基于症状/体征群的慢性胃炎常见证候特征选择
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摘要
目的在慢性胃炎常见中医症状/体征的特征组基础上,对脾胃湿热证、湿浊中阻证、脾胃气虚证、脾胃虚寒证、肝气郁滞证、肝胃郁热证共6种慢性胃炎常见证候进行特征挑选,探讨辨证理论与证候规范化的内涵。方法采用基于特征组的特征选择方法,对82个慢性胃炎症状/体征经近邻传播聚类算法分析后聚成22个症状/体征群,运用特征选择算法对其症状/体征群进行取舍,以分类器的分类准确率作为评价标准,进行慢性胃炎常见证候的症状/体征群选择。结果慢性胃炎症状/体征群选择结果分别为脾胃湿热证8个、湿浊中阻证4个、脾胃气虚证8个、脾胃虚寒证5个、肝气郁滞证5个、肝胃郁热证6个。结论慢性胃炎6种证候所选特征总体上与中医理论基本吻合,部分结果与中医理论有出入,可能与临床证候具有兼挟性、动态性、复杂性有关。
Objective To conduct feature selection of the six common syndromes of chronic gastritis of spleen-stomach damp-heat syndrome, dampness obstruction syndrome, spleen-stomach qi deficiency syndrome,spleen-stomach deficient cold syndrome, liver qi stagnation syndrome, and liver-stomach heat syndrome on the basis of the characteristic group of common TCM symptoms of chronic gastritis; To explore the connotation of TCM syndrome differentiation theory and TCM syndrome standardization. Methods Adopting the feature group-based selection method, 82 chronic gastritis symptoms(signs) were analyzed by affinity propagation clustering algorithm and then clustered into 22 symptom/signs groups. The feature selection algorithm was used to select the symptom group, and the classification accuracy of the classifier was used as the evaluation standard to select the symptom group of the common syndrome of chronic gastritis. Results The results of symptom/signs group selection of chronic gastritis were 8 groups of spleen-stomach damp-heat syndrome, 4 groups of dampness obstruction syndrome, 8 groups of spleen-stomach qi deficiency syndrome, 5 groups of spleen-stomach deficient cold syndrome, 5 groups of liver qi stagnation syndrome, and 6 groups of liver-stomach heat syndrome. Conclusion The selected features of six common syndromes of chronic gastritis are generally consistent with the TCM theories. Some of the results are different from TCM theories, which may be caused by the mixing, dynamic and complex clinical syndromes.
Objective To conduct feature selection of the six common syndromes of chronic gastritis of spleen-stomach damp-heat syndrome, dampness obstruction syndrome, spleen-stomach qi deficiency syndrome,spleen-stomach deficient cold syndrome, liver qi stagnation syndrome, and liver-stomach heat syndrome on the basis of the characteristic group of common TCM symptoms of chronic gastritis; To explore the connotation of TCM syndrome differentiation theory and TCM syndrome standardization. Methods Adopting the feature group-based selection method, 82 chronic gastritis symptoms(signs) were analyzed by affinity propagation clustering algorithm and then clustered into 22 symptom/signs groups. The feature selection algorithm was used to select the symptom group, and the classification accuracy of the classifier was used as the evaluation standard to select the symptom group of the common syndrome of chronic gastritis. Results The results of symptom/signs group selection of chronic gastritis were 8 groups of spleen-stomach damp-heat syndrome, 4 groups of dampness obstruction syndrome, 8 groups of spleen-stomach qi deficiency syndrome, 5 groups of spleen-stomach deficient cold syndrome, 5 groups of liver qi stagnation syndrome, and 6 groups of liver-stomach heat syndrome. Conclusion The selected features of six common syndromes of chronic gastritis are generally consistent with the TCM theories. Some of the results are different from TCM theories, which may be caused by the mixing, dynamic and complex clinical syndromes.
引文
[1]王忆勤.中医辨证学[M].北京:中国协和医科大学出版社,2003:4-5.
[2]傅延龄,刘渡舟.抓主症方法的认识与运用[J].中国医药学报,1993,8(4):43-44.
[3]YU L,LIU H.Efficient feature selection via analysis of relevance and redundancy[J].Journal of Machine Learning Research,2004,5(12):1205-1224.
[4]房静远,杜奕奇,刘文忠,等.中国慢性胃炎共识意见(2017年,上海)[J].胃肠病学,2017,22(11):670-687.
[5]周建中,陈泽民,危北海.慢性胃炎中西医结合诊断、辨证和疗效标准(试行方案)[J].中西医结合杂志,1990,10(5):318-319.
[6]国家技术监督局.中医临床诊疗术语:证候部分[M].北京:中国标准出版社,1997.
[7]刘国萍,王忆勤,董英,等.中医心系问诊量表的研制及评价[J].中西医结合学报,2009,7(1):20-24.
