肥胖的中医量化诊断模型构建  

Construction of Traditional Chinese Medicine Quantitative Diagnosis Model for Obesity

作　　者：成西 王琦[1] CHENG Xi;WANG Qi(National Institute of Traditional Chinese Medicine Constitution and Preventive Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学国家中医体质与治未病研究院,北京100029

出　　处：《山东中医杂志》2025年第4期422-429,共8页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:T2341006);中国中医科学院科技创新工程中国中医科学院学部委员学术传承与传播专项(编号:50990002)。

摘　　要：目的:基于王琦对肥胖的分型标准结合中医证型诊断标准,构建肥胖量化诊断模型。方法:①以《中医临床诊疗术语:证候部分》和王琦对肥胖分型的认识为量化标准,利用单因素分析和二元Logistic回归筛选量化诊断模型的症状,利用条件概率换算法为症状赋分;②绘制ROC曲线,根据ROC曲线下面积及敏感度、特异度选取最佳诊断阈值;③评估诊断模型的拟合度,依据诊断适应性原则,对量化标准进行回顾性检验。结果:得到肥胖的量化诊断模型如下,痰湿证包括腹部松软肥胖、头面部出油多、口黏腻、脉滑,评分分别为15、10、15、11,诊断阈值为26;气虚证包括肤白肌松、疲乏,评分分别为26、9,诊断阈值为17;痰湿夹瘀证包括腹部松软肥胖、皮肤色素沉着、舌下络脉青紫、脉涩,评分分别为11、18、20、19,诊断阈值为20。结论:本研究构建的肥胖中医量化诊断模型,能反映肥胖中医证候特点,对肥胖中医证候具有良好的判别效果。Objective:To construct a quantitative diagnosis model for obesity based on WANG Qi’s classification criteria for obesity and the traditional Chinese medicine(TCM)syndromes diagnostic standards.Methods:(1)Taking Clinical Diagnosis and Treatment Terms of Traditional Chinese Medicine:Syndromes Part and WANG Qi’s understanding of obesity classification as quantitative criteria,the symptoms of the quantitative diagnosis model were screened by single-factor analysis and binary Logistic regression,and the symptoms were scored by conditional probability conversion method;(2)The ROC curve was drawn,and the best diagnostic threshold was selected based on the area under the ROC curve and sensitivity and specificity;(3)The fitting degree of the diagnosis model was evaluated,and the quantitative criteria were retrospectively tested according to the principle of diagnostic adaptability.Results:The quantitative diagnosis model of obesity was obtained as follows:Phlegm-dampness syndrome included excessive belly fat,greasy face,sticky mouth,and slippery pulse,with scores of 15,10,15,and 11 respectively,and the quantitative diagnostic threshold was 26;Qi-deficiency syndrome included pale face,muscle laxity and fatigue,the scores were 26,9 respectively,and the quantitative diagnostic threshold was 17;Phlegm-dampness and blood stasis syndrome included excessive belly fat,skin pigmentation,sublingual complexoid cyanosis,and pulse astringency.The scores were 11,18,20,and 19 respectively,and the quantitative diagnostic threshold was 20.Conclusion:TCM quantitative diagnosis model for obesity constructed in this study can reflect the characteristics of the TCM syndromes of obesity,and it has a good discriminating effect on the TCM syndromes of obesity.

关 键 词：肥胖 量化诊断模型 气虚证 痰湿证 痰湿夹瘀证 中医体质 标准化 

分 类 号：R241[医药卫生—中医诊断学] R259.892[医药卫生—中医临床基础]