症状辨证意义级差探究意义及方法探析.docVIP

症状辨证意义级差探究意义及方法探析 　 作者：雍小嘉 陈云慧 徐姗姗 【摘要】 临床上的症状很多，每一个症状都具有一定程度的辨证意义，准确地对症状进行辨别分析，探讨其所反映的病理本质，对于病证诊断来说是极为重要的。但如何界定临床症状的辨证意义级差是目前没有克服的难题。症状的辨证意义级差不明确、不规范造成中医证的判断一直缺乏可以量化的标准，这也是中医诊断理论难以突破的症结。病案中所记录的症状及辨证结果就是来源于临床最直接、最真实的资料，如果结合先进的信息处理技术如数据挖掘方法，通过对大量病案的症状及辨证结果进行关联分析，探索不同症状的临床辨证意义级差，这是中医证候诊断客观化研究中，有别于实验研究的新的理论研究途径。 【关键词】 症状 辨证意义 级差 Abstract：Clinical symptoms are enormous and each of them is of certain significance for syndrome differentiation. To make a correct analysis on those symptoms and the pathogenic essences reflected by them is vital to the diagnosis of disease and syndrome. However, the ambiguous and nonstandard syndrome significance range of symptom has been long-known as the sticking point which results in the lack of quantifiable standard of TCM syndrome differentiation and the difficulty of making breakthrough in the field of researching TCM diagnostic theory. And currently the issue of how to define the syndrome differentiation significance range of clinical symptom is still a difficult problem. Since symptoms and syndrome differentiations in the medical record constitute data which directly and authentically reflect the clinic practices, this article holds that when such advanced information processing technology as data mining method is adopted to analyze the correlation between various symptoms and syndrome differentiation which were described by those medical records and to explore the clinic syndrome differentiation significance range of various symptoms, a new theoretical approach of objective researching on TCM syndrome diagnosis is available and is different from laboratorial research. Key words：Symptom； Syndrome differentiation significance； Range 中医对证的判断一直缺乏可以量化的标准，其关键问题之一就是临床症状的辨证意义级差不明确、不规范。而如何界定这些症状的辨证意义级差是目前没有克服的难题。这一问题不仅影响了中医临床辨证的统一性，而且也一直是中医诊断理论难以突破的症结。 1 症状辨证意义级差研究的意义 中医基础研究中，证候客观化研究是最重要的部分，而证候客观化研究包括证实质研究和证规范化研究两部分内容。证实质研究是从实验角度入手，对人体或动物的细胞、分子等结构的微观世界进行观察；证规范化研究则是以理论角度入手，包括证的命名规范、证的分类规范以及辨证规范三大类，属宏观研究。目前，证候客观化研究是以寻找证实质的实验研究为主，但由于人体复杂的