| 英文摘要 |
Objective: In traditional Chinese medicine syndrome differentiation under the guidance of the theory and methodology of ontology building typhoid fever syndrome classification database, through to the syndrome classification information parsing, comprehensive system of mining, combing typhoid to learn the contents contained in the cure of disease classification system, syndrome elements, and clear the ownership of the relationship between each other, realize the dialectical elements in systematic and structured. And the ancient and modern representative typhoid fever syndrome classification framework is analyzed, advantages and disadvantages of evaluation, to provide reference for the new unified dialectical classification framework. In addition, the further study of treatise on febrile disease related disease classification experts Mr. Yao trouble of treatise on febrile disease syndrome classification system. Yao finally in fully absorb the old treatise on febrile disease, on the basis of dialectical classification system, combined with syndrome differentiation of typhoid learning ontology elements and the advantages and disadvantages of past dynasties doctor dialectical classification framework, which can accommodate both has the classic content, can broaden the later development of the integration of syndrome classification framework, in order to establish a unified system of syndrome classification methodology, the logical basis. Methods :(1) literature research: first, to collect the current typhoid disease classification, disease of syndrome standardization, the disease such as the literature ontology research, to understand the current typhoid disease classification, disease of syndrome standardization, disease research status of ontology. Second, typhoid learning related literatures, understand the conditions of the typhoid learn about present situation of classification, for representative book on the theory of ancient and modern typhoid disease classification framework of classification features, advantages and disadvantages of comment. Third, study and research of Jiangxi typhoid fever, typhoid disease classification expert he-sheng Yao related typhoid disease taxonomy of literature. (2)ontology construction methods: term from typhoid, disease and determine the disease classification ontology classes and properties. Described disease confirmed cases as an object, with the classification and coding technique to the disease confirmed cases of the ontology classes, attributes and attribute values are encoded, library building ontology instance. Results:1. In the traditional Chinese medicine syndrome differentiation under the guidance of the theory and method of building ontology, surrounding the core of differentiation, this topic has constructed the typhoid disease ontology in the field of learning, illness, pathological mechanisms of ontology, the ontology is ontology, disease ontology, dialectical elements reference factors of ontology, and the ontology, the ontology and other Israeli certificate (contraindicated, degree certificate, the complexity of the class certificate, a similar card) ontology, disease (disease, symptoms, bad disease) ontology, a total of four levels of ontology. 1.1 the cause of ontology: according to the cause of the main causes of its attribute the source of pathogenic cause, pathogenic properties, measurement, the relationship between the cause to build; The default cause source including the loss of the crisis, diet, modern, trauma, etc.; Default of pathogenic properties including five, six exogenous and endogenous pathogenic products, tangible intangible, Qing Zhuo, size, nature of Yin and Yang, the primary secondary. 1.2 disease ontology: refers to the pathological changes of the patient's premises. Results show that the disease has the property of bearing, such as horizontal disease on a table and the longitudinal illness, in, under three; And what specific disease viscera, joints, muscles, as well as the specific material life level, involving who, camp, qi, blood, tianjin, fluid, Yin and Yang. Summarize these specific disease, can be summarized as three categories, namely, images, the sanjiao (triple energizer), up and down in the tables, for a regional concept, called ward; Joints, muscles, etc. For the location of the specific pathological changes of disease, called the disease; And pathological changes involved material, referred to as layer. Such disease classification from coarse to fine, all aspects involved in lesion site of action, should be able to describe accurately and fully ills. 1.3 pathological mechanisms of ontology: the abnormality of pathogenesis are disease development change; From pathogenesis ontology can be subdivided into gasification properties change, abnormal motion state two big aspects, gasification properties change is the nature of the material life changes, involved in the study more was cold, hot, Yin, Yang, essentially should include six gas gasification; Abnormal motion state refers to the body's qi activity (life substance or pathological motions) abnormal changes, mainly for movement, an abnormal discrepancy, clutch, an abnormal fluctuation. 1.4 even ontology: you have a sudden onset of potential, the change trend, potential of the course and outcome, outcome of including the degree of illness, the illness movements, life three aspects. 