Hyperthyroidism patient stratification and grading nursing system and method based on traditional Chinese medicine theory
Patent Information
- Application Number
- CN202611021256.X
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2026-07-09
- Publication Date
- 2026-09-25
AI Technical Summary
现有护理方案多基于西医指南制定，主要关注甲状腺功能指标的数值变化，未能将病情危重程度与中医证候进行有效结合，不同层级和证型的患者对护理措施的需求差异较大，采用统一护理方案容易导致高危患者护理强度不足、平稳期患者护理过度的问题；
该基于中医理论的甲亢患者分层分级护理系统及方法，通过构建候选护理措施集，并依据甲状腺功能指标与中医证候特征对患者进行高危层、中危层、平稳层的三个层级划分，结合中医辨证分型明确中医证型，实现对甲亢患者的多层次分类，通过计算积极系数、分层评估协调系数和分层重要性评分，并将三项指标融合生成分层共识权重值，构建具有分层权重标识的护理措施知识库，通过实时获取甲亢患者的生理参数数据和中医四诊信息，依据预设的分层分级标准将患者动态映射至对应层级，并识别中医证型，实现患者状态的动态感知与实时更新，能够及时捕捉病情变化，实现了从通用护理到精准护理，提高护理服务的针对性和患者满意度，根据患者当前所处的具体层级和中医证型，在护理措施知识库中检索对应的候选措施集，并按照分层共识权重值进行降序排序和阈值筛选，生成符合层级和证型特征的护理步骤序列，通过计算各层级的护理效果评价值，并根据效果评价值动态调整护理措施在对应层级下的分层共识权重值。
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Abstract
Description
Technical Field
[0001] This invention relates to the field of nursing management technology, and in particular to a stratified and graded nursing system and method for hyperthyroidism patients based on traditional Chinese medicine theory. Background Technology
[0002] Hyperthyroidism is a common endocrine disorder caused by excessive secretion of thyroid hormones, leading to hypermetabolism and sympathetic nerve excitation. Hyperthyroidism is a chronic disease that is prone to recurrence, affecting not only the patient's physical health but also often accompanied by symptoms of emotional imbalance such as anxiety and irritability. Traditional Chinese medicine classifies hyperthyroidism under the categories of goiter, palpitations, and diabetes, believing that its pathogenesis is mostly related to qi stagnation, phlegm accumulation, blood stasis, and yin deficiency with fire excess. Treatment and nursing care emphasize syndrome differentiation and overall conditioning. In clinical practice, the severity of hyperthyroidism varies significantly among patients. High-risk patients may experience serious complications such as thyroid storm, while patients in the stable phase mainly rely on medication and lifestyle adjustments. Traditional nursing models often employ relatively fixed standard nursing procedures, making it difficult to dynamically adjust according to the severity of the patient's condition and the characteristics of TCM syndromes.
[0003] Specifically, the existing nursing care system has the following technical deficiencies: Existing nursing protocols are mostly based on Western medicine guidelines and focus primarily on changes in thyroid function indicators. They fail to effectively combine the severity of the illness with TCM syndromes. Patients at different levels and with different syndromes have significantly different needs for nursing interventions. Using a uniform nursing protocol can easily lead to insufficient nursing intensity for high-risk patients and excessive nursing for patients in the stable phase. Nursing plans are based on the personal experience of nurses and routine departmental practices, lacking an assessment of the importance of nursing interventions, which may lead to significant differences in nursing plans for the same patient among different nurses; To address the aforementioned technical shortcomings, a solution is proposed. Summary of the Invention
[0004] The purpose of this invention is to construct a knowledge base of nursing interventions with hierarchical weighting, and to integrate the evaluator's positive coefficient, coordination coefficient, and importance score into a hierarchical consensus weight value, so that the generated nursing procedure sequence has an evidence-based basis and clinical acceptance.
[0005] To achieve the above objectives, the present invention adopts the following technical solution: a hierarchical nursing system for hyperthyroidism patients based on traditional Chinese medicine theory, including a nursing framework construction module, a nursing consensus analysis module, a patient status mapping module, a nursing matching module, and a nursing optimization module; The nursing framework construction module is used to build a set of candidate nursing measures based on clinical guidelines and to classify hyperthyroidism patients into three levels: high-risk, intermediate-risk and stable, based on the patient's thyroid function indicators and TCM syndrome characteristics, and to classify TCM syndrome types based on TCM syndrome differentiation. The nursing consensus analysis module is used to conduct multiple rounds of expert scoring on candidate nursing measures through expert consultation. For each nursing measure, the expert activity coefficient, expert coordination coefficient, and average importance score are calculated at each nursing level. The three indicators are integrated to generate a hierarchical consensus weight value for the nursing measure at each level, and a nursing measure knowledge base with hierarchical weight identifiers is constructed. The patient status mapping module is used to acquire physiological parameter data and TCM four diagnostic information of hyperthyroidism patients in real time. According to the preset hierarchical and grading standards, the module dynamically maps and identifies the patient's current TCM syndrome type. The nursing matching module is used to retrieve the corresponding candidate measure set in the nursing measure knowledge base according to the patient's current specific level and TCM syndrome type, and sort and filter the nursing measures in descending order according to the hierarchical consensus weight value under the current level, and generate a nursing step sequence that conforms to the characteristics of level and syndrome type. The nursing optimization module is used to calculate the nursing effect evaluation value at each level, and adjust the stratified consensus weight value of nursing measures at the corresponding level based on the effect evaluation value, and perform real-time dynamic updates and optimizations.
