Construction and optimization of traditional Chinese medicine constitution prediction models based on deep learning

Objective To cater to the demands for personalized health services from a deep learning per-spective by investigating the characteristics of traditional Chinese medicine(TCM)constitu-tion data and constructing models to explore new prediction methods.Methods Data from students at Chengdu University of Traditional Chinese Medicine were collected and organized according to the 24 solar terms from January 21,2020,to April 6,2022.The data were used to identify nine TCM constitutions,including balanced constitution,Qi deficiency constitution,Yang deficiency constitution,Yin deficiency constitution,phlegm dampness constitution,damp heat constitution,stagnant blood constitution,Qi stagnation constitution,and specific-inherited predisposition constitution.Deep learning algorithms were employed to construct multi-layer perceptron(MLP),long short-term memory(LSTM),and deep belief network(DBN)models for the prediction of TCM constitutions based on the nine constitution types.To optimize these TCM constitution prediction models,this study in-troduced the attention mechanism(AM),grey wolf optimizer(GWO),and particle swarm op-timization(PSO).The models’performance was evaluated before and after optimization us-ing the F1-score,accuracy,precision,and recall.Results The research analyzed a total of 31655 pieces of data.(i)Before optimization,the MLP model achieved more than 90%prediction accuracy for all constitution types except the balanced and Qi deficiency constitutions.The LSTM model's prediction accuracies exceeded 60%,indicating that their potential in TCM constitutional prediction may not have been fully realized due to the absence of pronounced temporal features in the data.Regarding the DBN model,the binary classification analysis showed that,apart from slightly underperforming in predicting the Qi deficiency constitution and damp heat constitution,with accuracies of 65%and 60%,respectively.The DBN model demonstrated considerable discriminative power for other constitution types,achieving prediction accuracy rates and area under the receiver op-erating characteristic(ROC)curve(AUC)values exceeding 70%and 0.78,respectively.This indicates that while the model possesses a certain level of constitutional differentiation abili-ty,it encounters limitations in processing specific constitutional features,leaving room for further improvement in its performance.For multi-class classification problem,the DBN model’s prediction accuracy rate fell short of 50%.(ii)After optimization,the LSTM model,enhanced with the AM,typically achieved a prediction accuracy rate above 75%,with lower performance for the Qi deficiency constitution,stagnant blood constitution,and Qi stagna-tion constitution.The GWO-optimized DBN model for multi-class classification showed an increased prediction accuracy rate of 56%,while the PSO-optimized model had a decreased accuracy rate to 37%.The GWO-PSO-DBN model,optimized with both algorithms,demon-strated an improved prediction accuracy rate of 54%.Conclusion This study constructed MLP,LSTM,and DBN models for predicting TCM consti-tution and improved them based on different optimisation algorithms.The results showed that the MLP model performs well,the LSTM and DBN models were effective in prediction but with certain limitations.This study also provided a new technology reference for the es-tablishment and optimisation strategies of TCM constitution prediction models,and a novel idea for the treatment of non-disease.

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.

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.

Discrimination of TCM constitutions by biochemical and routine urine indexes

Objective:To investigate whether the specific traditional Chinese medicine(TCM)constitution of individuals can be defined by certain biological indexes instead of answering the questionnaire,and to explore the possibility of discriminating nine TCM constitutions from each other simultaneously using biological indexes.Methods:Blood and urine samples from 152 individuals with nine TCM constitutions were collected,and the related biological indexes were analyzed combining ANOVA,multiple comparison,discriminant analysis,and support vector machine.Results:We found that 4 out of 24 blood routine indexes,7 out of 10 urine routine indexes,and 12 out of 32 biochemical indexes showed differences among the constitutions.High-sensitivity C-reactive protein,apolipoprotein A1,and alkaline phosphatase were potential candidates for screening out individuals with unbalanced constitutions.Combining uric acid,high-density lipoprotein,apolipoprotein A1,creatine kinase,total protein,aspartate aminotransferase,total bile acid,dehydrogenase,sodium,and calcium levels had the potential to directly distinguish the nine TCM constitutions from each other.Among these indexes,the highest ratio of discriminant analysis between two constitutions was 95.5%,while the lowest was 66.1%.Conclusion:Our results suggest that some biochemical and urine indexes are related to various TCM constitutions,and thus they have the potential to be used for TCM constitution classification.

