A clinical thinking training method and system based on six-merit transmission evidence reasoning

Abstract

The present application relates to the technical field of clinical simulation, and discloses a clinical thinking training method and system based on six-meridian transmission evidence reasoning, which comprises an evidence collection module, an evidence category marking module, a six-meridian candidate scoring module, a classical combination reward and repeated weighting inhibition module, a conflict evidence grading verification module, a candidate sorting and evidence sufficiency determination module, a six-meridian transmission relationship judgment module, a six-meridian-meridian-collateral three-dimensional model linkage module and a teaching feedback and history review module. The present application adopts a standardized case evidence scoring method, and the evidence reasoning has good executability; at the same time, the six-meridian transmission prompt has a clear calculation boundary, and through the six-meridian preset order, the inside-outside pairing relationship, the strong candidate threshold and the disease course condition, the training prompts of loop transmission, cross-transmission, inside-outside transmission, combined disease, concurrent disease and direct transmission are programmatically judged, so that the six-meridian transmission judgment process is executable and reviewable.

Description

Technical Field

[0001] This invention relates to the field of clinical simulation technology, and in particular to a clinical thinking training method and system based on evidence reasoning of the Six Channels Transmission. Background Technology

[0002] Clinical thinking training in Traditional Chinese Medicine (TCM) nursing requires learners to comprehensively extract symptoms, tongue quality, tongue coating, pulse, disease course, and the location of the disease in the previous stage from simulated cases. They must compare the six meridians (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, and Jueyin) and understand the relationships between meridian transmission, cross-meridian transmission, exterior-interior transmission, combined diseases, concurrent diseases, and direct involvement. However, current teaching mainly relies on textbook lectures, case discussions, question banks, static meridian atlases, ordinary online courses, or independent 3D human body demonstrations. There is no set of executable, traceable, and standardized methods for handling case evidence. The location of the disease, disease course, the order of the six meridians, and the pairing of exterior and interior often rely on manual interpretation. The judgment of meridian transmission, cross-meridian transmission, exterior-interior transmission, combined diseases, concurrent diseases, and direct involvement is difficult to grasp, resulting in less than ideal learning and training effects. Summary of the Invention

[0003] The purpose of this invention is to provide a clinical thinking training method and system based on the evidence of the Six Channels Transmission, and to provide at least a beneficial option or create conditions for solving one or more technical problems existing in the prior art.

[0004] To achieve the above objectives, the present invention adopts the following technical solution.

[0005] A clinical reasoning training method based on the evidence of the Six Channels Transmission and Transformation, for clinical reasoning training in traditional Chinese medicine nursing, includes the following steps:

[0006] S01. The collected case evidence is scored and statistically analyzed according to the Six Channels and a traceable scoring reason is formed. The highest score and the second highest score are obtained according to the Six Channels score. The highest score corresponds to the primary candidate channel and the second highest score corresponds to the secondary candidate channel.

[0007] S02. Calculate the number of case evidence K for the primary and secondary candidate pathways, and calculate the absolute difference Δ=S1-S2 and the relative difference R=Δ / S1;

[0008] When S1≥12, K≥3, Δ≥3 and there is no key conflict, the case evidence and the principal candidate are judged to have high evidence sufficiency.

[0009] When 12 > S1 ≥ 7 and K ≥ 2, the case evidence and the principal candidate are judged to be of moderate sufficiency.

[0010] When S1 < 7, the case evidence and the principal candidate are judged to have low evidence sufficiency.

[0011] S03. Select strong candidate courses with a score not lower than max(3, S1×0.65); when there are no less than two strong candidate courses, generate training prompts for combined disease or concurrent disease based on whether the course of the disease is no more than 1 day or more than 1 day.

[0012] S04. Based on the previous location of the disease, the current primary candidate meridian, the fixed order of the six meridians and the pairing of exterior and interior, generate prompts for meridian transmission, meridian crossing, exterior-interior transmission or atypical transmission.

[0013] S05. When the current primary candidate meridian belongs to the Yin meridian, the course of the disease is no more than 2 days, and the total score of the Yin meridian is not lower than max(4, total score of the Yang meridian +2), a direct hit prompt will be added.

[0014] S06. Based on the main candidate meridian, map a hand meridian and a foot meridian onto the human body model for three-dimensional display, and output the main candidate meridian, secondary candidate meridian, candidate score, sufficiency of evidence, reasoning for evidence, conflict warning, suggestion for follow-up questions, and transmission change prompts.

[0015] More preferably, in step S01, there is also a case evidence marking step, which marks the source of the case evidence and whether it belongs to the classic combination;

[0016] The sources of evidence for the case include symptom evidence, tongue and pulse evidence, disease course evidence, and evidence from the previous location of the disease.

