不同证候慢性心衰生物学指标神经网络建模对比研究
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摘要
目的应用CytoScape软件和神经网络挖掘方法分别构建慢性心衰(CHF)阴虚证和阳虚证多系统理化指标信息的诊断模型,探索慢性心衰阴虚证和阳虚证病人理化指标信息的组合模式及其生物学意义。方法收集100例CHF病人四诊信息和生物样本进行多系统理化指标的检测。在应用分析差异指标基础上,综合应用CytoScape软件及神经网络数据挖掘方法进行相关性分析和数据建模,从而形成慢性心衰不同证候患者多系统理化指标的诊断模型。结果应用上述方法筛选出阴虚证和阳虚证有统计学意义的多系统理化指标,依次进入神经网络数据挖掘并建模,每种证候都取得了较高的准确性和预测度。结论神经网络数据挖掘方法不仅可以用于临床理化指标信息数据进行CHF病人证候的建模分析,而且还能深入挖掘和揭示与CHF不同证候相关的多系统理化指标信息,为深入揭示不同中医证候心衰的生物学基础提供参考。
Objective To explore the combined model of physicochemical index information of chronic heart failure(CHF) patients with different patterns and its biological significance,CytoScape software and neural network mining methods were used to construct the diagnostic model of multiple systematic physicochemical index information of yin-deficiency-pattern and yang-deficiency-pattern CHF.Methods 100 CHF patients' four diagnostic information and biological samples were collected for the detection of multiple systematic physicochemical indexes.On the basis of the analysis of the differential indicators,the correlation analysis and data modeling were carried out with CytoScape software and data mining method of neural network to form a diagnosis model of multiple systematic physical and chemical indicators for patients with different syndromes of CHF.Results The physical and chemical indexes with statistical significance of yin deficiency and yang deficiency were screened out with the above methods;the neural network data mining and modeling were conducted accordingly.Conclusion The neural network data mining method can not only be used for the modeling and analysis of clinical physicochemical index information of CHF patients,but also can deeply explore and reveal the multi-system physicochemical index information related to different patterns of CHF,providing references for the in-depth exploration of the biological basis of different TCM patterns of CHF.Key
Objective To explore the combined model of physicochemical index information of chronic heart failure(CHF) patients with different patterns and its biological significance,CytoScape software and neural network mining methods were used to construct the diagnostic model of multiple systematic physicochemical index information of yin-deficiency-pattern and yang-deficiency-pattern CHF.Methods 100 CHF patients' four diagnostic information and biological samples were collected for the detection of multiple systematic physicochemical indexes.On the basis of the analysis of the differential indicators,the correlation analysis and data modeling were carried out with CytoScape software and data mining method of neural network to form a diagnosis model of multiple systematic physical and chemical indicators for patients with different syndromes of CHF.Results The physical and chemical indexes with statistical significance of yin deficiency and yang deficiency were screened out with the above methods;the neural network data mining and modeling were conducted accordingly.Conclusion The neural network data mining method can not only be used for the modeling and analysis of clinical physicochemical index information of CHF patients,but also can deeply explore and reveal the multi-system physicochemical index information related to different patterns of CHF,providing references for the in-depth exploration of the biological basis of different TCM patterns of CHF.Key
引文
[1] 张碧华,杨莉萍,唐鹏.慢性心力衰竭与中医相关病证的渊源与发展[J].中国中西医结合杂志,2018,38 (5):633-635.Zhang BH, Yang LP, Tang P. The history and development of chronic heart failure related to traditional Chinese medicine[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2018,38 (5):633-635.
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[3] 中国中西医结合学会心血管疾病专业委员会,中国医师协会中西医结合医师分会心血管病学专家委员.慢性心力衰竭中西医结合诊疗专家共识[J].中国中西医结合杂志,2016,36(2):133-141. Chinese Society of Integrated Traditional and Western Medicine, Cardiovascular Diseases Committee, Chinese Medical Doctor Association of Integrative Medicine, Cardiovascular Specialist Member. Consensus on integrative medicine for chronic heart failure[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2016,36(2):133-141.
[4] 周仲英,金妙文,吴勉华,等.益阴助阳活血通脉法治疗充血性心力衰竭的临床研究[J].南京中医药大学学报(自然科学版),2000,16(1):13-16.Zhou ZY, Jin MW, Wu MH, et al. Clinical study on treatment of congestive heart failure with Yiyin Huyang Huoxue Tongmai method[J]. Journal of Nanjing University of Traditional Chinese Medicine (natural science), 2000,16(1):13-16.
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[6] 王科,张弘,李曦. 益气活血汤对气虚血瘀型心衰患者中医证候及生活质量的影响[J].陕西中医,2018,39(1):32-34.Wang K, Zhang H, Li X. Effect of Yiqi Huoxue Decoction on TCM syndrome and quality of life in patients with qi deficiency and blood stasis type heart failure[J]. Shaanxi Traditional Chinese Medicine,2018,39(1):32-34.
