刘金宝
198 lines
12 KiB
SQL
198 lines
12 KiB
SQL
USE `medical_consultation_agent`;
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SET NAMES utf8mb4;
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INSERT INTO `departments` (`id`, `name`, `code`, `parent_id`, `sort_order`, `is_active`)
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VALUES (1, '儿科', 'PEDIATRICS', NULL, 1, 1)
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ON DUPLICATE KEY UPDATE `name` = VALUES(`name`), `is_active` = VALUES(`is_active`);
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INSERT INTO `users` (`id`, `external_user_id`, `display_name`)
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VALUES (1, 'system_seed', '系统种子数据')
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ON DUPLICATE KEY UPDATE `display_name` = VALUES(`display_name`);
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INSERT INTO `cases` (
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`id`,
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`case_code`,
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`department_id`,
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`title`,
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`difficulty`,
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`patient_name`,
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`patient_age`,
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`patient_gender`,
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`patient_occupation`,
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`chief_complaint`,
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`present_illness`,
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`past_history`,
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`personal_history`,
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`family_history`,
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`physical_exam`,
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`auxiliary_exam`,
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`diagnosis_primary`,
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`diagnosis_differential`,
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`diagnosis_basis`,
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`treatment_plan`,
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`consultation_config`,
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`inquiry_options`,
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`knowledge_videos`,
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`quiz_questions`,
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`key_symptoms`,
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`key_exams`,
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`key_points`,
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`evidence_reasoning_chain`,
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`assessment_config`,
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`ai_patient_profile`,
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`patient_opening`,
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`hidden_patient_info`,
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`has_teaching_video`,
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`has_knowledge_points`,
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`has_quiz`,
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`source_pdf_name`,
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`supported_training_type`,
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`supported_mode`,
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`is_active`,
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`created_by`
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) VALUES (
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1,
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'PED_PNEUMONIA_001',
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1,
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'支气管肺炎 - 6岁男性患儿',
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'medium',
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'王**',
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6,
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'male',
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'学龄前儿童',
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'发热、咳嗽4天，喘息1天。',
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'患儿4天前出现发热，体温最高39.2℃，伴阵发性咳嗽，夜间明显。1天前出现喘息及精神稍差，在社区门诊口服退热药后体温反复。无惊厥，无呕吐腹泻。',
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'既往体健，出生足月，疫苗接种基本完整；有湿疹病史，无明确哮喘诊断史；无药物过敏史。',
