發(fā)布時(shí)間：2018-07-01 11:09

  本文選題：亞健康狀態(tài) + 流行病學(xué)調(diào)查��； 參考：《南方醫(yī)科大學(xué)》2007年博士論文

【摘要】： 【背景】20世紀(jì)80年代，前蘇聯(lián)布赫曼教授通過研究發(fā)現(xiàn)，除健康狀態(tài)和疾病狀態(tài)之外，人體還存在著一種非健康非患病的中間狀態(tài)，稱之為“第三狀態(tài)”。世界衛(wèi)生組織(WHO)一項(xiàng)全球性調(diào)查結(jié)果表明，全世界真正健康的人(第一狀態(tài))僅占5％，經(jīng)醫(yī)生檢查、診斷有病的人(第二狀態(tài))也只占20％，75％的人處于健康和患病之間的“第三狀態(tài)”。由于亞健康狀態(tài)的高發(fā)率以及其對(duì)國(guó)民生活質(zhì)量的影響，國(guó)內(nèi)醫(yī)學(xué)界已經(jīng)把“亞健康狀態(tài)”作為危害國(guó)人健康的重要課題，對(duì)亞健康狀態(tài)的研究，已經(jīng)成為生命科學(xué)研究的重要組成部分。 亞健康狀態(tài)是指人的身心處于疾病與健康之間的狀態(tài)，是機(jī)體雖無明確的疾病，但在軀體上、心理上和人際交往上出現(xiàn)種種不適應(yīng)的感覺和癥狀，從而呈現(xiàn)出活力、反應(yīng)能力和對(duì)外界適應(yīng)能力降低的一種狀態(tài)，這種狀態(tài)多由人體生理機(jī)能或代謝機(jī)能低下所致，雖然尚未達(dá)到疾病水平，但已嚴(yán)重影響人的工作效率和生活質(zhì)量。目前認(rèn)為亞健康狀態(tài)的發(fā)生可能與個(gè)人的生理狀況、心理狀況、生活方式、職業(yè)情況、居住環(huán)境及社會(huì)交往等多種因素有關(guān)。國(guó)內(nèi)已有關(guān)于大學(xué)生、高校教師、機(jī)關(guān)干部、軍人等特定人群進(jìn)行了亞健康狀態(tài)的小樣本研究，，結(jié)果顯示，不同人群亞健康狀態(tài)的發(fā)生因素、臨床表現(xiàn)等是有所不同的。因此，在特定人群中開展大型亞健康狀態(tài)流行病調(diào)查有利于亞健康狀態(tài)的防治。 亞健康狀態(tài)缺乏明確診斷為“某病”的理化依據(jù)，沒達(dá)到疾病的診斷標(biāo)準(zhǔn)，它實(shí)際上是機(jī)體生理活動(dòng)規(guī)律失常的綜合的表現(xiàn)，是一種還達(dá)不到器質(zhì)性改變的功能性變化，是人體身心整體調(diào)整異常的早期反映。因此，以具體的“形態(tài)結(jié)構(gòu)學(xué)”為基礎(chǔ)，以單純的“生物性疾病”為研究對(duì)象，以數(shù)字化的檢驗(yàn)數(shù)據(jù)為診療依據(jù)的現(xiàn)代醫(yī)學(xué)很難把握亞健康狀態(tài)的診治規(guī)律。中醫(yī)學(xué)是一門以整體觀念為指導(dǎo)，以辨證論治為主要診療特點(diǎn)的醫(yī)學(xué)理論體系，其有別于現(xiàn)代醫(yī)學(xué)的最大特點(diǎn)之一就是對(duì)人體“生理特性”和“功能活動(dòng)規(guī)律”的重視。因此，中醫(yī)學(xué)在對(duì)亞健康狀態(tài)的認(rèn)識(shí)以及診斷治療方法等方面較現(xiàn)代醫(yī)學(xué)具有全方位的優(yōu)勢(shì)。 辨證論治是中醫(yī)學(xué)診治疾病的基礎(chǔ)，是中醫(yī)學(xué)中最富有特色的科學(xué)精華。