基于多层次证据融合理论确立《伤寒杂病论》方治疗慢性病循证决策研究

On the basis of "the research of the treatment of advantage diseases in'Treatise on Febrile Disease' evidence-based medicine" for the National Natural Science Foundation of China, It can conclude that evidence of clinical literature of"Treatise on Febrile Disease" has significant spectrum of disease aggregation. There is corresponding relationship of evidence between advantage disease and prescription of"Treatise on Febrile Disease", there is similar corresponding relationship between each prescription and advantage disease, This kind of advantage disease - prescription form the networked corresponding structure of evidence-based evidence, especially in the clinical literature evidence of"Treatise on Febrile Disease"of chronic diseases.Therefore,Taking the common chronic diseases as the object of study, further refining, sublimation, The formation of decision-making evidence information can effectively guide the clinical practice. It has important practical significance and clinical value in promoting the clinical application of scientific, standardized of "shanghanzabinglun" prescription in clinical. In this research taking the common chronic diseases as the object of study, using the evidence fusion theory of multiple levels supported by analytic hierarchy process(D-S/AHP) to quantify the clinical evidence of shanghanzabinglun". Through the integration of qualitative evidence by Delphi Methed, and then, the formation of the fuzzy matrix of evidence to support each other, thus reduce the uncertainty of information, The final formation clinical decision of D-S evidence fusion theory and the corresponding evidence information. For this reason, establishing evidence-based decision of " Shanghanzabinglun" in the treatment of chronic diseases. To provide the guidance for clinical doctors in treatment of chronic disease of"Shanghanzabinglun ". Expected to total about 30 kinds of chronic diseases, including department of internal medicine, surgery, gynecology, etc. The study can also promote Chinese medicine treatment further objective,scientific.

在国家自然科学基金资助"基于循证医学《伤寒论》方治疗优势病证规律研究"基础上，扩大了研究范围，同时获取《伤寒杂病论》方临床文献证据，其有显著病证聚集性，优势病证与《伤寒杂病论》方之间存在证据对应关系，此对应结构在慢性病治疗中尤为突出，因此以高频的慢性病证为研究对象，形成能够有效指导临床实践决策的证据信息，对促进《伤寒杂病论》方在临床中科学、规范的应用具有重要的现实意义和临床价值。本课题进一步用多层次证据融合理论，对应用《伤寒杂病论》方的文献证据与通过德尔菲法获取的定性证据信息，进行层次分析、量化，进而融合，形成证据的判断数值，最终确定《伤寒杂病论》方治疗优势病证的可信空间，全面提升临床证据的科学性。以此建立《伤寒杂病论》方治疗慢性病证的循证决策，为临床各科医生提供《伤寒杂病论》方对慢性病的治疗指导。预期涉及内、外、妇各科慢性病证共约30余种。此研究可提高临床医生的循证决策、意识和能力。

在前期研究的基础上，扩大研究范围，获取《金匮要略》方的临床研究文献证据，并更新了《伤寒论》方的临床研究文献证据。结合两部分临床研究文献证据，提炼获得《伤寒杂病论》方治疗的病症谱，其显示有显著的聚集性。提炼出的优势病症与《伤寒杂病论》方之间存在对应关系，此关系在多数涉及的慢性病治疗中尤为突出，因此以高频的慢性病证为研究对象，形成能够有效指导临床实践决策的证据信息，对促进《伤寒杂病论》方在临床中科学、规范的应用具有重要的现实意义和临床价值。本课题进一步用多层次证据融合理论，对获得的《伤寒杂病论》方的临床研究文献证据与通过德尔菲法获取的专家定性证据，进行多层次分析、量化，进而融合，形成证据的判断数值，最终确定《伤寒杂病论》方治疗优势病证的可信空间，全面提升临床证据的科学性。 以此建立《伤寒杂病论》方治疗慢性病证的循证决策依据，为临床各科医生提供《伤寒杂病论》方对慢性病的治疗指导。预期涉及内、外、妇各科慢性病证共约30余种。此研究可提高临床医生的循证决策、意识和能力。