[0017] The classic combination is Taiyang typhoid fever, Taiyang stroke, Yangming meridian syndrome, Yangming bowel syndrome, Shaoyang original syndrome, Taiyin deficiency and cold, Shaoyin cold transformation, Shaoyin heat transformation, and Jueyin upper heat and lower cold.

[0018] More preferably, the symptom evidence includes one or more of the following: evidence of chills, fever, sweating and overall condition; evidence of head, face, neck and back; evidence of heart, chest and abdomen; evidence of sleep and mood; evidence of bowel movements and sweating; and supplementary evidence.

[0019] The tongue and pulse evidence includes one or more of the following: pulse characteristics, tongue body, and tongue coating;

[0020] The evidence of the course of the disease is 1-30 days;

[0021] The evidence for the previous location of the disease is Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin, or unspecified.

[0022] More preferably, the scoring statistics include individual scoring, bonus scoring, and conflict deductions. The individual scoring is the score corresponding to each piece of case evidence. The bonus scoring includes general combination bonus scoring and exact hit bonus scoring. The general combination bonus scoring is lower than the exact hit bonus scoring and is a choice between the two. The conflict deductions include general conflict deductions and critical conflict deductions. The score for general conflict deductions is lower than the score for critical conflict deductions, and the deduction scores are accumulated.

[0023] More preferably, the individual scoring values ​​are 1 to 5, and the scores corresponding to the evidence of each case are fixed in the system or can be actively modified.

[0024] More preferably, the general combination reward score varies depending on the corresponding Six Classics, while the exact hit reward score remains the same.

[0025] More preferably, the general contradictions include the conflict between sweating and a floating and tight pulse, and the conflict between insomnia and a desire to sleep, and the key contradictions are diarrhea with undigested food or cold hands and feet accompanied by a faint pulse; when a key contradiction exists, a high degree of sufficiency of evidence is not output.

[0026] More preferably, step S02 includes a candidate proximity judgment, where a candidate proximity prompt is output when S1≥5, S2>0 and R≤15%, or S1≥12 and Δ≤2.

[0027] More preferably, in step S04, when the previous disease location and the current primary candidate meridian are adjacent in the preset six meridians sequence and the current primary candidate meridian is located in the next position, it indicates meridian transmission; when the previous disease location and the current primary candidate meridian skip at least one meridian in the preset six meridians sequence, it indicates meridian crossing transmission; when the previous disease location and the current primary candidate meridian belong to the Taiyang-Shaoyin, Yangming-Taiyin or Shaoyang-Jueyin pair, it indicates exterior-interior transmission.

[0028] This invention also provides a clinical reasoning training system based on the evidence of the Six Channels Transmission, which is used to implement the clinical reasoning training method based on the evidence of the Six Channels Transmission as described above, including:

[0029] 1) Evidence collection module, used to collect case evidence information from simulated cases;

[0030] 2) Evidence category marking module, used to record the source of case evidence and whether it belongs to a classic combination;

[0031] 3) The Six Classics Candidate Scoring Module is used to establish candidate scores for the Six Classics and individual case evidence scores, calculate the Six Classics evidence scores based on case evidence, and form traceable reasons for adding points;

[0032] 4) The classic combination reward and repetition weighted suppression module is used to verify whether the collected case evidence belongs to the classic combination. If it does, it adds a score reward to the target six meridians and suppresses the score reward of the target six meridians to avoid repeated scoring at the combination layer.

[0033] 5) Conflict evidence classification and verification module, used to identify general conflicts and key conflicts and deduct points accordingly, and restrict the output of high evidence sufficiency when key conflicts exist;

[0034] 6) Candidate ranking and evidence sufficiency determination module, used to obtain candidate ranking based on the six classics score, determine the primary candidate classics and secondary candidate classics, calculate the number of case evidence corresponding to the primary candidate classics and secondary candidate classics, as well as the absolute score difference Δ and relative score difference R, and output high, medium and low evidence sufficiency and candidate proximity prompts accordingly.

[0035] 7) The Six Channels Transmission Relationship Judgment Module is used to read the previous disease location, the current main candidate channel, the set of strong candidate channels, and the number of days of disease course. Combined with the fixed order of the Six Channels and the pairing of exterior and interior, it generates training prompts for transmission along the channel, transmission across channels, transmission between exterior and interior, combined diseases, concurrent diseases, direct hit or atypical transmission.

[0036] 8) The Six Meridians-Meridian-3D Model Linkage Module is used to map the six meridians corresponding to the main candidate meridians to the corresponding hand and foot meridians, load the human body model and normalize the acupoint node names, read the model nodes or spare coordinates, and generate meridian curves, pipelines, start and end marks and flowing light spots.