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'与父母同住，近期幼儿园同班多人有上呼吸道感染；被动吸烟暴露。',
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'母亲有过敏性鼻炎史，否认家族遗传代谢病史。',
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JSON_OBJECT(
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'general', JSON_OBJECT('temperature','38.7℃','pulse','126次/分','respiration','30次/分','blood_pressure','96/60mmHg','mental_status','精神稍差','nasal_flaring','轻度鼻翼煽动'),
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'lung', '双肺呼吸音粗，可闻及散在湿啰音及少量哮鸣音',
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'heart', '心音有力',
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'abdomen', '腹软，无压痛，肝脾未触及肿大，肠鸣音正常',
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'neuro', '神经系统查体未见定位体征'
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),
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JSON_ARRAY(
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JSON_OBJECT('name','血常规','result','WBC 12.4×10^9/L，中性粒细胞72%','is_abnormal',true,'is_key',false),
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JSON_OBJECT('name','CRP','result','32 mg/L','is_abnormal',true,'is_key',false),
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JSON_OBJECT('name','胸片','result','双下肺纹理增多，右下肺片状模糊影','is_abnormal',true,'is_key',true),
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JSON_OBJECT('name','肺炎支原体抗体IgM','result','弱阳性','is_abnormal',true,'is_key',false),
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JSON_OBJECT('name','血氧饱和度','result','室内空气 SpO2 94%','is_abnormal',true,'is_key',true)
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),
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'支气管肺炎',
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JSON_ARRAY('毛细支气管炎','支气管哮喘急性发作','肺结核'),
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'患儿发热咳嗽伴喘息，肺部听诊有湿啰音，胸片示右下肺片状模糊影，炎症指标升高，符合支气管肺炎诊断。',
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JSON_OBJECT(
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'principle', JSON_ARRAY('抗感染','止咳平喘','改善氧合','严密观察病情变化'),
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'measures', JSON_ARRAY('根据病情和病原学选择抗感染治疗','必要时雾化吸入缓解喘息','监测体温、呼吸、血氧饱和度','评估是否住院观察'),
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'risk_plan', JSON_ARRAY('关注低氧','关注呼吸困难加重','关注持续高热','关注精神反应差'),
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'communication', JSON_ARRAY('向家属说明病情','说明观察指标','说明用药注意事项','说明复诊指征')
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),
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JSON_OBJECT(),
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JSON_ARRAY(),
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JSON_ARRAY(),
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JSON_ARRAY(
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JSON_OBJECT('question','该患儿的首要诊断是？','type','single','answer','支气管肺炎'),
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JSON_OBJECT('question','本病例关键检查包括哪些？','type','multiple','answer',JSON_ARRAY('肺部湿啰音','胸片异常','血氧饱和度下降'))
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),
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JSON_ARRAY('发热','咳嗽','喘息'),
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JSON_ARRAY('肺部湿啰音','胸片异常','血氧饱和度下降'),
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JSON_ARRAY('问诊完整性','儿科查体规范','关键症状识别','诊断准确性','治疗计划合理性'),
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JSON_OBJECT(
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'clinical_prediction_rule','根据患儿症状（发热、咳嗽、喘息）及体征（肺部湿啰音），结合实验室炎症指标升高和胸部影像学典型新发浸润影，符合儿童支气管肺炎临床诊断标准，参考《儿童社区获得性肺炎诊疗规范（2019年版）》。',
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'severity_assessment', JSON_ARRAY(
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'问题识别：判断患儿是否为重症肺炎，以决定治疗地点。',
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'证据检索与整合：检索儿童肺炎严重程度评估工具，结合儿童CURB-65改良标准或WHO儿童肺炎分级。',
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'应用评分：本例呼吸30次/分、SpO2 94%、无意识障碍、血压正常，尚未达到重症肺炎阈值。',
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'决策：判断为非重症肺炎，因血氧偏低和喘息存在，纳入住院观察和严密随访讨论。'
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)
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),
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JSON_OBJECT(
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'score_dimensions', JSON_ARRAY('信息获取','分析推理','处置决策','沟通人文','临床整合'),
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'must_cover', JSON_ARRAY('发热持续时间','咳嗽特点','喘息出现时间','精神食欲睡眠','疫苗接种','过敏史','既往喘息史','肺部听诊','胸片','血氧饱和度')
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),
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JSON_OBJECT(
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'role','患儿家属',
