JP2002288340A - Diagnosing method by oriental medicine and computer for performing diagnosing method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a diagnosing method that enables even a nonspecialist and a nonexpert to very easily utilize oriental medicine knowledge that is conventionally difficult to represent in an objective form, for actual diagnosis and medical treatment and to provide a computer for performing the diagnosing method. SOLUTION: This diagnosing method has a step for quantifying symptoms of a diagnosis item in each diagnosis item and making a computer store the quantified symptoms as a symptom database, a step for quantifying the goodness of fit of the diagnosis item to symptoms with respect to each prescription in each diagnosis item and making the computer store the quantified goodness of fit as a prescription database, a step for inputting patient's symptoms in each diagnosis item to the computer, a step for quantifying the patient's symptoms inputted in the computer on the basis of the symptom database, and a step for deciding an optimum prescription or an optimum combination of prescriptions for the patient by the computer on the basis of the quantified patient's symptoms and the prescription database.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

The present invention relates to a diagnostic method for oriental medicine using a computer database, and a computer for executing the diagnostic method.

[0002]

2. Description of the Related Art In so-called western medicine, examination by scientific methods is emphasized, and in the treatment, a combination of treatments and medications that exert appropriate effects on individual symptoms or affected areas is mainly applied. There are many. Of course, the number of diseases that can be treated for the first time by Western medicine is unknown, but in recent years, improper treatment due to individual differences in the constitution of patients and side effects of the ever increasing number of drugs have become problems. It is becoming.

[0003] In contrast, in so-called oriental medicine, it is said that a relatively long time is used for a medical examination that makes extensive use of the five senses. Also, instead of focusing on individual symptoms alone, it is not a treatment method that is uniformly grouped by disease name and symptoms, but by taking into account the pre-morbid background factors such as the patient's individual constitution, past medical history, lifestyle habits, Determine a prescription that subtly combines a wide variety of crude drugs.

[0004] In the case of diabetes, for example, the number of patients who died from diabetic coma has dramatically decreased since the discovery of insulin, a work of Western medicine. However, an increasing number of patients die from complications of diabetes, especially microangiopathy and renal failure. This is said to be due, in part, to the side effects of insulin, and polyneuritis, cataracts, hyperlipidemia, arterial thrombosis and the like are relatively common. There are also Western medicines for these individual complications, but none of them has been sufficiently effective especially from the viewpoint of improving the total health.

[0005] For such diseases, Kampo medicines having relatively few side effects even if taken for a long time are effective. Some diseases can be completely treated with Chinese medicine alone, but in many cases it is best to use it in combination with Western medicine. For example, in the case of the above-mentioned diabetes, a Chinese medicine is prescribed for a long period of time while suppressing blood sugar level by appropriately administering insulin together with a diet therapy or the like.

[0006]

As mentioned above, diagnostic and therapeutic methods of Oriental medicine, which are promising as supplements to Western medicine, are not limited to specialized hospitals and pharmacies, but have been diagnosed and treated by Western medicine. It is desirable that it can be performed at a hospital that has only been used, or at home if it is simple.

[0007] However, there are many kinds of medicines used in Chinese medicine, and most of them are crude drugs, so that the effects of prescription often depend on the delicate environment such as the physical condition of the patient. Also,
Oriental medicine's method of analyzing and diagnosing symptoms was relatively qualitative and its expression was subjective, so that knowledge was described in standardized expressions and the learning effect of books that could be shared was obtained. It is hard to be. Therefore, it is very difficult for non-specialists and unskilled persons, such as physicians of Western medicine, to appropriately adopt and use treatments by Oriental medicine.

[0008] In addition, the fact that the contents of diagnosis and the course of symptoms after the start of treatment are not objectively expressed poses a problem from the point of accountability of doctors to third parties.

[0009] Therefore, experienced Chinese therapists possess
Quantify vast amounts of knowledge and intuition about medical examinations, prescriptions, and follow-up of medical conditions so that they can be expressed and utilized in an objective form that can be easily shared by non-experts. Is strongly required.