[0006] Furthermore, based on patients' thyroid function indicators and TCM syndrome characteristics, they are divided into three levels: high-risk, intermediate-risk, and stable. Additionally, TCM syndrome types are classified according to TCM differentiation. The specific classification process is as follows: Based on the nursing needs of hyperthyroidism patients throughout the entire course of the disease, a set of candidate nursing measures covering six dimensions, including nutrition, exercise, acupoints, emotions, medication, and follow-up, was constructed. Based on the patient's serum thyroid function indicators, the patient was dynamically divided into three levels: high-risk, intermediate-risk, and stable, which correspond to the crisis period during the initial diagnosis and treatment, the drug reduction period, and the stable period during the drug maintenance period, respectively. Based on the TCM syndrome differentiation criteria, patients were classified into four syndrome types: Liver Qi Stagnation Syndrome, Yin Deficiency and Yang Hyperactivity Syndrome, Qi and Yin Deficiency Syndrome, and Phlegm Stagnation and Blood Stasis Syndrome. By integrating and constructing hierarchical and graded nursing intervention databases through hierarchical levels, four types of certificates, and candidate nursing intervention sets, a hierarchical and graded nursing intervention database is formed.
[0007] Furthermore, the expert positivity coefficient, stratified expert opinion coordination coefficient, and stratified importance score for each candidate measure are calculated at each level. The specific process is as follows: Based on the three levels of high-risk, medium-risk, and stable risk, nursing interventions were scored for each level. A multi-round scoring mechanism was adopted, and statistical analysis of the scoring data in each round was conducted to obtain the positive coefficient of each level in each round. For each candidate measure in each level, analyze the importance of the candidate measure, calculate the arithmetic mean of the importance scores, and calculate the frequency of full scores; The scores of all nursing interventions are converted into ranks. The total rank of each nursing intervention is calculated. The sum of squared deviations of the total rank is calculated. The coefficient of conformity is then calculated by combining the number of people assessed and the number of nursing interventions. The positive coefficient, coordination coefficient, and mean importance score of each measure are weighted and integrated to generate the consensus confidence level of each measure. Based on the full score frequency and the mean importance score of each measure, the threshold method is used for screening. The threshold value is the mean minus the standard deviation. The nursing measures selected form the final nursing measure library.
[0008] Furthermore, the three indicators are integrated to generate hierarchical consensus weight values for nursing interventions at each level, thus constructing a knowledge base of nursing interventions with hierarchical weight identifiers. The specific process is as follows: The three indicators of positive rating, coordination rating and importance rating were normalized, and weights were assigned to the positive rating, coordination rating and importance rating. For each nursing intervention at each level, a weighted summation formula is used to calculate the consensus weight value of each nursing intervention at each level. Each nursing intervention is then associated with and stored with its respective level and stratified consensus weight value to form a structured nursing intervention knowledge base.
[0009] Furthermore, it is used to acquire physiological parameter data and TCM four diagnostic information of hyperthyroidism patients in real time, and dynamically map and identify the patient's current TCM syndrome type according to the preset stratification and grading standards. The specific process is as follows: The system acquires physiological parameters and TCM diagnostic information of hyperthyroidism patients in real time, converts unstructured TCM diagnostic descriptions into structured codes, and forms a standardized and computable patient status dataset. Based on the preset thyroid function index stratification criteria, patients are divided into high-risk, intermediate-risk, and stable layers, and the stratification determination is automatically triggered each time new data is entered. Based on TCM internal medicine textbooks and consensus on the diagnosis and treatment of hyperthyroidism, a discrimination rule library was pre-constructed, which includes syndromes such as liver qi stagnation, yin deficiency and yang hyperactivity, qi and yin deficiency, and phlegm stagnation and blood stasis. Each syndrome consists of a set of feature entries and corresponding matching weight coefficients. The patient's four diagnostic methods information is compared item by item with the rule base of each syndrome type. The weighted matching score of each syndrome type is calculated, and the syndrome type with the highest score is taken as the recognition result. If there is a compound syndrome type, the main syndrome and the concurrent syndrome are marked at the same time. A dynamic update frequency is set, and re-recognition is automatically triggered when new data is entered.
