基于案例-规则推理的中医群体证据与个体化诊疗融合决策模式构建OA

Objective To construct a TCM clinical decision-making model integrating collective evidence and individualized characteristics based on a case-rule reasoning model.Method Evidence-based guidelines for TCM treatment of ischemic stroke and case literature from renowned senior TCM practitioners were retrieved.Cases included in these sources were used to construct case reasoning and rule reasoning protocols.A hybrid weighted cosine similarity algorithm was employed for case retrieval to generate a candidate pool of similar base prescriptions.Symptom-drug association analysis was conducted based on symptom and drug data,and rule-based reasoning was applied for formula modification.Following validation via intelligent review rules and clinical expert assessment,individualized TCM treatment plans were generated.Results A total of six guidelines(containing 31 cases)and 98 articles(containing 121 cases)were included,and 27 strong symptom-drug association rules were extracted.Case-rule inference was performed on extracted medical records.The results demonstrated that this model could enable the matching of base prescriptions and provide decision support for drug modification,facilitating the generation of clinical treatment plans based on the experiences of renowned senior TCM practitioners.Conclusion The case-rule integrated decision-making model can effectively enrich the theoretical framework of TCM clinical decision-making.It provides a novel pathway for systematizing the inheritance of renowned senior TCM practitioners'experience and serves as an effective tool for delivering precise clinical treatment plans tailored to individual patient characteristics.