[0010] In view of the various problems described above, the invention of the present application allows knowledge of Oriental medicine, which has conventionally been difficult to express in an objective form, to a non-expert or unskilled person. It is an object of the present invention to provide a diagnostic method and a computer for executing the diagnostic method, which can be very easily used for diagnosis and treatment of the disease.

[0011]

Means for Solving the Problems In order to solve the above problems, a first invention according to the present application is directed to a diagnostic method using oriental medicine, wherein (1) a symptom of each diagnostic item (2) for each diagnostic item, quantifying the degree of conformity of the diagnostic item to the symptom for each prescription and storing the same in the computer as a prescription database; (3) And (4) quantifying the symptom of the patient input to the computer based on the symptom database, and (5) quantifying the patient. The optimal prescription or the optimal prescription combination for the patient is determined by the computer based on the symptom and the prescription database. It is a diagnostic method characterized by a step that. According to the first aspect,
Conventionally, it has been difficult to share and utilize knowledge because it has not been quantitatively and objectively expressed. It can be done easily.

In a second aspect of the present invention, in the diagnostic method of the first aspect, the prescription is a Chinese medicine. According to the second invention, although it is expected to make up for the drawbacks of Western medicine, Chinese medicine, which has been considered to have considerable experience in its prescription, can be relatively easily used by non-skilled persons. Can be prescribed.

According to a third aspect of the present invention, in the diagnostic method according to the first or second aspect, the quantification of the symptom of the diagnostic item is performed using a membership function. According to the third aspect of the present invention, the membership function used for fuzzy control and the like is used to appropriately quantify the symptoms of symptoms caused by the doctor's diagnosis, which were conventionally subjective data based on experience. And provide a diagnostic method for determining an appropriate prescription for a complex condition.

According to a fourth aspect, in the diagnostic method according to the third aspect, the quantified conformity of each prescription is determined for each diagnostic item by the quantified symptom of the diagnostic item of the patient. Is weighted by the membership function value as the patient suitability, the sum of the patient suitability of each diagnostic item is determined for each prescription, and the prescription with the largest sum is the optimal prescription for the patient. According to the fourth aspect, even an unskilled person can easily determine an appropriate Oriental medical prescription based on a quantitative, objective, and easy-to-understand numerical value (sum).

According to a fifth aspect of the present invention, in the diagnostic method according to the fourth aspect, for each diagnostic item, the degree of suitability of the optimal prescription for the patient is expressed as a quantified symptom of the diagnostic item of the patient. Weighted by the membership function value of
The sum of them is used as an initial comprehensive index, and at an appropriate time after the patient starts receiving the optimal prescription, membership as a quantified symptom for each diagnostic item based on the symptom of the patient at that time. Find the function value, and for each diagnostic item,
The suitability for the patient of the optimal prescription is weighted by the obtained membership function value, the sum of them is used as a progress comprehensive index, and the treatment with the optimal prescription is performed based on the initial comprehensive index and the progress comprehensive index. Calculate the effect quantitatively. According to the fifth aspect, the prescription effect having the content determined in the above aspect can be measured over time. In addition, the measurement index is quantitative and objective, and is obvious and easy to understand even for patients without specialized knowledge.

According to a sixth aspect, in the diagnostic method according to the third aspect, the quantified fitness of each prescription is determined for each diagnostic item by the quantified symptom of the diagnostic item of the patient. Weighted by the membership function value as the patient fitness, the sum of the patient fitness of each diagnostic item is determined for each prescription, the amount according to the ratio of the sum of each prescription,
The combination of prescriptions is the optimal combination of prescriptions for the patient. According to the sixth aspect of the present invention, it is known that only a skilled person can properly prescribe a so-called "former" or "adjustment", such as a prescription such as a preparation prepared by mixing a plurality of Kampo medicines and the like. It can be performed relatively easily even by unskilled persons.