[7] 殷鑫,王相东,刘晓燕.循证医学对四诊客观化研究的启示[J].中国中医基础医学杂志,2006,12(4):299-300. Yin X, Wang XD, Liu XY. The enlightenment of evidence-based medicine on the objective study of four diagnoses[J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2006, 12 (4): 299-300.
[8] 邱德有,吴小红,黄璐琦.现代生命科学技术对中医药发展的影响[J].世界科学技术-中医药现代化,2001,3(2): 12-16.Qiu DY, Wu XH, Huang LQ. The impact of modern life science and technology on the development of traditional Chinese medicine [J]. World Science and Technology-Modernization of Traditional Chinese Medicine, 2001,3(2): 12-16.
[9] Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult—summary article[J]. Journal of the American College of Cardiology,2005,46(6): 1116-1143.
[10] 沈自尹.中医虚证辨证参考标准[J]. 中西医结合杂志,1989,9(2):11.Shen ZY. TCM syndrome differentiation reference standard[J]. Journal of Integrative Medicine, 1989, 9(2): 11.
[11] 刘旺华,洪净,李花,等.人工神经网络在中医诊断信息化中的应用[J].湖南中医药大学学报,2017,37(7):809-812.Liu WH, Hong J, Li H, et al. Application of artificial neural network in diagnosis informatization of traditional Chinese medicine[J]. Journal of Hunan University of Chinese Medicine,2017,37(7):809-812.
[12] 赵铁牛,于春泉,王惠君,等.人工神经网络在中医证候学中的应用初探[J].中华中医药杂志,2014,29(3):831-833.Zhao TN, Yu CQ, Wang HJ, et al. Application of artificial neural network in TCM diagnostic informationization[J].Chinese Journal of Traditional Chinese Medicine, 2014, 29 (3): 831-833.
[13] Maekawa Y, Anzai T, Yoshikawa T, et al. Prognostic significance of peripheral monocytosis after reperfused acute myocardial infarction: a possible role for left ventricular remodeling[J]. J Am Coll cardiol, 2002.39(2):241-246.
[14] Curtis JP, Sokol SI, Wang Y, et al. The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure[J]. J Am Coll Cardiol,2003, 42(4):736-742.
[15] Cohn JN. Structure basis for heart failure:ventricular remodeling and its pharmacological inhibition[J]. Circulation,1995, 91(10):2504-2507.
[16] Alah MA, Rand WM, Manjunath G, et al. Reduced kidney function and anemia as risk factors for mortality in patients with left ventricular dysfunction[J]. J Am Coll Cardio l, 2001, 38: 955-962.
[17] 孙伯青.益气活血法治疗充血性心力衰竭的临床研究[J].中国中西医结合急救杂志,2006,13(1):44-46.Sun BQ. Clinical study on the treatment of congestive heart failure with Yiqi Huoxue method[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2006, 13(1): 44-46.
[18] 吴时达,吴桐,吴昌碧,等.温阳健心灵口服液治疗收缩功能不全性心力衰竭的临床研究[J].中国中西医结合急救杂志,2001,8(2):223.Wu SD, Wu T, Wu CB, et al. Clinical observations on treatment with Wenyang Jianxin Ling Drink for deficient systolic heart failure[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2001,8(2):223.
[19] 李媛.冠心病慢性心功能不全患者心脏舒缩功能与中医证候相关性研究[D].北京:北京中医药大学,2009:67-82.Li Y. Correlation between cardiac systolic and diastolic function and TCM syndrome in patients with chronic heart failure due to coronary heart disease[D]. Beijing: Beijing University of Chinese Medicine, 2009: 67-82.
[20] 许朝霞,王忆勤,颜建军,等.基于支持向量机和人工神经网络的心血管疾病中医证候分类识别研究[J].北京中医药大学学报, 2011,34(8):539-543.Xu ZX, Wang YQ, Yan JJ, et al. Classification and recognition of TCM syndrome of cardiovascular disease based on support vector machine and artificial neural network[J]. Journal of Beijing University of Traditional Chinese Medicine, 2011,34(8):539-543.
[2] 谢华宁,任得志. 慢性心力衰竭中西医结合临床路径实施效果评价[J].中西医结合心脑血管病杂志,2018,16(4):455-457.Xie HN, Ren DZ. Evaluation of the implementation of clinical pathways in patients with chronic heart failure[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2018,16(4):455-457.
[3] 中国中西医结合学会心血管疾病专业委员会,中国医师协会中西医结合医师分会心血管病学专家委员.慢性心力衰竭中西医结合诊疗专家共识[J].中国中西医结合杂志,2016,36(2):133-141. Chinese Society of Integrated Traditional and Western Medicine, Cardiovascular Diseases Committee, Chinese Medical Doctor Association of Integrative Medicine, Cardiovascular Specialist Member. Consensus on integrative medicine for chronic heart failure[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2016,36(2):133-141.
[4] 周仲英,金妙文,吴勉华,等.益阴助阳活血通脉法治疗充血性心力衰竭的临床研究[J].南京中医药大学学报(自然科学版),2000,16(1):13-16.Zhou ZY, Jin MW, Wu MH, et al. Clinical study on treatment of congestive heart failure with Yiyin Huyang Huoxue Tongmai method[J]. Journal of Nanjing University of Traditional Chinese Medicine (natural science), 2000,16(1):13-16.
