本文選題：亞健康狀態(tài) + 流行病學(xué)調(diào)查��； 參考：《第一軍醫(yī)大學(xué)》2007年碩士論文

【摘要】： 研究背景 80年代中期，前蘇聯(lián)布赫曼教授通過研究發(fā)現(xiàn)，除了健康狀態(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)，稱為亞健康(sub-health)狀態(tài)。亞健康狀態(tài)是機(jī)體在無器質(zhì)性病變情況下發(fā)生了一些功能性改變，造成人體生理機(jī)能低下，嚴(yán)重影響人們的工作能力和生存質(zhì)量。WHO的一項(xiàng)全球性調(diào)查表明，真正健康的人僅占5％，患有疾病的人占20％，而75％的人處于亞健康狀態(tài)。處于亞健康狀態(tài)的人口在許多國(guó)家和地區(qū)呈上升趨勢(shì)。據(jù)有關(guān)文獻(xiàn)分析，中國(guó)處于亞健康狀態(tài)的人已經(jīng)超過7億，占全國(guó)總?cè)丝诘?0％～70％。亞健康已經(jīng)成為當(dāng)今危害人類健康的頭號(hào)隱形殺手，也是現(xiàn)代醫(yī)學(xué)難題之一。 目前，對(duì)亞健康狀態(tài)尚無一個(gè)公認(rèn)統(tǒng)一的定義和判斷，國(guó)內(nèi)學(xué)者對(duì)此作了大量的研究和探討。2006年在北京舉行的“世界中醫(yī)藥學(xué)會(huì)聯(lián)合會(huì)亞健康專業(yè)委員會(huì)成立暨首屆世界亞健康學(xué)術(shù)大會(huì)”上中華中醫(yī)藥學(xué)會(huì)亞健康分會(huì)，亞健康中醫(yī)臨床研究指導(dǎo)原則起草小組提出了亞健康狀態(tài)的最新概念。其概念為：亞健康是指人體處于健康和疾病之間的一種狀態(tài)。處于亞健康狀態(tài)者，不能達(dá)到健康的標(biāo)準(zhǔn)，表現(xiàn)為一定時(shí)間內(nèi)的活力降低、功能和適應(yīng)能力減退的癥狀，但不符合現(xiàn)代醫(yī)學(xué)有關(guān)疾病的臨床或亞臨床的診斷標(biāo)準(zhǔn)。我們課題組在這一概念的基礎(chǔ)上，參考相關(guān)研究文獻(xiàn)，并經(jīng)廣東省中醫(yī)藥學(xué)會(huì)亞健康專業(yè)委員會(huì)研討，制定了亞健康狀態(tài)的判斷參考標(biāo)準(zhǔn)。 流行病學(xué)是一門研究人群中疾病與健康狀況的分布及其影響因素，并研究防治疾病及促進(jìn)健康的策略和措施的科學(xué)。近年來，國(guó)內(nèi)學(xué)者已經(jīng)運(yùn)用流行病學(xué)橫斷面調(diào)查的方法對(duì)亞健康狀態(tài)人群進(jìn)行了不少的研究。文獻(xiàn)研究提示，目前對(duì)亞健康狀態(tài)的研究主要集中在腦力勞動(dòng)者(包括教師、機(jī)關(guān)干部、醫(yī)務(wù)人員、學(xué)生等)及軍人群體，到目前為止，在我國(guó)還未發(fā)現(xiàn)專門針對(duì)企業(yè)人群亞健康狀態(tài)的調(diào)查。而在現(xiàn)代社會(huì)中，企業(yè)人群所占人口的比重不斷攀升，對(duì)社會(huì)經(jīng)濟(jì)、醫(yī)療等方面的影響也日漸彰顯。企業(yè)人群由于繁重的工作任務(wù)、單調(diào)的工作環(huán)境、相對(duì)較低的工資、不完善的社會(huì)醫(yī)療保障、擁擠的住宿環(huán)境、缺乏的休閑娛樂，導(dǎo)致該群體亞健康狀態(tài)的發(fā)生率持續(xù)攀升，嚴(yán)重影響了人們的工作能力和生存質(zhì)量，這對(duì)于企業(yè)人群的個(gè)人身心健康，以及企業(yè)的正常運(yùn)作都產(chǎn)生了巨大的影響。