[8]刘国萍,王忆勤,董英,等.基于探索性因子分析的脾系疾病问诊症状分布及证候要素初探[J].上海中医药大学学报,2012,26(2):32-35.
[9]邓铁涛.中医诊断学[M].上海:上海科学技术出版社,1984:1-190.
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[11]王永炎.中医内科学[M].上海:上海科学技术出版社,1997:100-132.
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[13]周仲瑛.中医内科学[M].北京:中国中医药出版社,2003:80-120.
[14]LIU G P,LI G Z,YAN S X,et al.Association analysis between symptoms(signs)and syndromes of chronic gastritis based on associated density[J].Journal of Computational Information Systems,2012,8(19):131.
[15]FREY B J,DUECK D.Clustering by passing messages between data points[J].Science,2007,315(5814):972-976.
[16]HANCHUAN P,FUHUI L,CHRIS D.Feature selection based on mutual information:criteria of max-dependency,max-relevance,and min-redundancy[J].IEEE Transactions on Pattern Analysis&Machine Intelligence,2005,27(8):1226-1238.
[17]张声生,黄恒青,方文怡,等.脾胃湿热证中医诊疗专家共识意见(2017)[J].中医杂志,2017,58(11):987-990.
[18]王忆勤,郎庆波,李果刚,等.慢性胃炎中医湿证证候诊断标准研究[J].中国中西医结合杂志,2005,25(11):975-979.
[19]张心海,程玲.脾胃病常见证型中西医辨证要点[J].四川中医,2008,26(6):20-23.
[20]张万岱,李军祥,陈治水,等.慢性胃炎中西医结合诊疗共识意见(2011年天津)[J].中国中西医结合杂志,2012,32(6):738-743.
[21]王忆勤.中医诊断学[M].北京:高等教育出版社,2012:126.
[22]徐玮斐,刘国萍,王忆勤,等.近5年中医证候诊断客观化研究述评[J].中医杂志,2016,57(5):442-445.
[2]傅延龄,刘渡舟.抓主症方法的认识与运用[J].中国医药学报,1993,8(4):43-44.
[3]YU L,LIU H.Efficient feature selection via analysis of relevance and redundancy[J].Journal of Machine Learning Research,2004,5(12):1205-1224.
[4]房静远,杜奕奇,刘文忠,等.中国慢性胃炎共识意见(2017年,上海)[J].胃肠病学,2017,22(11):670-687.
[5]周建中,陈泽民,危北海.慢性胃炎中西医结合诊断、辨证和疗效标准(试行方案)[J].中西医结合杂志,1990,10(5):318-319.
[6]国家技术监督局.中医临床诊疗术语:证候部分[M].北京:中国标准出版社,1997.
[7]刘国萍,王忆勤,董英,等.中医心系问诊量表的研制及评价[J].中西医结合学报,2009,7(1):20-24.
[8]刘国萍,王忆勤,董英,等.基于探索性因子分析的脾系疾病问诊症状分布及证候要素初探[J].上海中医药大学学报,2012,26(2):32-35.
[9]邓铁涛.中医诊断学[M].上海:上海科学技术出版社,1984:1-190.
[10]王忆勤.中医诊断学[M].北京:中国中医药出版社,2004:8-189.
[11]王永炎.中医内科学[M].上海:上海科学技术出版社,1997:100-132.
[12]张伯臾.中医内科学[M].上海:上海科学技术出版社,2000:103-116.
[13]周仲瑛.中医内科学[M].北京:中国中医药出版社,2003:80-120.
[14]LIU G P,LI G Z,YAN S X,et al.Association analysis between symptoms(signs)and syndromes of chronic gastritis based on associated density[J].Journal of Computational Information Systems,2012,8(19):131.
[15]FREY B J,DUECK D.Clustering by passing messages between data points[J].Science,2007,315(5814):972-976.
[16]HANCHUAN P,FUHUI L,CHRIS D.Feature selection based on mutual information:criteria of max-dependency,max-relevance,and min-redundancy[J].IEEE Transactions on Pattern Analysis&Machine Intelligence,2005,27(8):1226-1238.
[17]张声生,黄恒青,方文怡,等.脾胃湿热证中医诊疗专家共识意见(2017)[J].中医杂志,2017,58(11):987-990.
[18]王忆勤,郎庆波,李果刚,等.慢性胃炎中医湿证证候诊断标准研究[J].中国中西医结合杂志,2005,25(11):975-979.
[19]张心海,程玲.脾胃病常见证型中西医辨证要点[J].四川中医,2008,26(6):20-23.
[20]张万岱,李军祥,陈治水,等.慢性胃炎中西医结合诊疗共识意见(2011年天津)[J].中国中西医结合杂志,2012,32(6):738-743.
[21]王忆勤.中医诊断学[M].北京:高等教育出版社,2012:126.
[22]徐玮斐,刘国萍,王忆勤,等.近5年中医证候诊断客观化研究述评[J].中医杂志,2016,57(5):442-445.