According to a seventh aspect of the present invention, in the diagnostic method according to the sixth aspect of the present invention, the suitability for the patient for each prescription for each diagnostic item, the ratio of the sum, and the quantitative determination of the patient for each diagnostic item An initial comprehensive index is obtained based on the membership function value as a generalized symptom, and at an appropriate time after the patient starts receiving the optimal prescription, based on the symptom of the patient at that time, for each diagnostic item The membership function value as a quantified symptom is determined, and the progression is performed based on the patient fitness of each prescription for each diagnosis item, the ratio of the sum, and the determined membership function value of the patient. A comprehensive index is determined, and a therapeutic effect by the optimal combination of prescriptions is quantitatively determined based on the initial comprehensive index and the progress comprehensive index. According to the seventh aspect, it is possible to measure the prescription effect of a preparation or the like that can more subtly respond to the patient's symptoms over time. In addition, the measurement index is quantitative and objective, and is obvious and easy to understand even for patients without specialized knowledge.

According to an eighth aspect of the present invention, there is provided a computer for executing the diagnostic method according to any one of the first to seventh aspects.

[0019]

DESCRIPTION OF THE PREFERRED EMBODIMENTS == Outline == A more specific embodiment of the present invention will be described in detail below with reference to the drawings. FIG. 1 is a diagram showing a configuration and a flow according to an embodiment of the diagnostic system of the present invention. When the content of the diagnosis is input, the diagnostic computer 1 performs various calculations with reference to the data in the symptom database 2 and the prescription database 3 to determine an optimal prescription, and displays the result to a doctor.

The diagnostic computer 1 is at the center of the hardware configuration of the diagnostic system. This may be configured by one workstation including the symptom database 2 and the prescription database 3, or may be configured to be connected online with another computer storing these databases. In that case, only the minimum elements required for diagnosis, such as a display and a keyboard, may be provided in the treatment room.

The symptom database contains various symptoms (diagnosis items) such as "throat dryness" and "urine volume".
Data quantifying the degree of the symptoms is stored in advance. In the prescription database, data quantifying the effectiveness (fitness) of various prescriptions, such as Chinese herbal medicines, with respect to each of the diagnostic items is stored in advance.

Here, an example will be described in which a diagnosis and a prescription are made for a certain patient. This patient complains of symptoms such as dry throat and constipation, and is treated using the following A to E5 kinds of herbal medicines. A: Hachimi-jio-maru, B: Byakko-ka-jinsin-to, C: Hochu-ekki-to, D: Dai-saiko-to, E: Gurisha-neki-maru.

== Quantification of Symptoms == FIG. 2 shows the contents of the symptom database (the graph on the left) for the diagnostic item “throat dryness” and the Chinese medicines A to E for this diagnostic item. , That is, the contents of the prescription database (the graph on the right). In the graph on the left, the degree of throat dryness is represented by three levels: strong, moderate, and weak, and discrete values of 1.0, 0.5, and 0.1 are given for each degree. Have been. This is a membership function used in so-called fuzzy control or the like. According to this membership function, not only the binary logic of "having" and "not having" the symptoms, but also the subtle and subjective expressions such as "heavy", "light" and "slightly heavy" are quantified. Can be handled strictly.

Also, in the graph on the right side,
The general degree of effect on thirst is represented by numerical values in increments of 0.1, with 1.0 being extremely effective and 0 being not effective at all.

FIGS. 3 to 7 also show the degree of symptoms of various diagnostic items and the general fitness of AE to the diagnostic items, similarly to FIG. The item names are, in order from FIG. 3, "amount of urine", "roughness of the body", "constipation tendency", "degree of obesity", and "numbness of lower limbs". Of these, only the "obesity degree" shown in FIG. 6 has a continuous value in the graph of the degree of symptoms. When the body weight is extremely thin, it is 0.1, and the body mass index 35 or more is uniformly set to the obesity degree 1.

The graphs on the left side of FIGS. 8 to 13 show numerical values of the symptoms of a specific patient for each of the above diagnostic items. This numerical value is one of numerical values (membership function values) determined in the symptom database (discrete values other than “obesity degree”). The doctor inputs the degree of the symptom of the patient to the diagnostic computer for each diagnostic item based on a diagnosis such as an interview. When the degree of the symptom is input, if the degree of the symptom such as "strong", "medium", or "weak" is input or selected, the symptom is converted into a corresponding numerical value by referring to the symptom database.

