Gout catgut bloodletting dynamic regulation system based on crp feedback and syndrome typing

Abstract

The application provides a gout collaterals bloodletting dynamic regulation system based on CRP feedback and syndrome typing, relates to the technical field of clinical collateral auxiliary judgment systems, and comprises the following function modules: a data acquisition module, an initial strategy generation module, a real-time data acquisition module and a dynamic adjustment module. The system can assist in realizing quantification, standardization and objectivity, significantly improves the stability and repeatability of the curative effect, improves the safety, and can shorten the treatment course.

Description

Technical Field

[0001] This application relates to the technical field of clinical bloodletting auxiliary judgment system, specifically to a dynamic control system for bloodletting in gout based on CRP feedback and syndrome differentiation. Background Technology

[0002] Gout is a recurrent inflammatory disease caused by purine metabolism disorders and / or impaired uric acid excretion, leading to elevated serum uric acid levels and the deposition of urate crystals in the joints and surrounding tissues. Its acute phase is characterized by redness, swelling, heat, and severe pain in the joints, significantly impacting the patient's quality of life.

[0003] In terms of treatment, modern medicine mainly uses nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, or glucocorticoids to control acute inflammation, as well as drugs such as allopurinol and febuxostat to control uric acid levels long-term. However, these drugs are often accompanied by many side effects such as gastrointestinal damage, liver and kidney toxicity, and allergic reactions, resulting in poor compliance or intolerance among some patients.

[0004] Bloodletting therapy, an important component of external treatments in Traditional Chinese Medicine, demonstrates unique advantages in the treatment of acute gout attacks. This therapy follows the principle of "removing stagnant blood," puncturing superficial blood vessels at the site of the lesion to expel a certain amount of "stagnant blood," thereby achieving the goals of clearing heat and toxins, removing blood stasis and unblocking the meridians, reducing swelling and relieving pain. Clinical practice shows that this therapy can rapidly alleviate the redness, swelling, heat, and pain symptoms of acute gout attacks.

[0005] However, existing methods of bloodletting therapy for gout suffer from reliance on experience and subjectivity. This is primarily reflected in the fact that current bloodletting strategies (such as acupoint selection, bloodletting volume, and treatment intervals) heavily depend on the physician's personal experience, lacking an objective, quantifiable, and standardized dynamic diagnostic system. Significant differences in the procedures among physicians make it difficult to guarantee stable and repeatable efficacy. Furthermore, treatment plans are typically fixed throughout the entire course of treatment once determined at the initial stage, lacking a dynamic adjustment mechanism based on real-time changes in the patient's condition. This prevents the application of individualized and timely treatment strategies, hindering the clinical promotion and maximization of efficacy of bloodletting therapy for gout. Therefore, the dynamic control system of this invention is proposed. Summary of the Invention

[0006] In view of the above-mentioned defects or deficiencies in the prior art, this application aims to provide a dynamic regulation system for bloodletting therapy for gout based on CRP feedback and syndrome differentiation, so as to realize the clinical promotion and maximize the efficacy of bloodletting therapy for gout; the method includes the following functional modules:

[0007] Data acquisition module: Acquires baseline clinical data of the target subject, including serum uric acid level, initial C-reactive protein level, erythrocyte sedimentation rate, disease stage markers, and hormone use history markers;

[0008] Initial strategy generation module: Based on the baseline clinical data, generates an initial bloodletting strategy plan, which includes a basic bloodletting volume and basic bloodletting target acupoints;

[0009] Real-time data acquisition module: At a preset time point after the implementation of the initial strategy, acquire the real-time C-reactive protein value of the target object;

[0010] Dynamic adjustment module: If the real-time C-reactive protein value does not reach the preset target value, the syndrome classification result of the target object is determined, and a dynamic adjustment plan is generated for the initial strategy generation module based on the syndrome classification result. The dynamic adjustment plan includes adding acupoints and / or adjusting the amount of bloodletting and / or adjusting the stimulation method.

[0011] According to the technical solution provided in this application, the dynamic adjustment module for determining the syndrome differentiation result of the target object includes the following procedure:

[0012] Based on the initial C-reactive protein value, the erythrocyte sedimentation rate, and the disease stage identifier in the data acquisition module, an acute inflammation tendency score is calculated.

[0013] The inflammatory response rate index is calculated based on the real-time C-reactive protein value and the initial C-reactive protein value.

[0014] The acute inflammation tendency score and the inflammation response rate index were fused and analyzed.

[0015] If both the acute inflammation tendency score and the inflammation response rate index are higher than their respective decision thresholds, the syndrome classification result will be displayed as damp-heat accumulation type.

[0016] If both the acute inflammation tendency score and the inflammation response rate index are lower than their respective decision thresholds, the syndrome classification result will be displayed as damp-heat toxicity type.

[0017] According to the technical solution provided in this application, the calculation of the acute inflammation tendency score in the dynamic adjustment module includes the following procedure:

[0018] The initial C-reactive protein value and the erythrocyte sedimentation rate were standardized to obtain the standardized initial C-reactive protein value and the standardized erythrocyte sedimentation rate.

[0019] Based on the disease stage markers, a stage adjustment factor is introduced, and the standardized initial C-reactive protein value, the standardized erythrocyte sedimentation rate, and the stage adjustment factor are weighted and fused to obtain the acute inflammation tendency score.

[0020] According to the technical solution provided in this application, the dynamic adjustment module calculates the inflammatory response rate index, including the following procedure:

[0021] Calculate the absolute value of the decrease in the real-time C-reactive protein value compared to the initial C-reactive protein value;

[0022] The absolute value of the decrease is correlated with the first time interval to obtain the rate of decrease in inflammation level per unit time, and this rate is used as the inflammation response rate index; wherein, the first time interval is the time interval between the implementation of the initial bloodletting strategy and the preset time point.

[0023] According to the technical solution provided in this application, the disease stage markers include acute phase markers and chronic phase markers;

[0024] The introduction of staging adjustment factors based on the disease stage markers includes the following procedures:

[0025] If the disease stage identifier is the acute phase identifier, then the stage adjustment factor is dynamically assigned a value based on the level of the initial C-reactive protein value, and the assignment result is positively correlated with the initial C-reactive protein value;

[0026] If the disease stage identifier is the chronic stage identifier, then the stage adjustment factor is dynamically assigned a value based on the level of serum uric acid, and the assignment result is positively correlated with the serum uric acid level.

[0027] According to the technical solution provided in this application, the initial strategy generation module includes the following program:

[0028] The initial inflammatory burden index is calculated based on the serum uric acid value, the initial C-reactive protein value, and the erythrocyte sedimentation rate.

[0029] The target inflammation load index is obtained based on the initial inflammation load index and the hormone use history identifier;

[0030] The baseline bloodletting volume is determined based on the target inflammatory burden index.

[0031] Obtain the location information of the diseased joint of the target object, including the first metatarsophalangeal joint, ankle joint, or knee joint;

[0032] Based on the location information of the diseased joint, a set of initial candidate acupoints is determined from the preset acupoint mapping relationship. The preset acupoint mapping relationship is used to define the set of local acupoints and meridian acupoints corresponding to different joint locations.