1.5 syndrome elements reference factors ontology: the sick body, sick as reference factors of disease because of sick body and disease can be one or several elements have a disease and instructional role. 1.6 six-channel class: the ontology by six-channel diseases, including the six-channel lesions that the certificate itself, subdivided into outline card, master card, card, master card for a once major, the notion of a class of common disease, according to outline of syndrome often hint this often see disease, so the outline card belong to the master card; Change card is in addition to the main card outside the other diseases by; This credit points outline card, master card, certificate is to show six-channel lesion of primary and secondary, often change, to know to change often. And clip card points or disease, and disease, syndrome, intermediate and inclusions and the other card, or disease for more than two approved by or two the disease at the same time, and disease for has not appeared again and let the other disease is disease, while the joint disease, and disease are two lesions occur, but has the onset is different; With the prompt ferrite gas, physical causes such as v bias. In the middle is the transition of two diseases disease syndrome, have the characteristics of two parts of the disease. The variable conditions of the card is what disease have changed, the change certificate should be divided into lost pass card, the disease spread, from a large number of preach change certificate can be summed up in a certain change rule, in order to clinical can judge the trend of the change as soon as possible and timely give truncation, instances in the ontology can be seen in the treatise on febrile disease become the relatively rich, prompt disease's development and changes, remind to pay close attention to the disease, especially the new disease and cure disease, the disease of disease. 1.7 and class certificate ontology: Ephraim class certificate ontology is describe disease in treatment methods, treatment points card first categorize treatment, treatment classified content is rich, have six-channel treatment, the treatment table, treatment, therapeutic principle and taboo, treatment; Six-channel treatment that is right to treatment, discernment method, strain and save the inverse method, the mediation method, type of disease, treatment, complex treatment, message method, the treatment is mainly based on six-channel diseases often set, change, the primary and secondary treatment of six-channel various lesions guiding is stronger., vomiting, and under the treatment of sweat, fill, warm, clear, and guide the method, including in an attempt to classify, such as "urgent, urgent" in the "urgent" and even "urgent" in photograph echo, yes treatment suit with you. Taboo treatment is a kind of way to delimit the treatment scope, is a clinical treatment must follow the principle of the least; Treatment is a variety of treatment of the final implementation. Treatment points of syndrome is helpful to master the method of corresponding relation, its clinical forensic typical bluff can quickly determine the treatment, so it's treatise on febrile disease (disease research a kind of important method, but is a hindrance when forensic atypical. 1.8 class certificate Israeli ontology: Israel class that should be a part of the ontology hierarchy should be first class party card, this study, a total of 19 class, class party card points under specific prescriptions, concrete under class certificate for specific prescriptions of TCM prescriptions class certificate, specific treatment of each party by the class certificate is given priority to treat certificate, cure and change cure, the certificate and miscellaneous cure syndrome, save the inverse, unprepared certificate, weight certificate, weight certificate, simple and complex syndrome, similar certificate, contraindicated. The attending of syndrome is the most commonly used in the treatment of the disease in his own, and the treatment of disease is put to the next to the card, change cure syndrome is flexible treatment of disease, the certificate should continue to use his own conditions of the treatment, save inverse card is used for the conditions of the lost after the crisis; According to its main disease is, complexity have weight, simple and complex, in order to follow a similar card for identification, special column similar syndrome; According to the performance of the disease and typicality points every card, in order to master it is difficult to identify party card. Can say prescription card points to build a more system disease classification system, classification is very fine. Formed by the party card can quickly when the clinical syndrome differentiation in the typical directly determine the formulas, provides a method of syndrome differentiation and treatment of the fastest, but when the party card is not a typical hard to syndrome differentiation. 