== Determining the Optimal Prescription == The graphs on the right in FIGS. 8 to 13 are apparently similar to the graphs on the right side in FIGS. It is a graph of the adaptability (fitness for patients) which considered the degree. Each numerical value in this graph is obtained by multiplying the numerical value in the graph of the degree of fitness in FIGS. 2 to 7 by the membership function value shown in the left graph in FIGS. In other words, the general fitness value is weighted with a value reflecting the symptoms of each patient, and the fitness for each patient is calculated.

Referring to FIG. 8, since the throat of this patient is strong (membership function value = 1), the value of the fitness of each Chinese medicine for this patient is multiplied by one, resulting in FIG. Is the same as the general fitness. On the other hand, when looking at FIG. 10, since the body is moderate (meaning of membership function value = 0.5), each numerical value in the graph of the patient fitness on the right side is the general value of FIG. Each numerical value of the graph of the fitness is multiplied by 0.5.

Here, the overall fitness of the Chinese medicines A to E for this patient is obtained by calculating the sum of the effectiveness of each symptom as follows. That is, the overall fitness of A = 1.0 + 1.0 + 0.15 + 0.1 + 0.3 = 2.55 B〃 = 0.5 + 1.0 = 1.5 C〃 = 0.5 D〃 = 1.0 + 0.0. 5 = 1.5 E 〃 = 0.15 + 1.0 = 1.15 In this case, the priority of the Chinese medicine to be prescribed is A, B = D, E, C in descending order. Therefore, first, A Hachimi-jio-gan was administered and a follow-up was performed. Add B's white tiger kanin ginseng hot water and D's Daisaiko hot water as needed.

In this example, the membership function value is set to 0.
Although the setting is made in three stages of 1, 0.5, and 1.0, it can be set more finely. In addition, if symptoms are described using the membership function in this way, a delicate diagnosis based on a subjective expression can be expressed quantitatively and objectively, and as a result, individual patients with slightly different symptoms can be expressed. On the other hand, detailed prescription can be performed relatively easily.

== Measurement of therapeutic effect == Next, follow-up observation for measuring the prescription effect for this patient over time will be described. It is assumed that the patient's condition has changed as shown in FIG. 14 with the membership function value defined in the condition database. It is assumed that this patient was eventually prescribed only the Hachimi-jio-gan of A, which had the largest sum of the effects.

A method of calculating the therapeutic effect at a certain point will be described. As can be seen from FIGS. 7 to 13, the fitness of A for this patient at the start of treatment is 1.% for “throat dryness” to “numbness of lower limbs”, respectively.
0, 1.0, 0.15, 0, 0.1 and 0.3.
When these numerical values are used as “weights” and weighted and added to the membership function values at the start of treatment, the prescription effect at the start of treatment (although not strictly yet “effect by prescription”) is obtained. That is, the prescription effect at the start of treatment =
1.0 × 1.0 + 1.0 × 1.0 + 0.5 × 0.15 +
1.0 × 0 + 0.5 × 0.1 + 1.0 × 0.3 = 2.4
(3) This value is used to measure the therapeutic effect of the prescription of A because the weight is small for symptoms to which A does not fit well (propensity for constipation and body stiffness).

Similarly, when the therapeutic effect after 2 weeks and 1 month is obtained, the prescription effect after 2 weeks = 0.5 × 1.0 + 1.0 × 1.0
+ 0.5 × 0.15 + 1.0 × 0 + 0.5 × 0.1 +
0.5 × 0.3 = 1.83 Prescription effect after one month = 0.5 × 1.0 + 0.5 × 1.0
+ 0.1 × 0.15 + 1.0 × 0 + 0.5 × 0.1 +
0.1 × 0.3 = 1.10 Therefore, the symptom that was 2.43 immediately after the start of treatment was changed to A
1.83 after 2 weeks and 1.1 after 1 month
It can be seen that it was improved to 0. Since this index is a quantitative and self-explanatory value, the patient himself can objectively know and understand the therapeutic effect.