[0033] Based on the target inflammatory burden index, at least one acupoint with the most significant response is selected from the initial candidate acupoints according to the screening criteria as the basic bloodletting target acupoint; the screening criteria include skin temperature, tenderness, and visible redness and swelling at the acupoint.

[0034] According to the technical solution provided in this application, the dynamic adjustment module dynamically adjusts the initial bloodletting strategy based on the syndrome differentiation results, including the following procedures:

[0035] If the syndrome differentiation result shows the damp-heat accumulation type, the dynamic adjustment module will provide the following prompt:

[0036] Based on the basic bloodletting target acupoints, additional acupoints for clearing heat and promoting diuresis are added, including Neiting, Yinlingquan, or Quchi.

[0037] Increase the basic bloodletting volume by 10% to 20%, and the total bloodletting volume in a single session shall not exceed 8 ml;

[0038] Cupping is applied after acupuncture to increase the amount of bleeding after bloodletting.

[0039] If the syndrome differentiation result shows the damp-heat toxicity type, the dynamic adjustment module will provide the following prompt:

[0040] Based on the basic bloodletting target acupoints, additional acupoints for clearing heat and detoxifying are added, including Chize, Dazhui, or Quchi.

[0041] Increase the basic bloodletting volume by 20% to 30%, and the total bloodletting volume in a single session shall not exceed 10ml;

[0042] Additional acupoints are pre-punctured with filiform needles, and after obtaining the Qi sensation, the needles are removed and bloodletting is performed.

[0043] According to the technical solution provided in this application, obtaining the target inflammatory burden index based on the initial inflammatory burden index and the hormone use history identifier includes the following procedure:

[0044] If the target subject's history of hormone use is identified as having a history of hormone use, the initial inflammatory load index is corrected to obtain the target inflammatory load index;

[0045] If the target subject's history of hormone use is identified as having no history of hormone use, then the initial inflammatory load index is used as the target inflammatory load index.

[0046] According to the technical solution provided in this application, the following steps are also included:

[0047] After any dynamic adjustment to the initial bloodletting strategy, the real-time C-reactive protein value of the target object is monitored at a preset period.

[0048] If the real-time C-reactive protein value monitored twice consecutively is lower than the first preset threshold, and the inflammatory response rate index tends to stabilize, then the target subject is determined to have entered the inflammatory remission period, and a downgrade treatment strategy is initiated.

[0049] According to the technical solution provided in this application, the downgraded treatment strategy includes reducing the amount of bloodletting to 50% to 70% of the current amount of bloodletting, extending the treatment interval to once every 7 to 10 days, and adjusting the stimulation method to only perform acupuncture without bloodletting;

[0050] During the implementation of the downgrade treatment strategy, real-time C-reactive protein levels are continuously monitored at the preset intervals.

[0051] If the real-time C-reactive protein value at any monitoring time point rebounds to more than 20% of the first preset threshold, the downgraded treatment strategy is terminated, and the last non-downgraded bloodletting strategy used before triggering the current downgraded treatment strategy is executed retrospectively.

[0052] Compared with the prior art, the beneficial effects of this application are as follows:

[0053] First, this invention achieves the quantification, standardization, and objectification of the treatment process, significantly improving the stability and repeatability of therapeutic effects. It abandons the model that relies solely on physician experience, introducing objective laboratory indicators such as serum uric acid, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) as core decision-making criteria, and generating initial strategies based on these data (including calculating bloodletting volume and selecting acupoints). This makes the formulation of treatment plans based on evidence, greatly reducing the differences caused by different physicians' operations. The system ensures the homogenization of treatment levels, making the therapeutic effect more stable and predictable.

[0054] Second, a new closed-loop dynamic model system of "monitoring-feedback-regulation" has been established, achieving truly individualized precision treatment. Real-time C-reactive protein (CRP) values ​​are introduced as a key feedback signal. By comparing post-treatment monitoring values ​​with preset target values, the efficacy can be assessed promptly and accurately. For target subjects who do not meet the target, the system further adjusts the strategy precisely and dynamically based on objective data-driven syndrome differentiation results (such as damp-heat accumulation type, damp-heat toxin accumulation type) (e.g., adding acupoints, adjusting bloodletting volume, adjusting stimulation methods). This makes the treatment plan no longer static, but an intelligent system that can adaptively optimize according to the specific response of the target subject, truly achieving "treatment according to syndrome," greatly improving the accuracy and effectiveness of treatment.

[0055] Third, it overcomes the subjectivity and ambiguity of TCM syndrome differentiation, providing modern objective data support for TCM syndrome differentiation. It establishes a scientific and quantitative correspondence between modern medical inflammatory markers (CRP, ESR) and their dynamic change rates (inflammatory response rate indicators) and TCM syndrome types such as "damp-heat accumulation" and "phlegm-blood stasis." By calculating and comparing decision thresholds, it achieves objectification and algorithmization of syndrome classification, enabling TCM syndrome differentiation to move from traditional qualitative description to modern quantitative analysis, reducing the risk of misdiagnosis and mistreatment, and representing a significant advancement in the field of integrated traditional Chinese and Western medicine.

[0056] Fourth, the system improves treatment safety and may shorten the treatment course. Through real-time CRP monitoring, the system can quickly identify target subjects who are not sensitive to initial treatment and provide timely adjustment plans, avoiding the risk of delaying the condition and prolonging the course of the disease due to ineffective treatment. At the same time, linking parameters such as bloodletting volume to objective indicators and setting a safety upper limit (such as no more than 15ml per session) also ensures treatment safety. Attached Figure Description

[0057] Figure 1 A schematic diagram of the dynamic regulation system for gout bloodletting based on CRP feedback and syndrome differentiation provided in this application.

[0058] The text labels in the image represent:

[0059] 1. Data acquisition module; 2. Initial strategy generation module; 3. Real-time data acquisition module; 4. Dynamic adjustment module. Detailed Implementation

[0060] The present application will now be described in further detail with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are merely illustrative of the invention and not intended to limit it. Furthermore, it should be noted that, for ease of description, only the parts relevant to the invention are shown in the accompanying drawings.

[0061] It should be noted that, unless otherwise specified, the embodiments and features described in this application can be combined with each other. This application will now be described in detail with reference to the accompanying drawings and embodiments.

[0062] Example 1

[0063] As mentioned in the background section, to address the problems in the existing technology, this application proposes a dynamic regulation system for gout bloodletting based on CRP feedback and syndrome differentiation, such as... Figure 1 As shown, it includes the following functional modules:

[0064] Data acquisition module 1: Acquires baseline clinical data of the target subject, including serum uric acid level, initial C-reactive protein level, erythrocyte sedimentation rate, disease stage markers, and hormone use history markers;

[0065] Initial strategy generation module 2: Based on the baseline clinical data, generate an initial bloodletting strategy plan, which includes a basic bloodletting volume and a basic bloodletting target acupoint;

[0066] Real-time data acquisition module 3: At a preset time point after the implementation of the initial strategy, acquire the real-time C-reactive protein value of the target object;

[0067] Dynamic adjustment module 4: If the real-time C-reactive protein value does not reach the preset target value, the syndrome classification result of the target object is determined, and a dynamic adjustment plan is generated for the initial strategy generation module 2 based on the syndrome classification result. The dynamic adjustment plan includes adding acupoints and / or adjusting the amount of bloodletting and / or adjusting the stimulation method.