以三伏贴为例探究中医药科普现状及其提升路径

[目的]以三伏贴为例,调查居民中医药科普知识现状及其影响因素,为制定中医药科普宣教策略与方法提供科学建议。[方法]采用网络调查问卷及Logistic回归分析法,研究居民对三伏贴的认知、行为、意愿及影响因素,探讨中医药科普的有效策略及方法。[结果]居民对其治病类型的认知正确率分别为支气管炎或慢性阻塞性肺疾病(22.9%)、鼻炎(21.4%)、保健和增强免疫力(19.3%);对治疗方式的认知正确率分别为医保可报销(35.0%)和每疗程用药次数(20.3%);只有7.8%居民曾有治疗体验;获取知识途径单一,主要为口口相传(26.6%)和网络(22.6%)。治病类型认知正确率的最大促进因素为基础疾病患者,其比值比(odds ratio,OR)为2.44(P<0.05);治疗方式认知正确率的促进因素有女性(OR=1.70,P<0.01)和参保人员(OR=2.41,P<0.01)。居民知识需求率为71.7%,60岁及以上老年人为100%,国内外科普宣教认同率为78.2%和80.0%。[结论]居民三伏贴科普知识及应用水平较低,但治疗意愿、知识需求及科普宣教认同率较高。建议加大特定疗法的微观宣教,以女性、基础病患者、参保居民与老年人为突破口,扩大科普宣教的受众人群,开拓多元化科普宣教路径,进行科普宣教的精准施策,从而提高居民健康素养,助力健康中国。

高等中医药院校西医内科学教学的创新探索

在高等中医药院校中医专业的学习中,西医内科学亦为重要的临床专业课程之一,但西医内科学教学面临与中医课程交叉、课时压缩、学生基础薄弱等相应问题,增加了该课程的学习难度。随着现代社会对医学人才的要求不断提高,中医药院校的临床专业学生也必须掌握西医的理论基础和临床疾病。为了贯彻国家“新医科”建设,提高中医专业西医内科学教学水平,提升本科生分析及解决临床问题的能力,笔者所在教研室总结出内科专业主讲教师+教学秘书责任制、现代化教学手段+问题/病例切入式教学、充分利用现代网络和床旁教学等不同教学模式,在实际运用中取得了很好的教学效果,得到授课教师和学生的广泛认可。文章就相关教学经验进行总结,以期为中医药院校本科生的西医内科学教学提供一定的有益建议,提高本科生的西医内科学教学水平。

新医科背景下合作性学习在中医基础理论教学的应用

面对新医科背景下医学教育新形势,中医基础课程的教学模式创新迎来了新的挑战。文章介绍了合作性学习理念在中医基础理论教学中的应用,主要从理论课、讨论课两个角度,线上、线下、线上线下混合式三种形式,对教学模式、教学内容组织、教学环节实施和多元化考核评价等方面进行探讨,展示了合作性学习理念下中医基础理论的教学改革实践,为新形势下中医基础理论教学的改革思路和发展方向提供借鉴与参考。

融合STEAM与PBL的中药生物技术课程教学改革探索与实践

为适应新医科对中药专业人才培养的新要求,本文对中药生物技术课程教学现状进行分析,提出了融合STEAM教育理念和PBL教学模式的教学改革措施。通过课前、课中和课后3个阶段,对该教学模式进行改革与实践,并对其实施效果与评价进行研究。通过该教学模式,学生的学习兴趣得到提高,创新思维和实践能力得到锻炼,有助于培养中药学复合型创新专业人才,满足中药产业发展的新需求。

中医优势病种临床决策支持系统在“混合痔”中医病历质量控制中的应用

目的:运用中医优势病种临床决策支持系统,提升中医辨证分型的准确性,提升中医病历书写理法方药的一致性,提高中医病历书写质量,提高中医诊疗服务质量。方法:采集2023年3—5月运用中医优势病种临床决策支持系统的混合痔病例163例和2022年3—5月未运用中医优势病种临床决策支持系统的混合痔病例176例,回顾性调查分析两组的方药使用量、中医辨证分型准确性、中药饮片的用药记录、病历书写的理法方药一致性。结果:两组方药使用人次、人均开方次数、人均辨证次数、方药病历记录比较,差异均无统计学意义(P>0.05)。智慧医疗辨证论治组方药内容与病历记录一致性比例[95.45%(147/154)]高于传统医疗辨证论治组[90.36%(150/166)],但差异无统计学意义(P>0.05)。智慧医疗辨证论治组的病历记录中患者病象与疾病证型一致比例[96.75%(149/154)],证型、治则治法、方药三者一致比例[86.14%(143/166)],辨证证型变更比例[56.49%(87/154)]均高于传统医疗辨证论治组的86.14%(143/166)、77.77%(129/166)和7.22%(12/166),差异均有统计学意义(P<0.01或P<0.05)。结论:使用中医优势病种临床决策支持系统有助于规范中医辨证思路,培养中医思维模式,提升病历书写者理法方药的逻辑性,有利于提高中医诊疗服务质量。