[5] 梁东辉.充血性心力衰竭的辨证分析及中西医结合治疗规律初探[J].实用中西医结合杂志,1997,10(11):1069. Liang DH. Dialectical analysis of congestive heart failure and preliminary study of the combined treatment of Chinese and Western medicine[J]. Practical Chinese and Western Medicine Integration Magazine, 1997,10(11):1069.
[6] 王科,张弘,李曦. 益气活血汤对气虚血瘀型心衰患者中医证候及生活质量的影响[J].陕西中医,2018,39(1):32-34.Wang K, Zhang H, Li X. Effect of Yiqi Huoxue Decoction on TCM syndrome and quality of life in patients with qi deficiency and blood stasis type heart failure[J]. Shaanxi Traditional Chinese Medicine,2018,39(1):32-34.
[7] 殷鑫,王相东,刘晓燕.循证医学对四诊客观化研究的启示[J].中国中医基础医学杂志,2006,12(4):299-300. Yin X, Wang XD, Liu XY. The enlightenment of evidence-based medicine on the objective study of four diagnoses[J]. Chinese Journal of Basic Medicine in Traditional Chinese Medicine, 2006, 12 (4): 299-300.
[8] 邱德有,吴小红,黄璐琦.现代生命科学技术对中医药发展的影响[J].世界科学技术-中医药现代化,2001,3(2): 12-16.Qiu DY, Wu XH, Huang LQ. The impact of modern life science and technology on the development of traditional Chinese medicine [J]. World Science and Technology-Modernization of Traditional Chinese Medicine, 2001,3(2): 12-16.
[9] Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult—summary article[J]. Journal of the American College of Cardiology,2005,46(6): 1116-1143.
[10] 沈自尹.中医虚证辨证参考标准[J]. 中西医结合杂志,1989,9(2):11.Shen ZY. TCM syndrome differentiation reference standard[J]. Journal of Integrative Medicine, 1989, 9(2): 11.
[11] 刘旺华,洪净,李花,等.人工神经网络在中医诊断信息化中的应用[J].湖南中医药大学学报,2017,37(7):809-812.Liu WH, Hong J, Li H, et al. Application of artificial neural network in diagnosis informatization of traditional Chinese medicine[J]. Journal of Hunan University of Chinese Medicine,2017,37(7):809-812.
[12] 赵铁牛,于春泉,王惠君,等.人工神经网络在中医证候学中的应用初探[J].中华中医药杂志,2014,29(3):831-833.Zhao TN, Yu CQ, Wang HJ, et al. Application of artificial neural network in TCM diagnostic informationization[J].Chinese Journal of Traditional Chinese Medicine, 2014, 29 (3): 831-833.
[13] Maekawa Y, Anzai T, Yoshikawa T, et al. Prognostic significance of peripheral monocytosis after reperfused acute myocardial infarction: a possible role for left ventricular remodeling[J]. J Am Coll cardiol, 2002.39(2):241-246.
[14] Curtis JP, Sokol SI, Wang Y, et al. The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure[J]. J Am Coll Cardiol,2003, 42(4):736-742.
[15] Cohn JN. Structure basis for heart failure:ventricular remodeling and its pharmacological inhibition[J]. Circulation,1995, 91(10):2504-2507.
[16] Alah MA, Rand WM, Manjunath G, et al. Reduced kidney function and anemia as risk factors for mortality in patients with left ventricular dysfunction[J]. J Am Coll Cardio l, 2001, 38: 955-962.
[17] 孙伯青.益气活血法治疗充血性心力衰竭的临床研究[J].中国中西医结合急救杂志,2006,13(1):44-46.Sun BQ. Clinical study on the treatment of congestive heart failure with Yiqi Huoxue method[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2006, 13(1): 44-46.
[18] 吴时达,吴桐,吴昌碧,等.温阳健心灵口服液治疗收缩功能不全性心力衰竭的临床研究[J].中国中西医结合急救杂志,2001,8(2):223.Wu SD, Wu T, Wu CB, et al. Clinical observations on treatment with Wenyang Jianxin Ling Drink for deficient systolic heart failure[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2001,8(2):223.
[19] 李媛.冠心病慢性心功能不全患者心脏舒缩功能与中医证候相关性研究[D].北京:北京中医药大学,2009:67-82.Li Y. Correlation between cardiac systolic and diastolic function and TCM syndrome in patients with chronic heart failure due to coronary heart disease[D]. Beijing: Beijing University of Chinese Medicine, 2009: 67-82.
[20] 许朝霞,王忆勤,颜建军,等.基于支持向量机和人工神经网络的心血管疾病中医证候分类识别研究[J].北京中医药大学学报, 2011,34(8):539-543.Xu ZX, Wang YQ, Yan JJ, et al. Classification and recognition of TCM syndrome of cardiovascular disease based on support vector machine and artificial neural network[J]. Journal of Beijing University of Traditional Chinese Medicine, 2011,34(8):539-543.