[0010] Furthermore, the corresponding candidate measure set is retrieved from the nursing measure knowledge base, and sorted in descending order according to the hierarchical consensus weight value of the nursing measures at the current level, and then filtered by threshold to generate a nursing step sequence that conforms to the hierarchical and syndrome characteristics. The specific process is as follows: Upon receiving the patient’s current hierarchical level L and TCM syndrome type S, the nursing intervention set that simultaneously meets the hierarchical level and syndrome type is retrieved using (L,S) as the exact matching condition, forming an original candidate intervention pool with a hierarchical structure of primary and alternative interventions. Each measure in the candidate measure pool is sorted in descending order according to its hierarchical consensus weight value at that level. The mutation point of the candidate measure weight sequence is calculated, and the weight value corresponding to the mutation point is used as the adaptive screening threshold to select the set of advantageous measures. The selected set of advantageous measures is arranged sequentially according to the preset nursing time sequence rules to generate the final nursing step sequence. The generated nursing step sequence is stored in association with the patient information to form a nursing plan version record. When the patient's status changes, it automatically triggers re-retrieval and sorting to generate a nursing step sequence adapted to the new status.
[0011] Furthermore, the nursing effectiveness evaluation values for each level are calculated, and the stratified consensus weight values of nursing measures at the corresponding level are adjusted based on the effectiveness evaluation values, with real-time dynamic updates and optimizations. The specific process is as follows: Based on the indicators for evaluating the nursing outcomes of hyperthyroidism patients, quantitative data at each level were collected before and after intervention to construct an evaluation system. For each level, based on the improvement of various indicators, the nursing effectiveness evaluation value for that level is calculated. The execution frequency and patient compliance rate of each nursing measure at each level are statistically analyzed, and the correlation coefficient between the intensity of measure execution and the effectiveness evaluation value at each level is calculated. The deviation between the hierarchical effect evaluation value and the benchmark value is used as the basis for overall adjustment. Combined with the difference between the contribution of the measures and the average contribution, the weight adjustment amount of each measure is calculated. Three trigger conditions are set: minimum sample size, fixed period, or abnormal fluctuations, to initiate batch updates periodically. Each update generates a new version of the knowledge base, records the weight change trajectory, and dynamically updates and evolves the knowledge base in real time.
[0012] Furthermore, the nursing matching module also includes a nursing intervention conflict detection unit, which is used to detect potential conflicts between nursing interventions at different levels and syndrome types when generating a nursing step sequence. The specific process is as follows: Construct a knowledge base for nursing intervention conflicts, predefine the incompatible combinations of nursing interventions between different levels and syndrome types, including nursing interventions that are prohibited in the high-risk level but are prohibited in the intermediate level, nursing operations that cause conflicts between different syndrome types of the same patient, and therapeutic nursing interventions that cannot be performed simultaneously within the same time window. After the nursing matching module generates a set of candidate measures that match the current patient level and syndrome type, the conflict detection unit performs a matching analysis on each nursing measure in the candidate set based on the conflict knowledge base, and identifies combinations of conflicting measures. For detected conflicting measures, automatic resolution is carried out according to the measure priority rules and clinical safety principles. Measures with higher priority or better safety are retained, while conflicting measures are eliminated. Conflicting measures are allocated to different time windows for execution through staggered scheduling to ensure the safety and feasibility of the nursing plan.
[0013] A stratified and graded nursing care method for hyperthyroidism patients based on traditional Chinese medicine theory includes the following steps: Step 1: Construct a set of candidate nursing interventions based on clinical guidelines and classify hyperthyroidism patients into three levels: high-risk, intermediate-risk, and stable, based on the patients' thyroid function indicators and TCM syndrome characteristics, and classify TCM syndrome types based on TCM syndrome differentiation. Step 2: The candidate nursing measures are evaluated by experts through multiple rounds of expert consultation. For each nursing measure, the expert activity coefficient, expert coordination coefficient and the average importance score are calculated at each nursing level. The three indicators are integrated to generate the hierarchical consensus weight value of the nursing measure at each level, and a nursing measure knowledge base with hierarchical weight labels is constructed. Step 3: Real-time acquisition of physiological parameter data and TCM four diagnostic information of hyperthyroidism patients; dynamic mapping and identification of the patient's current TCM syndrome type based on preset stratification and grading standards. Step 4: Based on the patient's current specific level and TCM syndrome type, retrieve the corresponding candidate measure set in the nursing measure knowledge base, and sort and filter the nursing measures in descending order according to the hierarchical consensus weight value under the current level, and generate a nursing step sequence that conforms to the characteristics of level and syndrome type. Step 5: Calculate the nursing effect evaluation value for each level, and adjust the stratified consensus weight value of nursing measures at the corresponding level based on the effect evaluation value, and perform real-time dynamic updates and optimizations.