== Modified Example == Next, another embodiment of the present invention will be described. In this embodiment, the process of quantifying symptoms is exactly the same as the previous embodiment, and the process after the process of determining the optimal prescription is different. A description of the same processes as in the previous embodiment will be omitted.

In the above embodiment, of the Chinese medicines A to E, only A having the highest overall fitness, which is obtained as the sum of the fitness for the patient, is prescribed. It is formulated at a ratio according to the ratio of typical compatibility and formulated as a composite preparation. That is, A = 2.55 / (2.55 + 1.5 + 0.5 + 1.5 +
1.15) = 2.55 / 7.2 = 0.35 B = 1.5 / 7.2 = 0.21 C = 0.5 / 7.2 = 0.07 D = 1.5 / 7. 2 = 0.21 E = 1.15 / 7.2 = 0.16, A: 35%, B: 21%, C: 7%, D: 21
%, E: 16%.

In many cases, a prescription based on such a combination can provide a higher therapeutic effect than prescription of one optimal type as in the above embodiment.

In order to measure the therapeutic effect of this combination-type prescription, first, the effectiveness for each symptom, weighted by the above-mentioned blending ratio (35 to 16%), is obtained as a sum of products. That is, throat dryness = A: 1.0 × 0.35 + B: 0.5 × 0.
21 = 0.46 urine volume = A: 1.0 x 0.35 + B: 1.0 x 0.21
= 0.56 Slackness of the body = A: 0.15 x 0.35 + C: 0.5 x
0.07 = 0.09 Constipation tendency = D: 1.0 × 0.21 = 0.21 Obesity = A: 0.1 × 0.35 + D: 0.5 × 0.21
+ E: 0.15 × 0.16 = 0.16 Numbness of lower limb = A: 0.3 × 0.35 + E: 1.0 ×
0.16 = 0.27

Therefore, assuming that the degree of symptoms at two weeks and one month after the start of the treatment is as shown in FIG. 15, the comprehensive index indicating the prescription effect at each time point is as follows: treatment start time = 1.0 × 0.46 + 1.0 × 0.56 +
0.5 × 0.09 + 1.0 × 0.21 + 0.5 × 0.1
6 + 1.0 × 0.27 = 1.63 After 2 weeks = 0.5 × 0.46 + 1.0 × 0.56 + 0.
5 × 0.09 + 1.0 × 0.21 + 0.5 × 0.16 +
0.5 × 0.27 = 1.26 One month later = 0.5 × 0.46 + 0.5 × 0.56 + 0.
1 × 0.09 + 1.0 × 0.21 + 0.5 × 0.16 +
0.1 × 0.27 = 0.84.

Therefore, the symptom which was 1.63 immediately after the start of the treatment was changed to 1.63 two weeks later by administration of this composite preparation.
26, it can be seen that it improved to 0.84 one month later. This index is also quantitative and objective, and is obvious to the patient as in the previous embodiment. Also,
The membership function values that set the patient's symptoms can be adjusted deliberately over the course of the treatment effect. For example, in the example of FIG. 15, since there is no improvement in the symptom of the tendency of constipation, if the membership function value is changed as shown in FIG. Can be formulated.

The content of the prescription of the present invention is not limited to Chinese herbal medicine, but is the same for various oriental medical treatments, such as acupressure and acupuncture, for which the effects were conventionally difficult to achieve objectively. Can be used.

[0041]

According to the present invention, knowledge of Oriental medicine, which was conventionally difficult to express in an objective form, can be easily applied to actual diagnosis and treatment even by non-experts and non-experts. Can be used.

[Brief description of the drawings]

FIG. 1 is a diagram showing an outline of a diagnostic system according to an embodiment of the present invention.

FIG. 2 is a graph of throat dryness according to the embodiment, the left graph shows the contents of a symptom database showing the degree of symptoms, and the right graph shows the effectiveness (fitness) of each Chinese medicine. This is the contents of the prescription database.

FIG. 3 is a graph similar to FIG. 2 for the amount of urine.

FIG. 4 is a graph similar to FIG. 2 for body slackness.

