短暂性脑缺血发作中医证候量化诊断标准研究  

Study of Quantified Diagnostic Standard of TCM Syndromes in Transient Ischemic Attack

作　　者：袁国强[1] 李叶双[1] 吴以岭[2] 贾振华[1] 西广成[3] 陈静[3] 谷春华[1] 陈建新[3] 高怀林[1] 吴相春[1] 魏聪[1] 

机构地区：[1]河北医科大学附属以岭医院,河北石家庄050017 [2]河北医科大学医药研究院络病研究室,河北石家庄050035 [3]中国科学院自动化研究所复杂系统与智能科学重点实验室,北京100080

出　　处：《上海中医药大学学报》2007年第3期23-27,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家重点基础研究发展计划("973"计划)基金资助项目(2005CB523301)

摘　　要：目的:建立短暂性脑缺血发作中医证候量化诊断标准。方法:根据文献研究、专家咨询、临床流行病学调查获得短暂性脑缺血发作四诊信息。将493例临床患者随机分为运算组(370例)和考核组(123例),以基于熵的复杂系统分划方法提取运算组患者症状信息,分析证候之间组合规律,确立症状对证候贡献度,以诊断性试验ROC曲线分析方法建立诊断阈值,并依据考核组数据对其进行前瞻性检验。结果:短暂性脑缺血发作存在以络气郁滞、络气虚滞、痰湿、血瘀、阴虚、火热等基本证候,分别确立了不同症状对证候诊断的贡献度,建立了诊断阈值,前瞻性检验显示其具有良好的灵敏度、特异度及符合率。结论:基于熵的复杂系统分划方法可用于中医证候的量化研究,建立的短暂性脑缺血发作量化诊断标准具有良好的诊断效能,为中医证候规范化及进一步开展络病与血管病变相关性研究奠定了基础。Objective：To set up the quantified diagnostic standard of TCM syndromes in transient ischemic attack. Methods： The four-diagnosis information of transient ischemic attack was obtained by literature research, expert consultation and investigation of clinical epidemiology. 417 patients with transient ischemic attack were randomly divided into two groups： calculation group with 370 cases and examination group with 123 cases. The symptom information in calculation group was obtained by entropybased complex systems partition method, and the rule of syndrome combination was analyzed to establish the contribution of symptoms to syndrome, and diagnostic threshold was determined by analysis of reveiver operating characteristic curves. At last, the resuits were prospectively tested according to the data of examination group. Results： Transient ischemic attack had basic syndromes, such as syndrome of depressed collaterals qi, syndrome of deficiency and stagnation of collateral qi, phlegm and damp syndrome, blood stasis syndrome, phlegm-heat syndrome, fire stagnation syndrome, and so on. The contribution of symptoms to syndrome and diagnostic threshold were established. Entropy-based complex systems partition method showed good sensitivity, specificity and coincidence in the prospective test. Conclusions： Entropy-based complex systems partition method can be used to establish the quantified diagnostic criteria of syndrome. This study lays foundation for research of normalization of TCM syndrome and research of correlation between collaterals disease and vascular lesion.

关 键 词：短暂性脑缺血发作 基于熵的复杂系统 中医证候 诊断标准 量化研究 

分 类 号：R277.7[医药卫生—中医学]