Research On The Methodology Of TCM Medical Records Based On Case-based Reasoning

TCM medical case research has been valued by medical doctors of all generations,and is of great value to inherit medical scholars' academic thoughts,guide clinical practice,and expand clinical thinking.This study compares the methodology of commonly used TCM medical case research methods,and proposes ideas for TCM medical case research based on case reasoning.The project design and construction of the research system of Chinese medicine medical case research under case reasoning mode,and the development of medical case research of Chinese medicine treatment of diabetic nephropathy based on case reasoning.The research content mainly includes two aspects.On the one hand,how to build a research system suitable for traditional Chinese medicine medical cases under the basic framework of case reasoning method;on the other hand,after the completion of the research system,the effectiveness of traditional Chinese medicine in treating diabetic nephropathy The medical record is an example to verify the feasibility of the case reasoning method used in the research of Chinese medical records.1.Research Purpose1.1 Facing the research needs of TCM medical records to assist clinical decision-making,construct a TCM medical case research system based on case reasoning,and suggest new ideas for TCM medical record research;1.2 Completion of case-based reasoning research on traditional Chinese medicine treatment of diabetic nephropathy,construction of a similar medical case retrieval model of traditional Chinese medicine treatment of diabetes and kidney disease,realization of similar medical record search results output,assisting clinical decision-making of traditional Chinese medicine treatment of diabetes and kidney disease.2.Research methodsCase reasoning method is a relatively mature branch in the field of artificial intelligence.It is widely used in many research fields with rich field knowledge but difficult to summarize clear rules.This research is based on the research of traditional Chinese medical records,and uses the case-based reasoning method as the basic framework to construct the methodology system of traditional Chinese medical records research,and uses the ontological method to model the medical record knowledge representation method in the medical case representation of case reasoning In the similar medical record search link,the random forest method is used to screen the important symptom characteristics of the medical record,and the nearest neighbor method is used to perform similar medical record search to construct a similar medical record search model.3.Research results3.1 After comparative research and analysis,different methods of each link of case reasoning are selected and combined to form a case-based method system of TCM medical case research;3.2 Based on case-based reasoning method,the medical records of traditional Chinese medicine treatment of diabetes and kidney disease were studied,and the knowledge representation model and similar medical record retrieval model of medical records were constructed;3.3 From the literature,320 medical literatures and medical doctors'clinical experience in treating diabetic nephropathy were selected from the literature.After extracting the diagnosis and treatment information and preprocessing the data,a 292 data,60 symptom attributes,and 3 syndrome types were obtained.A classified data set of experience in diagnosis and treatment of diabetic nephropathy.Random forest method was used to perform machine learning on the obtained data set and calculate the importance of symptoms for syndrome differentiation.I selected edema,tinnitus,chills and cold limbs,thick/greasy tongue coating,anorexia,dry mouth and throat,fever,35 symptom features such as burnout and fatigue are important hints for the diagnosis of diabetic nephropathy.Combining the principal component analysis method and the nearest neighbor method,the 35 symptom features selected by the random forest method are reduced to a comprehensive index containing 20 principal components,and the similarity calculation is performed on the data in the data set according to the Euclidean distance formula to complete Construction of similar case retrieval model.After a 10-fold cross-validation,the accuracy of the model to correctly classify the data is 74%.3.4 Based on the similar medical record retrieval model,input the symptom data of the test medical record,and after the calculation of the similarity,you can output the 3 medical record data subsets that are most similar to the test medical case symptom data in the data set,and perform similarity from high to low similarity Degree sorting.Comparative analysis of symptoms and syndrome types,treatment methods,and prescription medications of test medical records and similar medical records exported.It is found that due to the complexity of TCM syndrome differentiation of diabetic nephropathy,similar symptoms will be caused by medical doctors' experience Differences are divided into different syndrome types,but even if different doctors have different opinions on the syndrome differentiation of similar symptoms,there are similarities and mutual reference values in treatment ideas and specific prescription medications.4.Research conclusionThe idea of carrying out TCM medical case research based on case reasoning has certain feasibility.The retrieval mode of similar medical cases can save more complete medical case information,and the search results can be directly returned to the original medical case for diagnosis and treatment.The research conclusion can directly support clinical decision-making by bringing the results of similar medical case diagnosis and treatment ideas and treatment plans,displaying the overall medical case information to give hints to clinical ideas,and with the continuous storage and real-time feedback of medical cases to form a dynamic development of medical case research status.The research idea starts from the symptoms of the patient's current condition,analyzes and extracts important symptom characteristics,and finds similar situations and treatment options that have occurred in the previous medical case.It can more directly and effectively support the clinical diagnosis and treatment path based on the classification treatment.Clinical decision.This study also proposes a method of constructing a TCM medical case research system based on case reasoning methods,which can provide ideas and methods for the study of TCM medical cases of other diseases,and suggest new ideas for the treatment of TCM case data from a methodological perspective.