[0014] In summary, due to the adoption of the above technical solution, the beneficial effects of the present invention are: This stratified and graded nursing system and method for hyperthyroidism patients based on Traditional Chinese Medicine (TCM) theory constructs a set of candidate nursing interventions and classifies patients into three tiers—high-risk, intermediate-risk, and stable—based on thyroid function indicators and TCM syndrome characteristics. It further clarifies TCM syndrome types by combining TCM diagnostic methods, achieving multi-level classification of hyperthyroidism patients. By calculating the positivity coefficient, stratification assessment coordination coefficient, and stratification importance score, and integrating these three indicators to generate a stratification consensus weight value, a nursing intervention knowledge base with stratification weight identifiers is constructed. The system acquires real-time physiological parameter data and TCM four diagnostic methods information of hyperthyroidism patients and classifies them according to preset stratification and grading standards. Patients are dynamically mapped to corresponding levels and their TCM syndrome types are identified, enabling dynamic perception and real-time updates of patient status. This allows for timely capture of changes in the patient's condition, transitioning from general nursing to precision nursing, thus improving the targeted nature of nursing services and patient satisfaction. Based on the patient's current specific level and TCM syndrome type, the system retrieves the corresponding candidate measure set from the nursing measure knowledge base, sorts them in descending order according to the hierarchical consensus weight value, and filters them using a threshold. This generates a nursing step sequence that conforms to the characteristics of the level and syndrome type. By calculating the nursing effect evaluation value for each level, the system dynamically adjusts the hierarchical consensus weight value of the nursing measures at the corresponding level based on the effect evaluation value. Attached Figure Description
[0015] Figure 1 A schematic diagram of the overall system steps of the present invention is shown;
[0016] Figure 2 A schematic diagram of the overall structure of the method flow of the present invention is shown. Detailed Implementation
[0017] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.
[0018] Example 1: like Figure 1 As shown, the hierarchical nursing system for hyperthyroidism patients based on traditional Chinese medicine theory includes a nursing framework construction module, a nursing consensus analysis module, a patient status mapping module, a nursing matching module, and a nursing optimization module. The nursing framework construction module is used to build a set of candidate nursing measures based on clinical guidelines and to classify hyperthyroidism patients into three levels: high-risk, intermediate-risk and stable, based on the patient's thyroid function indicators and TCM syndrome characteristics, and to classify TCM syndrome types based on TCM syndrome differentiation. The nursing consensus analysis module is used to conduct multiple rounds of expert scoring on candidate nursing measures through expert consultation. For each nursing measure, the expert activity coefficient, expert coordination coefficient, and average importance score are calculated at each nursing level. The three indicators are integrated to generate a hierarchical consensus weight value for the nursing measure at each level, and a nursing measure knowledge base with hierarchical weight identifiers is constructed. The patient status mapping module is used to acquire physiological parameter data and TCM four diagnostic information of hyperthyroidism patients in real time. According to the preset hierarchical and grading standards, the module dynamically maps and identifies the patient's current TCM syndrome type. The nursing matching module is used to retrieve the corresponding candidate measure set in the nursing measure knowledge base according to the patient's current specific level and TCM syndrome type, and sort and filter the nursing measures in descending order according to the hierarchical consensus weight value under the current level, and generate a nursing step sequence that conforms to the characteristics of level and syndrome type. The nursing optimization module is used to calculate the nursing effect evaluation value at each level, and adjust the stratified consensus weight value of nursing measures at the corresponding level based on the effect evaluation value, and perform real-time dynamic updates and optimizations.
[0019] In this plan, based on the clinical nursing needs of hyperthyroidism patients, a set of candidate nursing measures covering six dimensions is constructed. Patients are divided into three levels according to thyroid function indicators and disease stage: High-risk zone: during the initial diagnosis and treatment period or the pre-thyroid storm stage, serum TSH is decreased, FT3 / FT4 is increased, and TRAb is positive; Intermediate risk level: During the tapering period of antithyroid drugs, serum FT3 / FT4 has returned to normal, but TSH and TRAb have not yet returned to normal; Stable phase: During the maintenance dose period of antithyroid drugs, serum FT3 / FT4 / TSH were all normal, and TRAb turned negative.
[0020] According to the diagnostic criteria of traditional Chinese medicine, patients are divided into four syndrome types: Liver Qi stagnation syndrome: emotional depression, chest and rib pain, frequent sighing, pale red tongue with thin white coating, and wiry pulse; Yin deficiency with yang excess syndrome: dizziness and tinnitus, hot flashes in the palms, soles, and chest, flushed cheeks and night sweats, red tongue with little coating, and thready and rapid pulse; Qi and Yin deficiency syndrome: fatigue, shortness of breath, reluctance to speak, dry mouth and throat, pale red tongue with little coating, and weak pulse; Phlegm-blood stasis syndrome: swelling and hardness of the neck, chest tightness and excessive phlegm, dark red tongue with petechiae, greasy tongue coating, slippery and hesitant pulse; Candidate nursing interventions are associated with three levels and four syndrome types to form a hierarchical nursing intervention library, where each intervention can be associated with multiple levels and syndrome types.
