應用多元尺度法及文字雲於小兒腦性麻痺症狀初探

Preliminary study for the symptoms of cerebral palsy in children using multidementional scaling and word cloud

"背景： 腦性麻痺屬於非進行性的腦部損傷，會造成肢體障礙及合併感覺、知覺及發展上多重障礙，是一種不可逆的慢性疾病，也是造成兒童肢體殘疾最常見原因之一。治療以西醫復健為主，中醫針灸為輔。 目的： 探討中醫小兒腦性麻痺症狀，輔助護理人員中醫護理評估能力及辨證施護。 方法： 以某醫院2019 年1 月至6 月腦性麻痺病患中醫電子病歷為樣本，利用文字雲斷字斷詞及TF-IDF 統計法，找出腦性麻痺重要症狀，運用MDS 知覺圖找出症狀間的關係，再應用Excel VBA 將MDS 文字雲視覺化。 結果： 腦性麻痺先天症狀以視覺障礙、四肢肌肉無力、運動發展遲緩、口唇鬆弛、語言發展遲緩、項軟、語言不利及項強最常見；後天症狀以便祕、滯頤、苔薄白、舌紅、脈細與脈細數為多。這與古代醫家認為腦性麻痺理論基礎相符。 結論： 經由文字雲、TF-IDF 及MDS 知覺圖，再應用Excel VBA 視覺化，可協助中醫師及護理師找到腦性麻痺症狀進行辨證，也可輔助中醫護理人員護理評估及辨證施護。"

"Background: Cerebral palsy (CP) is one of a non-progressive brain injuries. CP can cause physical disorders and multiple disfuntions in sensation, perception, and development. It is an irreversible chronic disease and one of the most common causes of physical disabilities in the children. CP modern treatment is mainly based on rehabilitation of western medicine, combining with Traditional Chinese Medicine (TCM), including acupuncture, massage, acupressure in Taiwan. Objective: Our aim was to discuss the symptoms of cerebral palsy children using TCM classification. It can assist our nursing staff to evaluate the diagnostic ability of TCM nursing care and TCM patterns differentiation. Method: We used a hospital’s electronic medical records of cerebral palsy patients from January to June 2019. We used word cloud hyphenation and TF-IDF statistical method to identify the most important symptoms of cerebral palsy. We also used multidementional scaling (MDS) perceptual map to identify association among symptoms. Finally, we used Excel VBA to visualize the MDS word cloud. Results: The most common congenital symptoms of cerebral palsy were visual disturbance, muscle weakness of the limbs, delayed movement development, loose lips, delayed language development, soft nape, poor language and strong nape; the common acquired symptoms included constipation, stagnation, thin white fur, red tongue. The most common pulse patterns were thin and faint and rapid pulse. This signs and symptom were consistent with the ancient TCM doctors' thinking process about the palsy pattern. Conclusion: Through the word cloud, TF-IDF, and MDS perception map, and then using Excel VBA visualization, Chinese medicine practitioners and nurses could identify the most common symptoms of cerebral palsy for syndrome differentiation to facilitate TCM diagnosis"