[0037] 9) The teaching feedback and historical review module is used to output candidate scores, evidence and reasons, conflict warnings, suggested follow-up questions, transmission and change prompts, nursing technology learning content and learning paths, and save training results, supporting comparative review.

[0038] The present invention, by employing the above technical solution, has at least the following beneficial effects:

[0039] I. This invention employs a standardized case evidence scoring method, combined with structured training involving unidirectional scoring, combined scoring, and conflict deduction. This reduces the risk of repeated weighting of the same evidence, enhances the binding effect of conflicting evidence on the calculation results, and improves the consistency, interpretability, and verifiability of candidate ranking, resulting in good executability of evidence reasoning. Simultaneously, it provides clear calculation boundaries for the Six Channel Transmission Prompts. Through the preset order of the Six Channels, the pairing relationship between exterior and interior, strong candidate thresholds, and disease course conditions, it performs procedural judgments on training prompts such as channel-following transmission, channel-crossing transmission, exterior-interior transmission, combined diseases, concurrent diseases, and direct transmission, making the Six Channel Transmission Prompts judgment process executable and verifiable.

[0040] Second, by scoring case evidence and labeling case evidence categories, symptom evidence, tongue and pulse evidence, disease course evidence, and previous lesion location evidence are converted into computer-processable data, and the evidence source and calculation rationale corresponding to each candidate score are recorded, thereby improving the structuring and traceability of case data.

[0041] Third, by accurately identifying classic combinations and then suppressing the repeated rewards of general combinations of the same six meridians after accurate identification, we can prevent the same set of symptoms and tongue and pulse evidence from being reinforced by multiple layers of repeated rewards, including single evidence, classic combination rewards, and general combination rewards.

[0042] Fourth, by deducting points for general and critical conflicts, and by limiting the sufficiency of high evidence for critical conflicts, conflicting evidence can substantially affect candidate ranking and output level.

[0043] Fifth, by combining the highest score, second highest score, number of evidence, absolute score difference, relative score difference, and number of key conflicts, we can distinguish training states such as insufficient evidence, tied low-scoring candidates, close high-scoring candidates, and relatively clear main candidates.

[0044] VI. By mapping the six main candidates of meridians to the corresponding hand meridians, foot meridians, acupoint nodes and GLB human body model objects, and generating meridian curves, tubular paths, start and end marks and flowing light spots according to the node coordinates, the candidate results are converted into observable three-dimensional spatial feedback, realizing the automatic linkage between the evidence reasoning results and the three-dimensional meridian model.

[0045] VII. By providing evidence, conflict warnings, suggested follow-up questions, nursing skills learning content and learning paths, and saving a preset number of historical training records, we provide a basis for learners' self-examination, training review and teacher feedback, forming an interpretable teaching and training review closed loop.

[0046] It should be noted that the output of this invention is the ranking of candidates for the Six Channels in a simulated case, the sufficiency of evidence, the transmission of information, and the teaching feedback. It does not directly constitute a disease diagnosis, treatment decision, or nursing prescription for real patients. Attached Figure Description

[0047] Figure 1 The diagram shown is an overall structural diagram of the training system in this invention.

[0048] Figure 2 The diagram shown is a flowchart of the training method in this invention.

[0049] Figure 3 The diagram illustrates the combined disease, concurrent disease, and the progression of the disease through the six channels.

[0050] Figure 4 The image shown is a schematic diagram of the training results in one embodiment. Detailed Implementation

[0051] To facilitate a better understanding of the essence of the present invention by those skilled in the art, the specific embodiments of the present invention will be described in detail below with reference to the accompanying drawings.

[0052] See Figure 1 As shown, a clinical reasoning training system based on the evidence-based reasoning of the Six Channels is executed by electronic devices. The system includes:

[0053] 1) Evidence entry and collection module, used to collect case evidence information of simulated cases, such as symptoms, tongue quality, tongue coating, pulse, number of days of illness, previous location of disease and training case number.

[0054] 2) Evidence category marking module, used to record the source of case evidence and whether it belongs to the classic combination.

[0055] 3) The Six Channels Candidate Scoring Module is used to establish candidate scores (general rewards) and individual case evidence scores for the six channels: Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin and Jueyin. Individual case evidence scores are processed with discrete weights of 1 to 5 points. The Six Channels evidence scores are calculated based on case evidence and traceable reasons for bonus points are formed.

[0056] 4) The Classic Combination Reward and Repetition Weighted Suppression module is used to verify whether the collected case evidence belongs to the classic combination. If it does, additional points are awarded to the target six meridians and the reward for candidate points of the target six meridians is suppressed to avoid duplicate scoring at the combination layer. During verification, only when all the mandatory symptoms, optional symptoms, pulse characteristics, and specified tongue quality or tongue coating conditions are met is it determined to be a precise hit of the classic combination, and only then will additional points be awarded.