1.9 other class certificate (show degree class certificate, complexity class certificate, a certificate card, contraindicated) ontology appear degree certificate including the typical venereal card and card of atypical venereal, refers to the typical disease clinical manifestations, on the one hand is relatively familiar disease of, on the other hand prompt clinical manifestations of disease and significantly. Complexity class description including pure venereal disease and syndrome and complex disease, simply by a number of causes, what disease is relatively limited, less disease pathogenesis is relatively single, complicated by a number of causes, causes more complex relationship, disease and clip, pathogenesis, even more difficult to judge .Classification complexity disease often prompt diagnosis and treatment of disease and difficulty level, good or bad prognosis and outcome .Similar syndrome classification mainly to similar disease between identification, so that accurate judgement. Taboo told in the class certificate for treatment, medication, therapy and specify a range of treatment, the formulas to prevent the disease. 1.10 disease (disease, symptoms, bad disease) the disease class of ontology ontology based on disease principles, classification of syndrome, such as thoracic disease points cold solid chest, hot solid knot chest card, big chest, subtotal chest card. To be sure disease classification is different from western medicine of traditional Chinese medicine, Chinese medicine disease often with symptoms or pathogenesis, disease, cause of disease such as element combination. So essentially should belong to the cause of syndrome and disease class, pathogenesis, or multiple factors combined with class certificate. Symptoms class certificate ontology, such certificate is gather those who can appear the symptom of the syndromes of classification methods, to achieve further reveal the nature of symptoms, and suggest the possibility of multiple pathological essence of a symptom, not a symptom alone give symptomatic treatment. Bad disease class certificate ontology. Bad disease is through a variety of conditions of the treatment is still unsolved, often hint pathological factors of complex, which causes the inclusion, and pathogenesis of multiple, outcome difficult sentence, syndrome differentiation, treatment is difficult. 1.11 to achieve the connection of 36 this book on the theory of typhoid fever in treatise on febrile disease conditions of the original text of article 398 of the classification of knowledge ontology expression. Using framework of ontology to 36 kind books on the theory of typhoid fever in the treatise on febrile disease (disease classification knowledge of article 398 of the original expression, constituted with each of the original factors of disease knowledge set. So, intuitive, and a summary introduction to the various of various provisions related disease classification knowledge, a kind of literature on through the ages and collecting the results is essential elements of the disease through the comparison of each of the original nature of the disease and learning and research. 2. The elements of disease classified can be divided into classification, disease and even classification, the classification of disease, disease classification, classification six aspects of classification, treatment of 38 projects. The disease classification of 23:1 item (cause) containing etiology, classification, disease classification by seven (images, table, gasification, 3, qi and blood, body fluid, god), pathogenesis, classification of the five (gasification, Yin and Yang, fever, false or true, abnormal condition), the relationship between disease and 10 (master certificate change certificate, specimens, and clip, disease and disease/two feeling, intermediate certificate, similar certificate, typicality atypical, pure complex and miscellaneous diseases). Attempt classification of 11 diseases (good or poor, outcome, attack way, over weight, recurrence, heritage, after the change, the bad card, have puzzled, showing changes, the new long duration).Disease classification paragraphs 1 (name), disease classification 1 (conditions), the classification of 2 item (Ephraim to certificate, the israelis to card, with treatment 1 item). Visible, the classification of syndrome differentiation for projects in nearly three points to two projects, highlight the note home is paid great attention to the connotation of the treatise on febrile disease syndrome classification, among them, the identification of the classification of six-channel top (172-74.78%, on the table, the fever, the actual attention were also among the eight principles element such as (respectively: 115-50%, 99-43.04%, 88-38.26%, with abnormal 55-23.91%, for images combined with and clamp, the inner parts, the gasification theory, has been more forward (100-43.48% respectively 80-34.78%, 76-33.04%, 49-21.30%, and for the classification of the camp gas blood, body fluid, such as 3 have some consideration (respectively:36-l 5.65%, 35-15.22%, the relationship between disease, also have a master (often) become the obvious distinguish, specimens, and made a similar card (79-34.35%), individual typical or not, simple, complex inclusions, intermediate syndrome (1～2,0.43%～0.87%) concepts such as, to recognize the diversity of all the diseases and a variety of relations, also have a positive significance. Will find in the table, disease classification, although only one, but the proportion is large, more than half (143-62.17%) , shows that a significant percentage of physicians still decided that on a philosophical points, mainly for treating diseases epidemic disease, especially for these cold disease and stand. Also found in the table, even classification is highlighted, 11 projects of diseases (good or poor, outcome, attack way, over