Chinese Joumal of library and Information Science for Traditional Chinese medicine Aug 2014 Vol 38 No 4 基于临床病历数据化的名老中医经验 传承方法学研究 周霞继',王映辉",刘保延?,张润顺,周雪忠3,薛燕星 1.中国中医科学院广安门医院,北京100053:2.中国中医科学院,北京100070 3.北京交通大学计算机学院,北京100044 摘要:目的以中医临床诊疗信息采集系统为技术平台,获取名老中医临床诊疗数据,以数据挖掘分析 平台为工具,构建名老中医经验传承研究的方法学。方法在不干扰名老中医诊疗实践的前提下,利用结构 化名老中医临床诊疗信息采集系统,全面、动态地采集临床信息。在保留原始文本病历信息的前提下,使名 老中医临床诊疗数据直接转化为可分析的结构化数据,再利用名老中医临床经验分析挖掘平台,人机结合, 以人为主,总结名老中医经验。对名老中医经验进行临床验证,明确分析挖掘方法的可靠性及名老中医经验 的有效性、稳定性。结果利用结构化临床诊疗信息采集系统,采集51位名老中医、42209例患者的临床 诊疗数据,建立结构化名老中医病例数据仓库。研发了5种适用于名老中医经验的数据分析挖掘方法,用于 名老中医辨证经验、用药经验等综合分析。形成了26位名老中医专家经验总结报告。结论确定了名老中医 经验传承研究的方法,即利用结构化临床诊疗信息采集系统对临床病历数据化,利用数据挖掘分析平台进行 分析挖掘,形成知识库,在临床上进行应用验证,将证明有效的经验形成治疗方案及治疗理论来指导临床 并进一步在临床上推广应用 关键词:名老中医;临床病历;数据化;经验传承;方法学 doi:10.3969issn.2095-5707201404.002 A Methodological Study Based on Digitization of Clinical Medical Records of Famous TCM Veteran Doctors Experience Inheritanc Zhou Xiaji, Wang Yinghui, Liu Baoyan, Zhang Runshun, Zhou Xuezhong, Xue Yanxin (l Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China; 2. China academy of Chinese Medical Sciences, Bejing 100700, China; 3. College of Computer Sciences, Beijing Jiaotong University, Beijing 100044, China) Abstract: Objective By using traditional Chinese medicine(TCM) clinical diagnosis information collection system as the technical platform, and employing data analysis and mining platform as the tool, the authors constructed the methodology of famous TCM doctors'veteran experience inheritance based on their clinical treatment data. Methods Under the premise of without disturbing the treatment of famous TCM veteran doctors the authors collected comprehensive and dynamic clinical information through famous TCM clinical d information collection system. Famous TCM veteran doctors'clinical treatment data were directly transformed into structured data for analysis. The authors still preserved the original text medical information and summarized famous TCM veteran doctors'clinical experience by using famous TCM analysis mining platform, with the features of human-machine combination and people orientation. The authors verified famous TCM veteran doctors clinical experience, and clearly analyzed reliability of mining method and validity and stability of famous TCM veteran 基金项目:“十一五”国家科技支撑计划项目(2007BA10B06-01);北京市科技计划项目(D08050703020803) 2012年中医药行业科研专项(201207001) 第一作者:周霞继,主治医师,研究方向:中医临床信息学,中医临床术语规范应用研究。E-mai zhouxiaji20080163.com 通讯作者:王映辉,研究员,研究方向:名医经验传承方法,临床信息学方法。E-mail:wyhOwyhchotmai.com 21994-2014ChinaAcademicJournalElectronicPublishingHouse.Allrightsreservedhttp:/www.cnki.net• 4 • Chinese Journal of Library and Information Science for Traditional Chinese Medicine Aug. 2014 Vol. 38 No. 4 基于临床病历数据化的名老中医经验 传承方法学研究 周霞继 1，王映辉 1*，刘保延 2，张润顺 1，周雪忠 3，薛燕星 1 1.中国中医科学院广安门医院，北京 100053；2.中国中医科学院，北京 100070； 3.北京交通大学计算机学院，北京 100044 摘要：目的 以中医临床诊疗信息采集系统为技术平台，获取名老中医临床诊疗数据，以数据挖掘分析 平台为工具，构建名老中医经验传承研究的方法学。方法 在不干扰名老中医诊疗实践的前提下，利用结构 化名老中医临床诊疗信息采集系统，全面、动态地采集临床信息。在保留原始文本病历信息的前提下，使名 老中医临床诊疗数据直接转化为可分析的结构化数据，再利用名老中医临床经验分析挖掘平台，人机结合， 以人为主，总结名老中医经验。对名老中医经验进行临床验证，明确分析挖掘方法的可靠性及名老中医经验 的有效性、稳定性。结果 利用结构化临床诊疗信息采集系统，采集 51 位名老中医、42 209 例患者的临床 诊疗数据，建立结构化名老中医病例数据仓库。研发了 5 种适用于名老中医经验的数据分析挖掘方法，用于 名老中医辨证经验、用药经验等综合分析。形成了 26 位名老中医专家经验总结报告。结论 确定了名老中医 经验传承研究的方法，即利用结构化临床诊疗信息采集系统对临床病历数据化，利用数据挖掘分析平台进行 分析挖掘，形成知识库，在临床上进行应用验证，将证明有效的经验形成治疗方案及治疗理论来指导临床， 并进一步在临床上推广应用。 关键词：名老中医；临床病历；数据化；经验传承；方法学 doi: 10.3969/j.issn.2095-5707.2014.04.002 A Methodological Study Based on Digitization of Clinical Medical Records of Famous TCM Veteran Doctors’ Experience Inheritance Zhou Xiaji1 , Wang Yinghui1* , Liu Baoyan2 , Zhang Runshun1 , Zhou Xuezhong3 , Xue Yanxing1 (1. Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China; 2. China Academy of Chinese Medical Sciences, Beijing 100700, China; 3. College of Computer Sciences, Beijing Jiaotong University, Beijing 100044, China) Abstract: Objective By using traditional Chinese medicine (TCM) clinical diagnosis information collection system as the technical platform, and employing data analysis and mining platform as the tool, the authors constructed the methodology of famous TCM doctors’ veteran experience inheritance based on their clinical treatment data. Methods Under the premise of without disturbing the treatment of famous TCM veteran doctors, the authors collected comprehensive and dynamic clinical information through famous TCM clinical diagnosis information collection system. Famous TCM veteran doctors’ clinical treatment data were directly transformed into structured data for analysis. The authors still preserved the original text medical information and summarized famous TCM veteran doctors’ clinical experience by using famous TCM analysis mining platform, with the features of human-machine combination and people orientation. The authors verified famous TCM veteran doctors’ clinical experience, and clearly analyzed reliability of mining method and validity and stability of famous TCM veteran 基金项目：“十一五”国家科技支撑计划项目（2007BAI10B06-01）；北京市科技计划项目（D08050703020803）； 2012 年中医药行业科研专项（201207001） 第一作者：周霞继，主治医师，研究方向：中医临床信息学，中医临床术语规范应用研究。E-mail: zhouxiaji2008@163.com *通讯作者：王映辉，研究员，研究方向：名医经验传承方法，临床信息学方法。E-mail: wyh0wyh@hotmail.com