【目的】以卵巢早衰为例，基于病程细分模型探究中医优势治疗领域的病程识别理论的可行性和可操作性。【方法】采 用分层贝叶斯模型对125例卵巢早衰（premature ovary failure，POF）病例进行病程时期区分，包括隐匿期及卵巢储备功能减 退（diminished ovarian reserve，DOR）、早发性卵巢功能不全（premature ovarian insufficiency，POI）、POF阶段，结合配对样本 t检验、Pearson相关分析和专家深度访谈法对不同病程时期的中医治疗效果进行分析。【结果】（1）相比POF阶段，DOR和POI阶 段中成药的介入程度更高。（2）在DOR（合并POI）阶段和POF阶段，中医介入程度与治疗效果的差异具有统计学意义（t = -3.70， P＜0.001）。（3）DOR阶段中医介入程度与治疗效果呈显著正相关关系（r = 0.679，P＜0.001），POF阶段中医介入程度与治疗效 果也呈显著正相关关系（r = 0.432，P＜0.001），但相关性略低于DOR阶段。（4）中医妇科专家深度访谈结果表明，在POF的隐 匿期，如果能够通过中医的调理和治疗，预后效果是最好的；其次是DOR阶段和POI阶段，通过中医方剂的方式一般能够 起到较好的疗效和预后效果；但是对于POF阶段来说，要看患者的依从性和治疗周期，效果相对没有前几个病程阶段好。 【结论】在DOR和POF阶段，对于接受过西医治疗的患者来说，中医介入程度越高，预后效果越好；在POF阶段，中医介入 后疗效与DOR阶段相比有一定程度的降低。基于病程细分模型识别中医优势病程具有可行性和可操作性。

Objective To explore the feasibility and operability in identifying the therapeutic dominant stages of traditional Chinese medicine（TCM）based on subdivision model of disease course. Methods The hierarchical 625 Bayesian model was used to differentiate the disease course of 125 cases of premature ovarian failure（POF），and the disease course of POF were divided into the occult stage，diminished ovarian reserve（DOR）stage，premature ovarian insufficiency（POI）stage，and POF stage. An then the paired sample t-test，Pearson correlation analysis and expert in-depth interview were used for the analysis of the therapeutic effects of TCM for POF at various stages. Results （1） Compared with POF stage， DOR and POI stages were frequently intervened by Chinese patent medicine.（2）In DOR（complicated with POI）stage and POF stage，there was significant difference between the degree of TCM intervention and the therapeutic effect（t = -3.70，P＜0.001）.（3）The degree of TCM intervention was positively correlated with treatment outcomes in the DOR stage（r = 0.679，P＜0.001），so did in the POF stage（r = 0.432，P＜0.001），but the correlation in the POF stage was slightly lower than that in the DOR stage. （4）The results of in-depth interviews with experts of TCM gynecology showed that in the concealed phase of POF， the prognosis would be most favorable if TCM regulation and intervention were performed. In the DOR stage and POI stage， treatment with Chinese medicine prescriptions usually brought about better curative effect and prognosis. For the patients at POF stage，the therapeutic effect of TCM depended on the patients’compliance and the treatment course，and the effect was relatively not as good as that of the previous stages. Conclusion In the DOR stage and POF stage，the higher the degree of TCM intervention，the better the prognosis will be achieved for the patients treated with western medicine. In the POF stage，the efficacy of TCM intervention is reduced to a certain extent compared with the DOR stage. The results indicated that it is feasible and operable to identify the TCM therapeutic dominant stages based on the subdivision model of disease course.

R2-03

广东省哲学社会科学创新工程2022年度特别委托项目（编号：GD22TWCXGC09）；广州市哲学社会科学发展“十四五”规划 2023年度共建课题（编号：2023GZGJ65）；广东省社科联重点实验室“数字中医药文化研究与传播创新重点实验室”2022-2023年 度中医药文化研究与传播创新专项重点课题（编号：SSZ202203）