周小青　李金霞　郑彩杏　赖丽娜　童天昊　张运辉　刁承林　杨梦琳

〔摘要〕 中医诊察疾病应用望、闻、问、切四诊合参作为诊察手段，重视人体的自我感觉，全面、细致地挖掘临床资料，注重人与时间、空间的多维关系以及人体自身的调节能力，即全时程、多维时空、因人制宜，反映了患者的真实状态，是区别于现代检测手段的不同维度的精准。基于以上特点，开展中医计量诊断，需要建立在对中医基础知识的要素解析、临床资料的多维诊察基础上，规范基于主诉的中医临床诊疗基本路径，再进一步进行量化，对单一症状进行主次、诱因、程度、频率、持续时间、范围、缓解方式等定量，同时边问边辨，对症对、症队进行关联分析，根据症状的主次、贡献度进行加权与赋值，使辨证过程更为规范、标准、客观，中医诊断更为精准，为中医诊疗路径规范化、诊疗自动化提供有益借鉴。

〔关键词〕 中医计量诊断;诊疗路径;诊疗自动化;精准诊断

〔中图分类号〕R241       〔文献标志码〕A       〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.01.001

〔Abstract〕 Traditional Chinese medicine （TCM） diagnosis applies inspection， auscultation， inquiry and pulse-taking as means of diagnosis. TCM attaches importance to the feeling of the human body， collects clinical data comprehensively and meticulously， it pays attention to the multi-dimensional relationship with the time， space， and body's adjusting ability， namely， full-time， multi-space and individual treatment， this mode of diagnosis reflects the true state of patients， which is the precise standard of different dimensions different from modern detection means. Based on the above characteristics， we believe that the TCM metrological diagnosis should be based on the disassemble of the elements of basic knowledge of TCM and multi-dimensional analysis of clinical data. The basic path of TCM clinical diagnosis and treatment， which based on the chief complaint should be standardized and further quantified. The primary and secondary symptoms， causes， degree， frequency， duration， range and remission mode of a single symptom should be quantified. A correlation analysis between the symptom pair and the symptom team should be make after simultaneously inquiring and syndrome differentiating. Each symptom should be weighted and assigned according to the priority and contribution of the diagnosis， which means to make the syndrome differentiation process more standardized and objective， and make the diagnosis of TCM more accurate. This article will provide beneficial reference for the standardization of TCM diagnosis path and the realization of automation of diagnosis and treatment.

〔Keywords〕 traditional Chinese medicine metrological diagnosis; diagnosis and treatment path; automatic diagnosis and treatment; accurate diagnosis

中醫计量诊断的目的在于把疾病诊断的过程，在精确的数量化基础上，运用人工智能实现诊疗自动化，这也是精准医学对患者实施量身定制的保健医疗和临床决策的要求。受古代科技水平的限制，古人仅能通过人体感观上的望、闻、问、切收集临床资料，因而中医先辈对四诊的诊查相较于当代部分医生更为细致，对临床资料的分类更为细微，同时注重人与时间、空间的多维关系以及人体自身的调节能力，即全时程、多时空、因人制宜，这也是注重实验室检查的现代医学所欠缺的，或者说应当重视的。……