[0068] Specifically, when a target patient first visits the clinic, the physician systematically collects their baseline clinical data through consultation, physical examination, and laboratory tests. For serum uric acid levels: obtained by drawing venous blood from the target patient and using the uricase method, the unit is μmol / L. This value is the basis for diagnosing gout and hyperuricemia. Initial C-reactive protein (CRP) level: considering the adaptability of different hospitals, conventional CRP is used, the unit is mg / L. This value is a core objective indicator for measuring the level of acute inflammation in the body. Erythrocyte sedimentation rate (ESR): obtained by drawing venous blood from the target patient and using the Westergren method, the unit is mm / h. This indicator is another reference reflecting inflammation and non-specific immune responses. Disease stage identification: determined by inquiring about the target patient's medical history and current symptoms. If the target patient is in the acute phase of joint redness, swelling, heat, and pain, it is identified as the "acute phase"; if the target patient is in a stage with mild joint pain but possibly tophi or chronic dull pain, it is identified as the "chronic phase". Hormone use history identification: This is determined by asking the target subject whether they have recently (e.g., within 1 month) taken glucocorticoids (such as prednisone or dexamethasone), and indicating "yes" or "no". This data is crucial because hormones can artificially suppress inflammatory markers, affecting the assessment of the true condition.

[0069] Specifically, the real-time C-reactive protein (CRP) value is acquired in the real-time data acquisition module 3: at a preset time point (e.g., 48 or 72 hours after the initial strategy (i.e., the first bloodletting treatment) is implemented, the target subject returns to the hospital for a repeat CRP test to obtain the real-time CRP value. Dynamic adjustment: the system or physician will compare the real-time CRP with the initial CRP. If real-time CRP does not drop to the preset target value (defined as simultaneously meeting the following two conditions: absolute value condition: real-time CRP value ≤ 10 mg / L; relative value condition: real-time CRP value decreases by ≥ 50% compared to the initial CRP value. Only when both conditions are met is the preset target value considered reached; if either condition is not met, the preset target value is not reached, triggering subsequent syndrome differentiation and dynamic adjustment procedures. The above thresholds are based on a retrospective analysis of multicenter clinical data, determining that when CRP drops below 10 mg / L and the decrease exceeds 50%, the probability of significant relief of acute symptoms such as joint redness, swelling, heat, and pain in the target subjects exceeds 85%. Therefore, this dual standard is set as the target for initial inflammation control. For special populations (such as those with severe infections or autoimmune diseases), adaptive fine-tuning can be performed within the range of 10 mg / L ± 2 mg / L and 50% ± 5%), indicating that the initial strategy is ineffective and intervention is required. At this time, the system will initiate the syndrome differentiation judgment process (see below). The initial strategy is dynamically adjusted based on the classification results (damp-heat accumulation type or damp-heat toxicity accumulation type).

[0070] Specifically, in the dynamic adjustment module 4, "adding acupoints" refers to adding new acupoints to the existing ones. "Adjusting bloodletting amount" refers to increasing or maintaining the existing bloodletting amount. "Adjusting stimulation method" refers to changing the acupuncture and bloodletting techniques, such as whether to add cupping or whether to perform filiform needle acupuncture first.

[0071] The technical effects and principles are explained below: The dynamic control system constructed in this implementation method achieves a leap from empirical and static to standardized, dynamic, and precise gout bloodletting treatment. Its core effects are: improved treatment efficiency: The dynamic control system, through rapid feedback from the sensitive indicator CRP, can promptly identify ineffective treatments, avoid ineffective waiting for the target patient, and shorten the course of the disease; personalized treatment: Based on objective data classification and adjustment, each treatment closely matches the current actual pathological state of the target patient, significantly improving efficacy and safety; and a closed-loop treatment system: A continuous optimization cycle of assessment-treatment-reassessment-adjustment is established, giving the treatment process adaptive capabilities, consistent with the concept of modern precision medicine. Its working principle originates from the closed-loop control theory of integrated traditional Chinese and Western medicine. The human body is considered a black box system, with bloodletting as the input control signal and C-reactive protein as the output feedback signal. The system judges the effectiveness of the control signal (initial treatment strategy) by comparing the deviation between the feedback signal and the expected target value. When the deviation is too large (CRP does not meet the target), the system uses the built-in syndrome differentiation model algorithm to diagnose the internal state of the system (whether it is damp heat or phlegm stasis), and then recalculates and outputs an optimized control signal (adjusted strategy) to reduce the deviation and make the system converge stably towards the expected healthy state (inflammation subsidence).

[0072] It is important to note that this method has contraindications: if the target patient is confirmed to have anemia or thrombocytopenia before the consultation, a complete blood count should be performed before bloodletting. Also, please note: aseptic technique must be followed according to the bloodletting protocol to prevent infection.

[0073] In a preferred embodiment, the dynamic adjustment module 4 determines the syndrome classification result of the target object through the following procedure:

[0074] Based on the initial C-reactive protein value, the erythrocyte sedimentation rate, and the disease stage identifier in the data acquisition module, an acute inflammation tendency score is calculated.

[0075] The inflammatory response rate index is calculated based on the real-time C-reactive protein value and the initial C-reactive protein value.

[0076] The acute inflammation tendency score and the inflammation response rate index were fused and analyzed.

[0077] If both the acute inflammation tendency score and the inflammation response rate index are higher than their respective decision thresholds, the syndrome classification result will be displayed as damp-heat accumulation type.

[0078] If both the acute inflammation tendency score and the inflammation response rate index are lower than their respective decision thresholds, the syndrome classification result will be displayed as damp-heat toxicity type.

[0079] Specifically, the damp-heat accumulation type corresponds to the acute phase of gout, while the damp-heat toxin accumulation type corresponds to the acute phase of refractory gout.

[0080] Furthermore, the calculation of the acute inflammation tendency score in the dynamic adjustment module 4 includes the following procedure:

[0081] The initial C-reactive protein value and the erythrocyte sedimentation rate were standardized to obtain the standardized initial C-reactive protein value and the standardized erythrocyte sedimentation rate.

[0082] Based on the disease stage markers, a stage adjustment factor is introduced, and the standardized initial C-reactive protein value, the standardized erythrocyte sedimentation rate, and the stage adjustment factor are weighted and fused to obtain the acute inflammation tendency score.

[0083] Specifically, the initial C-reactive protein (CRP) value is the initial CRP value, and the real-time CRP value is the CRP monitoring value. The system reads the initial CRP value (e.g., 60 mg / L), erythrocyte sedimentation rate (ESR) (e.g., 45 mm / h), and disease stage identifier (e.g., "acute phase") from the baseline data. First, CRP and ESR are standardized (e.g., using Z-score standardization, i.e., (measured value - mean of similar target subjects) / standard deviation) to eliminate the influence of dimensions and make them comparable values. Then, based on the "acute phase" identifier, a stage adjustment factor (F) is introduced. The stage adjustment factor (F) is used as a dynamic weighting coefficient to adjust the importance of different indicators.

