信息分析技术在脾胃阴虚证鉴别诊断中的运用

运用信息学原理和计算机技术建立量化的脾胃阴虚证鉴别诊断体系。将脾胃阴虚证出现的 13项主要症状、体征的出现频率用信息论原理 ,求出熵、信息传递系数和对诊断的贡献率 ,基于贝叶斯判别分析和简化评分法建立鉴别诊断体系。并回到临床进行考核。结果 ,腹胀、嘈杂、呃逆嗳气、大便不调、胃脘不适、消瘦、善饥等症状有较大的鉴别诊断意义 (单项贡献率 >10 % )。而烦热、乏力、纳差、渴饮、脉象改变在鉴别诊断中意义相对较小(单项贡献率 <10 % )。证候的熵为 0 2 935 ,13项症状引入后传递信息量的总和为 0 2 70 8,其对鉴别诊断总贡献率为 92 %。提示鉴别的把握度较高。脾胃阴虚证各 2 5例的考核结果其敏感度和特异度均超过了 90 %。初步建立了基于贝叶斯判别分析和简化评分法的鉴别诊断的体系 ,对中医鉴别诊断的客观化有一定的启示。

A New Approach to Establish Measurable Differential Diagnosis Criterion of Yin Deficiency in Stomach or Spleen with Information Science and Computer Technology

Objective :To establish measurable differential diagnosis criterion of “yin deficiency in stomach or spleen” in traditional Chinese medicine(TCM),information science and computer technology were employed. Methods :To get the entropy,information transmission quotient and dedicated ratio to diagnosis,the frequencies of the 13 main syndromes were processed according to principle of information.The differential diagnosis systems,which based on the Bayesian discriminate analysis and simplified score,were constructed and reexamined in clinical practice. Results: The differential value(individual dedication ratio>10%) of abdominal distension,discomfort in stomach,singultus,belching,irregular bowel movement,emaciated constitution,and liability to hunger were significant higher than that(individual dedication ratio<10%) of fidgets,inertia,loss of appetite,polydipsia and alteration of pulse.The 13 main syndromes transmitted information amount to 0 2708,which account for 92% of the total TCM syndrome entropy(0 29354).This demonstrates the power of the system to differential diagnosis was considerable.The sensitivity and specificity of the criterion was over 90% in the 25 clinical cases. Conclusions: The value of the main 13 syndromes to different“yin deficiency in spleen or in stomach” from others was analyzed.A miniature form embryo of the differential diagnosis system was presented,which maybe enlighten the way of the TCM differential diagnosis standardization.