[0057] 5) Conflict evidence grading and verification module, used to identify general conflicts and key conflicts and deduct points accordingly, and restrict the output of high evidence sufficiency when there are key conflicts; 2 points are deducted for general conflicts and 5 points are deducted for key conflicts and key conflicts are recorded.

[0058] 6) Candidate ranking and evidence sufficiency determination module, used to obtain candidate ranking based on the six classics score, determine the primary candidate classic (highest score) and secondary candidate classic (second highest score), calculate the number of case evidence corresponding to the primary candidate classic and secondary candidate classic, as well as the absolute score difference Δ and relative score difference R, and output high, medium and low evidence sufficiency and candidate proximity prompts accordingly.

[0059] 7) The Six Channel Transmission Relationship Judgment Module is used to read the previous disease location, the current main candidate channel, the set of strong candidate channels, and the number of days of disease course. Combined with the fixed order of the Six Channels and the pairing of exterior and interior, it generates training prompts for transmission along the channel, transmission across channels, transmission between exterior and interior, combined disease, concurrent disease, direct hit or atypical transmission.

[0060] 8) The Six Meridians-Meridian-3D Model Linkage Module is used to map the six meridians corresponding to the main candidate meridians to the corresponding hand and foot meridians, load the human body model and normalize the acupoint node names, read the model nodes or spare coordinates, and generate meridian curves, pipelines, start and end marks and flowing light spots.

[0061] 9) The teaching feedback and historical review module is used to output candidate scores, evidence and reasons, conflict warnings, suggested follow-up questions, transmission and change prompts, nursing technology learning content and learning paths, and save training results, supporting comparative review.

[0062] See Figure 2 As shown, the training method for the clinical reasoning training system based on the evidence of the Six Channels Transmission is as follows:

[0063] S01. Collect one or more pieces of case evidence from the following six channels: symptoms, pulse, tongue and pulse, duration of illness, and location of the disease. Score and statistically analyze the collected case evidence according to the six channels, and mark the source of the case evidence to form a traceable scoring rationale. Obtain the highest and second-highest scores based on the six channel scores. The highest score corresponds to the primary candidate channel, and the second-highest score corresponds to the secondary candidate channel.

[0064] In step S01, the Six Classics score includes individual item scores, bonus scores, and conflict deductions. Individual item scores range from 1 to 5 points, with the score potentially varying for different cases and determined based on experience. Bonus scores include general bonuses and exact hit bonuses; an exact hit bonus is 3 points, while a general bonus is 0 or 1 point. General conflicts deduct 2 points; critical conflicts deduct 5 points and are recorded; the presence of critical conflicts restricts the output of high evidence sufficiency.

[0065] In step S01, it is determined whether the case evidence belongs to the classic combination; the classic combination is Taiyang typhoid fever, Taiyang stroke, Yangming meridian syndrome, Yangming bowel syndrome, Shaoyang original syndrome, Taiyin deficiency and cold, Shaoyin cold transformation, Shaoyin heat transformation, and Jueyin upper heat and lower cold. Only when the corresponding mandatory symptoms, optional symptoms, pulse and prescribed tongue quality or tongue coating conditions are all met (when precisely hit), an additional 3 points of limited reward are added to the target six meridians, and the precisely hit subtype and target six meridians are recorded.

[0066] In step S01, when a certain classic has accurately matched a classic combination, the general combination reward of that classic is suppressed, but the individual evidence score is retained to avoid repeated superposition of the same classic combination layer.

[0067] S02. Count the number of case evidence K for the primary candidate and secondary candidate pathways, and calculate the absolute difference Δ=S1-S2 and the relative difference R=Δ / S1.

[0068] When S1≥12, K≥3, Δ≥3 and there is no key conflict, the case evidence and the principal candidate are deemed to have high evidence sufficiency.

[0069] When 12 > S1 ≥ 7 and K ≥ 2, the case evidence and the principal candidate evidence are judged to be of moderate sufficiency.

[0070] When S1 < 7, the case evidence and the primary candidate evidence are judged to have low evidence sufficiency.

[0071] Output candidate proximity prompts only when S1≥5, S2>0 and R≤15%, or S1≥12 and Δ≤2, to exclude false prompts caused by low-score ties.

[0072] It should be noted that the sufficiency of evidence is only a graded measure in engineering teaching and is not equivalent to diagnostic probability, clinical accuracy, or efficacy evaluation.

