基于医案数据挖掘对血瘀证概率性诊断的研究

发布时间：2019-03-04 12:29

【摘要】：目的:分析研究血瘀证在发病时间、患者生活环境和自身状况等方面的特征,以及按照兼夹证素分型后,不同分型的分布特点,对数据进行统计学处理,探讨血瘀证整体以及不同分型的分布规律及易发条件,初步探讨血瘀证概率性诊断的可能性。方法:运用《中华医典》软件,筛选和收集古代医案中信息较全、符合入选条件的血瘀证医案,对患者信息进行提取、规范,建立数据库,运用频次统计,聚类分析和简易数学模型对数据进行归纳、分析和总结,探讨血瘀证及不同分型的高发条件,区分诸因素不同时,在血瘀证辨证中的贡献度,建立简易数学模型进行表达。结果:古代血瘀证医案按照证素分型主要包括气滞型血瘀证、气虚型血瘀证、阳虚型血瘀证、痰浊型血瘀证和邪热型血瘀证等,不同型血瘀证所占比例差别明显:邪热型血瘀证占比最高,达到38.8%,阳虚型、痰浊型和气滞型血瘀证比重相近,约为16.5%,气虚型血瘀证最少,为12.4%。不同型血瘀证在发病时间、患者生活环境和自身状况等方面表现出不同的倾向性,说明不同因素对血瘀证的发病证型贡献度不同。邪热型血瘀证在不同地域均有分布,南方明显多于北方地区,在相对温度较低的北方地区,其百分比也较多(占比25.5%);时间分布方面,秋冬少发,在炎热的夏季比例较高,但是在寒冷的冬季,其占比反而超越了夏季的发病频次。气滞型血瘀证在女性中的比重明显大于在男性中的比重,并且发生气滞型血瘀证的患者其家庭生活环境较为优越。阳虚型和气虚型血瘀证主要发生在秋季的老年人身上。痰浊型血瘀证在不同地域和发病时间上均有分布。气虚型血瘀证占比最少,这与医案记录者的记录习惯有关。结论:患者的发病时间、生活环境和自身状况等因素可以在一定程度上影响血瘀证的发生以及发病类型,这是概率性诊断的前提。研究表明,可以通过分析患者相关因素,包括发病时间、患者生活环境和自身状况,以及补充现代技术可探测信息,进行血瘀证的概率性诊断。概率性诊断的结果作为传统辨证论治的补充,与传统辨证论治进行结合使用。
[Abstract]:Objective: to analyze and study the characteristics of blood stasis syndrome (BSS) in terms of onset time, living environment and self-condition of the patients, as well as the distribution characteristics of different types according to the classification of blood stasis syndrome, and to carry on the statistical processing to the data. To explore the distribution of blood stasis syndrome as a whole and the distribution of different types and the conditions of occurrence, and to discuss the possibility of probability diagnosis of blood stasis syndrome. Methods: using the software of "Chinese Medical Book", we selected and collected the medical records of blood stasis syndrome, which met the conditions of selection, to extract and standardize the information of the patients, to establish the database, and to use the statistics of frequency, and to collect the medical records of blood stasis syndrome according to the conditions of selection. Cluster analysis and simple mathematical model were used to sum up, analyze and summarize the data, discuss the high incidence conditions of blood stasis syndrome and different types, distinguish the different factors, and establish a simple mathematical model to express the contribution degree in syndrome differentiation of blood stasis syndrome. Results: the medical records of ancient blood stasis syndrome mainly included Qi stagnation type, Qi deficiency type, Yang deficiency type, phlegm and turbid blood stasis type and evil heat type, according to the classification of blood stasis syndrome of the ancient times, the syndrome of blood stasis of qi stagnation, blood stasis of qi deficiency, blood stasis of yang deficiency, blood stasis of phlegm and heat, etc. The proportion of different types of blood stasis syndrome was obviously different: the proportion of evil-heat type of blood stasis syndrome was the highest, reaching 38.8%, that of Yang deficiency type, phlegm turbidity type and qi stagnation type was similar, about 16.5%, and 12.4% of Qi-deficiency type was the least, and the proportion of blood stasis syndrome of Qi-deficiency type was the least, which reached 38.8%, Yang deficiency type, phlegm-turbid type and qi stagnation type. Different types of blood stasis syndrome showed different tendency in terms of onset time, living environment and their own condition, which indicated that different factors contributed different degrees to the pathogenesis of blood stasis syndrome. The blood stasis syndrome of evil-heat type was distributed in different regions, the proportion of the blood stasis syndrome in the south was obviously more than that in the north, and the percentage was also more in the north where the relative temperature was lower (25.5%). In the aspect of time distribution, the incidence of autumn and winter is less and the proportion is higher in hot summer, but in cold winter, the proportion is higher than that of summer. The proportion of qi stagnation blood stasis syndrome in female was significantly higher than that in male, and the family living environment of patients with qi stagnation blood stasis syndrome was superior. Yang-deficiency type and Qi-deficiency type blood stasis syndrome mainly occur in the elderly in autumn. Phlegm-turbid blood stasis syndrome was distributed in different regions and onset time. Qi-deficiency blood stasis syndrome is the least, which is related to the record habit of medical record-takers. Conclusion: the onset time, living environment and self condition of the patients can influence the occurrence and type of blood stasis syndrome to a certain extent, which is the premise of probability diagnosis. The study shows that the probability diagnosis of blood stasis syndrome can be carried out by analyzing the related factors, including the time of onset, the living environment and the condition of the patients, as well as by supplementing the information that can be detected by modern technology. The result of probability diagnosis is used in combination with traditional syndrome differentiation as the supplement of traditional syndrome differentiation.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R242

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