[0021] Independent evaluation groups were formed for the three levels of high risk, medium risk, and stable risk. Questionnaires containing candidate measures for each level were distributed to the evaluators at each level. The importance of each measure was scored using the Likert 5-point scoring method. A section for comments and suggestions was provided. After the questionnaires were collected, the average score and the frequency of full marks for each measure were calculated. Expert opinions were compiled to form a second round of questionnaires. The first round of statistical results were fed back to the experts, who were asked to re-evaluate the scores after considering the overall opinions. This process was repeated until the convergence condition was met: the coefficient of variation of the scores for each measure was less than 0.3, or the rate of change of scores between two consecutive rounds was less than 5%. After each round of consultation, the following three indicators will be calculated: Evaluator participation coefficient: Number of valid returned questionnaires / Total number of questionnaires distributed × 100%, reflecting the experts' participation enthusiasm; Mean importance score: ; Kendall's concordance coefficient is used to calculate the consensus of expert opinions. The formula for the concordance coefficient is: ; in, For the level of measure i, For grade and mean, To evaluate the number of personnel, This represents the total number of nursing interventions.
[0022] The threshold method was used to screen measures: the maximum frequency threshold = mean - standard deviation, measures with frequencies higher than this value were selected; The arithmetic mean threshold is calculated as mean minus standard deviation; measures exceeding this value are selected. The coordination coefficient threshold is calculated as mean + standard deviation; measures below this value are selected. Measures that do not meet all three requirements are eliminated. The three indicators are then normalized, and each measure and its hierarchical consensus weight value are stored in a structured manner to form a nursing measure knowledge base. The knowledge base table structure includes: measure ID, measure name, specific content, applicable level, applicable certificate type, hierarchical consensus weight value, version number, and construction time.
[0023] In this solution, the patient status mapping module obtains real-time physiological parameter data of patients through the hospital information system interface, including TSH, FT3, FT4, TRAb, heart rate, and blood pressure. Simultaneously, it collects information from the four diagnostic methods of Traditional Chinese Medicine (TCM) via a mobile nursing terminal. A structured form is used to convert the information from these four methods into codes. Based on preset thyroid function index standards, a stratified judgment is automatically triggered each time new data is entered. Based on TCM internal medicine textbooks and consensus on hyperthyroidism diagnosis and treatment, a discrimination rule base for four syndrome types is constructed. Each syndrome type consists of a set of feature items and weight coefficients. The patient's four diagnostic information is compared item by item with each syndrome type rule base, and a weighted matching score for each syndrome type is calculated. : ; The feature conformity is set to 0, 0.5, or 1 based on the clarity of the information. The highest-scoring certificate type is taken as the identification result. If the difference between the highest and second-highest scores is less than 0.1 and there is a possibility of the two certificate types being combined, it is determined to be a composite certificate type, and the main certificate and the composite certificate are marked. The identification result is automatically updated every 24 hours or every time new data is entered.
[0024] After receiving the patient's current level L and syndrome type S, the system uses (L,S) as the exact matching condition to retrieve nursing interventions that simultaneously match the level and syndrome type from the nursing intervention knowledge base, forming an initial candidate intervention pool.
[0025] The measures in the candidate measure pool are sorted in descending order of their hierarchical consensus weight values to obtain the weight sequence. Calculate the mutation points of the sequence, where m is the total number of candidate measures, i.e., satisfying... , Let the first position of sensitivity be defined, and the weight value corresponding to this point be used as the adaptive screening threshold. Measures with weight values higher than the threshold are retained to form a set of advantageous measures. For the first Weight sequence of one nursing intervention For the first A weighted sequence; The set of advantageous measures is arranged sequentially according to a pre-defined nursing timeline: Priority rule: Emergency measures, such as hazard identification, take precedence over routine measures; Dependency rules: assessment measures, such as health monitoring, are implemented beforehand; execution measures, such as acupressure massage, are implemented afterward. Frequency rules: High-risk areas are implemented daily, medium-risk areas every 2-3 days, and stable areas weekly; Generate the final nursing step sequence, including measure ID, measure name, execution time, and execution frequency information; build a nursing measure conflict knowledge base and predefine contraindication combinations. The conflict detection unit iterates through all pairwise combinations in the candidate measures set and compares them with the conflict knowledge base. If a conflict is detected, it is automatically resolved according to the following rules: Priority retention: Measures that retain those with high consensus weight values in the hierarchical system; Safety first: retain measures with lower risk to patients; Staggered timing: Distribute conflict-related measures to different time windows for execution, with an interval of at least 2 hours; The generated nursing step sequence is stored in association with patient ID, timestamp, level, and syndrome type to form a personalized nursing plan version record. When the patient's status changes, it automatically triggers re-retrieval and sorting to generate a new version sequence.
[0026] The nursing optimization module dynamically adjusts the consensus weights of nursing interventions to achieve continuous evolution of the knowledge base. It collects data from all levels before and after intervention, normalizes the changes in various indicators, and calculates the execution frequency of each intervention within the evaluation period. and average patient compliance rate Calculate the correlation coefficient between the intensity of measure implementation and the evaluation value of effect. Normalized contribution ; Based on the hierarchical effect evaluation value and the benchmark value The deviation is used as the basis for overall adjustment, and the benchmark value is used as the reference value. Calculate the weight adjustment for each measure based on the historical average effect at this level. : Where λ=0.2 is the learning rate. Adjust the direction to reflect the average contribution: ; ; Updated formula: ; in The coefficient of variation for the effect data. This is the sample size, used to reduce the adjustment range when data fluctuates. For the updated consensus weights, The consensus weights before the update.