[0073] S03. Select strong candidate lines with a score not lower than the strong candidate threshold T, where T = max(3, S1 × 0.65). When there are at least two strong candidate lines, generate training prompts for co-occurring or concurrent diseases based on whether the course of the disease is less than 1 day or more than 1 day. A co-occurring disease is indicated when the course of the disease is ≤ 1 day, and a concurrent disease is indicated when the course of the disease is > 1 day.

[0074] S04. Based on the previous disease location L0, the current primary candidate meridian, the fixed six-meridian sequence, and the exterior-interior pairing, generate prompts for meridian-based transmission, meridian-crossing transmission, exterior-interior transmission, or atypical transmission. When the previous disease location and the current primary candidate meridian are adjacent in the preset six-meridian sequence and the current primary candidate meridian is in the next position, a meridian-based transmission prompt is generated. When at least one meridian is skipped, a meridian-crossing transmission prompt is generated. When the pairing is Taiyang-Shaoyin, Yangming-Taiyin, or Shaoyang-Jueyin, an exterior-interior transmission prompt is generated.

[0075] S05. When the current primary candidate meridian belongs to the Yin meridian, the course of the disease is no more than 2 days, and the total score of the Yin meridian is not lower than max(4, total score of the Yang meridian +2), a direct hit prompt will be added.

[0076] S06. Based on the main candidate meridian, map a hand meridian and a foot meridian on the human body model for three-dimensional display, locate acupoint nodes from the GLB scene tree and read world coordinates; for missing nodes, use spare coordinates, and generate meridian curves, pipelines, start and end marks and flowing light spots.

[0077] S07. Output the primary candidate meridian, secondary candidate meridian, candidate scores, sufficiency of evidence, reasons for evidence, conflict warnings, suggested follow-up questions, transmission prompts, three-dimensional meridians, nursing technology learning content and learning paths, and save the most recent 10 training results locally in the browser.

[0078] In this invention, the candidate scoring and deduplication rules are as follows: individual pieces of evidence are weighted by integers from 1 to 5 points: strong supporting evidence is usually worth 5 points, important supporting evidence is usually worth 4 points, moderate supporting evidence is usually worth 3 points, and general supporting evidence is usually worth 1 to 2 points. All nine classic combinations receive an additional 3 points as a limited bonus. After accurately matching a classic combination of the Six Classics, the general combination bonus for that classic is no longer added, but its individual evidence score is retained.

[0079] The final score of the Six Classics candidates is Si = max{0, ∑eWi, e·Xe+3·Ii, exact+∑cbi, c·Ii, c-2Ni, general-5Ni, critical}.

[0080] Where Si is the final score of the i-th candidate of the Six Classics; Xe indicates whether the e-th piece of evidence appears, with 1 for appearance and 0 for absence; Wi,e is the preset weight of the evidence for the i-th candidate; Ii,exact indicates whether the classic combination of the candidate is exactly matched, with 1 for matching and an additional 3 points; Ii,c indicates whether the general combination condition of the c-th item is met; bi,c is the corresponding general combination reward; Ni,general and Ni,critical are the number of general contradictions and critical conflicts, respectively. When the classic combination is exactly matched, the reward for the same classic combination that overlaps with the classic combination is suppressed; if the calculated result is less than 0, it is treated as 0 points.

[0081] The above-mentioned individual evidence scores of 1 to 5, classic combinations receiving a bonus of 3 points, general conflicts deducting 2 points, key conflicts deducting 5 points, and the evidence sufficiency threshold are initial configurable parameters set according to the Six Classics teaching rules, the relative importance of evidence, the design goal of avoiding double scoring, and the simulated training case procedure test settings. These are not national standards or medically recognized clinical diagnostic weights, nor do they represent the probability of disease occurrence, diagnostic accuracy, or efficacy. These parameters can be adjusted based on expert-annotated training case sets, teaching evaluation results, and sensitivity analysis.

[0082] See Figure 3 As shown, steps S03-S05 above refer to the transmission of the six meridians. The transmission relationship is calculated after the candidate scores and ranking are completed, and can be expressed as H=f(L0, L1, L2, D, Δ, R), where H is the transmission training prompt, L0 is the previous disease location, L1 and L2 are the primary and secondary candidate meridians, respectively, D is the number of days of disease course, Δ is the absolute difference between the primary and secondary candidates, and R is the relative difference. The transmission judgment is used to generate prompts for meridian transmission, meridian crossing transmission, exterior-interior transmission, combined disease, concurrent disease, direct hit, or pending review, without modifying the above candidate scores Si in the reverse direction.

