抑郁症肝郁气滞证诊断模型构建方法比较及量表的应用形式  

Comparison of methods for constructing diagnostic models of depression with liver depression and qi stagnation syndrome and the application form of scales

作　　者：方格 谈宇权 廉坤 张君宇 李新纯[2] 张雪花[2] 周旋 陈家旭 李先涛[4] 胡志希 FANG Ge;TAN Yu-quan;LIAN Kun;ZHANG Jun-yu;LI Xin-chun;ZHANG Xue-hua;ZHOU Xuan;CHEN Jia-xu;LI Xian-tao;HU Zhi-xi(School of Traditional Chinese Medicine,Hunan University of Chinese Medicine,Changsha 410208,China;Department of Psychatry,Hunan Brain Hospital,Changsha 410007,China;Formula-Pattern Research Center,School of Traditional Chinese Medicine,Jinan University,Guangzhou 510632,China;School of Basic Medical Science,Guangzhou University of Chinese Medicine,Guangzhou 510006,China)

机构地区：[1]湖南中医药大学中医学院,长沙410208 [2]湖南省脑科医院精神科,长沙410007 [3]暨南大学中医学院方证研究中心,广州510632 [4]广州中医药大学基础医学院,广州510006

出　　处：《中华中医药杂志》2023年第4期1774-1777,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：广东省重点领域研发计划(No.2020B1111100001);湖南省自然科学基金项目(No.2020JJ4062,N o.2020J J5408);湖南省教育厅科学研究项目(No.21A0230);湖南中医药大学研究生创新课题项目(No.2021CX04)。

摘　　要：目的:探讨抑郁症肝郁气滞证诊断模型构建的方法比较,及应用于临床量表的形式。方法:分别计算主观赋权法、客观赋权法、综合赋权法对量表各条目的权重值,比较各自ROC曲线下的面积(AUC),确定最佳证候诊断权重值,形成应用于临床的量表。结果:AUC从高到低的排序:客观赋权法、主观赋权法、综合赋权法,将最优客观权重进行归一化处理,得到目标组合权重值及阈值,明确该证候主次舌脉不同维度的临床量表,诊断模式:主症2条+次症至少1条(共6条)+舌象/脉象至少1类。结论:本研究用客观赋权法对抑郁症肝郁气滞证中医诊断量表的权重进行标准化处理,得到量表的应用形式。Objective:To explore the method comparison of constructing the diagnostic model of depression with liver depression and qi stagnation syndrome,and the form of clinical scale.Methods:The weight values of subjective weighting method,objective weighting method and comprehensive weighting method for each item of the scale were calculated respectively,and the area under their ROC curve(AUC)was compared to determine the best weight value of syndrome diagnosis,which was applied to the form of clinical scale.Results:AUC was ranked from high to low:objective weighting method,subjective weighting method and comprehensive weighting method.The optimal objective weight was normalized to obtain the target combination weight and threshold value,and the clinical scales of different dimensions of primary and secondary tongue veins of the syndrome were defined.Diagnosis mode:2 primary symptoms+at least 1 secondary symptom(6 items in total)+at least 1 category of tongue/pulse condition.Conclusion:The objective weighting method is used to standardize the weight of the traditional Chinese medicine diagnostic scale of liver depression and qi stagnation syndrome,and the application form of the scale is obtained.

关 键 词：抑郁症 肝郁气滞证 权重 阈值 临床量表 诊断模式 主观赋权法 客观赋权法 综合赋权法 

分 类 号：R277.7[医药卫生—中医学]