證候是辨證論治的前提和基礎(chǔ)，是連接中醫(yī)理論和臨床診療體系的橋梁和關(guān)鍵。證候的研究是中醫(yī)現(xiàn)代化研究的關(guān)鍵，證候本質(zhì)研究也一直是中醫(yī)研究的熱點(diǎn)。然而始終是有進(jìn)步而無突破，究其原因，可能是研究思路、方法學(xué)存在問題。我們經(jīng)過研究發(fā)現(xiàn)，從亞健康狀態(tài)入手研究中醫(yī)證候本質(zhì)是一個(gè)非常理想的切入點(diǎn)。因?yàn)閬喗】禒顟B(tài)是介于健康和疾病之間的中間狀態(tài)，各項(xiàng)檢查未發(fā)現(xiàn)異常，西醫(yī)無法確診某種疾病，但已經(jīng)出現(xiàn)各種癥狀，亦即其已經(jīng)表現(xiàn)出各種中醫(yī)證候，此證候不受西醫(yī)疾病的干擾，因此該證候是最理想的研究對(duì)象。當(dāng)然，這也存在一定的不足，因?yàn)閬喗】禒顟B(tài)所表現(xiàn)出的癥狀，也許不可能代表全部的中醫(yī)證候特征，但可能會(huì)找到證候的最本質(zhì)的特征。因此，開展亞健康狀態(tài)的中醫(yī)證候臨床流行病學(xué)研究，不僅為防治亞健康狀態(tài)提供理論基礎(chǔ)和實(shí)踐指導(dǎo)，而且還將促進(jìn)中醫(yī)證候?qū)W進(jìn)一步的發(fā)展和完善。我們前期對(duì)腎陰虛證的研究工作較為充分，而且根據(jù)我們的預(yù)調(diào)查顯示，亞健康狀態(tài)中的腎陰虛證的病例較多，居所有證候的前三位，因此，我們就選擇腎陰虛證為切入點(diǎn)，然后再進(jìn)行其它典型證候的研究。 腎陰虛證的主要臨床表現(xiàn)為干咳少痰，短氣喘息，口燥咽干，甚至可見午后低熱，五心煩熱，潮熱盜汗，頭暈耳鳴，眩暈?zāi)繚例X松動(dòng)或疼痛，腰膝酸痛，失眠多夢(mèng)，遺精早泄，性欲亢進(jìn)，顴紅目赤，大便干結(jié)，小便短少，舌紅，苔黃，脈細(xì)數(shù)等。長(zhǎng)期以來，臨床上都是以上述指標(biāo)作為依據(jù)，進(jìn)行臨床診斷和治療。但是上述表現(xiàn)在同一個(gè)腎陰虛證患者身上不一定全部表現(xiàn)出來，可能還會(huì)兼見其他證候的表現(xiàn)，這些都會(huì)給腎陰虛證的臨床辨證帶來麻煩，為了研究哪些才是腎陰虛證的特異性表現(xiàn)，我們通過對(duì)亞健康狀態(tài)下的腎陰虛證表現(xiàn)的研究，排除疾病干擾的因素，以尋找腎陰虛本質(zhì)的特征，為中醫(yī)證候本質(zhì)的研究提供一個(gè)思路。目前腎陰虛證實(shí)質(zhì)研究還處在籠統(tǒng)、多指標(biāo)的模糊狀態(tài)，有待進(jìn)一步多學(xué)科綜合研究。證候蛋白質(zhì)組學(xué)的提出，為整體評(píng)價(jià)證候?qū)嵸|(zhì)提供可能。血清中含有近萬種蛋白質(zhì)，成分復(fù)雜，包括各種不同器官、組織和細(xì)胞分泌的多種蛋白質(zhì)，機(jī)體任一時(shí)間階段的病理生理改變均可在血清中反映出來。因而，從血清蛋白質(zhì)組學(xué)的角度，將蛋白質(zhì)組學(xué)和中醫(yī)證型研究結(jié)合起來，探討。腎陰虛證在某一特定時(shí)期的相關(guān)蛋白質(zhì)，對(duì)從整體水平評(píng)價(jià)腎陰虛證的實(shí)質(zhì)具有重要的現(xiàn)實(shí)意義。 