[0083] In this invention, the symptom evidence includes: evidence of chills, fever, sweating, and overall condition; evidence of the head, face, neck, and back; evidence of the heart, chest, and abdomen; evidence of sleep and emotional state; evidence of bowel movements and sweating; and supplementary evidence. The evidence of chills, fever, sweating, and overall condition includes one or more of the following: fever, chills, aversion to wind, alternating chills and fever, hot flashes, aversion to heat, body aches, and fatigue. The evidence of the head, face, neck, and back includes one or more of the following: headache, stiff neck, dizziness, bitter taste in the mouth, dry throat, vertigo, and tinnitus. The evidence of the heart, chest, and abdomen includes... Palpitation, irritability, fullness and discomfort in the chest and hypochondrium, abdominal distension, abdominal pain, vomiting, loss of appetite, thirst, dry mouth, restlessness, burning sensation in the chest, or burning pain in the heart; the sleep-related emotional evidence includes insomnia, excessive dreaming, drowsiness, restlessness, or delirium; the evidence of urination, defecation, and sweating includes diarrhea, watery stools, constipation, dysuria, sweating, or anhidrosis; the supplementary evidence includes cold hands and feet, cough, wheezing, or hunger without appetite.

[0084] In this invention, the tongue and pulse evidence includes one or more of the following: pulse characteristics, tongue body, and tongue coating. The pulse characteristics can be selected as floating, floating and slow, floating and tight, wiry and thin, large, deep and solid, slippery and rapid, weak, faint and thin, deep, deep and slow, wiry, etc. The tongue body can be selected as pale red, red, crimson, pale white, purplish-dark, etc. The tongue coating can be selected as thin white, thin yellow, yellow and dry, yellow and greasy, white and greasy, little coating, no coating, etc.

[0085] In this invention, the evidence of disease course is generally 1-30 days;

[0086] In this invention, the evidence for the previous location of the disease is Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin, or unspecified.

[0087] In this invention, the classic combination includes:

[0088] 1) Taiyang typhoid fever: chills, headache and neck pain, no sweating, and a floating and tight pulse.

[0089] 2) Taiyang stroke: aversion to wind, sweating, and a floating and slow or floating pulse.

[0090] 3) Yangming meridian syndrome: fever, sweating, and a large or slippery and rapid pulse, and a red tongue.

[0091] 4) Yangming bowel syndrome: abdominal distension, constipation, and a deep, forceful or slippery and rapid pulse.

[0092] 5) Shaoyang syndrome: bitter taste in the mouth, dry throat, dizziness, alternating chills and fever or fullness and discomfort in the chest and hypochondrium, and a wiry and thready or wiry pulse.

[0093] 6) Taiyin deficiency and cold: abdominal distension, loss of appetite, diarrhea, weak or floating and slow pulse, and pale tongue.

[0094] 7) Shaoyin cold transformation: only wanting to sleep, and the pulse is weak, thready, deep or deep and slow.

[0095] 8) Lesser Yin heat transformation: irritability, insomnia, and red tongue with little coating.

[0096] 9) Jueyin syndrome: upper heat and lower cold: thirst, qi rising to the heart, heart pain and heat, hunger but no appetite.

[0097] In this invention, common conflicts include the simultaneous occurrence of sweating and a floating, tight pulse, and the simultaneous occurrence of insomnia and a desire to sleep.

[0098] In this invention, the key conflict is diarrhea with empty stomach or cold extremities accompanied by a faint pulse. When a key conflict exists, a high degree of sufficiency of evidence should not be output.

[0099] See Figure 4As shown, in one embodiment, the input is chills, headache and neck stiffness, no sweating, floating and tight pulse, pale red tongue with thin white coating, and a course of illness of 1 day. The classic combination of Taiyang typhoid fever is awarded 3 points; chills 3 points, no sweating 2 points, headache and neck stiffness 4 points, floating and tight pulse 3 points, pale red tongue with thin white coating 2 points, and short course of illness 1 point. Because the Taiyang combination is accurately matched, the general Taiyang combination bonus is not added, resulting in a total Taiyang score of 18 points. This covers multiple types of evidence without key conflicts, resulting in a high level of evidence sufficiency.

[0100] It should also be noted that any process or method description in the flowcharts or otherwise described herein can be understood as representing a module, segment, or portion of code comprising one or more executable instructions for implementing a particular logical function or process, and the scope of the preferred embodiments of the invention includes additional implementations in which functions may be performed not in the order shown or discussed, including substantially simultaneously or in reverse order according to the functions involved, as should be understood by those skilled in the art to which embodiments of the invention pertain.