近年來，隨著經(jīng)濟(jì)的快速發(fā)展，尤其在珠江三角洲地區(qū)，工廠企業(yè)迅速增多，企業(yè)人群的數(shù)量也快速膨脹，在當(dāng)?shù)厝丝谥兴急壤絹碓礁�，其在社�?huì)建設(shè)中所起的作用也越來越大，該群體的身心健康也倍受重視。故了解這部分人群的亞健康狀態(tài)，研究亞健康狀態(tài)的影響因素，有針對(duì)性地防治企業(yè)人群的亞健康狀態(tài)，保障其身心健康，對(duì)于促進(jìn)企業(yè)及社會(huì)穩(wěn)定發(fā)展有著重要的意義。而這一領(lǐng)域的研究目前尚是一片空白，，對(duì)企業(yè)人群的亞健康狀況缺乏研究，也未見相關(guān)的文獻(xiàn)報(bào)道，所以對(duì)這一人群進(jìn)行流行病學(xué)調(diào)查有著非常重要的現(xiàn)實(shí)意義。 研究目的 本課題屬于亞健康狀態(tài)系列研究中的一個(gè)子課題，采用流行病學(xué)橫斷面研究方法，研制亞健康狀態(tài)流行病學(xué)調(diào)查問卷，應(yīng)用此問卷首次專門針對(duì)企業(yè)人群開展亞健康狀態(tài)的大樣本流行病學(xué)調(diào)查，了解企業(yè)人群中亞健康狀態(tài)的流行病學(xué)情況，探討該特定人群亞健康狀態(tài)的現(xiàn)患率、臨床表現(xiàn)、相關(guān)因素等。這不僅填補(bǔ)了國(guó)內(nèi)企業(yè)人群亞健康狀態(tài)流行病學(xué)調(diào)查的空白，為亞健康狀態(tài)干預(yù)策略的制定提供客觀、科學(xué)的依據(jù)，還將為今后進(jìn)一步研究確定干預(yù)措施及治療方案奠定基礎(chǔ)，對(duì)提高該人群的整體健康水平、工作效率及生活質(zhì)量等方面均具有非常重大的意義。 研究方法 我們南方醫(yī)科大學(xué)南方醫(yī)院亞健康流行病學(xué)調(diào)查課題組在課題開始之初就嚴(yán)格按照橫斷面流行病學(xué)調(diào)查的方法，遵循科學(xué)的研究程序，對(duì)調(diào)查中的各個(gè)環(huán)節(jié)進(jìn)行精心的設(shè)計(jì)，制定了本研究的詳細(xì)實(shí)施步驟，包括研究目的的確定，研究對(duì)象及研究方法的確定，亞健康狀態(tài)流行病學(xué)調(diào)查問卷的制定及評(píng)價(jià)，資料的收集、整理、分析及結(jié)果的解釋，流行病學(xué)調(diào)查的質(zhì)量控制等步驟。 流行病學(xué)調(diào)查步驟制定及亞健康狀態(tài)流行病學(xué)調(diào)查問卷研制成功后，我們以兩個(gè)企業(yè)為研究對(duì)象(其中一個(gè)為深圳寶安地區(qū)私營(yíng)企業(yè)，另一個(gè)為東莞市外資企業(yè))，利用我們課題組研制的亞健康狀態(tài)流行病學(xué)調(diào)查問卷，按照預(yù)先制定的流行病學(xué)調(diào)查步驟對(duì)其所有員工進(jìn)行流行病學(xué)調(diào)查，排除患有疾病的人群，建立亞健康狀態(tài)人群資料庫，內(nèi)容包括年齡、性別、職業(yè)、學(xué)歷、婚姻、亞健康狀態(tài)癥狀及影響因素等；采用計(jì)算機(jī)技術(shù)及數(shù)理統(tǒng)計(jì)等現(xiàn)代科學(xué)方法進(jìn)行亞健康狀態(tài)的流行病學(xué)研究。 結(jié)果 1研制成功適用的亞健康狀態(tài)流行病學(xué)調(diào)查問卷，并經(jīng)過現(xiàn)場(chǎng)試用及效度、信度等評(píng)價(jià)，證明該問卷能達(dá)到預(yù)期研究的目的；應(yīng)用此問卷，在國(guó)內(nèi)首次對(duì)企業(yè)人群開展亞健康狀態(tài)流行病學(xué)調(diào)查。 2深圳私營(yíng)企業(yè)總的亞健康狀態(tài)現(xiàn)患率為62.1％。