[0084] Specifically, in the acute phase: In this phase, inflammation is the primary concern. The staging adjustment factor F is positively correlated with the initial C-reactive protein (X_crp) value (e.g., F = a * (X_crp / R_crp), where a is a coefficient and R_crp is a reference value). The formula for calculating the Acute Inflammatory Propensity Score (S_acute) will give Z_crp a greater weight and incorporate the influence of the F value. A feasible fusion formula is: S_acute = (W1 * Z_crp * F) + (W2 * Z_esr), where W1 and W2 are preset weights, and W1 > W2). This reflects that in the acute phase, CRP level is the core of assessing the severity of inflammation, and the higher its value, the greater its importance in the score. In the chronic phase: Persistent hyperuricemia and chronic inflammation are characteristic. The adjustment factor F is positively correlated with the serum uric acid value (X_ua) (e.g., F = b * (X_ua / R_ua)). The scoring formula will be adjusted to: S_acute = (W1 * Z_crp) + (W2 * Z_esr) + (W3 * F), or F can be used as the weight for standardizing serum uric acid. This is to strengthen the role of hyperuricemia as a key pathological factor in the chronic phase in the scoring.

[0085] Specifically, the Z-score standardization method is adopted, and the formula is: Where X is the measured value, μ is the mean of the index in the reference population, and σ is the standard deviation. In a preferred embodiment, based on the statistical results of clinical data of the target subjects in the acute phase of gout, the following settings are made: For the initial C-reactive protein (CRP) value: reference mean μ CRP =25mg / L, σ CRP =15 mg / L; For erythrocyte sedimentation rate (ESR): reference mean μ ESR =30mm / h, σ ESR =20mm / h.

[0086] After standardization, we get: ; ;

[0087] The staging adjustment factor F is calculated based on the dynamic assignment of disease stage markers. Its assignment principle can be expressed as a linear relationship: F ​​= a * (X_crp / R_crp), obtained through fitting clinical data.

[0088] If it is an acute phase marker: coefficient a = 1.0, reference value Rcrp = 50 mg / L, i.e. F = 1.0 × (X_crp / 50)

[0089] To maintain the robustness of the calculation and to conform to clinical practice, the lower limit of F is set to 1.0. When Xcrp < 50, F = 1.0 is taken.

[0090] For chronic phase markers: the adjustment factor is related to serum uric acid level, and the expression is F = b* (X_ua / R_ua), where the coefficient b = 1.0, the reference value Rua = 500 μmol / L, that is, F = 1.0 × (X_ua / 500); similarly, the lower limit of F is set to 1.0.

[0091] In practical calculations, to facilitate linear weighted fusion, the above proportional form can be converted into an offset form compared to the benchmark value. Both are numerically equivalent to the above proportional form and are more conducive to smooth weighting in the scoring formula, i.e.:

[0092] If it is the acute phase: F = 1.0 + 0.02 × (X) crp 50), where X crp The initial CRP value (mg / L) is given, and F is not less than 1.0;

[0093] If it is the chronic phase: F = 1.0 + 0.001 × (X) ua 500), where X ua The value is the serum uric acid level (μmol / L), and F is not less than 1.0.

[0094] The formula for calculating the weighted fusion score of acute inflammation tendency is S_acute = (W1 * Z_crp * F) + (W2 * Z_esr), where the weight coefficients W1 and W2 are determined by multivariate regression analysis based on multicenter clinical retrospective data, and the preferred values ​​are: W1=0.7, W2=0.3.

[0095] Furthermore, the dynamic adjustment module 4 calculates the inflammatory response rate index, including the following procedure:

[0096] Calculate the absolute value of the decrease in the real-time C-reactive protein value compared to the initial C-reactive protein value;

[0097] The absolute value of the decrease is correlated with the first time interval to obtain the rate of decrease in inflammation level per unit time, and this rate is used as the inflammation response rate index; wherein, the first time interval is the time interval between the implementation of the initial bloodletting strategy and the preset time point.

[0098] Specifically, the system obtains the real-time C-reactive protein value (Crp_real-time) and the initial C-reactive protein value (Crp_initial). Calculate the absolute value of the decrease (ΔCrp): ΔCrp = Crp_initial - Crp_real-time. Define the first time interval (T): that is, the time interval (unit: days) from the implementation of the initial bloodletting therapy strategy to the real-time CRP value of this monitoring. Calculate the inflammation response rate index (V_i): V_i = ΔCrp / T. The unit of this index is mg / L / day, which intuitively represents the speed at which the CRP level of the target object decreases per day.

[0099] Specifically, in the dynamic adjustment module 4, fusion analysis and typing determination are performed: The system compares the calculated acute inflammation tendency score (S_acute) and the inflammation response rate index (V_i) with the decision thresholds determined in advance through clinical big data analysis. The decision thresholds include a score threshold (S_threshold) and a rate threshold (V_threshold). It is determined as the damp-heat accumulation type: S_acute > S_threshold and V_i > V_threshold. This indicates that the target object has a high basal inflammation level (excessive pathogenic qi), and at the same time, is responsive and sensitive to bloodletting treatment (sufficient healthy qi, unobstructed channels, and can quickly expel pathogenic factors). It is determined as the damp-heat toxin accumulation type: if S_acute < S_threshold and V_i < V_threshold. This indicates that the target object has a mild basal inflammation level (latent pathogenic factors), and is slow to respond to treatment (insufficient healthy qi or phlegm and stasis blocking the channels, making it difficult for pathogenic factors to exude). Based on a retrospective analysis of the historical clinical data of at least 300 target objects in the acute stage of gout, the optimal cut-off point is determined through ROC curve analysis. In one embodiment: the value range of the score threshold S_threshold is 5.0 - 7.0, and the preferred value is 6.0. The value range of the rate threshold V_threshold is 2.5 - 4.0 mg / L / day, and the preferred value is 3.2 mg / L / day. The thresholds can be adjusted according to different populations (such as age, gender, complications). The adjustment method is: re-perform ROC analysis based on the clinical data of this population, or make fine adjustments within the range of ±15% based on the preferred values given in this embodiment.

[0100] The technical principle of this implementation method is based on the intersection of clinical pathophysiology and data-driven decision-making. The modern medical essence of damp-heat accumulation is an acute inflammatory storm, manifested as a strong activation of the innate immune system (a sharp increase in CRP and ESR). In traditional Chinese medicine, its pathogenesis is "pathway obstruction," but the body's vital energy is still sufficient; therefore, once bloodletting is used to open the "floodgates," inflammatory markers (pathogenic factors) will rapidly decrease. This system model accurately captures this state using high S_acute and high V_inflammation. The modern medical essence of "damp-heat toxin accumulation" is chronic immune activation and tissue fibrosis; inflammatory markers may be slightly elevated or normal. In traditional Chinese medicine, its pathogenesis is "insufficient vital energy" or "phlegm and blood stasis," leading to impaired blood and qi circulation, which is more severe, resulting in a slower treatment response. This model accurately reflects this characteristic using low S_acute and low V_inflammation. Through Z-score standardization and the introduction of staging adjustment factors, the model cleverly coordinates the relationship between different indicators and different disease stages, making it a robust and universally applicable classifier. This is not just a simple mathematical calculation, but a highly abstract and quantitative modeling of the inherent laws of disease.