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'personality','担心、焦虑，但配合问诊',
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'speech_style','以家长口吻回答，描述孩子症状，回答简洁',
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'visible_info', JSON_ARRAY('发热咳嗽4天','喘息1天','精神稍差'),
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'rules', JSON_ARRAY('只回答病例内事实','不主动给出诊断','不一次性泄露所有隐藏信息')
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),
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'家长：医生，孩子发烧咳嗽好几天了，昨天开始喘得厉害，精神也不太好。',
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JSON_ARRAY('近期幼儿园同班多人上呼吸道感染','被动吸烟暴露','母亲有过敏性鼻炎史','有湿疹病史','无明确哮喘诊断史'),
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0,
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1,
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1,
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'儿科 病例样例（SOAP+循证）.pdf',
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'diagnosis_treatment',
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'free_chat',
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1,
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1
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) ON DUPLICATE KEY UPDATE
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`title` = VALUES(`title`),
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`updated_at` = CURRENT_TIMESTAMP;
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INSERT INTO `case_exam_items` (`case_id`, `item_code`, `item_name`, `item_type`, `category`, `result_text`, `result_structured`, `is_key`, `is_abnormal`, `score_weight`, `display_order`)
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VALUES
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(1, 'blood_routine', '血常规', 'lab', '炎症指标', 'WBC 12.4×10^9/L，中性粒细胞72%。', JSON_OBJECT('WBC','12.4×10^9/L','neutrophil_percent','72%'), 0, 1, 3.00, 1),
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(1, 'crp', 'CRP', 'lab', '炎症指标', 'CRP 32 mg/L。', JSON_OBJECT('CRP','32 mg/L'), 0, 1, 2.00, 2),
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(1, 'chest_xray', '胸片', 'imaging', '影像学', '双下肺纹理增多，右下肺片状模糊影。', JSON_OBJECT('finding','右下肺片状模糊影'), 1, 1, 5.00, 3),
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(1, 'mp_igm', '肺炎支原体抗体IgM', 'lab', '病原学', '肺炎支原体抗体IgM 弱阳性。', JSON_OBJECT('mp_igm','弱阳性'), 0, 1, 2.00, 4),
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(1, 'spo2', '血氧饱和度', 'vital_sign', '生命体征', '室内空气 SpO2 94%。', JSON_OBJECT('SpO2','94%','condition','室内空气'), 1, 1, 5.00, 5)
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ON DUPLICATE KEY UPDATE
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`result_text` = VALUES(`result_text`),
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`result_structured` = VALUES(`result_structured`);
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INSERT INTO `knowledge_sources` (`id`, `source_code`, `source_name`, `source_type`, `authority_level`, `is_active`)
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VALUES
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(1, 'CAP_2019', '儿童社区获得性肺炎诊疗规范（2019年版）', 'clinical_guideline', 5, 1),
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(2, 'HUMANISTIC_CARE', '卫健委人文关怀与医患沟通要求', 'humanistic_care', 4, 1),
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(3, 'PED_EXAM_REQ', '儿科期末考试问诊与诊疗评分要求', 'exam_requirement', 3, 1)
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ON DUPLICATE KEY UPDATE `source_name` = VALUES(`source_name`);
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INSERT INTO `knowledge_documents` (`id`, `source_id`, `department_id`, `title`, `task_type`, `summary`, `is_active`)
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VALUES
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(1, 1, 1, '儿童社区获得性肺炎诊疗规范（2019年版）评分参考', 'diagnosis_treatment', '儿童肺炎诊断、严重程度评估和治疗原则参考。', 1),
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(2, 2, 1, '儿科场景人文关怀评分参考', 'diagnosis_treatment', '儿童患者家属沟通、病情告知和健康教育评分参考。', 1),
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(3, 3, 1, '儿科问诊考试评分要求', 'diagnosis_treatment', '儿科病史采集、查体、诊断依据和治疗计划评分参考。', 1)
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ON DUPLICATE KEY UPDATE `summary` = VALUES(`summary`);
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INSERT INTO `knowledge_chunks` (`document_id`, `department_id`, `task_type`, `chunk_text`, `keywords`, `weight`, `is_active`)
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VALUES
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(1, 1, 'diagnosis_treatment', '儿童支气管肺炎诊断需结合发热、咳嗽、喘息等症状，肺部湿啰音等体征，炎症指标升高以及胸部影像学新发浸润影。', JSON_ARRAY('支气管肺炎','发热','咳嗽','喘息','胸片'), 5.00, 1),