其中男性亞健康狀態(tài)現(xiàn)患率為60.2％，女性為64.4％；年齡在20歲以下的人群亞健康狀態(tài)現(xiàn)患率為62.3％，年齡在20～30歲之間的人群為65.6％，年齡在30歲以上的人群為46.3％；工人亞健康狀態(tài)現(xiàn)患率為62.3％，行政人員為60.8％，其他職業(yè)人員為62.0％；學(xué)歷在高中及高中以下的人員亞健康狀態(tài)現(xiàn)患率為61.3％，學(xué)歷為中專的人員為66.9％，學(xué)歷為大專以上的人群為57.1％；未婚人員亞健康狀態(tài)現(xiàn)患率為64.4％，已婚人員為51.3％。 3深圳私營(yíng)企業(yè)亞健康狀態(tài)人群中出現(xiàn)頻率為60％以上的癥狀有：疲倦乏力、情緒低落；出現(xiàn)頻率為50％以上的癥狀有：容易感冒、時(shí)常嘆氣、怕熱、頭痛、急躁易怒、腰背酸痛、注意力差、健忘、動(dòng)則汗出、情緒不穩(wěn)、失眠、工作效率低下及食欲不振；出現(xiàn)頻率為40％以上的癥狀有：精神不振、孤獨(dú)感、咽干、心慌、空虛寂寞、焦慮、精神緊張、難以承擔(dān)相應(yīng)的社會(huì)角色、脫發(fā)、反應(yīng)遲鈍、人際關(guān)系緊張、交往頻率下降、惡風(fēng)怕冷、眼花、腿膝酸軟、逃避現(xiàn)實(shí)、手足麻木及苦悶等；另外痛經(jīng)、月經(jīng)量異常及白帶過多等多見于女性亞健康狀態(tài)。 4深圳私營(yíng)企業(yè)亞健康狀態(tài)的危險(xiǎn)因素為超時(shí)工作、遇到挫折或事故，保護(hù)因素為個(gè)人收入、安全感、體育鍛煉、生活環(huán)境。 5東莞外資企業(yè)亞健康狀態(tài)總的現(xiàn)患率為72.0％。其中男性亞健康狀態(tài)現(xiàn)患率為67.3％，女性為74.0％；年齡在20歲以下的人群亞健康狀態(tài)現(xiàn)患率為77.6％，年齡在20～30歲之間的人群為74.8％，年齡在30歲以上的人群為44.6％；工人亞健康狀態(tài)現(xiàn)患率為72.7％，行政人員為50.5％，其他職業(yè)人員為73.9％；學(xué)歷在高中及高中以下的人群亞健康狀態(tài)現(xiàn)患率為73.0％，學(xué)歷為中專的人群為70.1％，學(xué)歷為大專以上的人群為65.1％；未婚人員亞健康狀態(tài)現(xiàn)患率為75.4％，已婚人員為59.8％。 6東莞外資企業(yè)亞健康狀態(tài)人群中出現(xiàn)頻率為60％以上的癥狀為疲倦乏力；出現(xiàn)頻率為50％以上的癥狀有：情緒低落、怕熱、頭痛、頭暈、容易感冒、時(shí)常嘆氣、腰背酸痛；出現(xiàn)頻率為40％以上的癥狀有：失眠多夢(mèng)、動(dòng)則汗出、記憶力差、急躁易怒、食欲不振、注意力差、工作效率低下、情緒不穩(wěn)、脫發(fā)、心慌、精神不振、腿膝酸軟、咽干等；另外白帶過多、痛經(jīng)、月經(jīng)量多、經(jīng)期異常等多見于女性亞健康狀態(tài)。 7東莞外資企業(yè)亞健康狀態(tài)的危險(xiǎn)因素為超時(shí)工作、遇到挫折或事故，保護(hù)因素為體育鍛煉、生活環(huán)境、個(gè)人收入以及健康狀況。 8東莞外資企業(yè)人群亞健康狀態(tài)總的現(xiàn)患率、男性及女性現(xiàn)患率、工人現(xiàn)患率均高于深圳私營(yíng)企業(yè)。 結(jié)論 1深圳私營(yíng)企業(yè)與東莞外資企業(yè)人群亞健康狀態(tài)常見癥狀基本一致，現(xiàn)患率及影響因素不完全相同。 2企業(yè)人群亞健康狀態(tài)現(xiàn)患率較高，其高發(fā)人群為30歲以下的青年。 3企業(yè)人群亞健康狀態(tài)癥狀表現(xiàn)多樣，涉及到軀體、心理、社會(huì)三方面。 4企業(yè)人群的健康狀況不容樂觀，應(yīng)采取各種干預(yù)措施加以改善。
[Abstract]:Background of the study






