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从“模糊性与精确性”探讨中医辨证诊断的智能化思路

Intelligentization of Syndrome Differentiation and Diagnosis in Traditional Chinese Medicine from the Perspective of "Ambiguity and Accuracy"
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摘要 从中医诊断过程入手,对中医辨证诊断的“非标准化”现象进行剖析,提出中医通过望、闻、问、切四诊采集的症状体征信息天然地存在一定模糊性,这种模糊性可以通过对大量、多维临床数据的分析比对和综合凝练(四诊合参)得以消减,从而实现中医从模糊性四诊数据到精确性诊断结论的升华。基于上述假设,进一步提出中医辨证智能化的研究思路,即以中医师临床思维能力为核心,借助以知识图谱可视化技术为基础的人工智能技术,融合以病机为纽带的“症状-病机-证候”复杂网络关联和推理方法,通过对大量、多维、模糊性临床数据的自动分析和推理过程,从而实现中医辨证诊断的智能化。 This paper analyzed the"non-standardization"phenomenon of syndrome differentiation in traditional Chinese medicine(TCM)from the diagnosis process.It is proposed that the symptoms and signs collected by the four examinations of inspection,listening/smelling,inquiry,and palpation naturally have a certain"ambiguity",which can be reduced by the comparison and comprehensive condensation(comprehensive analysis of the four examinations)of a large amount of multi-dimensional clinical data,thereby realizing the sublimation of TCM diagnosis from"ambiguity"of four examinations to"accuracy"of diagnostic conclusion.Based on the above assumptions,this paper further proposed that a research idea of intelligent syndrome differentiation in TCM,that is,by taking the clinical thinking ability of TCM physicians as the core,adopting artificial intelligence technology based on knowledge graph visualization,integrating the complex network association and reasoning method of"symptom-pathogenesis-syndrome"linked by pathogenesis,and through the automatic analysis and reasoning process of a large amount of multi-dimensional and ambiguous clinical data,the intelligent TCM diagnosis based on syndrome differentiation can be realized.
作者 李新龙 王世华 赵欣然 张瑜 刘岩 LI Xinlong;WANG ShiHua;ZHAO Xinran;ZHANG Yu;LIU Yan(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,100700;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences;Dongfang Hospital,Beijing University of Chinese Medicine)
出处 《中医杂志》 CSCD 北大核心 2024年第15期1555-1558,1564,共5页 Journal of Traditional Chinese Medicine
基金 国家自然科学基金(82305058) 中央高校基本科研业务费专项资金项目(2024-JYB-JBZD-044) 北京中医药大学东直门医院青年后备人才计划项目(DZMG-QNHB0007) 北京中医药大学东直门医院科技创新专项(DZMKJCX-2024-010)。
关键词 中医诊断 辨证论治 人工智能 模糊性 精确性 TCM diagnostic treatment based on syndrome differentiation intelligence ambiguity accuracy
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