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(1, 1, 'diagnosis_treatment', '儿童肺炎严重程度评估关注呼吸频率、血氧饱和度、意识状态、血压和全身情况。SpO2 94%属于需要密切观察的临界表现。', JSON_ARRAY('严重程度','SpO2','呼吸频率','血氧'), 4.50, 1),
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(2, 1, 'diagnosis_treatment', '儿科沟通需面向家属解释病情、观察指标、用药注意事项、复诊指征，并回应家属焦虑。', JSON_ARRAY('人文关怀','家属沟通','健康教育'), 4.00, 1),
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(3, 1, 'diagnosis_treatment', '儿科病例考核重点包括问诊完整性、儿科查体规范、关键症状识别、诊断准确性、治疗计划合理性。', JSON_ARRAY('考核','问诊完整性','治疗计划'), 4.00, 1);
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INSERT INTO `prompt_templates` (`template_code`, `agent_type`, `scene`, `version_no`, `model_type`, `output_format`, `file_path`, `is_active`)
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VALUES
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('patient_free_chat', 'patient', 'free_chat', 'v1', 'fast', 'text', 'backend/app/prompts/patient/free_chat.md', 1),
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('patient_practice', 'patient', 'practice', 'v1', 'fast', 'text', 'backend/app/prompts/patient/practice.md', 1),
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('patient_novice', 'patient', 'novice', 'v1', 'fast', 'text', 'backend/app/prompts/patient/novice.md', 1),
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('patient_teaching', 'patient', 'teaching', 'v1', 'fast', 'text', 'backend/app/prompts/patient/teaching.md', 1),
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('scoring_default_percentage', 'scoring', 'default_percentage', 'v1', 'reason', 'json', 'backend/app/prompts/scoring/default_percentage.md', 1),
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('scoring_default_five_point', 'scoring', 'default_five_point', 'v1', 'reason', 'json', 'backend/app/prompts/scoring/default_five_point.md', 1),
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('scoring_pediatrics_pneumonia', 'scoring', 'pediatrics_pneumonia', 'v1', 'reason', 'json', 'backend/app/prompts/scoring/pediatrics_pneumonia.md', 1),
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('report_evaluation', 'report', 'evaluation_report', 'v1', 'fast', 'json', 'backend/app/prompts/report/evaluation_report.md', 1),
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('novice_hint', 'hint', 'novice', 'v1', 'fast', 'text', 'backend/app/prompts/hint/novice_hint.md', 1),
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('doctor_question_polish', 'polish', 'doctor_question', 'v1', 'fast', 'text', 'backend/app/prompts/polish/doctor_question_polish.md', 1),
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('guideline_search_query', 'knowledge', 'guideline_search', 'v1', 'fast', 'json', 'backend/app/prompts/knowledge/guideline_search_query.md', 1)
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ON DUPLICATE KEY UPDATE `file_path` = VALUES(`file_path`);
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INSERT INTO `rubric_templates` (`rubric_code`, `rubric_name`, `version_no`, `department_id`, `training_type`, `score_type`, `dimensions`, `is_active`)
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VALUES
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('PED_DIAG_TX_PERCENTAGE', '儿科诊疗训练百分制评分规则', 'v1', 1, 'diagnosis_treatment', 'percentage',
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JSON_ARRAY(
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JSON_OBJECT('dimension','信息获取','max_score',25,'items',JSON_ARRAY('问诊完整性','查体针对性','辅助检查')),
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JSON_OBJECT('dimension','分析推理','max_score',25,'items',JSON_ARRAY('病例归纳','诊断准确性','鉴别诊断')),
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JSON_OBJECT('dimension','处置决策','max_score',20,'items',JSON_ARRAY('检查计划','治疗方案','风险预案')),
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JSON_OBJECT('dimension','沟通人文','max_score',15,'items',JSON_ARRAY('信息告知','共情回应','共识达成')),
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JSON_OBJECT('dimension','临床整合','max_score',15,'items',JSON_ARRAY('时间管理','流程连贯','整体思维'))
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), 1),
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('PED_DIAG_TX_FIVE_POINT', '儿科诊疗训练五分制评分规则', 'v1', 1, 'diagnosis_treatment', 'five_point',
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JSON_ARRAY(
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JSON_OBJECT('dimension','综合表现','max_score',5,'conversion','percentage / 20')
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), 1)
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ON DUPLICATE KEY UPDATE `dimensions` = VALUES(`dimensions`);
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