[0101] In a preferred embodiment, the disease stage identifier includes an acute phase identifier and a chronic phase identifier;

[0102] The introduction of staging adjustment factors based on the disease stage markers includes the following procedures:

[0103] If the disease stage identifier is the acute phase identifier, then the stage adjustment factor is dynamically assigned a value based on the level of the initial C-reactive protein value, and the assignment result is positively correlated with the initial C-reactive protein value;

[0104] If the disease stage identifier is the chronic stage identifier, then the stage adjustment factor is dynamically assigned a value based on the level of serum uric acid, and the assignment result is positively correlated with the serum uric acid level.

[0105] Specifically, the system first reads the disease stage marker. If the system identifies the disease stage marker as acute, the assignment principle is as follows: In the acute phase of gout, the redness, swelling, heat, and pain of the joints are mainly driven by an acute inflammatory response driven by neutrophils. Its severity is highly correlated with the concentration of circulating inflammatory mediators (especially IL-1β and IL-6). C-reactive protein (CRP) is synthesized and released by the liver under the stimulation of IL-6, making it the most sensitive serological marker. Therefore, the level of inflammatory activity in the acute phase is directly positively correlated with the initial CRP value. The specific operation involves the system calling an assignment function. The input to this function is the initial CRP value (X_crp), and the output is the stage adjustment factor (F). Optionally, the assignment function can be in the form of a linear relationship: F ​​= α + β * (X_crp / R_crp). Here, α is a base coefficient (e.g., 1.0), β is a scaling factor (e.g., 0.5), and R_crp is a reference value (e.g., 50 mg / L, representing a significantly elevated CRP level). Thus, the calculated adjustment factor F for an acute-phase target subject with an initial CRP of 100 mg / L will be significantly higher than that for a target subject with an initial CRP of 30 mg / L. Dynamic assignment in the chronic phase: Assignment principle: In the chronic phase of gout, acute inflammation may have subsided or become insignificant, but the pathological basis lies in the long-term hyperuricemia leading to the continuous deposition of urate crystals. These crystals act as chronic irritants, causing low-grade, persistent inflammatory responses and tissue remodeling (such as the formation of tophi). Therefore, disease activity in the chronic phase is directly and positively correlated with serum uric acid levels. Specific operation: The system will call another assignment function, whose input is the serum uric acid value (X_ua), and whose output is the stage adjustment factor (F). Optionally, the function form of this assignment function is: F = γ + δ * (X_ua / R_ua). Where γ is the base coefficient, δ is the scaling factor, and R_ua is the reference value of serum uric acid (e.g., 600 μmol / L). A target subject in the chronic phase with a serum uric acid level of 700 μmol / L will have a higher calculated F value than a target subject with a serum uric acid level of 450 μmol / L.

[0106] In a preferred embodiment, the initial strategy generation module 2 generates an initial bloodletting strategy based on baseline clinical data, including the following procedures:

[0107] The initial inflammatory burden index is calculated based on the serum uric acid value, the initial C-reactive protein value, and the erythrocyte sedimentation rate.

[0108] The target inflammation load index is obtained based on the initial inflammation load index and the hormone use history identifier;

[0109] Further, obtaining the target inflammatory burden index based on the initial inflammatory burden index and the hormone use history identifier includes the following steps:

[0110] If the target subject's history of hormone use is identified as having a history of hormone use, the initial inflammatory load index is corrected to obtain the target inflammatory load index;

[0111] If the target subject's history of hormone use is identified as having no history of hormone use, then the initial inflammatory load index is used as the target inflammatory load index.

[0112] Specifically, if the target individual is identified as having a history of hormone use, it is determined that the initial inflammatory burden index (L_initial) is at risk of being underestimated. The system will invoke a correction function to adjust L_initial upwards. The correction function can be a simple multiplicative model: L_target = L_initial * K. The correction coefficient K is a value greater than 1, determined based on clinical research. (The correction coefficient K was determined based on a prospective study of 120 patients with a history of hormone use during acute gout attacks. This study compared the correlation between CRP, ESR, and other indicators before and after hormone intervention and the true inflammatory burden (synovial blood flow signal grading detected by joint ultrasound). The results showed that hormone use could underestimate inflammatory indicators by an average of approximately 20%–50%. Statistical analysis used the median of 25% as the correction margin, therefore the correction coefficient K ranged from 1.2 to 1.5, with the optimal value being K=1.25. Those skilled in the art can fine-tune this range according to the specific type, dosage, and duration of use of the hormone in the target patient. For example, for patients with a daily oral prednisone dose >20 mg and use for more than one week, K=1.5 can be used; for short-term users with low doses, K=1.2 can be used.) This means that the system considers the true inflammatory burden of the target patient to be 25% higher than the current indicators indicate. If marked as "no history of hormone use," it indicates that the target patient's laboratory indicators accurately reflect their inflammatory status. Therefore, no correction is needed; simply set L_target = L_initial. Output target value: The corrected target inflammatory burden index (L_target) will be used for all subsequent decisions, including determining the amount of bloodletting and selecting auxiliary acupoints.

[0113] The baseline bloodletting volume is determined based on the target inflammatory burden index.

[0114] Obtain the location information of the diseased joint of the target object, including the first metatarsophalangeal joint, ankle joint, or knee joint;

[0115] Based on the location information of the diseased joint, a set of initial candidate acupoints is determined from the preset acupoint mapping relationship. The preset acupoint mapping relationship is used to define the set of local acupoints and meridian acupoints corresponding to different joint locations.

[0116] Based on the target inflammatory burden index, at least one acupoint with the most significant response is selected from the initial candidate acupoints according to the screening criteria as the basic bloodletting target acupoint; the screening criteria include skin temperature, tenderness, and visible redness and swelling at the acupoint.

[0117] Specifically, the system reads the serum uric acid level (X_ua), initial C-reactive protein level (X_crp), and erythrocyte sedimentation rate (X_esr). An initial inflammatory burden index (L_initial) is calculated using a weighted formula. The formula is as follows: L_initial = (W_ua * N_ua) + (W_crp * N_crp) + (W_esr * N_esr). Here, W_ua, W_crp, and W_esr are weighted coefficients determined beforehand through statistical analysis (such as multiple regression), and N_ua, N_crp, and N_esr are the corresponding index values ​​after normalization to eliminate dimensions. The target inflammatory burden index is then obtained: the system reads the history of hormone use. Correction logic: If the indicator is "history of hormone use," it means that the current inflammatory indicators (especially CRP and ESR) may have been artificially suppressed and fail to fully reflect the true level of inflammation. Therefore, the initial index needs to be corrected. The correction formula is as follows: L_target = L_initial * K. Here, K is a correction factor >1 (e.g., 1.2 or 1.3), the value of which is determined based on clinical studies and is used to “restore” the inflammatory burden masked by hormones. If identified as “no history of hormone use,” then L_target = L_initial.

[0118] Specifically, L_initial = (W_ua * N_ua) + (W_crp * N_crp) + (W_esr * N_esr), where N_ua, N_crp, and N_esr are the normalized values ​​of serum uric acid, CRP, and ESR, respectively. The min-max normalization method is used to map each indicator to the [0,10] interval. ;

[0119] The reference range is set as follows:

[0120] Serum uric acid Xmin = 200 μmol / L, Xmax = 800 μmol / L;

[0121] CRPXmin=5mg / L, Xmax=100mg / L;

[0122] ESRXmin=10mm / h, Xmax=80mm / h;

[0123] The weighting coefficients were determined based on statistical analysis of the contribution of inflammation in clinical studies, with the preferred values ​​being:

[0124] W_ua=0.3,W_crp=0.5,W_esr =0.2;

[0125] If the target subject has a history of hormone use, the correction factor K should be determined based on the results of clinical cohort studies, with a recommended range of 1.2-1.5 and an optimal value of K=1.25. The corrected target inflammatory burden index is:

[0126] Ltarget = Linitial × K; if there is no history of hormone use, then Ltarget = Linitial.