【目的】通過對(duì)不同人群的亞健康狀態(tài)流行病學(xué)調(diào)查，研究亞健康狀態(tài)在不同人群中的發(fā)生的一般規(guī)律，進(jìn)而探討亞健康狀態(tài)在高危人群中發(fā)生的原因，為其防治提供指導(dǎo)。并研究亞健康狀態(tài)中腎陰虛證的中醫(yī)證候特征，拋開疾病的干擾因素，從癥狀表現(xiàn)、舌苔、舌質(zhì)、脈象等方面探討腎陰虛證的證候本質(zhì)。最后利用蛋白質(zhì)組學(xué)的方法，研究亞健康狀態(tài)腎陰虛證的分子機(jī)制，與不同疾病狀態(tài)下腎陰虛證進(jìn)行對(duì)比，探討亞健康狀態(tài)中醫(yī)腎陰虛證的分子實(shí)質(zhì)。本研究不僅對(duì)亞健康狀態(tài)的防治有著深遠(yuǎn)意義，還將促進(jìn)中醫(yī)證候研究的拓展和深入。 【方法】首先采用現(xiàn)場(chǎng)調(diào)查的方式，讓參加體檢的職工現(xiàn)場(chǎng)填寫亞健康狀態(tài)調(diào)查問卷，根據(jù)被調(diào)查者填寫內(nèi)容，結(jié)合查體結(jié)果，參考《亞健康狀態(tài)的中醫(yī)臨床研究指導(dǎo)原則(試行)》，判斷亞健康狀態(tài)。然后根據(jù)被調(diào)查者填寫的量表內(nèi)容和現(xiàn)場(chǎng)調(diào)查醫(yī)師通過中醫(yī)四診掌握的資料，按有關(guān)中醫(yī)證候的辨證標(biāo)準(zhǔn)，進(jìn)行辨證。將合格問卷錄入Epidata3.02，采用SPSS 11.5對(duì)錄入數(shù)據(jù)進(jìn)行描述性分析、x~2檢驗(yàn)、單因素Logistic回歸分析、因子分析等，統(tǒng)計(jì)分析不同職業(yè)人群亞健康狀態(tài)發(fā)生的一般情況、影響因素、中醫(yī)證候分布，以及亞健康狀態(tài)下腎陰虛證的癥狀、舌苔、脈象，探討亞健康狀態(tài)腎陰虛證的證候特征。最后，應(yīng)用病證結(jié)合的方法，應(yīng)用二維凝膠電泳和生物質(zhì)譜結(jié)合的技術(shù)對(duì)。腎陰虛證的差異蛋白點(diǎn)進(jìn)行分離和鑒定，與不同疾病狀態(tài)下腎陰虛證作比較，從分子生物學(xué)角度研究亞健康狀態(tài)下腎虛證的分子實(shí)質(zhì)，以期發(fā)現(xiàn)腎陰虛證的物質(zhì)基礎(chǔ)。 【結(jié)果】在6110例被調(diào)查人員中，有3981人處于亞健康狀態(tài)，亞健康狀態(tài)的現(xiàn)患率為65.1％，其中工人亞健康狀態(tài)現(xiàn)患率為66.5％。健康人有792例，占總數(shù)的13.0％；疾病有1337例，占總數(shù)的21.9％。這提示外來打工人員社會(huì)弱勢(shì)群體的亞健康狀態(tài)現(xiàn)患率也非常高，他們的健康狀況不容樂觀。女性職工較男性職工亞健康狀態(tài)現(xiàn)患率高，這可能與其特殊的生理及心理因素有關(guān)。年齡在30歲以下亞健康狀態(tài)的現(xiàn)患率最高，隨著年齡的增大，健康人群的亞健康現(xiàn)患率遞減。可能是因?yàn)楸敬握{(diào)查人群的職業(yè)多為工人，人群的年齡也偏小，多為30歲以下的打工人員(83.3％)，調(diào)查對(duì)象的年齡結(jié)構(gòu)偏態(tài)較為嚴(yán)重。學(xué)歷為高中或高中以下的工人亞健康狀態(tài)現(xiàn)患率為68.2％，隨著學(xué)歷的增高亞健康狀態(tài)現(xiàn)患率遞減。