[0027] Set trigger conditions: Batch update will be initiated when a fixed number of patients are accumulated, monthly, or when the effect value fluctuates abnormally by more than 2 standard deviations.
[0028] Example 2: like Figure 2 As shown, the stratified and graded nursing method for hyperthyroidism patients based on traditional Chinese medicine theory includes the following steps: Step 1: Construct a set of candidate nursing interventions based on clinical guidelines and classify hyperthyroidism patients into three levels: high-risk, intermediate-risk, and stable, based on the patients' thyroid function indicators and TCM syndrome characteristics, and classify TCM syndrome types based on TCM syndrome differentiation. Step 2: The candidate nursing measures are evaluated by experts through multiple rounds of expert consultation. For each nursing measure, the expert activity coefficient, expert coordination coefficient and the average importance score are calculated at each nursing level. The three indicators are integrated to generate the hierarchical consensus weight value of the nursing measure at each level, and a nursing measure knowledge base with hierarchical weight labels is constructed. Step 3: Real-time acquisition of physiological parameter data and TCM four diagnostic information of hyperthyroidism patients; dynamic mapping and identification of the patient's current TCM syndrome type based on preset stratification and grading standards. Step 4: Based on the patient's current specific level and TCM syndrome type, retrieve the corresponding candidate measure set in the nursing measure knowledge base, and sort and filter the nursing measures in descending order according to the hierarchical consensus weight value under the current level, and generate a nursing step sequence that conforms to the characteristics of level and syndrome type. Step 5: Calculate the nursing effect evaluation value for each level, and adjust the stratified consensus weight value of nursing measures at the corresponding level based on the effect evaluation value, and perform real-time dynamic updates and optimizations.
[0029] The size of the interval and threshold is set to facilitate comparison. The size of the threshold depends on the amount of sample data and the number of bases set by those skilled in the art for each set of sample data; as long as it does not affect the ratio between the parameter and the quantized value.
[0030] The above formulas are all dimensionless calculations. The formulas are derived from software simulations based on a large amount of collected data to obtain the most recent real-world results. The preset parameters in the formulas are set by those skilled in the art according to the actual situation. In the two embodiments provided in this application, it should be understood that the disclosed apparatus and system can be implemented in other ways; for example, the apparatus embodiments described above are merely illustrative, and the division of modules is merely a logical functional division. In actual implementation, there may be other division methods, such as multiple modules or components can be combined or integrated into another system, or some features can be ignored or not executed; furthermore, the coupling or direct coupling or communication connection between the shown or discussed mutuals can be through some interfaces, and the indirect coupling or communication connection between the apparatus or modules can be electrical, mechanical or other forms. The above description is only a preferred embodiment of the present invention, but the scope of protection of the present invention is not limited thereto. Any equivalent substitutions or modifications made by those skilled in the art within the scope of the technology disclosed in the present invention, based on the technical solution and inventive concept of the present invention, should be covered within the scope of protection of the present invention.
Claims
1. A tiered and graded nursing system for hyperthyroidism patients based on traditional Chinese medicine theory, characterized in that: It includes a nursing framework construction module, a nursing consensus analysis module, a patient status mapping module, a nursing matching module, and a nursing optimization module; The nursing framework construction module is used to build a set of candidate nursing measures based on clinical guidelines and to classify hyperthyroidism patients into three levels: high-risk, intermediate-risk and stable, based on the patient's thyroid function indicators and TCM syndrome characteristics, and to classify TCM syndrome types based on TCM syndrome differentiation. The nursing consensus analysis module is used to conduct multiple rounds of expert scoring on candidate nursing measures through expert consultation. For each nursing measure, the expert activity coefficient, expert coordination coefficient, and average importance score are calculated at each nursing level. The three indicators are integrated to generate a hierarchical consensus weight value for the nursing measure at each level, and a nursing measure knowledge base with hierarchical weight identifiers is constructed. The patient status mapping module is used to acquire physiological parameter data and TCM four diagnostic information of hyperthyroidism patients in real time. According to the preset hierarchical and grading standards, the module dynamically maps and identifies the patient's current TCM syndrome type. The nursing matching module is used to retrieve the corresponding candidate measure set in the nursing measure knowledge base according to the patient's current specific level and TCM syndrome type, and sort and filter the nursing measures in descending order according to the hierarchical consensus weight value under the current level, and generate a nursing step sequence that conforms to the characteristics of level and syndrome type. The nursing optimization module is used to calculate the nursing effect evaluation value at each level, and adjust the stratified consensus weight value of nursing measures at the corresponding level based on the effect evaluation value, and perform real-time dynamic updates and optimizations.
