Xia Shujie, Zhang Jia, Du Guodong, Li Shaozi, Vong Chi Teng, Yang Zhaoyang, Xin Jiliang, Zhu Long, Gao Bizhen, Li Candong
Research Base of Traditional Chinese Medicine Syndrome, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
Department of Artificial Intelligence, Xiamen University, Xiamen 361005, China.
Evid Based Complement Alternat Med. 2020 Nov 26;2020:9081641. doi: 10.1155/2020/9081641. eCollection 2020.
Metabolic syndrome (MS) is a complex multisystem disease. Traditional Chinese medicine (TCM) is effective in preventing and treating MS. Syndrome differentiation is the basis of TCM treatment, which is composed of location and/or nature syndrome elements. At present, there are still some problems for objective and comprehensive syndrome differentiation in MS. This study mainly proposes a solution to two problems. Firstly, TCM syndromes are concurrent, that is, multiple TCM syndromes may develop in the same patient. Secondly, there is a lack of holistic exploration of the relationship between microscopic indexes, and TCM syndromes. In regard to these two problems, multilabel learning (MLL) method in machine learning can be used to solve them, and a microcosmic syndrome differentiation model can also be built innovatively, which can provide a foundation for the establishment of the next model of multidimensional syndrome differentiation in MS.
The standardization scale of TCM four diagnostic information for MS was designed, which was used to obtain the results of TCM diagnosis. The model of microcosmic syndrome differentiation was constructed based on 39 physicochemical indexes by MLL techniques, called ML-kNN. Firstly, the multilabel learning method was compared with three commonly used single learning algorithms. Then, the results from ML-kNN were compared between physicochemical indexes and TCM information. Finally, the influence of the parameter on the diagnostic model was investigated and the best value was chosen for TCM diagnosis.
A total of 698 cases were collected for the modeling of the microcosmic diagnosis of MS. The comprehensive performance of the ML-kNN model worked obviously better than the others, where the average precision of diagnosis was 71.4%. The results from ML-kNN based on physicochemical indexes were similar to the results based on TCM information. On the other hand, the value had less influence on the prediction results from ML-kNN.
In the present study, the microcosmic syndrome differentiation model of MS with MLL techniques was good at predicting syndrome elements and could be used to solve the diagnosis problems of multiple labels. Besides, it was suggested that there was a complex correlation between TCM syndrome elements and physicochemical indexes, which worth future investigation to promote the development of objective differentiation of MS.
代谢综合征(MS)是一种复杂的多系统疾病。中医在预防和治疗MS方面具有疗效。辨证是中医治疗的基础,由病位和/或病性证候要素组成。目前,MS的客观、全面辨证仍存在一些问题。本研究主要针对两个问题提出解决方案。其一,中医证候具有兼夹性,即同一患者可能出现多种中医证候。其二,缺乏对微观指标与中医证候之间关系的整体探索。针对这两个问题,机器学习中的多标签学习(MLL)方法可用于解决,还可创新性地构建微观辨证模型,为后续MS多维辨证模型的建立提供基础。
设计MS中医四诊信息规范化量表,用于获取中医诊断结果。基于39项理化指标,采用MLL技术构建微观辨证模型,即ML-kNN。首先,将多标签学习方法与三种常用的单标签学习算法进行比较。然后,比较ML-kNN在理化指标和中医信息方面的结果。最后,研究参数对诊断模型的影响,选择最佳值用于中医诊断。
共收集698例病例用于MS微观诊断建模。ML-kNN模型的综合性能明显优于其他模型,诊断平均精度为71.4%。基于理化指标的ML-kNN结果与基于中医信息的结果相似。另一方面,参数对ML-kNN的预测结果影响较小。
本研究中,采用MLL技术构建的MS微观辨证模型擅长预测证候要素,可用于解决多标签诊断问题。此外,提示中医证候要素与理化指标之间存在复杂相关性,值得未来深入研究以推动MS客观辨证的发展。