1.上海中医药大学中医方证信息研究中心(上海 201203)
2.上海中医药大学交叉科学研究院(上海 201203)
3.上海岐黄信息技术有限公司(上海 201203)
4.上海中医药大学科技人文研究院(上海 201203)
李明,男,博士,副研究员,硕士研究生导师,主要从事中医标准、中医方证、数据挖掘等的研究工作
朱邦贤,教授,博士研究生导师;E-mail:zbx5100@hotmail.com。
严世芸,上海中医药大学终身教授,全国名中医,博士研究生导师;E-mail:yansy514@126.com
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李明, 周强, 董全伟, 等. 形制之变(一)——新旧中医国家标准疾病部分异同解读[J]. 上海中医药杂志, 2021,55(2):1-8.
Ming LI, Qiang ZHOU, Quanwei DONG, et al. Changes in form and system (I): a comparative study on new and old editions of TCM National Standards of disease part[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(2):1-8.
李明, 周强, 董全伟, 等. 形制之变(一)——新旧中医国家标准疾病部分异同解读[J]. 上海中医药杂志, 2021,55(2):1-8. DOI: 10.16305/j.1007-1334.2021.2011119.
Ming LI, Qiang ZHOU, Quanwei DONG, et al. Changes in form and system (I): a comparative study on new and old editions of TCM National Standards of disease part[J]. Shanghai Journal of Traditional Chinese Medicine, 2021,55(2):1-8. DOI: 10.16305/j.1007-1334.2021.2011119.
目的,2,解读中医国家标准(简称“国标”)《中医病证分类与代码:GB/T 15657—1995》(简称“GB95”)与《中医临床诊疗术语:GB/T 16751—1997》(简称“GB97”)新旧版本中疾病部分在编制方法及内容上的差异,推动新版中医国标的应用。,方法,2,编制新旧国标的中医疾病名术语映射关系表,通过数据统计、文本比对等方法,从其编码方式、命名规范、编写体例、收录范围、分类体系、定义格式等方面进行分析和比较。,结果,2,①《中医病证分类与代码(修订版)》根据其疾病术语及分类体系对编码方式进行了改进,采用了较为简便、便于扩充和有更大术语容量的编码方式,所有病证名术语均为一码一义。②新版国标制定了中医疾病名术语的命名原则,所有的疾病名术语遵循一词一义的原则,通过术语定义确定其内涵及临床诊断依据;取消术语名中的括号,将原GB95、GB97中用括号所标识的信息通过上下层级及可选用词(即同义词)的方式表示。③与GB97相比较,新版国标术语编号单独成行,新增了术语英译名和注。④《中医病证分类与代码(修订版)》和《中医临床诊疗术语 第1部分:疾病(修订版)》收录了疾病名术语1 369个,其术语名称完全相同,相互对应。⑤新版国标弃用了原GB95临床分科的分类方式,形成了以中医病因、病机、病位等为基本要素,既与WHO ICD-11疾病分类思想相衔接,又具有中医学术理论支持,与中医临床路径相统一的疾病分类体系;同时将GB97中的“症状性名称”改为“临时诊断用术语”。⑥新版国标的术语定义格式规定,中医疾病名术语应包含该病的病因、病机、病位、特征性症状及所属类目等要素;将术语分为具有类目属性的术语和具体术语两大类,还对疾病名术语的定义描述词进行规范表述。,结论,2,与旧版国标相比较,新版中医国标对疾病名术语的编码方式、命名规范、编写体例、收录范围、分类体系、定义格式等进行了优化,使其能更好地适用于中医医疗质量评定、健康管理、卫生统计等工作,也更加合乎我国当代医学信息管理标准化、国际化的要求。
Objective,2,To interpret the differences in the compilation methods and content of the part of diseases between the old and new editions of Traditional Chinese Medicine (TCM) National Standards-,Classification and Codes of Diseases and Patterns of Traditional Chinese Medicine,(GB/T 15657—1995) and ,Clinic Terminology of Traditional Chinese Medical Diagnosis and Treatment,(GB/T 16751—1997) for the purpose of promoting the application of the new editions of TCM National Standards.,Methods,2,Relational mappings of TCM disease terms in the new and old TCM National Standards were compiled for the statistical analysis and text comparison of the coding mode, naming standard, compilation style, inclusion scope, classification system and definition format.,Results,2,①The revised edition of ,Classification and Codes of Diseases and Patterns of Traditional Chinese Medicine, improved its coding mode by referring to its disease classification, which was simpler to understand, and much easier to expand terms due to its larger terminological capacity. All the terms of diseases and patterns realized one-to-one correspondence between code and term. ②The naming standard formulated in the new editions of TCM National Standards. All the terms of diseases followed the principle that one term corresponds to only one meaning. There were no square brackets or parentheses in the terms. The information in the brackets or parentheses in the old editions(GB/T 15657—1995 and GB/T 16751—1997) was expressed in hierarchical order or with optional words (i.e. synonyms). ③Compared with GB/T 16751—1997, the new editions of TCM National Standards had a separate line for each code, and also added an English translation of disease name and corresponding annotations for each term were added. ④One thousand three hundred and sixty-nine terms of disease names were included in the revised edition of ,Classification and Codes of Diseases and Patterns of Traditional Chinese Medicine, and ,Clinic Terminology of Traditional Chinese Medical Diagnosis and Treatment,-,Part, 1: ,Diseases,. The terms of disease names in new TCM National Standards were exactly the same and corresponded to each other. ⑤The new editions of TCM National Standards abandoned the classification system used in GB/T 16751—1997, and formed a disease classification system with basic elements of TCM etiology, pathogenesis and disease location, which was not only connected with the disease classification principles in WHO ICD-11, but also supported by TCM academic theories and unified with TCM clinical practice. The "symptomatic naming" in GB/T 16751—1997 was changed to "terminology for provisional diagnosis" . ⑥The new editions of TCM National Standards stipulated the format for term definitions. The definition of TCM disease terms should include the corresponding etiology, pathogenesis, disease location, characteristic symptoms and categories of the disease. Meanwhile, the terms to be defined should be divided into two categories: category words and specific terms. Descriptors for the definition of disease terms were also standardized.,Conclusion,2,Compared with the old editions, the new editions of TCM National Standards has been optimized and revised in terms of the coding mode, naming standard, compilation style, inclusion scope, classification system, definition format and other aspects of disease terms to better facllitate the quality evaluation, health management, health statistics and other TCM related work, and the new editions are more in line with the contemporary demands for medical informatics and TCM standardization and internationalization in China.
中医国家标准中医疾病名术语《中医病证分类与代码:GB/T 15657—1995》《中医临床诊疗术语:GB/T 16751—1997》中医疾病分类体系中医标准化
TCM National StandardsTCM disease terminologyClassification and Codes of Diseases and Patterns of Traditional Chinese MedicineClinic Terminology of Traditional Chinese Medical Diagnosis and TreatmentTCM disease classification systemTCM standardization
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国家技术监督局. 中医病证分类与代码:GB/T 15657—1995[S]. 北京:中国标准出版社,1995.
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柴瑞霭,柴崑,李鹏涛,等.从中医“寒湿疫”角度探讨新型冠状病毒肺炎的诊治思路[J].中国中医急症,2020,29(4): 565-567,574.
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