2. The tiered and graded nursing system for hyperthyroidism patients based on traditional Chinese medicine theory according to claim 1, characterized in that, This includes classifying patients into a three-tiered system—high-risk, intermediate-risk, and stable—based on their thyroid function indicators and TCM syndrome characteristics, as well as classifying them into TCM syndrome types based on TCM differentiation. The specific construction process for this classification is as follows: Based on the nursing needs of hyperthyroidism patients throughout the entire course of the disease, a set of candidate nursing measures covering six dimensions, including nutrition, exercise, acupoints, emotions, medication, and follow-up, was constructed. Based on the patient's serum thyroid function indicators, the patient was dynamically divided into three levels: high-risk, intermediate-risk, and stable, which correspond to the crisis period during the initial diagnosis and treatment, the drug reduction period, and the stable period during the drug maintenance period, respectively. Based on the TCM syndrome differentiation criteria, patients were classified into four syndrome types: Liver Qi Stagnation Syndrome, Yin Deficiency and Yang Hyperactivity Syndrome, Qi and Yin Deficiency Syndrome, and Phlegm Stagnation and Blood Stasis Syndrome. By integrating and constructing hierarchical and graded nursing intervention databases through hierarchical levels, four types of certificates, and candidate nursing intervention sets, a hierarchical and graded nursing intervention database is formed.
3. The tiered and graded nursing system for hyperthyroidism patients based on traditional Chinese medicine theory according to claim 1, characterized in that, The specific process for calculating the expert positivity coefficient, stratified expert opinion coordination coefficient, and stratified importance score for each candidate measure at each level is as follows: Based on the three levels of high-risk, medium-risk, and stable risk, nursing interventions were scored for each level. A multi-round scoring mechanism was adopted, and statistical analysis of the scoring data in each round was conducted to obtain the positive coefficient of each level in each round. For each candidate measure in each level, analyze the importance of the candidate measure, calculate the arithmetic mean of the importance scores, and calculate the frequency of full scores; The scores of all nursing interventions are converted into ranks. The total rank of each nursing intervention is calculated. The sum of squared deviations of the total rank is calculated. The coefficient of conformity is then calculated by combining the number of people assessed and the number of nursing interventions. The positive coefficient, coordination coefficient, and mean importance score of each measure are weighted and integrated to generate the consensus confidence level of each measure. Based on the full score frequency and the mean importance score of each measure, the threshold method is used for screening. The threshold value is the mean minus the standard deviation. The nursing measures selected form the final nursing measure library.
4. The tiered and graded nursing system for hyperthyroidism patients based on traditional Chinese medicine theory according to claim 1, characterized in that, The three indicators are integrated to generate hierarchical consensus weight values for nursing interventions at each level, and a knowledge base of nursing interventions with hierarchical weight identifiers is constructed. The specific process is as follows: The three indicators of positive rating, coordination rating and importance rating were normalized, and weights were assigned to the positive rating, coordination rating and importance rating. For each nursing intervention at each level, a weighted summation formula is used to calculate the consensus weight value of each nursing intervention at each level. Each nursing intervention is then associated with and stored with its respective level and stratified consensus weight value to form a structured nursing intervention knowledge base.
5. The tiered and graded nursing system for hyperthyroidism patients based on traditional Chinese medicine theory according to claim 1, characterized in that, This system is used to acquire physiological parameter data and TCM four diagnostic information of hyperthyroidism patients in real time. Based on preset stratification and grading standards, it dynamically maps and identifies the patient's current TCM syndrome type. The specific process is as follows: The system acquires physiological parameters and TCM diagnostic information of hyperthyroidism patients in real time, converts unstructured TCM diagnostic descriptions into structured codes, and forms a standardized and computable patient status dataset. Based on the preset thyroid function index stratification criteria, patients are divided into high-risk, intermediate-risk, and stable layers, and the stratification determination is automatically triggered each time new data is entered. Based on TCM internal medicine textbooks and consensus on the diagnosis and treatment of hyperthyroidism, a discrimination rule library was pre-constructed, which includes syndromes such as liver qi stagnation, yin deficiency and yang hyperactivity, qi and yin deficiency, and phlegm stagnation and blood stasis. Each syndrome consists of a set of feature entries and corresponding matching weight coefficients. The patient's four diagnostic methods information is compared item by item with the rule base of each syndrome type. The weighted matching score of each syndrome type is calculated, and the syndrome type with the highest score is taken as the recognition result. If there is a compound syndrome type, the main syndrome and the concurrent syndrome are marked at the same time. A dynamic update frequency is set, and re-recognition is automatically triggered when new data is entered.
