| Objective:To better utilize the role of Chinese medicine in primary care and to provide a basis for the development of the training syllabus for primary Chinese medicine general practitioners.In this article,the reasons for consultation and diagnosis of famous and veteran Chinese medicine cases are systematically classified and analysed according to the International Classification of Primary Care-Third Edition(ICPC-3),in order to gain a comprehensive and systematic understanding of the main reasons why patients seek Chinese medicine consultation and the main directions of contemporary famous and veteran Chinese medicine practitioners,as well as the(3)To provide a comprehensive and systematic understanding of the main reasons why patients seek Chinese medicine consultation and the main directions of contemporary Chinese medicine practitioners’ consultations,as well as the main clinical problems they solve,and hence the advantages and characteristics of Chinese medicine in primary care.Method:1.Review and analysis of "Research on clinical treatment experience and inheritance methods of famous and old Chinese medicine practitioners based on information mining technology",a project of the National Science and Technology Tackling Program of the Tenth Five-Year Plan from 2005 to 2006 The first consultation complaints and complete diagnostic cases of famous and old Chinese medicine practitioners collected under the Jiangxi Provincial Key R&D Project from2017 to 2021 were analyzed.The analysis process is as follows:(1)The symptoms of complaints are extracted and coded according to ICPC-3,and the coding process is carried out automatically using regular expressions.(2)Disease diagnoses are converted by the relationship between International classification of diseases(ICD)codes and ICPC-3 codes,and diagnoses that do not correspond are coded manually.(3)Frequency and percentage statistics were performed on symptom,diagnosis and related coded data according to the ICPC-3 classification.Regular expression extraction and statistical analysis processes were carried out on the SAS 9.4 software platform.2.ICPC-3 coding data from the International Classification of Primary Care website(https://browser.icpc-3.info/),including ICPC-3 basic codes and entries,ICPC-3 basic entry-related relationship data,relationship data including definitions,index entries,included entries,excluded entries,and relationships to the International Classification of Diseases 10 th Revision(ICD-10)and 11 th Revision(ICD-11),Systematized Nomenclature of Medicine-Clinical Terms(SNOMED CT),etc.The above data were managed using an Access database,translated into Chinese using the Baidu machine translation function,and manually checked.Results:1.Basic information of medical cases: 20878 medical cases of famous old Chinese medicine practitioners met the inclusion criteria,of which there were a total of 20701 cases with perfect gender information,of which 10521 cases(about 51%)were male and 10180 cases(49%)were female;there were a total of 19843 cases with perfect age information,age 15d-99 years old,average(42.72±19.57)years old;the time span of patients’ consultation was 1926-2021,with 12,738 cases from2003-2006(from the Tenth Five-Year Plan Project)and 2,176 cases from 2009-2020(from the Jiangxi Province Key Research and Development Programme Project).2.Reasons for consultation of famous veteran Chinese medicine cases:(1)Distribution of reasons for consultation by system: The top 3 were digestive system(7466),general and non-specific(4698)and musculoskeletal system(4524),together accounting for 50.75%.(2)Distribution of reasons for visits by ICPC-3tertiary classification: The top 50 were 25,230 visits,accounting for 76.68%.The top 20 reasons for visits were,in descending order: cough(1395),generalized weakness/fatigue(1247),epigastric pain(1220),lower back symptoms or complaints(1131),vertigo/dizziness(1071),fever(987),flatulence/bloating/hiccups(941),palpitations/feeling of heartbeat(862),other specific respiratory symptoms,complaints and unusual findings(851),other limited abdominal pain(774),swelling and generalised oedema(753),calf/thigh symptoms/complaints(730),shortness of breath(606),headache(604),bloating or abdominal mass,or both(530),diarrhoea(504),other symptoms/complaints of digestive system(485),lack of appetite(481),sleep disturbance(474),abdominal pain of a total abdominal nature(473).3.Diagnosis of famous veteran Chinese medicine practitioners’ cases:(1)Distribution of diagnosis by system: The top 4 ranked in order are digestive system(5640),circulatory system(3190),respiratory system(2461)and musculoskeletal system(2437),accounting for a total of 56.06%.(2)Distribution of diagnoses by ICPC-3 tertiary classification: The frequency of the top 50 diagnoses was16,473,accounting for 67.28%.The top 20 diagnoses in order were:gastritis/duodenitis(1350),medical complications(931),other digestive system diseases(908),uncomplicated hypertension(780),chronic ischaemic heart disease(683),renal disease(645),liver disease NOS(587),viral hepatitis(561),rheumatoid arthritis and related conditions(453),stroke/ cerebrovascular accident(432),non-insulin-dependent diabetes mellitus(429),back syndrome with radiating pain(424),acute upper respiratory tract infection(421),cholecystitis/cholestasis(406),coagulation disorder(377),trauma/injury NOS(360),other specified diagnoses and disorders of the musculoskeletal system(357),other specified or unknown neurological diagnoses and disorders(341),other specified and unknown diagnoses and disorders of the reproductive system(327),cardiac arrhythmia/conduction disorders(318).Conclusion:1.Based on the ICPC analysis of the causes and diagnoses of the cases of famous and veteran TCM practitioners,it is clear that the advantages of TCM in primary general practice can be seen,and more than half of the causes and diagnoses of TCM treatment are concentrated in the digestive system,general and non-specific system and musculoskeletal system,circulatory system and respiratory system.This can provide a reference for the development of targeted training programmes and rapid improvement of the clinical competence of primary care general practitioners.2.In terms of specific reasons for consultation,patients more often seek consultation from renowned Chinese medicine practitioners for epigastric pain,cough,generalized weakness/fatigue,lower back symptoms or complaints,vertigo/dizziness,fever,palpitations/feeling of heartbeat,other specific respiratory symptoms,complaints and abnormal findings,other limited abdominal pain,swelling and generalized oedema;disease diagnoses are more common for gastritis/duodenitis,medical complications,other digestive system The diagnoses of diseases are more common for gastritis/duodenitis,medical complications,other digestive disorders,hypertension,chronic ischaemic heart disease,kidney disease,liver disease NOS,viral hepatitis,rheumatoid arthritis and related conditions,and stroke/cerebrovascular accident.The above reasons for consultation and diagnosis are also clinical strengths of TCM,and primary TCM general practitioners can learn from the relevant experience of renowned veteran TCM practitioners in a targeted and systematic manner.3.ICPC-3,as the international primary care classification standard,is also suitable for classifying TCM cases for statistical purposes,so as to bring into play the role of TCM cases as a guide for primary care general practitioners and to enhance the clinical practice of primary care general practitioners. |
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