证候要素诊断量表研制的方法学研究(以慢性萎缩性胃炎为范例)

We will take chronic atrophic gastritis as an example to study of computational methods about disease syndrome diagnostic scale development. 0n the basis of previous work,we will advance a complex systems science, which is in line with the data characteristics of the disease and syndrome,by the determination of four diagnostic information entry pool, entry weights and syndrome diagnosis threshold.So this computational science can dig out the combination rule of four diagnostic information with high sensitivity, specificity and accuracy,which is implicit in the four diagnostic information of chronic gastritis,and then we will form a scale.Compared with the traditional diagnostic method of chronic gastritis which bases on main symptom and secondary symptom,we will explore the percent of contact area between two diagnostic methods and clinical practice from an objective computing angle.We will form a set of syndrome form which is easy to identify, capitalize and promote.Meanwhile,we will explore a suitable computational methodology which can discover association rule with the disease and severity by the entry of the scale, the total score of syndrome and so on. We will study the syndrome diagnostic scale in order to explore the complex network of four diagnostic information in the scale and its associated rule with syndrome and diseases.We will provide a new way for the objectification of syndrome,and we will provide an important prerequisite which can eventually reveal the biological basis of syndrome and accurate evaluation of the efficacy of Chinese medicine.This study will have important theoretical and practical significance.

本项目以慢性萎缩性胃炎为范例，以证候要素为切入点，进行疾病证候诊断量表研制的计算方法学研究。在既往的工作基础上，从四诊信息条目池确定，条目赋分和证候要素诊断阈值三个方面，提出符合病证数据特点的方法学，使之能够挖掘出隐含在慢性萎缩性胃炎四诊信息数据中“敏感性、特异性和准确性”高的四诊信息组合规律并形成量表，并与传统的基于主症、次症的慢性萎缩性胃炎诊断方法相比较，从客观的计算角度探讨两种诊断方法与临床实际的吻合度，在形成一套“易辨识、可把握、好推广”的证候量表的同时，探讨适宜的方法学，并从量表的条目及证候总分数等探讨与疾病病情程度的关联规律。研究证候要素的诊断量表，探讨量表内四诊信息的复杂网络及其与证候、疾病的关联规律，不但为证候的客观化提供新的方式，也为最终揭示证候的生物学基础和准确评价中药的药效提供了前提，具有重要的理论和现实意义。

本项目以慢性萎缩性胃炎为范例，以证候要素为切入点，进行疾病证候诊断量表研制的计算方法学研究。在既往的工作基础上，从四诊信息条目池确定，条目赋分和证候要素诊断阈值三个方面，提出符合病证数据特点的方法学，使之能够挖掘出隐含在慢性萎缩性胃炎四诊信息数据中“敏感性、特异性和准确性”高的四诊信息组合规律并形成量表，并与传统的基于主症、次症的慢性萎缩性胃炎诊断方法相比较，从客观的计算角度探讨两种诊断方法与临床实际的吻合度，在形成一套“易辨识、可把握、好推广”的证候量表的同时，探讨适宜的方法学，并从量表的条目及证候总分数等探讨与疾病病情程度的关联规律。.运用循证医学方法，系统评价我国慢性萎缩性胃炎（CAG）的中医证候分布情况，了解其证候分布规律。结果表明，慢性萎缩性胃炎脾胃虚弱证、肝胃不和证、脾胃湿热证的分布相对较多；五种证候类型的分布情况存在地域、Hp感染、萎缩程度等方面的差异。.在中国中医科学院西苑医院，运用调查表进行了160列慢性萎缩性胃炎患者的症状、证候的调查。160例慢性萎缩性胃炎患者中，肝胃气滞证49例、肝胃郁热证18例、脾胃虚弱证45例、脾胃湿热证43例、胃阴不足证24例、胃络瘀血证8例。相关数据正在分析中。.研究证候要素的诊断量表，探讨量表内四诊信息的复杂网络及其与证候、疾病的关联规律，不但为证候的客观化提供新的方式，也为最终揭示证候的生物学基础和准确评价中药的药效提供了前提，具有重要的理论和现实意义。