[0127] Specifically, the baseline bloodletting volume is determined in the initial strategy generation module 2: the system internally pre-defines a bloodletting volume mapping table. This table defines the recommended bloodletting volume range corresponding to different target inflammatory burden indices (e.g., L_target<3: 3-5ml; 3≤L_target<5: 5-8ml; L_target≥5: 8-10ml). The system can determine the baseline bloodletting volume by querying this table based on the calculated L_target value.

[0128] Specifically, in the initial strategy generation module 2, the basic bloodletting target acupoints are determined: The location of the affected joint is obtained: this is done through physician input or extraction from electronic medical records (e.g., "first metatarsophalangeal joint"). Initial candidate acupoints are mapped: the system has a built-in database of preset acupoint mapping relationships. This database stores corresponding acupoint groups indexed by joint location. For example, the preset acupoint mapping relationship database is shown in Table 1:

[0129] Table 1

[0130]

[0131] In the initial strategy generation module 2, the final acupoints are selected: the system prompts the physician to examine the local reaction of each acupoint in the candidate acupoint group (screening criteria). The physician assesses the acupoints through palpation (degree of tenderness), observation (visible redness and swelling), and the use of a skin thermometer (skin temperature). The physician inputs these assessment results into the system (e.g., scoring the reaction of each acupoint from 0 to 3). The system combines the target inflammatory burden index (L_target) and the acupoint scores to select 1-3 acupoints with the most significant reactions as the final base bloodletting target acupoints. The principle is: the higher the inflammatory burden, the more acupoints can be selected, with a greater emphasis on acupoints with severe reactions.

[0132] Specifically, to achieve objectivity and standardization in acupoint selection, a quantitative scoring system for local acupoint reactions is provided. This system quantifies and scores three selection criteria: skin temperature, tenderness, and visible redness and swelling. The specific standards are as follows:

[0133] Skin temperature (T_s) scoring criteria:

[0134] Measure the body surface temperature at the center point of the candidate acupoint and the same location on the opposite healthy side using an infrared thermometer. Calculate the temperature difference (ΔT = temperature on the affected side - temperature on the healthy side).

[0135] 0 points: ΔT < 0.5°C

[0136] 1 point: 0.5°C ≤ ΔT < 1.0°C

[0137] 2 points: 1.0°C ≤ ΔT < 1.5°C

[0138] 3 points: ΔT≥1.5°C

[0139] Tenderness (P_s) scoring criteria:

[0140] The doctor uses the pad of their thumb to press on candidate acupoints with a vertical pressure of about 2 kilograms (equivalent to the force that slightly whitens the nail bed of the examinee's thumb) and asks the target subject how they feel.

[0141] 0 points: No pain or only normal pressure sensation.

[0142] 1 point (mild tenderness): The subject complains of pain, but there is no avoidance response such as frowning or withdrawing.

[0143] 2 points (moderate tenderness): The subject complains of significant pain and exhibits frowning or mild avoidance response.

[0144] 3 points (severe tenderness): The subject complains of severe pain and exhibits a strong avoidance response, such as quickly withdrawing the limb or crying out in pain.

[0145] Redness and swelling condition (S_s) scoring criteria:

[0146] Observe the acupoints and surrounding skin visually.

[0147] 0 points: No redness or swelling, normal skin color and texture.

[0148] 1 point (mild redness and swelling): The skin is slightly red and there is no obvious swelling.

[0149] 2 points (moderate redness and swelling): The skin is obviously red, with slight swelling and skin lines are present.

[0150] 3 points (severe redness and swelling): The skin is bright red or dark red, with obvious swelling, and the skin lines disappear or become tight and shiny.

[0151] Calculation of the comprehensive response score (Point_Score) for acupoints: The comprehensive response score for each candidate acupoint is calculated using the following formula:

[0152] Point_Score=(WT×Ts)+(WP×Ps)+(WS×Ss)

[0153] Ts, Ps, and Ss represent the skin temperature, tenderness, and redness / swelling scores of the acupoint, respectively. The weighting coefficients WT, WP, and WS were determined based on clinical studies on the correlation between various signs and inflammatory activity, with the preferred values ​​being WT=0.3, WP=0.4, and WS=0.3.

[0154] Quantitative screening and final selection of acupoints: The system prompts the physician to evaluate each acupoint in the "initial candidate acupoint group" according to the above criteria and enter three scores. The system automatically calculates the Point_Score for each acupoint.

[0155] First, set a basic inclusion threshold (e.g., Point_Score ≥ 1.5). Acupoints with scores below this threshold will not be considered.

[0156] Then, the final number of acupoints selected is determined by combining the target inflammatory burden index (L_target):

[0157] If L_target < 3, then select the acupoint with the highest Point_Score.

[0158] If 3 ≤ L_target < 5, then select the 1 to 2 acupoints with the highest Point_Score.

[0159] If L_target≥5, then select the 2 to 3 acupoints with the highest Point_Score.

[0160] The selected acupoints are then determined as the target acupoints for basic bloodletting.

[0161] In a preferred embodiment, the dynamic adjustment module 4 dynamically adjusts the initial bloodletting strategy based on the syndrome differentiation results, including the following procedures:

[0162] If the syndrome differentiation result shows the damp-heat accumulation type, the dynamic adjustment module 4 will provide the following prompt:

[0163] Based on the basic bloodletting target acupoints, additional acupoints for clearing heat and promoting diuresis are added, including Neiting or Yinlingquan.

[0164] Increase the basic bloodletting volume by 10% to 20%, and the total bloodletting volume in a single session shall not exceed 8 ml;

[0165] Cupping is applied after acupuncture to increase the amount of bleeding after bloodletting.

[0166] If the syndrome differentiation result shows the damp-heat toxicity type, the dynamic adjustment module 4 will provide the following prompt:

[0167] Based on the basic bloodletting target acupoints, additional acupoints for clearing heat and detoxifying are added, including Chize, Dazhui, or Quchi.

[0168] Increase the basic bloodletting volume by 20% to 30%, and the total bloodletting volume in a single session shall not exceed 10ml;

[0169] Additional acupoints are pre-punctured with filiform needles, and after obtaining the Qi sensation, the needles are removed and bloodletting is performed.