In the mid - 1980s , Professor Buchmann of the former Soviet Union found that , in addition to the state of health and disease , there was a non - healthy , non - diseased , intermediate state , known as sub - health . A global survey of WHO showed that the real health was only 5 % , people with disease accounted for 20 % , and 75 % of the people were in sub - health . According to the literature analysis , China is in a sub - health state more than 700 million , making up 60 % -70 % of the country ' s total population . Subhealth has become one of today ' s health - threatening stealth killers and one of modern medical problems .






At present , there is no universally accepted definition and judgment of sub - health status , and domestic scholars have made a great deal of research and discussion . The concept of sub - health status is that sub - health is a state between health and disease . The concept is that sub - health is a state in which the human body is in a state of health and disease . It does not meet the clinical or sub - clinical diagnostic criteria of modern medical related diseases .






Epidemiology is a scientific research on the distribution of disease and health in the population and its influencing factors , and studies the strategies and measures to prevent and cure diseases and promote health . In recent years , domestic scholars have used epidemiological cross - sectional survey methods to study the sub - health status .






Purpose of study






This topic belongs to a sub - topic in the research of subhealth status series , and uses the method of epidemiological cross - sectional study to study the epidemiology of sub - health status in the enterprise population , and to explore the prevalence rate , clinical manifestation and related factors of sub - health status of the specific population . This not only fills up the blank of the epidemiological investigation of sub - health status in the enterprise population , and lays a foundation for further research and determination of intervention measures and treatment programmes in the future , and has great significance for improving the overall health level , working efficiency and quality of life of the population .






Research Methods






At the beginning of the project , the sub - health epidemiology investigation team of the South Hospital of South Medical University has carefully designed the various links in the investigation according to the method of cross - sectional epidemiological investigation . The detailed implementation steps of this study are formulated , including the determination of the study purpose , the determination of the study object and the research method , the development and evaluation of the sub - health status epidemiology questionnaire , the development and evaluation of the sub - health status epidemiology questionnaire , the interpretation of the data collection , the analysis and the results , the quality control of the epidemiological investigation , and the like .






The symptoms with frequency of more than 40 % are : insomnia , multi - dream , dynamic sweating , poor memory , irritability , inappetence , poor attention , low working efficiency , unstable mood , alopecia , palpitation , listlessness , soreness of the legs and knees , pharyngeal dryness and the like ;
Epidemiological study on sub - health status using modern scientific methods such as computer technology and mathematical statistics .






Results






1 The questionnaire of sub - health status epidemiology survey successfully applied and evaluated by field trial and validity , reliability and so on , which proves that the questionnaire can achieve the purpose of expected research ;
This questionnaire was used for the first time in China to carry out an epidemiological investigation on the sub - health status of the enterprise population .