這可能是因?yàn)樵诠S里，工作性質(zhì)、收入、待遇與學(xué)歷密切相關(guān)，學(xué)歷低的工人往往只能從事簡(jiǎn)單、機(jī)械、繁雜且收入較低的體力勞動(dòng)，因而更容易發(fā)生亞健康狀態(tài)。另外，企業(yè)、醫(yī)科高校等特定人群亞健康狀態(tài)的相關(guān)因素有經(jīng)常加班、缺乏體育鍛練、很少休閑活動(dòng)、學(xué)歷較低、工作能力不滿意、錢不夠用、居住條件不滿意等12項(xiàng)。亞健康人群的臨床表現(xiàn)非常復(fù)雜，涉及到軀體、心理和社會(huì)等多種癥狀，如疲倦乏力、失眠、咽干、大便異常、腹脹、納差、健忘、腰背酸痛、手腳發(fā)涼、眼澀、眼脹、頭痛、頭暈、耳鳴、手腳心熱、夜尿頻數(shù)、脫發(fā)、性欲減退、胸悶、氣短、心慌、易汗出、易感冒、精神不振、情緒低落、急躁易怒、空虛、時(shí)常嘆氣、反應(yīng)遲鈍、交往頻率低下、工作效率低下、人際關(guān)系緊張、苦悶等。進(jìn)一步應(yīng)用因子分析，以特征根大于1為公因子提取原則，應(yīng)用最大方差正交旋轉(zhuǎn)法進(jìn)行因子旋轉(zhuǎn)，共得到十個(gè)共因子，結(jié)合醫(yī)學(xué)知識(shí)，根據(jù)上述結(jié)果亞健康狀態(tài)的臨床表現(xiàn)可分為社會(huì)型(公因子6)、心理型(公因子1)、疲勞型(公因子3、公因子4和公因子9)、眼口不適型(公因子7)、二便異常型(公因子2)、月經(jīng)不調(diào)型(公因子5)以及體質(zhì)型(公因子8和公因子10)等七個(gè)亞型。這為亞健康狀態(tài)的分類提供了依據(jù)，為進(jìn)一步防治亞健康狀態(tài)奠定了基礎(chǔ)。 對(duì)706例亞健康狀態(tài)的中醫(yī)證型分布研究顯示，亞健康狀態(tài)的中醫(yī)證型較為分散，共涉及到34個(gè)中醫(yī)證型，其中只有脾氣虛證(78例)、肝郁脾虛證(75例)的比例超過10％，分別為10.8％和10.6％。肝腎陰虛證(69例)、腎陰虛證(65例)、肝郁氣滯證(51例)、腎陽虛證(44例)等亦較多，分別占9.7％、9.2％、7.2％、6.2％。其余證候出現(xiàn)的頻率均小于5％。表明亞健康狀態(tài)的中醫(yī)證候以虛證為主，與腎、肝、脾、心、肺等五臟密切相關(guān)。實(shí)證僅有肝郁氣滯(51例)、肝火熾盛(12例)出現(xiàn)的頻數(shù)高些，分別占總數(shù)的7.2％和1.7％，也說明了心理壓力過大是導(dǎo)致發(fā)生亞健康狀態(tài)的重要原因。進(jìn)一步對(duì)其中65例亞健康狀態(tài)腎陰虛證的表現(xiàn)研究發(fā)現(xiàn)，較為常見的癥狀有腰背酸痛、疲倦乏力、頭暈、記憶力差、怕熱、耳鳴、腿膝酸軟、咽干、失眠多夢(mèng)、心慌、反應(yīng)遲鈍、手腳心熱、容易出汗、少氣懶言、入睡出汗、手足麻木等。亞健康狀態(tài)腎陰虛證的主要臨床表現(xiàn)有：腰背酸痛，疲倦乏力，腿膝酸軟，咽干，失眠多夢(mèng)，脫發(fā)，盜汗，大便干結(jié)，耳鳴，眼澀，手腳心熱等；另外，還有心慌、記憶力差、頭暈、聽力減退、眼花、眼脹、反應(yīng)遲鈍、小便短赤、性欲減退、手足麻木、怕熱、少氣懶言等等癥狀出現(xiàn)頻率較低，為亞健康狀態(tài)腎陰虛證較少見的臨床表現(xiàn)。進(jìn)一步應(yīng)用因子分析等方法分析，得出亞健康狀態(tài)腎陰虛證的主要證候特點(diǎn)有：①腎虛證表現(xiàn)(主要為腰背酸痛、腿膝酸軟、疲倦乏力、耳鳴、脫發(fā)等)；②陰液虧虛表現(xiàn)(主要為眼澀、咽干、大便干結(jié)等)；③陰虛火旺，熱擾心神等表現(xiàn)(主要為盜汗、手心發(fā)熱、失眠多夢(mèng)等；④亞健康狀態(tài)腎陰虛證的舌脈以舌紅、脈沉細(xì)為主。