基于病证结合的COPD急性加重风险预警模型的建立和验证

病证结合是目前中医临床诊疗的主要模式，AECOPD是导致COPD患者住院、致残致死和病情恶化的主要原因。AECOPD发生的风险因子较多，评估风险因子、构建病证结合风险预警模型是COPD防治的关键。基于既往研究，提出"AECOPD病证结合模式下风险预警体系和模型应包括疾病情况、临床症状、中医证候、生存质量、肺功能、生物学指标等，证候转归和积分变化等可作为疾病风险预测因子"的理论假说，拟开展以下研究：基于1000例临床研究数据，采用回归预测法和神经网络预测法，筛选AECOPD风险因子并建模；制定AECOPD风险因素专家问卷，进行三轮问卷调查，运用Delphi法进行因子筛选和赋权，构建风险预警体系和模型；开展120例AECOPD患者的风险预警模型验证研究，采用Cox 比例风险模型进行评价。为AECOPD发生的风险预测提供预警工具，为合理制定COPD临床诊疗方案提供决策依据。

Combination of disease and syndrome model was the main diagnosis and treatment models for Traditional Chinese Medicine at present. AECOPD were the main cause for hospitalization, disability, lethal and aggravation.There were much risk factor cause to lead to the AECOPD.Estimate risk factor and construction early warning model were the key links for COPD control.The theoretical hypothesis was proposed the risk early-warning system and model included the diseases condition, clinical symptom，TCM syndrome, quality of Life, pulmonary function and biological parameter with AECOPD for Combination of disease and syndrome model while the TCM syndrome transformation and integral changes would exemplify the diseases risk forecast factor based on the forepassed research.The study would been bring into effect.Screening risk factor and construction model for AECOPD based on the 1000 clinical research data with the regression forecast and neural networkpredictor.Constitute the risk factors expert questionnaire for AECOPD and proceed three rounds questionnaire survey and construction risk early-warning system and model with the Delphi method to filter risk factor and determining weights.The clinical verifications study for risk early-warning model would been conducted with 120 cases of patients with AECOPD to evaluate the model with the Cox proportional hazard model.This research should provide risk early-warning instrument to predict AECOPD happen happen and provide decision evidence for the COPD logical clinical diagnosis and treatment project.