weight, recurrence, heritage, after the change, bad card, the confused, showing changes, the new long duration). This is one aspect, because really focused on foreign feeling Yu Zhongjing original typhoid disease occurrence, development and change in dynamic process, so the rich content of typhoid disease to plant diversity evolvement of relationship between disease and, on the other hand, also reflects the classification of disease and unconsciously, the disease status and trends in the process of syndrome types in diseases, can have differences because of different diseases. Such as: lingya gan decoction syndrome, guangxi in typhoid disease, mainly in the table cold misused to vomit, injury of spleen Yang, change the transfer in cold trap still drink in, belongs to the scope of bad illness, but in the internal injuries miscellaneous disease, is happening in the spleen Yang this weak, drink water gradually stopped in one of the four drinks of master card, belongs to medium the scope of the certificate of phlegm retention. Also worth pointing out that there are two things: one is, disease classification, in the table is also 1 item and proportion is big, close to half (103-44.78%) the extension of is the method of disease classification, based on the traditional Chinese medicine disease classification not enough mature, and the key to primary symptom (often complain) for the identification of crude Jane disease classification. Second, in the table of classification of Ephraim to certificate, Israel to the 2 items, the proportion of small, (respectively: 112-48.70%> 47-20.43%) is a special flexible disease classification method, namely the ephah with classified with the same type of justification of syndrome elements, there are differences seeking, pare down, direct advantage of treatment. If no matter how different philosophical fever, but are not sweat, there are more table yu xuan, when the sweat method, can be the proof of ownership when khan, choose published for the formulas; If is not he, will and relieving gas not machine, reason attributable to the card, can choose in France. 3.(1) all previous dynasties on the conditions of the related book classification in general follow the idea is the same with images classification. 13 species classification framework, in addition to the "1. The sort with treatment" one type, the other types are the way to build a framework of images. But there is a significant part, is based on the original classic philosophical points of academic background, for those routes, and on the nature of philosophical classification basis, may not be carried on the thorough discussion. (2)the factors related to classification framework is rich, the diversified angles. In the second category, has combined with exogenous causes, such as "8. Images combined with six gas classification", "4. Images combined with cold WeiYing classification". With combination of disease pathogenesis, such as "4, Images combined with cold WeiYing classification", "six to 11. Six-channel combination classification"; With detailed specific disease, such as "3. Images combined with classification of zang-fu organs and meridians" "7. Philosophical sort table"; Any reference disease relationship, such as "6. Images combined with this and the classification"; Any reference course direction, such as "13. Six-channel combining course stage classification"; Has prominent corresponding treatment, such as "2. Sort images combined treatment", "9. Six-channel combination is becoming sort therapeutic principle"; Have direct specific license, such as "5. The images combined with the classification"; Any reference fusion of disease, such as "12. Images combined with sort of disease". Visible, classification of elements involved in etiology, duration of disease, pathogenesis, diagnosis, therapy and, even more, formula of many aspects, such as, not is not complete, but each have advantages and disadvantages between all kinds of framework, but said their limitations, based on historical conditions between each frame, each other has not been formed the pattern of the study, learn from each other and can fully mix, and further detailed study the framework system, there are lack of accurate classification levels, the type is incomplete, the distribution of disease under six-channel phenomenon such as density is different, therefore, up to now, the conditions of the typhoid learn classification framework is still in a state of all schools of thought contend. 4.he-shengYao sick syndrome classification results. (1)based on the principles of TCM pathogenesis, caught the syndrome pathological nature (the three elements of pathology) as the fundamental standpoint of syndrome classification. (2)the cause on the classification, causes to form the points of the crisis, or by its unknown variable and two straight;Causes the six evils of the main points (wind, cold, heat, dampness, dryness and fire) as well as the function material (camp, wei, qi, blood, tianjin, liquid, liquor, god, Yin and Yang) lesions become the cause (subdivided into water, phlegm, blood stasis etc. real evil qi deficiency and Yang deficiency, jing kui, such as the function material is insufficient for evil). (3)disease classification: by defining the essence of six-channel viscera, meridian, including form, obsessed with the officer, etc., will be inside the body, from top to bottom of the partition, table level 2 