FIG. 5 is a graph similar to FIG. 2 for constipation tendency.

FIG. 6 is a graph similar to FIG. 2 for the degree of obesity.

FIG. 7 is a graph similar to FIG. 2 for numbness of the lower limb.

FIG. 8 is a graph of throat dryness according to the same embodiment, the left graph shows the degree of a patient's symptom as a membership function value, and the right graph shows the effectiveness (fitness) of each Chinese medicine for this patient. Degree).

FIG. 9 is a graph similar to FIG. 8 for the amount of urine.

FIG. 10 is a graph similar to FIG.

FIG. 11 is a graph similar to FIG. 8 for constipation tendency.

FIG. 12 is a graph similar to FIG. 9 for the degree of obesity.

FIG. 13 is a graph similar to FIG. 9 for numbness of the lower limb.

FIG. 14 is a table of the transition of membership function values representing the course of a patient's symptoms.

FIG. 15 is a table of the transition of membership function values representing the course of a patient's symptoms according to another embodiment of the present invention.

[Explanation of symbols]

 1 diagnostic computer 2 symptom database 3 prescription database

Claims (8)

[Claims] 1. A diagnostic method according to Oriental medicine,
(1) quantifying the symptom of the diagnostic item for each diagnostic item and storing the same in a computer as a symptom database; and (2) quantifying the conformity of the diagnostic item to the symptom for each prescription for each diagnostic item. (3) inputting symptoms to the computer for each diagnostic item of the patient, and (4) quantifying the symptoms of the patient input to the computer based on the symptom database. (5) using a computer to determine an optimal prescription or an optimal prescription combination for the patient based on the quantified symptoms of the patient and the prescription database. Diagnostic method. 2. The diagnostic method according to claim 1, wherein the prescription is a Chinese medicine. 3. The diagnostic method according to claim 1, wherein the quantification of the symptoms of the diagnostic item is performed using a membership function. 4. The diagnostic method according to claim 3, wherein, for each diagnostic item, the quantified fitness of each prescription is a membership function value as a quantified symptom of the diagnostic item of the patient. The diagnostic method is characterized in that the sum of the patient fitness of each diagnostic item is obtained for each prescription, and the prescription having the largest sum is the optimal prescription for the patient. . 5. The diagnostic method according to claim 4, wherein, for each diagnostic item, the patient fitness of the optimal prescription is determined by a membership function value as a quantified symptom of the diagnostic item of the patient. Weighted, the sum of them as the initial comprehensive index, at an appropriate time after the patient starts receiving the optimal prescription, based on the patient's symptoms at that time, the quantified symptoms for each diagnostic item Determine the membership function value as, for each diagnostic item, the patient fitness of the optimal prescription, weighted by the found membership function value, the sum of them as a progress comprehensive index, the initial comprehensive index and A diagnostic method characterized by quantitatively determining a therapeutic effect of the optimal prescription based on the progress comprehensive index. 6. The diagnostic method according to claim 3, wherein, for each diagnostic item, the quantified fitness of each prescription is a membership function value as a quantified symptom of the diagnostic item of the patient. Weighted according to the patient suitability, the sum of the patient suitability of each diagnostic item is determined for each prescription, an amount according to the ratio of the sum of each prescription, a combination of prescriptions,
A diagnostic method characterized by using an optimal combination of prescriptions for the patient. 7. The diagnostic method according to claim 6, wherein the fitness of the patient for each prescription for each diagnostic item, the ratio of the sum, and the quantified symptom of the patient for each diagnostic item. Obtain an initial comprehensive index based on the membership function value, at an appropriate time after the patient starts receiving the optimal prescription, based on the patient's symptoms at that time, quantified symptoms for each diagnostic item Finding the membership function value as, the patient fitness of each prescription for each diagnostic item, the ratio of the sum, and, for the patient, the progress comprehensive index based on the found membership function value, A diagnostic method characterized by quantitatively obtaining a therapeutic effect of the optimal combination of prescriptions based on an initial comprehensive index and the progress comprehensive index. 8. A computer that executes the diagnostic method according to claim 1.