Research on Diagnostic Criteria of Common TCM Syndrome Elements of Chronicity Viral Hepatitis Type B
|School||Beijing University of Traditional Chinese Medicine|
|Course||Chinese and Western medicine combined with the basis|
|Keywords||Beijing University of Traditional Chinese Medicine TCM syndromes Report on the Work Post-doctoral Common Syndromes Clinical Epidemiological Investigation Expert survey Integrative Medicine Diagnostic criteria Constipation|
The subject is a national fundamental research development plan (973 plan):"syndromes standard and its fundamental research related with diseases, formula". It isthe eighth subtopic "diagnosis standard research of common Chinese medicalsyndromatic factors of the chronical viral hepatitis B---diagnosis method of criticalvalue of weight" in the first study "the research of syndromes standard and study ofdialectical method system" (serial number of the study: 2003 CB517101). Main purposewill combine modern document research, questionnaire investigation of expert withclinical Epidemiology survey together, through diagnosis standard research of commonChinese medical syndromatic factors of chronical viral hepatitis B, discussing Chinesemedicine syndromes in combining disease with syndrome(a single symptom, compoundsymptoms or syndrommatic factors)which is a kind of new method of differentiationand diaglosis---diagnosis method of critical value of weightsyndromatic factors stands for elemental factor of differentiation and diaglosis ofChinese medical syndromes, through identifying pathological information of symptoms,physical sign. etc, symptomatic factors differentiation is a king of attempt to establishnew Chinese differentiation system. Regarding image as factor, regarding symptom assyndrome, combining disease with syndrome which is centra theory of differentiationmethod system. Syndromatic factor, combining disease with syndrome are importantlink of differentiation method system, key point of this two ring-joint is lowerdimension and elevated grade. So-called "dimension", which refers to the mostelemental syndromatic factor. Within adequate limitation, more small dimension, moreeasy to controlling, maneuverability of user is more big. So-called "grade", which refersto assembly of the most elementary factors and its combination with other various kindsof differentiation method. On the condition of definitive dimension, more large grade,more large flexibility and adaptivity of system. Method of "lower dimension" canseperate complicated syndromatic system into simple syndromatic factor, then methodof "elevated grade" can combine disease with syndrome, through combination ofsyndromatie factors, and combination of syndromatic factors with other traditionaldifferentiation method, new system forms. We will combine document research,questionnaire investigation of expert with clinical Epidemiology survey together tobring forward concept "diagnosis method of critical value of weight", recognizestandard Chinese medical syndromes, separate Chinese syndromes into syndromaticfacors in accordance with teaching material. It is the most advanced method to establish diagnostic criteria of Chinese medical factor at present.We adopted "diagnosis method of critical value of weight", completed the researchof diagnosis standard of common Chinese medical syndromatic factors of chronicalviral hepatitis B. This research mainly included: accomplishing analysis and study ofmodern document of common Chinese medical syndromatic factors of chronical viralhepatitis B, on the basis of confirming searching purpose, establishing searchingstrategy, building up database, and choosing out 217 chinese medical syndromes and588 chinese medical symptoms, then choosing again 69 qualified documents whichhave not only Chinese medical differentiation but also corresponding symptoms,standardizing noun terms in accordance with《chinese medical noun》, separatingChinese medical syndromes into Chinese medical syndromatic factors referring to《chinese medical diagnosis》(edition sixth) to receive common 9 chinese medicalsyndromes and corresponding symptoms, separate into 14 syndromatic facors, arrivingat corresponding symptoms of 9 illness’s syndromatic factors, calculating priorprobability and conditional probability of each symptomatic factor corresponding toeach symptoms.On the basis of modern document research, we carry out questionnaireinvestigation of specialist and statistical analysis, investigation are divided into threephase: pre-investigation is to test whether questionnaire have problem, feasibility ofoperative procedure and choose item pool, furthermore perfect questionnaireinvestigation questionnaire investigation in the first turns mainly filtrate option of itempool. questionnaire investigation in the second turns is to filtrate again option of itempool, build up specialist questionnaire database. Through statistical analysis of database,we carry out corresponding common symptoms of common 9 syndromatic factors, andcalculate conditional probability of each common symptom corresponding to common 9syndromatic factors.The standard is 9 filtrated syndromatic factors from specialist questionnaire in thesecond turns separately corresponding to common chinese medical symptoms, and weseparately calculate average conditional probability of modern document and specialistquestionnaire. Then according to average conditional probability changing into indexnumber, transforming formula: I(Si|Zi)=[LogP(Si|Zi)+1]*10 (integral). these indexnumber can regard as calculation standard of each syndromatic factors exponent of eachcases, so we draw out 9 syndromatic factors corresponding to common chinese medicalsymptoms exponent figure. Each common Chinese medical symptoms correspond toeach syndromatic factors exponent, in fact it is weight of each common Chinese medical symptoms corresponding to each syndromatic factor, thereby weight value is defined.On the base, we make the clinical case of report form, finished the 120 casesepidemiologic survey of Chronicity viral hepatitis type B.Estimation of diagnose TCM Syndrome elements: to check above-mentionedpredict function of the threshold of the index number. According threshold of sum ofindex number to estimate final 20 cases in case report form date base. Then study splitTCM syndrome by clinician dialectical, calculate the coincidence. Through theprospective research, we can find that the coincidence of depressed vital energy、bloodstasis and deficiency of vital energy are all 100 per. Coincidence of wet is 72.72 per,Coincidence of heat is 70 per, and ofyin asthenia is 50 per. The result is fine.The research indicates that method of diagnosis by weight threshold is scientificand pragmatic. This method can personalize uniformity about make diagnostic criteria ofTCM Syndrome utmost. It is technology line to be worth recommending when makeTCM syndrome standardization, and also advanced method to establish unifieddiagnostic criteria of TCM syndrome on disease-syndrome.