[0101] The logic and / or steps represented in the flowchart or otherwise described herein, for example, can be considered as a sequenced list of executable instructions for implementing logical functions, and can be embodied in any computer-readable medium for use by, or in conjunction with, an instruction execution system, apparatus, or device (such as a computer-based system, a processor-included system, or other system that can fetch and execute instructions from, an instruction execution system, apparatus, or device). For the purposes of this specification, "computer-readable medium" can be any means that can contain, store, communicate, propagate, or transmit programs for use by, or in conjunction with, an instruction execution system, apparatus, or device. More specific examples (a non-exhaustive list) of computer-readable media include: an electrical connection having one or more wires (electronic device), a portable computer disk drive (magnetic device), random access memory (RAM), read-only memory (ROM), erasable and editable read-only memory (EPROM or flash memory), fiber optic devices, and portable optical disc read-only memory (CDROM). Alternatively, the computer-readable medium may be paper or other suitable media on which the program can be printed, since the program can be obtained electronically, for example, by optically scanning the paper or other medium, followed by editing, interpreting, or otherwise processing as necessary, and then stored in a computer memory.

[0102] It should be understood that various parts of the present invention can be implemented in hardware, software, firmware, or a combination thereof. In the above embodiments, multiple steps or methods can be implemented in software or firmware stored in memory and executed by a suitable instruction execution system. For example, if implemented in hardware, as in another embodiment, it can be implemented using any one or a combination of the following techniques known in the art: discrete logic circuits having logic gates for implementing logical functions on data signals, application-specific integrated circuits (ASICs) having suitable combinational logic gates, programmable gate arrays (PGAs), field-programmable gate arrays (FPGAs), etc.

[0103] Those skilled in the art will understand that all or part of the steps of the methods in the above embodiments can be implemented by a program instructing related hardware. The program can be stored in a computer-readable storage medium, and when executed, the program includes one or a combination of the steps of the method embodiments.

[0104] Although embodiments of the present invention have been shown and described above, it is understood that the above embodiments are exemplary and should not be construed as limiting the present invention. Those skilled in the art can make changes, modifications, substitutions and variations to the above embodiments within the scope of the present invention.

Claims

1. A clinical reasoning training method based on the evidence of the Six Channels Transmission and Transformation, used for clinical reasoning training in traditional Chinese medicine nursing, characterized in that... Includes the following steps: S01. The collected case evidence is scored and statistically analyzed according to the Six Channels and a traceable scoring reason is formed. The highest score and the second highest score are obtained according to the Six Channels score. The highest score corresponds to the primary candidate channel and the second highest score corresponds to the secondary candidate channel. S02. Calculate the number of case evidence K for the primary and secondary candidate pathways, and calculate the absolute difference Δ=S1-S2 and the relative difference R=Δ / S1; When S1≥12, K≥3, Δ≥3 and there is no key conflict, the case evidence and the principal candidate are judged to have high evidence sufficiency. When 12 > S1 ≥ 7 and K ≥ 2, the case evidence and the principal candidate are judged to be of moderate sufficiency. When S1 < 7, the case evidence and the principal candidate are judged to have low evidence sufficiency. S03. Select strong candidate courses with a score not lower than max(3, S1×0.65); when there are no less than two strong candidate courses, generate training prompts for combined disease or concurrent disease based on whether the course of the disease is no more than 1 day or more than 1 day. S04. Based on the previous location of the disease, the current primary candidate meridian, the fixed order of the six meridians and the pairing of exterior and interior, generate prompts for meridian transmission, meridian crossing, exterior-interior transmission or atypical transmission. S05. When the current primary candidate belongs to the Yin meridian, the course of the disease is no more than 2 days, and the total score of the Yin meridian is not lower than max(4, total score of the Yang meridian +2), a direct hit prompt is added; S06. Based on the main candidate meridian, map a hand meridian and a foot meridian onto the human body model for three-dimensional display, and output the main candidate meridian, secondary candidate meridian, candidate score, sufficiency of evidence, reasoning for evidence, conflict warning, suggestion for follow-up questions, and transmission change prompts.

2. The clinical reasoning training method based on the evidence of the Six Channels Transmission as described in claim 1, characterized in that, In step S01, there is also a case evidence marking step, which marks the source of the case evidence and whether it belongs to the classic combination; The sources of evidence for the case include symptom evidence, tongue and pulse evidence, disease course evidence, and evidence from the previous location of the disease. The classic combination is Taiyang typhoid fever, Taiyang stroke, Yangming meridian syndrome, Yangming bowel syndrome, Shaoyang original syndrome, Taiyin deficiency and cold, Shaoyin cold transformation, Shaoyin heat transformation, and Jueyin upper heat and lower cold.

3. The clinical reasoning training method based on the evidence of the Six Channels Transmission as described in claim 2, characterized in that, The symptom evidence includes one or more of the following: chills and fever, sweating and overall condition evidence; head, face, neck and back evidence; heart, chest and abdomen evidence; sleep and emotional evidence; bowel movements and sweating evidence; and supplementary evidence. The tongue and pulse evidence includes one or more of the following: pulse characteristics, tongue body, and tongue coating; The evidence of the course of the disease is 1-30 days; The evidence for the previous location of the disease is Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin, or unspecified.

