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基于部分可观测马尔可夫决策过程的中西医结合优化治疗不稳定型心绞痛方案

[Optimized treatment program for unstable angina by integrative medicine based on partially observable Markov decision process].

作者信息

Feng Yan, Xu Hao, Liu Kai, Zhou Xue-Zhong, Chen Ke-Ji

机构信息

Department of General Practice, Anzhen Hospital, Capital Medical University, Beijing 100029, China.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2013 Jul;33(7):878-82.

Abstract

OBJECTIVE

To initially optimize comprehensive treatment program for treating and preventing unstable angina (UA) by integrative medicine (IM).

METHODS

Based on partially observable Markov decision process model (POMDP), we chose 3 syndrome elements, i.e., qi deficiency, blood stasis, and phlegm turbidity from UA inpatients. The efficacy of treating UA by IM was objectively assessed by in-depth data mining and analyses.

RESULTS

The treatment programs for UA patients of qi deficiency syndrome, blood stasis syndrome, and phlegm turbidity syndrome were recommended as follows: nitrates +statins +clopidogrel +angiotensin II receptor blockers +heparins +Astragalus membranaceus +Condonopsis + poria and large-head atractylodes rhizome (ADR = 0.85077869); nitrates + aspirin + clopidogrel + statins + heparins + Astragalus membranaceus + safflower + peach seed + red peony root (ADR = 0.70773000); nitrates + aspirin + statins + angiotensin-converting inhibitors + snakegourd fruit + onion bulb + ternate pinellia + tangerine peel (ADR = 0.72509600).

CONCLUSION

As a POMDP based optimized treatment programs for UA, it can be used as a reference for further standardization and formulation of UA program by integrative medicine.

摘要

目的

初步优化中西医结合治疗及预防不稳定型心绞痛(UA)的综合治疗方案。

方法

基于部分可观测马尔可夫决策过程模型(POMDP),从UA住院患者中选取气虚、血瘀、痰浊3个证素。通过深入的数据挖掘与分析,客观评估中西医结合治疗UA的疗效。

结果

推荐气虚证、血瘀证、痰浊证UA患者的治疗方案如下:硝酸盐类+他汀类+氯吡格雷+血管紧张素II受体阻滞剂+肝素+黄芪+党参+茯苓和白术(平均决策风险=0.85077869);硝酸盐类+阿司匹林+氯吡格雷+他汀类+肝素+黄芪+红花+桃仁+赤芍(平均决策风险=0.70773000);硝酸盐类+阿司匹林+他汀类+血管紧张素转换酶抑制剂+瓜蒌+薤白+法半夏+陈皮(平均决策风险=0.72509600)。

结论

作为基于POMDP的UA优化治疗方案,可为进一步规范和制定中西医结合UA方案提供参考。

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