certificate, the certificate can be divided into tables, level 3 table certificate, the certificate, half exterior and half, four points method to subdivide table card to the fur, cou justified, muscle, miao qiao, meridians, joints, etc in the table, the table in the table of different; Card in the inner parts in the dirty points in the table, in the different; Half exterior and half points in half table and partial semi different;Points in the upper energizer, up and down in the middle of upper and lower the hardness of different. Had included viscera, meridian syndrome differentiation and syndrome differentiation through differentiation of disease classification, is more than a master of the disease. (4)On the pathogenesis of classification: according to the philosophical function contains substances camp, wei, qi, blood, tianjin, liquid come into the camp, Yin and Yang lesions disease, illness, disease, blood disease, disease, tianjin, fluid disease, Yin, Yang disease is different; To the shortcomings of the functional material in nature and the nature of the change were divided into deficiency syndrome and empirical. Which contains the syndrome differentiation, qi-blood who camp and pathogenesis of blood syndrome classification content gas, in addition to mental disease classification of Yin and Yang added. In addition to acting and pathogenesis pathology product will become secondary causes. (5)The classification of the classification method is eight principles embodied, final classification of the smallest unit, can be directly to guide the clinical diagnosis and determine accurate differentiation therapy and specific therapeutic principle, the formulas. (6)By using the theory of six gas will ably and ties into the heavens and the earth, and give full play to the role of the harmony thought in the understanding of traditional Chinese medicine disease, through six qi theory emphasizes the physiological and pathological pharmacological continuity, form the system of evidence theory system.is to expand the scope of table card: yao old combined with eight principles, in the table is divided into tables, half exterior and half the level of the three big, and put forward the images have table card, each card for table of disease classification, description is very fine, in the form, such as fur, muscle, cou justified, channels, joints, the miao qiao such as mouth, nose, throat, eyes and ears, the meridians, such as in the brotherhood of meridians so far to expand the scope of table card, from the basic theory in the correction of the current table card and issuing the wrong understanding of relative concepts unbecoming, such as exogenous pathogens from clinically effective instruction long outside the table don't understand, in phase and phase lead list certificate and related table certificate of diagnosis and treatment. (7)category to disease and disease for performance and the proposed closer to the miscellaneous diseases is more and more clinical syndrome and facts.With the improvement of social material life level, food diversification, and spiritual factors such as work stress, loss of crisis under the influence of many factors, such as, present a more miscellaneous disease, clinical performance for the photograph and, if only a single syndrome to recognize is far can not effectively guide the clinical diagnosis and treatment of disease. (8)for the specific classification of syndrome, and the content covers all the etiology, disease, pathogenesis, time, the main basis of primary symptom and diagnosis, and suspected to identify key points of syndrome, treatment of taboo, avoid boiling, nursing of appropriate drugs, medication that may occur after the reaction, response and recovery time, prognosis, and outcome of the rich content, such as the above certificate for content are all accurate syndrome classification of strong support.Cause (or direct classification on evil or came by it through), (how) disease pathogenesis and prognosis of outcome (change), is helpful to the understanding of the whole dynamic disease development change rule. 5.(1) To establish a universal disease of TCM syndrome classification framework based on the above ideas, we have every reason to establish a complete, clear logical structure and a dialectical elements disease covers the universality of rich disease of TCM syndrome classification framework.This classification framework begins with sum of Yin and Yang, across the border images, meticulous five body nine orifices of zang-fu organs and meridians, series with six to machine enclosed, covers six air gasification, containing camp guard spirit and qi-blood (yuan Yin yuan Yang) change, born to fit all can't out of the left and right sides, can accommodate the disease do. But different diseases, in which good hair will have different disease groups, and between disease and symptoms, the variable path will have bigger difference, relationship is also presented in different directions.Such as typhoid disease is disease, more sufficient sun meridians table of syndrome, cold more and more hurt more than sun be the spirit, so in a more about winning or losing depends a sun be the spirit of the ups and downs, etc.;Warm diseases while lunar disease, miao qiao table card, thermalization, injured Yin fluid, which in a winning more about Yin fluid loss, etc.;Internal injuries diseases are six-channel in the zang-fu