這為腎陰虛證標(biāo)準(zhǔn)化研究以及下一步制定亞健康狀態(tài)的診治方案奠定了基礎(chǔ)。 2-DE圖譜的差異分析發(fā)現(xiàn)有31個(gè)蛋白質(zhì)斑點(diǎn)在四個(gè)實(shí)驗(yàn)組凝膠中有顯著差異表達(dá)。在亞健康狀態(tài)腎陰虛證、系統(tǒng)性紅斑狼瘡腎陰虛證、糖尿病腎病腎陰虛證中均較正常人表達(dá)量升高的蛋白質(zhì)斑點(diǎn)有5個(gè)。選取3個(gè)點(diǎn)清晰且表達(dá)水平改變明顯的蛋白質(zhì)點(diǎn)做PMF質(zhì)譜鑒定，確定了一個(gè)蛋白質(zhì)點(diǎn)為熱休克蛋白27，表明HSP27與亞健康狀態(tài)下腎陰虛證的關(guān)系密切。 【結(jié)論】工人、教師、醫(yī)務(wù)人員等人群的身體健康狀況不容樂觀，采取干預(yù)措施刻不容緩。以亞健康狀態(tài)為切入點(diǎn)研究腎陰虛證的實(shí)質(zhì)收到了不錯(cuò)的效果，對(duì)亞健康狀態(tài)腎陰虛證的表現(xiàn)進(jìn)行因子分析，發(fā)現(xiàn)了一些特征表現(xiàn)，為中醫(yī)證候特征的研究提供了一個(gè)思路。我們也應(yīng)用蛋白組學(xué)的方法初步探索了亞健康狀態(tài)腎陰虛證分子實(shí)質(zhì)，確定了一個(gè)相關(guān)的血清特異表達(dá)蛋白質(zhì)為HSP27，表明從蛋白質(zhì)組的角度來研究腎陰虛證本質(zhì)是可行的。
[Abstract]:[background] in 1980s, Professor Buchtmann of the former Soviet Union found that in addition to the state of health and disease, the human body still has a non - healthy, non - ill intermediate state, called the "third state". A global survey of the WHO (WHO) shows that the world's truly healthy people (first state) are only accounted for. 5%, after a doctor's examination, only 20% of the patients (second states) were diagnosed, and 75% were in the "third state" between health and illness. Due to the high incidence of subhealth and the impact on the quality of national life, the domestic medical community has made the "subhealth state" as an important subject for endangering the health of the Chinese people, and to subhealth. The research of state has become an important part of life science research.