珠海市学龄前儿童中医体质类型及其影响因素分析

目的了解珠海市学龄前儿童中医体质类型并分析其影响因素,为制定珠海市儿童保健措施提供理论支持。方法2020年7月1日-2021年5月31日采用整群抽样的方法,抽取珠海市香洲区吉大街道幼儿园,将全部幼儿园儿童纳入研究对象,对符合条件儿童进行现场问卷调查和体格检查。结果共收集1006份有效问卷。通过Logistic回归模型分析发现,早产、儿童身高、儿童身高别体质量是中医体质类型的影响因素(P<0.05)。早产相比于足月产儿童更不容易出现偏颇体质(P<0.05),尤其是痰湿质,OR值为0.313,95%CI:0.104~0.946。儿童的身高与体质类型有关,身高低(身高≤-1SD)的儿童,发生除痰湿质之外的其他偏颇体质的概率更大(P<0.05)。与身高在正常范围的儿童相比,身高“中下”及以下(身高≤-1SD)儿童为阴虚质,OR值为2.307,95%CI:1.36~3.914;气郁质的OR值为2.788,95%CI:1.09~7.133;其他体质的OR值为3.485,95%CI:1.189~10.216。身高“中上”及以上(身高≥1SD)的儿童,体质类型为痰湿质的概率更大,其OR值为1.810,95%CI:1.091~3.001。与身高别体质量“中”的儿童相比,身高别体质量“中上”及以上(体质量≥1SD)的儿童体质类型为阴虚质概率更大,OR值为3.384,95%CI:2.162~5.296。结论对珠海市学龄前儿童应该重点关注阴虚质体质,儿童身高、身高别体质量偏低或者偏高都容易发生偏颇体质,对不同特征和中医体质的学龄前儿童应进行个性化的中医健康指导。

Polymorphisms in PPARD,PPARG and APM1 associated with four types of Traditional Chinese Medicine constitutions

Based on the theory of constitution of Traditional Chinese Medicine （TCM）, the human population is divided into nine constitutions including one balanced constitution （Normality） and eight unbalanced constitutions （Yang-deficiency, Yin-deficiency, Phlegm-wetness, Qi-deficiency, Wetness-heat, Blood stasis, Depressed constitution, and Inherited special constitution）. Different constitutions have specific metabolic features and different susceptibility to certain diseases. However, whether a genetic basis accounts for such constitution classification is yet to be determined. Here we performed a genetic study to assess the association between genetic variations of metabolic genes including PPARD, PPARG and APM1 and the constitutions. A total of 233 individuals of the Han population in China were classified into four groups, Normality, Yang-deficiency, Yin-deficiency and Phlegm-wetness with whom 23 single nucleotide polymorphisms （SNPs） in the three genes were genotyped using polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） method. Biased distribution of PPARD rs2267669 and rs2076167, APM1 rs7627128 and rs1063539 in Yang-deficiency, PPARG Prol2Ala in Yin-deficiency and PPARD rs2076167, APMI rs266729 and rs7627128 in Phlegm-wetness were observed. The frequencies of Haplotypel3 （Hapl3） of PPARG in Yin-deficiency, Hap25 of APM1 in Yang-deficiency and Hap2 of PPARD and Hapl4 of PPARG in Phlegm-wetness, were significantly different from those in Normality, suggesting those might be group-associated haplotypes. These results suggested that single SNP and haplotypes ofPPARD, PPARG and APM1 may underlie the genetic basis of the constitutions classified in TCM.

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。

中医住院医师规范化培训中的课程思政体系构建——以南京市中医院规培基地为例

思政课是落实立德树人根本任务的关键课程。“新医科”概念的提出对中医药人才培养提出了更高的要求与挑战。南京市中医院作为国家级中医住院医师规范化培训基地、构建了院校融合形势下的课程思政体系。文章以南京市中医院为例,详细阐述了在实施中医住院医师规范化培训教学过程中的思政目标、理论教学及临床教学中各个环节的课程思政设计以及规培导师制度中的思政元素构建。

浅析海南地方志中黎医药的应用

黎族作为海南最早的居民,其在长期的生活和劳动实践中总结出了一套独特的医学理论与用药体系。由于黎族没有本民族文字,其医疗知识只能口口相传而无法以书籍的形式保存,这严重制约了黎医药的传承与发展。海南地方志特有的性质使其成为研究海南黎族医学的首选。在查阅海南地方志后,发现黎医药对瘴疟、跌打损伤、火毒、疮毒等当地常见疾病有着较丰富的治疗经验。