4. The clinical reasoning training method based on the evidence of the Six Channels Transmission as described in claim 1, characterized in that, The scoring statistics include individual scoring, bonus scoring, and conflict deductions. Individual scoring is the score corresponding to each piece of case evidence. Bonus scoring includes general combination bonus scoring and exact hit bonus scoring. General combination bonus scoring is lower than exact hit bonus scoring and is a choice between the two. Conflict deductions include general conflict deductions and critical conflict deductions. The score for general conflict deduction is lower than the score for critical conflict deduction, and the deduction scores are accumulated.

5. A clinical reasoning training method based on the evidence of the Six Channels Transmission as described in claim 4, characterized in that, The individual scoring values ​​range from 1 to 5, and the scores corresponding to the evidence for each case are fixed in the system or can be actively modified.

6. A clinical reasoning training method based on the evidence of the Six Channels Transmission as described in claim 4, characterized in that, The general combination reward score varies depending on the corresponding Six Classics, while the exact hit reward score is consistent.

7. A clinical reasoning training method based on the evidence of the Six Channels Transmission as described in claim 4, characterized in that, The general conflicts include the conflict between sweating and a floating and tight pulse, and the conflict between insomnia and somnolence. The key conflicts are diarrhea with undigested food or cold hands and feet accompanied by a faint pulse. When a key conflict exists, a high degree of sufficiency of evidence is not output.

8. A clinical reasoning training method based on the evidence of the Six Channels Transmission as described in claim 1, characterized in that, In step S02, a candidate proximity judgment is performed. When S1≥5, S2>0 and R≤15%, or S1≥12 and Δ≤2, a candidate proximity prompt is output.

9. A clinical reasoning training method based on the evidence of the Six Channels Transmission as described in claim 1, characterized in that, In step S04, when the previous disease location and the current primary candidate meridian are adjacent in the preset six meridians sequence and the current primary candidate meridian is located in the next position, it indicates meridian transmission; when the previous disease location and the current primary candidate meridian skip at least one meridian in the preset six meridians sequence, it indicates meridian crossing transmission; when the previous disease location and the current primary candidate meridian belong to the Taiyang-Shaoyin, Yangming-Taiyin or Shaoyang-Jueyin pair, it indicates exterior-interior transmission.

10. A clinical reasoning training system based on the evidence of the Six Channels Transmission, characterized in that, A clinical reasoning training method based on the evidence of the Six Channels Transmission as described in any one of claims 1-9, comprising: 1) Evidence collection module, used to collect case evidence information from simulated cases; 2) Evidence category marking module, used to record the source of case evidence and whether it belongs to a classic combination; 3) The Six Classics Candidate Scoring Module is used to establish candidate scores for the Six Classics and individual case evidence scores, calculate the Six Classics evidence scores based on case evidence, and form traceable reasons for adding points; 4) The classic combination reward and repetition weighted suppression module is used to verify whether the collected case evidence belongs to the classic combination. If it does, it adds a score reward to the target six meridians and suppresses the score reward of the target six meridians to avoid repeated scoring at the combination layer. 5) Conflict evidence classification and verification module, used to identify general conflicts and key conflicts and deduct points accordingly, and restrict the output of high evidence sufficiency when key conflicts exist; 6) Candidate ranking and evidence sufficiency determination module, used to obtain candidate ranking based on the six classics score, determine the primary candidate classics and secondary candidate classics, calculate the number of case evidence corresponding to the primary candidate classics and secondary candidate classics, as well as the absolute score difference Δ and relative score difference R, and output high, medium and low evidence sufficiency and candidate proximity prompts accordingly. 7) The Six Channels Transmission Relationship Judgment Module is used to read the previous disease location, the current main candidate channel, the set of strong candidate channels, and the number of days of disease course. Combined with the fixed order of the Six Channels and the pairing of exterior and interior, it generates training prompts for transmission along the channel, transmission across channels, transmission between exterior and interior, combined diseases, concurrent diseases, direct hit or atypical transmission. 8) The Six Meridians-Meridian-3D Model Linkage Module is used to map the six meridians corresponding to the main candidate meridians to the corresponding hand and foot meridians, load the human body model and normalize the acupoint node names, read the model nodes or spare coordinates, and generate meridian curves, pipelines, start and end marks and flowing light spots. 9) The teaching feedback and historical review module is used to output candidate scores, evidence and reasons, conflict warnings, suggested follow-up questions, transmission and change prompts, nursing technology learning content and learning paths, and save training results, supporting comparative review.

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