The state of subhealth refers to the state of human body and mind between disease and health. Although the body has no definite disease, there is a variety of incompatible feelings and symptoms in the body, psychological and interpersonal communication, which presents a state of vitality, reaction ability and the reduction of the ability to adapt to the outside world. This state is mostly from the body's physiological machine. It has not yet reached the level of disease, but it has seriously affected the work efficiency and quality of life. At present, it is believed that the occurrence of subhealth may be related to a variety of factors, such as personal physical condition, psychological condition, lifestyle, occupation, living environment and social interaction. A small sample of sub health status of university teachers, organ cadres and military personnel has been carried out. The results show that the factors of subhealth and clinical manifestations of different groups are different. Therefore, carrying out an epidemiological survey of large subhealth status in a specific population is beneficial to the prevention and control of subhealth.
The subhealth state lacks a clear diagnosis as the physical and chemical basis of "a disease", and does not reach the diagnostic standard of the disease. It is actually a comprehensive manifestation of the abnormal physical activity of the body. It is a functional change that can not reach the qualitative change of the body. It is an early reflection of the abnormal adjustment of the body and body body and mind. Therefore, the specific "morphological structure" is used. It is difficult to grasp the rule of diagnosis and treatment in subhealth state. Traditional Chinese medicine is a medical theory system with the guidance of the whole concept and the characteristics of diagnosis and treatment based on the dialectical theory, which is different from the largest of modern medicine. One of the characteristics is to pay attention to the "physiological characteristics" of the human body and the law of functional activity. Therefore, traditional Chinese medicine has a comprehensive advantage over modern medicine in understanding the state of subhealth and the methods of diagnosis and treatment.
Syndrome differentiation is the basis of diagnosis and treatment of diseases in traditional Chinese medicine. It is the most characteristic essence of Science in traditional Chinese medicine. Syndrome is the premise and foundation of syndrome differentiation and treatment. It is the bridge and key to connect the theory of traditional Chinese medicine and clinical diagnosis and treatment system. The research of syndrome is the key to the research of TCM modernization, and the essence of syndrome is always the hot spot of traditional Chinese medicine. There is always progress without breakthroughs, which may be the research thinking and methodological problems. We have found that it is a very ideal point to study the essence of TCM syndrome from sub health state, because subhealth is intermediate between health and disease, and the examination has not been found to be abnormal, western medicine is not found. It is impossible to diagnose a certain disease, but there have been a variety of symptoms, that is, it has shown a variety of TCM syndromes, and this syndrome is not disturbed by the disease of Western medicine. Therefore, this syndrome is the most ideal object of research. Of course, there is also a certain deficiency, because the symptoms expressed in the subhealth state may not represent the whole TCM syndrome. However, it may find the most essential characteristics of the syndrome. Therefore, the study of clinical epidemiology of TCM syndromes in subhealth state not only provides theoretical basis and practical guidance for the prevention and control of subhealth, but will also promote the further development and improvement of TCM syndrome. According to our preliminary investigation, there are more cases of kidney yin deficiency syndrome in subhealth state and the top three of all syndromes. Therefore, we choose kidney yin deficiency syndrome as a breakthrough point, and then carry out other typical syndromes.