organs, deficiency syndrome, and the battle directly what about five viscera essence, etc., miscellaneous diseases diseases with internal and external coupling, the gas phase, list and characteristics, factors of certificate for good hair, etc..., but no matter what kind of change, they are the disease classification system in certain parts of the content. (2)discrete ZhuanBing type six-channel diseases classification framework, admittedly, diseases from philosophical scope, but because of the effect of different diseases on the philosophical system have different preferences, and so on the disease distribution, they have different characteristics and the change rule clear proof, to fully reflect their respective diseases on six-channel differentiation characteristics and laws, it is necessary, can also follow the above framework under the background of the overall logic, their enrichment, refining a version of the characteristics of six-channel ZhuanBing frame (frame).Such as typhoid ZhuanBing six-channel classification framework (zhongjing treatise on febrile disease with typhoid fever, is based on the material part of the original), warm disease ZhuanBing six-channel classification framework (in the pond the original article warm disease zen wu, is based on the material of warm disease), miscellaneous diseases ZhuanBing six-channel classification framework (in zhongjing miscellaneous diseases of the original from synopsis, is based on the material part), etc., one of the key points, is according to the diseases, such as etiology, adding their own master card, certificate, and certificate of classification identification, and drew the outline of the variable relationship, their common syndrome differentiation and treatment of the highlight and reflect their respective characteristics, focus and conventional!So as to achieve system disease of syndrome classification framework of universality and ZhuanBing dialectical cure law son particularity of organic unity!The so-called ZongZhongJing zhongjing typhoid fever syndrome classification of the solution and not writing the provision of higher realm! Conclusion: 1. This topic using ontology construction and relevant analysis methods of typhoid disease classification's literature collection, the classification of typhoid disease term conducted a comprehensive and detailed understanding, in order to determine the classes and properties of the field, with a selection of the conditions of the book on the theory of 36 typhoid classified content as the material, from top to bottom, to disease as a class, from class multiple attributes of etiology, disease, pathogenesis, even more, when sick body, illness, treatment, prescription, symptoms, disease, and complexity degrees, such as to all-round, systematic description of the disease, build the four levels of ontology, with strong inclusive;S econdly, from the first supplement ontology, the ontology from coarse to fine layout. In addition, everybody have a clear definition of classes and properties, and makes the classification more specification. At the same time also shows that the conditions of the ontology is a kind of practical classification knowledge expression method, worthy of further promotion. 2.The classification of disease and can consider from many Angle, but not out of the cause, the core of the disease and the pathogenesis of these diseases have problems, but by indirectly, multiple points of view, the three-dimensional relationship of disease and more comprehensively and diversification. Ancient and modern Chinese medicine eye to eye, treatise on febrile disease is still the excellent research of TCM classics, its principle and method for classification of syndrome differentiation and the system of governance, is one of the crown of excellent research of traditional Chinese medicine, ancient and modem physicians through continuous efforts, has been on the classification of syndrome differentiation methods and elements is fully tapped refining, formed the diversification can be built from the perspective of multidimensional framework, just because of the limitation of time conditions have not yet completed systematic carding and integration, now need from regression principle and principle of classification of disease and syndrome differentiation, absorbing the classification factors of the framework, to integration of organization associated with hierarchical arrangement, is expected to refine the home advantage in a furnace, the construction of a more systematic, three-dimensional disease classification framework. 3.he-shengYao treatise on febrile disease syndrome classification set up the framework of a larger inclusive, involve wide, almost include the etiology, disease, pathogenesis and pathologic factors of all content, especially in this kind of classification method under the guidance of syndrome differentiation and treatment after several generations of many years of clinical and teaching practice, made a number of famous doctors, set the benchmark for Chinese medicine diagnosis and treatment, can be used as a traditional Chinese medicine syndrome differentiation standardization of syndrome classification under the basic model for promotion. We think, the development of syndrome classification study, if you insist on Yao, causes, put forward by the old machine three-dimensional integ
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