马王堆医学对湖湘中医肛肠医学应用性研究的价值

从马王堆医学特别是《五十二病方》中关于肛肠疾病的原始记载出发,探讨其对湖湘中医肛肠医学应用性研究的价值,以期为湖湘中医肛肠医学的发展及应用提供有益的参考。通过对比研究,发现马王堆医学与后世湖湘中医肛肠医学在治疗方法和理论体系上存在显著差异,但同时也揭示了二者之间深厚的渊源和连续性,特别是在痔疮治疗方面,《五十二病方》中的多种复方和治法仍被现代湖湘中医广泛采用并创新发展,为湖湘中医肛肠学科的高质量发展提供了坚实的理论基础和实践指导。

Application and mechanisms of Sanhua Decoction in the treatment of cerebral ischemia-reperfusion injury

Cerebral ischemia-reperfusion is a process in which the blood supply to the brain is temporarily interrupted and subsequently restored.However,it is highly likely to lead to further aggravation of pathological damage to ischemic tissues or the nervous system.,and has accordingly been a focus of extensive clinical research.As a traditional Chinese medicinal formulation,Sanhua Decoction has gradually gained importance in the treatment of cerebrovascular diseases.Its main constituents include Citrus aurantium,Magnolia officinalis,rhubarb,and Qiangwu,which are primarily used to regulate qi.In the treatment of neurological diseases,the therapeutic effects of the Sanhua Decoction are mediated via different pathways,including antioxidant,anti-inflammatory,and neurotransmitter regu-latory pathways,as well as through the protection of nerve cells and a reduction in cerebral edema.Among the studies conducted to date,many have found that the application of Sanhua Decoction in the treatment of neurological diseases has clear therapeutic effects.In addition,as a natural treatment,the Sanhua Decoction has received widespread attention,given that it is safer and more effective than traditional Western medicines.Consequently,research on the mechanisms of action and efficacy of the Sanhua Decoctions in the treatment of cerebral ischemia-reperfusion injury is of considerable significance.In this paper,we describe the pathogenesis of cerebral ischemia-reperfusion injury and review the current status of its treatment to examine the therapeutic mechanisms of action of the Sanhua Decoction.We hope that the findings of the research presented herein will contribute to a better understanding of the efficacy of this formulation in the treatment of cerebral ischemia-reperfusion,and provide a scientific basis for its application in clinical practice.

经方治疗肥胖的研究进展

肥胖是一种慢性代谢性疾病,由多种因素引起体内脂肪过多或是异常堆积所致,也是导致其他疾病发生发展的危险因素之一。临床发现经方治疗肥胖显示出较为突出的优势,笔者通过阅读相关医案及文献,总结探求其机制。文章述大柴胡汤、五苓散、温胆汤、防风通圣散、防己黄芪汤及其作用机制,为经方在临床中应用提供理论支持。研究表明,经方能通过降低炎性因子的表达、改善胰岛素抵抗(IR)、调控糖脂代谢及基因表达等多种方式,达到减重的效果。

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.

基于CiteSpace近10年中医药科技伦理研究知识图谱分析

追踪和探索近10年中医药科技伦理研究的趋势与热点。检索中国知网数据库近10年相关文献,应用CiteSpace 6.1.R6软件分别对纳入的238篇文献的作者、机构、关键词绘制知识图谱并进行分析。从2013年1月1日-2023年1月1日,中医药科技伦理领域发文量总体呈波动性上升趋势。频数最多的5个关键词为伦理审查、中医药、临床研究、中医、伦理。研究显示中医药研究伦理审查、中医药现代化面临的伦理问题、中医学理论在伦理领域的新发展、中国传统医德研究是该领域关注的重点。大医精诚的相关研究可能成为未来研究方向。

基于机器学习的中医体质分类研究

目的 采用随机森林的过滤式特征选择方法,筛选出最优特征子集后构建梯度提升决策树(Gradient Boosting Decision Tree,GBDT)模型,对平和体质与偏颇体质进行分类研究。方法 选取2756例受试者为研究对象,使用横断面调查法进行问卷调查。采集受试者十二经脉上24个原穴的穴位信号与身高、体重、年龄、性别等信息构建数据集。对数据集预处理后使用随机森林特征选择方法筛选最优特征子集;使用GBDT算法构建基于机器学习的平和-偏颇体质二分类研究;采用十折交叉验证计算准确度、精准度、召回率、F1得分,并综合评价模型性能。结果 筛选出22个特征构成最优特征子集,使用筛选后的特征子集构建的GBDT模型准确度、精准度、召回率、F1得分分别是92.86%、93.65%、93.08%、0.92。结论 随机森林的特征选择方法有助于筛选最优特征子集,GBDT可为中医体质分类研究提供帮助。