CAJ | 학술논문

真实世界临床诊疗活动是一个复杂的决策过程。中医学中名老中医效验案例对日常诊疗行为的指导和诊疗知识的普及具有重要作用。本文基于临床实际中医病历数据，提出基于名老中医临床诊疗效验案例，基于案例推理的中医临床诊疗决策支持系统，用来辅助经验不足的临床医师做出临床决策，以提高临床疗效。该系统从中医临床数据仓库中筛选加工形成中医学临床效验案例库，基于案例推理和相似性计算实现类似案例的检索和展示。特别是针对不同案例的个体性特点，实现了基于症-诊断-药相关分析的灵活的案例修正方案，以满足临床诊疗过程中个体化诊疗决策的需求。最后，通过示范性临床实例应用，对系统的效果进行了初步评价。
진실세계림상진료활동시일개복잡적결책과정。중의학중명로중의효험안례대일상진료행위적지도화진료지식적보급구유중요작용。본문기우림상실제중의병력수거，제출기우명로중의림상진료효험안례，기우안례추리적중의림상진료결책지지계통，용래보조경험불족적림상의사주출림상결책，이제고림상료효。해계통종중의림상수거창고중사선가공형성중의학림상효험안례고，기우안례추리화상사성계산실현유사안례적검색화전시。특별시침대불동안례적개체성특점，실현료기우증-진단-약상관분석적령활적안례수정방안，이만족림상진료과정중개체화진료결책적수구。최후，통과시범성림상실례응용，대계통적효과진행료초보평개。
Real world clinical diagnosis and treatment activity is a complicated decision-making task. The effective clinical cases of traditional Chinese medicine (TCM) of highly experienced physicians play an important role in the routine diagnosis and treatment and the formulation of medical knowledge . Based on TCM electronic medical record data, this paper proposed a decision support prototype system on TCM clinical diagnosis and treatment based on TCM effective clinical cases and case-based reasoning (CBR) algorithm, which is used to assist inexperienced clinicians to make more reliable clinical decisions, and thereafter to improve the clinical curative effectiveness. The system integrates TCM clinical cases data set from a TCM clinical data warehouse, and retrieves the similar cases based on CBR method. In particular, according to the underlying personalized diagnosis and treatment for patients in TCM, this system implemented a flexible diagnosis and treatment modification mechanism based on correlation analysis among symptoms, diagnoses (syndrome or pattern in TCM) and medicine. Finally, through a demonstration of clinical application, we made an initial evaluation of the usefulness and practical effects of the system.