in polycystic ovary syndrome(draft)

Polycystic ovary syndrome （PCOS） is the most common endocrine and metabolic disorder of women, with complex pathogenesis and heterogeneous manifestations. Professor Jin Yu recently wrote an article entitled ＂Proposal of Diagnosis and Diagnostic Classification of PCOS in Integrated Traditional Chinese and Western Medicine.＂ From this, the Obstetrics and Gynecology branches of the Chinese Association of Integrative Medicine and the China Association of Chinese Medicine collaborated with the Gynecology branch of the Chinese Association for Research and Advancement of Chinese Medicine to draft a report on the consensus of criteria for the diagnosis and classification of PCOS in integrated traditional Chinese and Western medicine. The diagnosis for PCOS includes all three features： （1） oligo-ovulation or anovulation; （2） clinical and/or laboratory evidence of hyperandrogenism; （3） PCOS is classified into four types： types la, Ib, Ila, and lib. Syndrome differentiation types for PCOS in traditional Chinese medicine are as follows： Kidney deficiency with phlegm blockage syndrome, Kidney Yin deficiency with phlegm blockage and blood stasis syndrome, and Kidney deficiency with Liver Qi stagnation syndrome.

中医经典课程主题式教学及考核评价的探索

中医经典课程教学是中医教育的核心,通过将多年伤寒论课程教学的心得体会进行了总结,形成了中医学九年制本博贯通专业学生的伤寒琢课程。其以主题式教学为主要教学模式,在前期的模拟病案教学研究中,凝练了24个教学主题,并且通过课堂提问、组织讨论、查阅文献及心得分享等多种途径,激发学生的学习积极性及主观能动性。针对多维度的教学培养模式,该课程除传统主观题笔试外,又尝试引入学生试批、试诊、试写及试讲等多种考核方式,以此探索构建伤寒琢主题式教学课程的分类评价体系。同时,除中医本博贯通专业学生外,这一教考模式亦可在中医研究生、临床中医师等相关课程中进行阶梯式教学考核的拓展尝试,以此培养其岗位胜任能力。

高光谱结合人工神经网络鉴别不同来源的丹参饮片

提出了高光谱结合人工神经网络法(ANN)鉴别不同来源丹参饮片的方法。采集了9种不同来源丹参饮片的高光谱;分别采用最大最小归一化、均值中心化、标准正态变量变换、Savitzky-Golay平滑滤波、多元散射校正等5种光谱预处理方法,结合ANN建立了鉴别这些样品来源的分类模型。测试集验证结果表明,当隐含层节点数设置为17时,对光谱进行均值中心化预处理可建立最佳的ANN模型,分类准确率为98.77%。7种丹参样品判别结果的真正率、命中率和特异度均达到100.00%;其余2种丹参样品的真正率、命中率和特异度也不小于90.00%。

Classification of interventions in Traditional Chinese Medicine

OBJECTIVE: To describe the key systems used for Traditional Chinese Medicine(TCM) classification.METHODS: The TCM classifications used in the International Classification of Diseases-9 Clinical Modification(ICD-9-CM) volume 3, the ICD-10 Procedure Coding System, the International Classification of Health Interventions, and the Medical Subject Headings(Me SH) and Chinese Traditional Medicine and Materia Medica Subject Headings(TCMe SH) thesauruses were compared regarding descriptive terms, structure, and features of TCM interventions.RESULTS: The National Library of Medicine's Me SH thesaurus is ubiquitous. The ICD-9-CM(volume 3),ICD-10 Procedure Coding System, and International Classification of Health Interventions cover insufficient concepts of TCM, and cannot be used directly as classification systems for TCM interventions. In contrast, the TCM contents of the TCMe SH thesaurus are complete, systematic, and detailed, and its hierarchical structure can be used for effective TCM classification.CONCLUSION: TCM classification is very limited and flawed. The Me SH thesaurus helps decrease the detrimental effect of the language barrier. Similarly, the TCMe SH thesaurus can help those without full command of the Mandarin language to access Chinese literature, but the value of searches using TCMe SH could be improved by collaborative working with Information Specialists who are fluent in Mandarin and understand TCM.

