任晋宇 白琳 钟华

摘要：目的  研究和开发辅助中医医生诊疗的中医辅助诊疗推荐系统。方法  以中医历史病案数据为基础，利用数据挖掘技术和度量学习技术挖掘、整理中医诊疗经验知识，建立病案相似度计算方法，设计中医辅助诊疗推荐系统功能框架并开发应用系统。结果  设计并构建了中医辅助诊疗推荐系统，在四诊识别阶段为医生推荐候选症状，在辨证论治阶段为医生推荐诊疗方案，从而辅助经验不足的医生诊疗。结论  该系统可以在临床实践中辅助医生诊疗，从而降低中医传承难度、改善中医传承模式，更好地发展和利用中医药。

关键词：中医辅助诊疗;推荐系统;数据挖掘;度量学习

中图分类号：TP311.5;R241    文献标识码：A    文章编号：2095-5707（2021）03-0001-05

DOI： 10.3969/j.issn.2095-5707.2021.03.001        开放科学（资源服务）标识码（OSID）：

Design and Implementation of TCM Auxiliary Diagnosis and Treatment Recommendation System

REN Jin-yu， BAI Lin*， ZHONG Hua

（Institute of Software Chinese Academy of Sciences， Beijing 100190， China）

Abstract： Objective To research and develop a TCM auxiliary diagnosis and treatment recommendation system. Methods Based on TCM historical medical record data， this article established a method for calculating the similarity of medical records， designed the functional framework of TCM auxiliary diagnosis and treatment recommendation system， and developed the application system by using data mining technology and metric learning technology to mine and sort out the experience and knowledge of TCM diagnosis and treatment. Results A TCM auxiliary diagnosis and treatment recommendation system was built， which could recommend symptoms for doctors in the process of TCM four diagnostic methods， and recommend diagnosis and treatment plans for doctors in the stage of syndrome differentiation and treatment， so as to assist inexperienced doctors in diagnosis and treatment. Conclusion The system can assist TCM diagnosis and treatment in clinical practice， so as to reduce the difficulty of TCM inheritance， improve TCM inheritance model， and better develop and use TCM.

Key words： TCM auxiliary diagnosis and treatment; recommendation system; data mining; metric learning

中医学是现代医疗体系不可或缺的一部分。中医诊疗过程可概括为2个阶段：四诊识别阶段和辨证论治阶段。在四诊识别阶段，医生通过望、闻、问、切获得患者的四诊信息，从而了解患者身体状况。在辨证论治阶段，医生根据得到的四诊信息结合诊疗经验辨别患者证候，从而做出诊断和提出治法。整个诊疗过程以辨证论治理念为诊断依据，诊疗结果依赖医生个人经验，不确定的经验知识较多，传承难度大。同时，中医临床实践中也存在一些现象，如无证可辨、矛盾症状等，给经验不足的医生造成困难和挑战，缺乏诊疗经验可能导致其在四诊阶段不能全面获取患者身体状况信息;不同的辨证体系及多种不确定的经验诊断模式可能让其感到无所适从，导致诊疗方案疗效欠佳。……