[0170] Specifically, in the dynamic adjustment module 4, if the system's syndrome differentiation result is damp-heat accumulation type: this type corresponds to an excess of pathogenic factors and a lack of deficiency of vital energy, the treatment principle is mainly to clear heat and eliminate dampness, and additional acupoints are recommended: based on the basic bloodletting target acupoints determined in the initial strategy, the system will recommend adding a set of key acupoints for clearing heat and eliminating dampness. These acupoints are derived from traditional Chinese medicine theory: Neiting (Ying-Spring point, clears damp-heat in the Stomach Meridian); Yinlingquan (He-Sea point, strengthens the Spleen and eliminates dampness). The system will prompt the physician to select 1-2 additional acupoints based on the specific situation of the target patient. Bloodletting volume adjustment: the system will increase the basic bloodletting volume of the initial strategy by 10%~20%. At the same time, the system will set a safety upper limit (such as a single bloodletting volume not exceeding 8ml) and provide a warning on the interface to ensure treatment safety. Stimulation method adjustment: the system will suggest that the physician use cupping (such as glass jars) for suction for 5-10 minutes after needling the target acupoints. This operation utilizes negative pressure, which can significantly increase the bleeding volume at the puncture site and enhance the efficacy of clearing heat and eliminating pathogenic factors.

[0171] Specifically, in the dynamic adjustment module 4, if the system's syndrome differentiation result is damp-heat toxicity type: this type corresponds to a deficiency of vital energy or latent pathogenic factors, and the treatment principle is mainly to clear heat and detoxify. An additional set of acupoints for clearing heat and detoxifying is added: based on the basic bloodletting target acupoints, the system recommends adding a set of acupoints for clearing heat and detoxifying. These acupoints are also based on traditional Chinese medicine theory: Chize (clears lung heat); Dazhui (drains systemic yang heat and reduces high fever); Quchi (drains yangming heat, clears heat from the bowels, and clears heat from the skin). The physician selects these points as appropriate. The bloodletting volume is adjusted by increasing the blood volume by 20%~30%, and the total bloodletting volume in a single session does not exceed 10ml. Compared to the milder damp-heat toxicity type mentioned above, both the additional bloodletting volume and the total bloodletting volume in a single session are slightly increased. Stimulation method adjustment: the system will suggest different acupuncture techniques to the physician. The procedure involves first using filiform needles to puncture additional acupoints (such as Chize and Dazhui) until the patient experiences "deqi" (a sensation of soreness, numbness, distension, or heaviness in the target body), and then removing the needles. After needle removal, bloodletting is performed at or near the acupoint. This method of "regulating qi before bleeding" focuses on stimulating the flow of qi and blood, rather than simply removing stagnant blood.

[0172] In a preferred embodiment, the following procedures are also included:

[0173] In the dynamic adjustment module 4, after any dynamic adjustment of the initial bloodletting strategy, the real-time C-reactive protein value of the target object is monitored at a preset period.

[0174] If the real-time C-reactive protein value monitored twice consecutively is lower than the first preset threshold, and the inflammatory response rate index tends to stabilize, then the target subject is determined to have entered the inflammatory remission period, and a downgrade treatment strategy is initiated.

[0175] Specifically, the system has the following requirements: **Preset monitoring period:** After each dynamic adjustment of the bloodletting strategy, the system sets a fixed monitoring period (e.g., every 7 days) and prompts the target subject to return to the hospital at the end of this period for a follow-up real-time C-reactive protein (CRP_real-time) test. **Biochemical indicator requirements:** The system requires that the CRP_real-time values ​​monitored in two consecutive tests be below a first preset threshold. This threshold is a critical value indicating that inflammation has entered a low-level stable phase, typically set close to the upper limit of clinical normal values ​​(wherein, the first preset threshold is set to 8 mg / L. 8 mg / L is close to the upper limit of the clinical normal reference value for CRP in healthy individuals (usually 0-8 mg / L), indicating that the target subject's systemic inflammation has recovered to near physiological levels. Simultaneously, clinical observations show that when the target subject's CRP is stably below this level, the risk of acute relapse is significantly reduced, making it suitable for entering a reduced-intensity consolidation therapy phase). **Kinetic indicator requirements:** The system also assesses the trend of the inflammatory response rate indicator (V_i). The requirement that this indicator "tends to stabilize" can specifically mean that the latest calculated absolute value of Vi has become very small (e.g., <1 mg / L / day), and that it no longer shows a significant decrease in consecutive monitoring (meaning that the inflammation has reached a plateau and there is no longer room for rapid decline). Logical judgment: The system will automatically determine that the target subject has entered the inflammatory remission phase and generate a prompt, recommending that the physician initiate a de-escalation treatment strategy, only if both of the above conditions (biochemical indicator + kinetic indicator) are simultaneously met.

[0176] Specifically, the calculation example of the inflammatory response rate index Vi is as follows:

[0177] Assuming an initial CRP value of Crpinitial = 60 mg / L, and a real-time CRP value of Crpreal If time = 30 mg / L and the time interval between two tests is T = 2 days, then: ΔCrp = 60 30 = 30 mg / L; Vi = 30 / 2 = 15 mg / L / day. This indicator directly reflects the rate of decrease in inflammation level per unit time.

[0178] In a preferred embodiment, in the dynamic adjustment module 4, the downgraded treatment strategy includes reducing the amount of bloodletting to 50% to 70% of the current amount of bloodletting, extending the treatment interval to once every 7 to 10 days, and adjusting the stimulation method to perform acupuncture only without bloodletting;

[0179] During the implementation of the downgrade treatment strategy, real-time C-reactive protein levels are continuously monitored at the preset intervals.

[0180] If the real-time C-reactive protein value at any monitoring time point rebounds to more than 20% of the first preset threshold, the downgraded treatment strategy is terminated, and the last non-downgraded bloodletting strategy used before triggering the current downgraded treatment strategy is executed retrospectively.

[0181] Specifically, the downgraded treatment strategy includes: Reduced bloodletting volume: The bloodletting volume in the current non-downgraded strategy is reduced to 50%–70%. For example, if the current bloodletting volume is 10ml, it will be adjusted to 5ml–7ml after downgrading. This aims to maintain mild stimulation, avoid a rebound caused by completely stopping treatment, and significantly reduce the intensity of treatment. Extended treatment intervals: The treatment frequency (i.e., the interval between bloodletting) is significantly extended. For example, from once every 5 days to once every 7–10 days. This gives the body more time for self-recovery and adjustment, in line with the principles of long-term management of chronic diseases. Adjusted stimulation method: The stimulation method is changed from bloodletting to acupuncture only without bloodletting. That is, acupuncture is performed using filiform needles to achieve the desired effect of obtaining qi to unblock the meridians and harmonize qi and blood, but without bleeding or with only slight bleeding. This achieves a fundamental shift from purging to tonifying or balanced tonifying and purging methods, aiming to consolidate the therapeutic effect rather than continuing to attack the pathogenic factors.

[0182] Specifically, strategy retrospection: Once a relapse is detected, the system will automatically terminate the currently executing downgraded treatment strategy. The system will retrieve the complete parameters (including acupoint combination, bloodletting volume, treatment frequency, and stimulation method) of the last non-downgraded bloodletting strategy used before triggering this downgraded treatment strategy from the history. The system will prompt the physician: "Inflammation rebound detected, it is recommended to immediately retrospectively go back to the treatment plan executed on [YYYY-MM-DD] day", and automatically set the parameters of that plan as the current treatment strategy to be executed.

