数学模型应用于膝关节骨性关节炎证型识别的研究  

Application of Mathematics Model in the Diagnosis of Knee Osteoarthritis

作　　者：朱小虎[1] 王俊华[1] 万超[1] 彭小三[1] 陈霞平[1] 

机构地区：[1]湖北医药学院附属太和医院,湖北十堰442000

出　　处：《中国中医急症》2014年第6期1064-1065,1068,共3页Journal of Emergency in Traditional Chinese Medicine

基　　金：湖北医药学院优秀中青年科技创新团队资助计划项目(2011CXZ03)

摘　　要：目的运用模糊数学方法对膝关节骨性关节炎(KOA)的中医证侯进行客观量化,初步建立该病证型识别的模糊数学模型。方法依据《中医临床路径实用指南》膝痹病的4个常见证型,参照《中医诊断学》和《中药新药临床研究指导原则》,制定KOA中医辨证要素诊断标准。采用专家评判法,计算出各辨证要素的权重值。以个体模式识别数学模型公式,运用最大隶属度原则建立KOA证型识别数学模型。符合纳入标准的KOA患者分别以人工辨证法和模糊数学识别模型进行辨证。结果 105例病例中两种方法辨证结果一致者90例,辨证符合率为85.71%,一致性经配对卡方检验,Kappa=0.795(P<0.01)。结论本研究初步建立了KOA证型识别模糊数学模型,与专家辨证有较高的一致性,经进一步优化有望发展为KOA证型专家诊疗系统。Objectives：To apply fuzzy mathematical method to objectively quantify the syndromes of traditional Chinese medicine of KOA and to preliminarily establish the fuzzy mathematical recognition model for syndrome differentiation of KOA.Methods：Referring to A Practical Guide to The Clinical Pathway of Traditional Chinese Medicine,the common clinical syndromes of knee arthralgia （KOA） were summarized as four types.According to Diagnostics of Chinese Medicine and Clinical Research Guiding Principle of TCM New Drug,we formulated the TCM diagnostic criteria and differentiation factors of KOA.The weight values of differentiation factors were calculated by expert judgment method.By ndividual pattern recognition mathematical model and maximum membership principle,we built mathematical recognition model.KOA patients who met the inclusion criteria were dialectical with both artificial recognition method and fuzzy mathematics recognition model.Results：105 hospitalized KOA patients were all differentiated with both methods.Two methods were consistent in 90 cases and diagnosis coincidence rate was 85.71％.The consistency of them was examined by paired chi-square test,Kappa=0.795 （P＜ 0.01）.Conclusions：In this study,a fuzzy mathematical recognition model for syndrome differentiation of KOA has been preliminarily established.It has high consistency with expert diagnosis.The model should be made into expert diagnosis system by further optimization.

关 键 词：膝关节骨性关节炎 辨证分型 模糊数学 

分 类 号：R684.3[医药卫生—骨科学]