The prevalence rate of sub - health status in Shenzhen private enterprises is 62.1 % . Among them , the prevalence rate of male sub - health status is 60.2 % and female is 64.4 % ;
Under the age of 20 , the prevalence rate of sub - health status was 62.3 % , the age between 20 and 30 years was 65.6 % , and the age was 46.3 % .
The prevalence rate of sub - health status in workers was 62.3 % , 60.8 % in administrative staff and 62.0 % for other professionals .
In high school and high school , the prevalence rate of sub - health status is 61.3 % , and the degree of education is 66.9 % in secondary school and 57.1 % for those with higher education .
The prevalence of sub - health status of unmarried people is 64.4 % , and the married person is 51.3 % .






3 . There were more than 60 % of the symptoms in the sub - health status population of Shenzhen private enterprise : fatigue fatigue and depression ;
The symptoms with frequency of more than 50 % are : easy cold , frequent sigh , fear of heat , headache , irritability , soreness of waist and back , poor attention , amnesia , sweating , unstable emotion , insomnia , low working efficiency and inappetence ;
The symptoms with frequency of more than 40 % are : psychosis , loneliness , pharynx dryness , palpitation , emptiness loneliness , anxiety and mental stress . It is difficult to assume corresponding social role , hair loss , response delay , interpersonal tension , decrease in communication frequency , aversion to cold , eye flower , soreness of legs and knees , escape from reality , numbness of hands and feet , etc .
In addition , menstrual abnormalities and excessive leucorrhea were found in women ' s sub - health status .






4 The risk factors of sub - health status of Shenzhen private enterprise are overtime work , setbacks or accidents , and the protection factors are personal income , security , physical exercise and living environment .






The prevalence rate of sub - health status in Dongguan enterprise was 72.0 % . The prevalence rate of male sub - health was 67.3 % and 74.0 % , respectively .
The prevalence rate of sub - health status of people under 20 years of age was 77.6 % , the age between 20 and 30 years was 74.8 % , and the age was 44.6 % .
The prevalence rate of sub - health status of workers was 72.7 % , administrative staff was 50.5 % , and other occupations were 73.9 % ;
The prevalence rate of sub - health status in high school and high school was 73.0 % , with a degree of 70.1 % in secondary school and 65.1 % for those with higher education .
The prevalence of sub - health status of unmarried people is 75.4 % , and the married person is 59.8 % .






The symptoms of more than 60 % frequency in the sub - health status population of Dongguan enterprise are fatigue and fatigue ;
Symptoms such as depression , fear of heat , headache , dizziness , common cold , frequent sigh , and soreness of the back and back are symptoms of more than 50 % of the symptoms .
After the epidemiological investigation steps are formulated and the sub - health status epidemiology questionnaire is developed , we use two enterprises as the research object ( one of which is Shenzhen Bao ' an area private enterprise and the other is Dongguan enterprise ) . According to the sub - health status epidemiology questionnaire developed in our research group , the epidemiological investigation is carried out according to the pre - established epidemiology investigation procedure to exclude people with disease and establish a sub - health status population database , the content includes age , gender , occupation , education , marriage , sub - health status symptoms and influencing factors ;
In addition , excessive leucorrhea , dysmenorrhea , excessive menstrual flow , abnormal menstrual period , and so on are found in women ' s sub - health status .






7 The risk factors of the sub - health status of the Dongguan enterprise are overtime work , setbacks or accidents , and the protection factors are physical exercise , living environment , personal income and health status .






The prevalence rate of sub - health status in Dongguan foreign - funded enterprises , the prevalence of male and female , and the prevalence of workers are higher than that of private enterprises in Shenzhen .






Conclusion






Shenzhen private enterprise is basically consistent with the common symptoms of sub - health status of Dongguan enterprise of foreign - funded enterprises , and the prevalence rate and influencing factors are not identical .






2 The prevalence rate of sub - health status of the enterprise population is high , and the high - haired people are young people under the age of 30 .






The symptoms of sub - health status of three enterprises are diverse , involving physical , psychological and social aspects .






4 . The health status of the enterprise population is not optimistic , and various intervention measures should be taken to improve .
【學(xué)位授予單位】：第一軍醫(yī)大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2007
【分類號(hào)】：R181.3

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