[0183] This document uses specific examples to illustrate the principles and implementation methods of this application. The descriptions of the above embodiments are only for the purpose of helping to understand the methods and core ideas of this application. The above descriptions are only preferred embodiments of this application. It should be noted that due to the limitations of written expression, while there are objectively infinite specific structures, those skilled in the art can make several improvements, modifications, or changes without departing from the principles of this invention, and can also combine the above technical features in an appropriate manner. These improvements, modifications, changes, or combinations, or the direct application of the inventive concept and technical solution to other situations without modification, should all be considered within the scope of protection of this application.

Claims

1. A dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation, characterized in that, Includes the following functional modules: Data acquisition module (1): Acquires baseline clinical data of the target subject, including serum uric acid value, initial C-reactive protein value, erythrocyte sedimentation rate, disease stage identifier and hormone use history identifier; Initial strategy generation module (2): Based on the baseline clinical data, generate an initial bloodletting strategy plan, which includes a basic bloodletting volume and a basic bloodletting target acupoint; Real-time data acquisition module (3): At a preset time point after the implementation of the initial strategy scheme, acquire the real-time C-reactive protein value of the target object; Dynamic adjustment module (4): If the real-time C-reactive protein value does not reach the preset target value, the syndrome classification result of the target object is judged, and a dynamic adjustment plan is generated for the initial strategy generation module (2) according to the syndrome classification result. The dynamic adjustment plan includes acupoint addition and / or bloodletting volume adjustment and / or stimulation method adjustment.

2. The dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation according to claim 1, characterized in that: The dynamic adjustment module (4) includes the following procedure for determining the syndrome classification result of the target object: Based on the initial C-reactive protein value, the erythrocyte sedimentation rate, and the disease stage identifier in the data acquisition module, an acute inflammation tendency score is calculated. The inflammatory response rate index is calculated based on the real-time C-reactive protein value and the initial C-reactive protein value. The acute inflammation tendency score and the inflammation response rate index were fused and analyzed. If both the acute inflammation tendency score and the inflammation response rate index are higher than their respective decision thresholds, the syndrome classification result will be displayed as damp-heat accumulation type. If both the acute inflammation tendency score and the inflammation response rate index are lower than their respective decision thresholds, the syndrome classification result will be displayed as damp-heat toxicity type.

3. The dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation according to claim 2, characterized in that: The calculation of the acute inflammation tendency score in the dynamic adjustment module (4) includes the following procedure: The initial C-reactive protein value and the erythrocyte sedimentation rate were standardized to obtain the standardized initial C-reactive protein value and the standardized erythrocyte sedimentation rate. Based on the disease stage markers, a stage adjustment factor is introduced, and the standardized initial C-reactive protein value, the standardized erythrocyte sedimentation rate, and the stage adjustment factor are weighted and fused to obtain the acute inflammation tendency score.

4. The dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation according to claim 2, characterized in that: The dynamic adjustment module (4) calculates the inflammatory response rate index, including the following procedures: Calculate the absolute value of the decrease in the real-time C-reactive protein value compared to the initial C-reactive protein value; The absolute value of the decrease is correlated with the first time interval to obtain the rate of decrease in inflammation level per unit time, and this rate is used as the inflammation response rate index; wherein, the first time interval is the time interval between the implementation of the initial bloodletting strategy and the preset time point.

5. The dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation according to claim 3, characterized in that: The disease stage markers include acute phase markers and chronic phase markers; The introduction of staging adjustment factors based on the disease stage markers includes the following procedures: If the disease stage identifier is the acute phase identifier, then the stage adjustment factor is dynamically assigned a value based on the level of the initial C-reactive protein value, and the assignment result is positively correlated with the initial C-reactive protein value; If the disease stage identifier is the chronic stage identifier, then the stage adjustment factor is dynamically assigned a value based on the level of serum uric acid, and the assignment result is positively correlated with the serum uric acid level.

6. The dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation according to claim 2, characterized in that: The initial strategy generation module (2) includes the following program: The initial inflammatory burden index is calculated based on the serum uric acid value, the initial C-reactive protein value, and the erythrocyte sedimentation rate. The target inflammation load index is obtained based on the initial inflammation load index and the hormone use history identifier; The baseline bloodletting volume is determined based on the target inflammatory burden index. Obtain the location information of the diseased joint of the target object, including the first metatarsophalangeal joint, ankle joint, or knee joint; Based on the location information of the diseased joint, a set of initial candidate acupoints is determined from the preset acupoint mapping relationship. The preset acupoint mapping relationship is used to define the set of local acupoints and meridian acupoints corresponding to different joint locations. Based on the target inflammatory burden index, at least one acupoint with the most significant response is selected from the initial candidate acupoints according to the screening criteria as the basic bloodletting target acupoint; the screening criteria include skin temperature, tenderness, and visible redness and swelling at the acupoint.

7. The dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation according to claim 6, characterized in that: The dynamic adjustment module (4) dynamically adjusts the initial bloodletting strategy based on the syndrome differentiation results, including the following procedures: If the syndrome differentiation result shows the damp-heat accumulation type, the dynamic adjustment module (4) will provide the following prompt: Based on the basic bloodletting target acupoints, additional acupoints for clearing heat and promoting diuresis are added, including Neiting or Yinlingquan. Increase the basic bloodletting volume by 10% to 20%, and the total bloodletting volume in a single session shall not exceed 8 ml; Cupping is applied after acupuncture to increase the amount of bleeding after bloodletting. If the syndrome differentiation result shows the damp-heat toxicity type, the dynamic adjustment module (4) will provide the following prompt: Based on the basic bloodletting target acupoints, additional acupoints for clearing heat and detoxifying are added, including Chize, Dazhui, or Quchi. Increase the basic bloodletting volume by 20% to 30%, and the total bloodletting volume in a single session shall not exceed 10ml; Additional acupoints are pre-punctured with filiform needles, and after obtaining the Qi sensation, the needles are removed and bloodletting is performed.

8. The dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation according to claim 6, characterized in that: The process of obtaining the target inflammatory burden index based on the initial inflammatory burden index and the hormone use history identifier includes the following steps: If the target subject's history of hormone use is identified as having a history of hormone use, the initial inflammatory load index is corrected to obtain the target inflammatory load index; If the target subject's history of hormone use is identified as having no history of hormone use, then the initial inflammatory load index is used as the target inflammatory load index.

9. The dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation according to claim 2, characterized in that: It also includes the following programs: After any dynamic adjustment to the initial bloodletting strategy, the real-time C-reactive protein value of the target object is monitored at a preset period. If the real-time C-reactive protein value monitored twice consecutively is lower than the first preset threshold, and the inflammatory response rate index tends to stabilize, then the target subject is determined to have entered the inflammatory remission period, and a downgrade treatment strategy is initiated.

10. The dynamic control system for gout bloodletting based on CRP feedback and syndrome differentiation according to claim 9, characterized in that: The downgraded treatment strategy includes reducing the amount of bloodletting to 50% to 70% of the current amount, extending the treatment interval to once every 7 to 10 days, and adjusting the stimulation method to only perform acupuncture without bloodletting. During the implementation of the downgrade treatment strategy, real-time C-reactive protein levels are continuously monitored at the preset intervals. If the real-time C-reactive protein value at any monitoring time point rebounds to more than 20% of the first preset threshold, the downgraded treatment strategy is terminated, and the last non-downgraded bloodletting strategy used before triggering the current downgraded treatment strategy is executed retrospectively.

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