基于症状关联规则的小儿肺炎中医证候病机学研究﹡

目的基于症状关联规则对小儿肺炎进行中医证候病机学研究。方法以大样本、多中心的480例小儿肺炎病例为数据源,进行症状关联规则运算,将总样本、分证样本的运算结果结合中医理论与临床实践,分析小儿肺炎中医证候与病机的关系。结果对总样本症状体征的关联运算共获得超过30 000条关联规则,分析得到小儿肺炎的基本病机为化热、气郁与生痰。对分样本症状体征的关联运算共获得超过100 000条关联规则。化热为本病的主要病机,在风热犯肺证与痰热闭肺证中与热相关的病机之间有较高的关联度;与郁相关的病机之间痰热闭肺证比风热犯肺证关联度高;与痰相关的病机之间痰热闭肺证比风热犯肺证关联度高。结论基于症状关联规则的证候病机学研究有利于中医客观化、科学化和标准化的研究和发展。

Study of TCM patterns and mechanism for pediatric pneumonia based on symptom correlation

Objective To study TCM patterns and mechanism for pediatric pneumonia with the approach of symptom correlation analysis. Methods 480 cases records of pediatric pneumonia were collected from multiple centers as a large sample data source. Correlation analysis was conducted to analyze both the to-tal dataset and subgroups by patterns under the guidance of TCM theory and clinical practice so as to study TCM patterns and mechanism for pediatric pneumonia. Results More than 30 000 association rules were mined from the total samples, from which the basic pathogenesis of pediatric pneumonia was confirmed to be heat, stagnation and phiegm. And over 100 000 association rules were obtained from the subgroups. Heat pattern is the primary underlying one. Compared with the pattern of wind heat invading lung, the support and confidence of the pathogenesis related to heat were higher than the pattern of phlegm-heat obstructing lung, while those of the pathogenesis related to stagnation, to phlegm, were low-er than the pattern of phlegm-heat. Conclusion The approach of symptom correlation analysis could be used for a more standard, objective, and scientific TCM development as it is consistent with the spirit of evidence based practice.