The main clinical manifestations of kidney yin deficiency syndrome are dry cough and less phlegm, shortness of breath, mouth dryness, even low fever in the afternoon, five heart irritated fever, hot tide and night sweats, dizziness and tinnitus, dizziness and pain, pain in the waist and knees, insomnia, insomnia, insomnia, insomnia, insomnia, insomnia, insomnia, insomnia, insomnia, insomnia, insomnia, insomnia and many dreams. Since the above indicators have been used as a basis for clinical diagnosis and treatment, the above performance in the same kidney yin deficiency syndrome patients may not be all manifested, and may also meet the manifestations of other syndromes, which will bring trouble to the clinical syndrome differentiation of kidney yin deficiency syndrome, in order to study which is the deficiency syndrome of kidney yin. The heterosexual manifestation, through the study of the manifestation of kidney yin deficiency syndrome in subhealth state, we exclude the factors of the disease interference, in order to find the essence of the deficiency of kidney yin, and provide a way of thinking for the study of the essence of TCM syndrome. The essence of deficiency syndrome of kidney Yin is still in general and fuzzy state of multiple indexes, and it needs further comprehensive study of multidisciplinary. The presentation of proteomics is possible for the overall evaluation of the syndrome substance. There are nearly 10000 proteins in the serum, complex, including a variety of proteins in various organs, tissues and cells, and the pathophysiological changes in the body at any time of time can be reflected in the serum. Therefore, from the angle of serological proteomics, Combined with the study of proteomics and TCM syndrome type, the related proteins of kidney yin deficiency syndrome in a certain period are of great practical significance for evaluating the essence of kidney yin deficiency syndrome from the whole level.
[Objective] to study the general rule of subhealth status in different population by epidemiological investigation of subhealth status of different population, and to explore the causes of subhealth status in high risk population and provide guidance for its prevention and control. In the end, the molecular mechanism of kidney yin deficiency syndrome in subhealth state is studied by proteomics, and the molecular substance of kidney yin deficiency syndrome in subhealth state is discussed. This study is not only to study the molecular substance of kidney yin deficiency syndrome in subhealth state. The prevention and cure of sub health state has far-reaching significance, and it will also promote the expansion and deepening of TCM syndrome research.
[method] first of all, the method of field investigation was used to fill in the subhealth status questionnaire for the workers who participated in the physical examination. According to the contents of the respondents, the results of the examination were combined to refer to the guidelines of the clinical research guidance (Trial) of the sub health state of Chinese medicine (Trial) to judge the subhealth status. According to the syndrome differentiation standard of TCM syndrome, the field investigators carried on the syndrome differentiation according to the syndrome differentiation standard of TCM syndrome. The qualified questionnaire was entered into Epidata3.02, and SPSS 11.5 was used to carry out descriptive analysis, x~2 test, single factor Logistic regression analysis, factor analysis and so on, to analyze the subhealth status of different occupational groups. Conditions, influencing factors, distribution of TCM syndromes, symptoms of kidney yin deficiency syndrome in subhealth state, tongue coating, pulse image, study the syndrome characteristics of kidney yin deficiency syndrome in subhealth state. Finally, the method of combination of two-dimensional gel electrophoresis and biological mass spectrometry was applied to separate and identify the difference protein points of kidney yin deficiency syndrome by using the method of combination of disease and syndrome. Comparison of kidney yin deficiency syndrome in different disease states, the molecular substance of kidney deficiency syndrome in subhealth state is studied from the angle of molecular biology, in order to find the material basis of kidney yin deficiency syndrome.