中医药治疗晚期非小细胞肺癌的研究进展

非小细胞肺癌(NSCLC)是一种常见的肺部恶性肿瘤,已成为全球癌症死亡的主要原因之一,晚期NSCLC患者的预后普遍较差,该病已给全球公共卫生带来严重负担。晚期NSCLC的治疗一直是临床面临的难题,由于肿瘤细胞的扩散和转移,局部晚期可能会在新辅助治疗后行手术治疗,但效果往往不尽人意,且副作用较大。近年来,中医药在治疗晚期NSCLC方面取得了显著的进展,受到了广泛关注。该文对近几年中医药治疗晚期NSCLC的相关研究进行归纳总结,探讨了中医药治疗的作用机制,为临床实践提供参考。

基于异构图表示的中医电子病历分类方法

中医(TCM)电子病历由于结构复杂多样与诊疗术语不规范的特点导致数据挖掘难度大、利用率低、难以抽取到有效信息。针对上述问题,提出基于LERT(Linguistically-motivated bidirectional Encoder Representation from Transformer)预训练模型与图卷积网络(GCN)并用异构图表示的中医电子病历分类模型TCM-GCN,用于改善中医电子病历特征有效表征的提取与分类。首先,利用LERT层词嵌入的方式将病历转换为句向量融入异构图中,以补全图结构缺失的病历整体语义特征;随后,为了缓解中医电子病历结构特点对特征提取产生的负面影响,异构图将关键词加入节点,使用BM25与点间互信息(PMI)算法构建图中“病历-关键词”“关键词-关键词”的边以表达病历的特征;最后,TCM-GCN依靠LERT-BM25-PMI构建的异构图对病历之间的特征关系进行聚合与抽取,完成病历分类的任务。在中医电子病历数据集上的实验结果表明,相较于次优的LERT,TCM-GCN加权平均后的准确率、召回率、F1值分别提升了2.24%、2.38%、2.32%,验证了算法在捕捉病历间隐含特征与中医电子病历分类工作上的有效性。

中医体质辨证护理改善老年透析病人疲乏及生活质量的研究

目的探讨中医体质辨证护理对老年维持性血液透析病人疲乏状态及生活质量的改善效果。方法选取2022年6—12月在东南大学附属中大医院两个院区血液净化中心行维持性血液透析并符合纳排标准的病人146例,随机分为对照组和观察组,每组73例。对照组给予常规护理,观察组在常规护理基础上,同时接受包括中医饮食调护、穴位按摩在内的中医体质辨证护理,共干预24周。采用修订版Piper疲乏量表(RPFS)、简明健康状况调查表(SF-36)评估2组病人护理干预前后疲乏及生活质量的变化情况。结果干预24周后,观察组病人RPFS量表中的认知维度、情感维度、感觉维度得分以及RPFS总分明显低于对照组(P<0.05)。干预后观察组RPFS量表感觉维度、认知维度、情感维度以及总分较干预前明显降低(P<0.05),而对照组病人干预前后疲乏程度未明显改善(P>0.05);干预后观察组SF-36中的生理职能、躯体疼痛、总体健康、精力、社会功能、情感职能得分以及总分均明显高于对照组(P<0.05),且观察组生理职能、总体健康、精力、社会功能得分以及SF-36总分较干预前明显升高(P<0.05);对照组病人干预前后SF-36评分没有明显变化(P>0.05)。结论中医体质辨证护理对于改善老年维持性血液透析病人的疲乏状态以及生活质量有积极意义。

中医药治疗青光眼性视神经病变的研究进展

青光眼是全球首位不可逆性致盲眼病,青光眼性视神经病变是导致青光眼患者视力下降、视野缺损的主要原因。近年来,中医药治疗青光眼性视神经病变取得一定进展,本文从中医辨证论治、中药及其活性成分、针刺治疗等方面进行梳理和总结,发现中医药能有效控制青光眼性视神经病变的发生发展,保护部分受损的视神经,稳定或改善患者视功能,有一定的临床优势。本研究可为临床医师诊治青光眼性视神经病变提供参考。