6. The tiered and graded nursing system for hyperthyroidism patients based on traditional Chinese medicine theory according to claim 1, characterized in that, The corresponding candidate measure set is retrieved from the nursing measure knowledge base, and then sorted in descending order according to the hierarchical consensus weight value of the nursing measure at the current level and filtered by threshold to generate a nursing step sequence that conforms to the hierarchical and syndrome characteristics. The specific process is as follows: Upon receiving the patient’s current hierarchical level L and TCM syndrome type S, the nursing intervention set that simultaneously meets the hierarchical level and syndrome type is retrieved using (L,S) as the exact matching condition, forming an original candidate intervention pool with a hierarchical structure of primary and alternative interventions. Each measure in the candidate measure pool is sorted in descending order according to its hierarchical consensus weight value at that level. The mutation point of the candidate measure weight sequence is calculated, and the weight value corresponding to the mutation point is used as the adaptive screening threshold to select the set of advantageous measures. The selected set of advantageous measures is arranged sequentially according to the preset nursing time sequence rules to generate the final nursing step sequence. The generated nursing step sequence is stored in association with the patient information to form a nursing plan version record. When the patient's status changes, it automatically triggers re-retrieval and sorting to generate a nursing step sequence adapted to the new status.
7. The tiered and graded nursing system for hyperthyroidism patients based on traditional Chinese medicine theory according to claim 1, characterized in that, This is used to calculate the nursing effectiveness evaluation value at each level, and to adjust the stratified consensus weight value of nursing measures at the corresponding level based on the effectiveness evaluation value, performing real-time dynamic updates and optimizations. The specific process is as follows: Based on the indicators for evaluating the nursing outcomes of hyperthyroidism patients, quantitative data at each level were collected before and after intervention to construct an evaluation system. For each level, based on the improvement of various indicators, the nursing effectiveness evaluation value for that level is calculated. The execution frequency and patient compliance rate of each nursing measure at each level are statistically analyzed, and the correlation coefficient between the intensity of measure execution and the effectiveness evaluation value at each level is calculated. The deviation between the hierarchical effect evaluation value and the benchmark value is used as the basis for overall adjustment. Combined with the difference between the contribution of the measures and the average contribution, the weight adjustment amount of each measure is calculated. Three trigger conditions are set: minimum sample size, fixed period, or abnormal fluctuations, to initiate batch updates periodically. Each update generates a new version of the knowledge base, records the weight change trajectory, and dynamically updates and evolves the knowledge base in real time.
8. The tiered and graded nursing system for hyperthyroidism patients based on traditional Chinese medicine theory according to claim 1, characterized in that, The nursing matching module also includes a nursing intervention conflict detection unit, which is used to detect potential conflicts between nursing interventions at different levels and in different syndrome types when generating a nursing step sequence. The specific process is as follows: Construct a knowledge base for nursing intervention conflicts, predefine the incompatible combinations of nursing interventions between different levels and syndrome types, including nursing interventions that are prohibited in the high-risk level but are prohibited in the intermediate level, nursing operations that cause conflicts between different syndrome types of the same patient, and therapeutic nursing interventions that cannot be performed simultaneously within the same time window. After the nursing matching module generates a set of candidate measures that match the current patient level and syndrome type, the conflict detection unit performs a matching analysis on each nursing measure in the candidate set based on the conflict knowledge base, and identifies combinations of conflicting measures. For detected conflicting measures, automatic resolution is carried out according to the measure priority rules and clinical safety principles. Measures with higher priority or better safety are retained, while conflicting measures are eliminated. Conflicting measures are allocated to different time windows for execution through staggered scheduling to ensure the safety and feasibility of the nursing plan.
9. A stratified and graded nursing method for hyperthyroidism patients based on traditional Chinese medicine theory, used in the stratified and graded nursing system for hyperthyroidism patients based on traditional Chinese medicine theory as described in any one of claims 1-8, characterized in that, Includes the following steps: Step 1: Construct a set of candidate nursing interventions based on clinical guidelines and classify hyperthyroidism patients into three levels: high-risk, intermediate-risk, and stable, based on the patients' thyroid function indicators and TCM syndrome characteristics, and classify TCM syndrome types based on TCM syndrome differentiation. Step 2: The candidate nursing measures are evaluated by experts through multiple rounds of expert consultation. For each nursing measure, the expert activity coefficient, expert coordination coefficient and the average importance score are calculated at each nursing level. The three indicators are integrated to generate the hierarchical consensus weight value of the nursing measure at each level, and a nursing measure knowledge base with hierarchical weight labels is constructed. Step 3: Real-time acquisition of physiological parameter data and TCM four diagnostic information of hyperthyroidism patients; dynamic mapping and identification of the patient's current TCM syndrome type based on preset stratification and grading standards. Step 4: Based on the patient's current specific level and TCM syndrome type, retrieve the corresponding candidate measure set in the nursing measure knowledge base, and sort and filter the nursing measures in descending order according to the hierarchical consensus weight value under the current level, and generate a nursing step sequence that conforms to the characteristics of level and syndrome type. Step 5: Calculate the nursing effect evaluation value for each level, and adjust the stratified consensus weight value of nursing measures at the corresponding level based on the effect evaluation value, and perform real-time dynamic updates and optimizations.