[results] among the 6110 subjects, 3981 were in subhealth state and the prevalence rate of subhealth was 65.1%, of which 792 cases were 66.5%. healthy people, 13% of the total, and 1337 of the disease, which accounted for the subhealth status of the social vulnerable groups of migrant workers. The current incidence rate is very high, their health status is not optimistic. Women workers are higher than male workers in subhealth status, which may be related to their special physiological and psychological factors. The prevalence rate of sub health under the age of 30 is the highest. With the increase of age, the rate of subhealth in healthy people is decreasing. It may be because of this The occupations of the population are mostly workers, the age of the crowd is also small, and the workers under 30 years old (83.3%), the age structure of the respondents is more serious. The rate of subhealth of the workers with high school or high school is 68.2%. In the factory, the quality of work, income and treatment are closely related to educational background. Workers with low educational background are often engaged in simple, mechanical, complex and low income labor, and thus are more prone to subhealth. In addition, the related factors of subhealth state of specific people, such as enterprises and medical colleges and universities, are often overtime, lack of sports training, and few rest. Leisure activities, lower educational background, dissatisfaction of working ability, poor money and dissatisfaction with living conditions. The clinical manifestations of subhealthy people are very complex, involving physical, psychological and social symptoms such as fatigue, insomnia, dryness, bowel movement, abdominal distention, tolerance, forgetfulness, pain in the back and feet, hair and feet, eye astringency, headache, dizziness, and ears. Sounding, hot hand and foot, nocturnal frequency, hair loss, loss of sexual desire, chest tightness, shortness of breath, easy sweat, cold, deity, depression, irritability, emptiness, frequent sigh, slow reaction, low communication frequency, low work efficiency, interpersonal tension, depression, etc. further applied factor analysis to extract the original factor above 1 for public factors extraction of the original factor. Then, using the maximum variance orthogonal rotation method to carry out factor rotation, ten common factors were obtained, combined with medical knowledge, according to the above results, the clinical manifestations of subhealth state could be divided into social (public factor 6), psychological type (public factor 1), fatigue type (public factor 3, public factor 4 and public factor 9), eye and mouth discomfort (public factor 7), and two abnormal type (public factor) Sub 2), seven subtypes of irregular menstruation (male factor 5) and physical type (male factor 8 and public factor 10), which provided a basis for Subhealth classification, and laid a foundation for further prevention and control of subhealth state.
The distribution of TCM Syndrome Types in 706 subhealth states showed that the TCM syndrome type of subhealth state was more scattered, involving 34 TCM syndrome types, of which only spleen qi deficiency syndrome (78 cases) and liver depression and spleen deficiency syndrome (75 cases) were more than 10%, respectively 10.8% and 10.6%. liver kidney yin deficiency syndrome (69 cases), kidney yin deficiency syndrome (65 cases), stagnation of liver qi stagnation syndrome (51 cases), Kidney yang deficiency syndrome (44 cases) is also more, accounting for 9.7%, 9.2%, 7.2%, and the frequency of the other syndromes in 6.2%. is less than 5%., which indicates that the syndromes in the sub-health state are mainly related to the deficiency syndrome, which are closely related to the kidney, liver, spleen, heart, lung and other five zang organs. The syndrome is only stagnation of liver Qi (51 cases), and the frequency of liver fire (12 cases) is higher, accounting for 7. of the total. 2% and 1.7% also showed that excessive psychological pressure was an important cause of subhealth status. Further study of 65 cases of subhealth syndrome of kidney yin deficiency syndrome found that the common symptoms were low back pain, fatigue, dizziness, poor memory, fever, tinnitus, leg and knee soft, dry sore throat, insomnia, insomnia, insomnia, and slow reaction. Hands and feet are hot, sweating easily, less breath, lazy words, falling asleep sweating, numbness of hands and feet, etc. the main clinical manifestations of kidney yin deficiency syndrome in sub-health state are waist back.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2007
【分類號(hào)】：R256.5;R181.3

【引證文獻(xiàn)】

相關(guān)期刊論文 前2條

1 劉麗娜;孫志廣;潘濤;曹婷婷;;腎虛證的基因 蛋白 代謝組學(xué)研究進(jìn)展[J];遼寧中醫(yī)藥大學(xué)學(xué)報(bào);2010年12期

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相關(guān)碩士學(xué)位論文 前1條

1 劉雷;湖北省城鄉(xiāng)居民亞健康狀況及其與睡眠質(zhì)量關(guān)系研究[D];華中科技大學(xué);2009年

本文編號(hào)：2087581