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Chapter 1: Model essay on the relationship between health and sub-health
[Key words] Shandong Modern Vocational College healthy athletic sports
Sub health refers to the critical state between "health and disease". It generally refers to a physiological state in which the body shows reduced vitality and adaptability to different degrees, although there is no clear disease. It is a new concept proposed by the medical community in recent years. Sub health is a dynamic state of change. If handled properly, the body can transform to health; Otherwise, you will get sick. At present, global sub-health is on the rise year by year, which has obviously threatened young people under 30 years old, especially among college students, a special group. As the main force of national sustainable development, college students are future talents and national wealth. Studying the sub-health status and causes of college students is of great significance to prevent and reduce the proportion of sub-health students, further improve the health level of college students, and thus cultivate more qualified talents for the country.
1. Research objects and methods
1.1 Research objects
320 students of grade 09, 10 and 11 from 6 non sports majors of Shandong Modern Vocational College were randomly selected as the survey objects.
1.2 Research methods
1.2.1 Literature method
Extensive access to research results related to sub-health, read psychology, sports psychology, sociology, sports sociology, social sports and other books. Browsed the network electronic information, basically mastered the latest relevant information and detailed basic data.
1.2.2 Questionnaire survey method
Using the method of layering, classification and random sampling, the trained investigators conducted a field survey. A total of 320 questionnaires were distributed, and 312 questionnaires were recovered, with a recovery rate of 97.5%, including 300 valid questionnaires, with an effective recovery rate of 96.15%.
1.2.3 Mathematical statistics
According to the purpose and requirements of the study, the relevant data obtained from the questionnaire were statistically processed and analyzed, and finally tabulated.
2. Results and Analysis
2.1 Analysis of sub health types of students in Shandong Modern Vocational College
The survey shows that 61% of students feel some learning pressure, and 63% of students often suffer from fatigue, drowsiness, poor sleep and even insomnia. The proportion of students with irregular daily diet and irregular living accounted for 68% and 62%, respectively. Specifically, 50% did not eat breakfast, 42% did not like to eat or eat according to their personal preferences, and 40% and 56% did "burn the midnight oil" and use the Internet overnight, respectively. It can be seen that the health condition of students in Shandong Modern Vocational College is not optimistic. More than 50% of contemporary college students are only children. The lack of sports, special family life experience, higher task requirements for improving self quality, the negative impact caused by relatively narrow education mode and bad lifestyle make a considerable number of members of this group in a sub-health state. In order to timely grasp the health trends of students in Shandong Modern Vocational College and study the sub-health problems of college students, the specific analysis of their sub-health types is as follows:
2.1.1 Somatic sub-health
Table 1 Physical sub-health survey of students in Shandong Modern Vocational College
Projects never, sometimes and often
Percentage of people Percentage of people Percentage of people
Poor physique and susceptibility to disease 23 7.7 207 69.0 70 23.3
Long term continuous fatigue 19 6.3 171 57.0 110 36.7
Unexplained fear, anxiety and uneasiness 58 19.3 169 56.3 73 24.4
Feeling anxious and lonely 45 15.0 165 55.0 90 30.0
Frequent insomnia and dreaminess 27 9.0 189 63.0 84 28.0
The physical sub-health of college students has dizziness, headache, dry eyes, chest tightness, shortness of breath, nervousness, fatigue, fatigue, fatigue, lack of breath, lazy speech, poor appetite, indigestion, etc. According to the survey, the situation of physical sub-health of students in Shandong Modern Vocational College is not optimistic. About 80% of students sometimes or often have physical sub-health problems. (See Table 1 for details)
2.1.2 Mental sub health
College students' mental sub-health has symptoms such as low spirits, low mood, depressed or irritable, nervous and anxious, poor sleep, memory loss, no interest and hobbies, etc. Psychological sub health is the sub health of college students healthy Another important performance. Among them, anxiety is the most common, mainly manifested as worry and panic. Worry and panic is a kind of inherent uneasiness. The main mental reaction is anxiety and depression. If it persists and cannot be self liberated and controlled, it will enter the stage of mental disorder and mental illness. In addition to anxiety, it also manifests itself as irritability, irritability, poor sleep and other manifestations. The survey results show that college students are under great pressure (see Table 2 for details), mainly due to the fierce social competition and increasingly complex interpersonal relationships on campus relationship Caused by.
Table 2 Investigation and Analysis of Psychological Pressure of Students in Shandong Modern Vocational College
Statistical item: high pressure, high pressure, no pressure
Number of people 93 174 33 300
Percentage 31 58 11 100
College students with social adaptability and sub-health can not well assume the corresponding social obligations and responsibilities, work and study are difficult, interpersonal relationships are strained, students, teachers and students are not harmonious, there is no intimate friends, and it is difficult to carry out normal social interpersonal communication. Through a random sampling survey of the psychological quality of students in Shandong Modern Vocational College, it is found that most students in Shandong Modern Vocational College believe that they can basically adapt to the needs of social environment and social development, and have a high evaluation of themselves and others (see Table 3 and Table 4 for details), which shows that the social adaptability of students in Shandong Modern Vocational College is good, which is gratifying.
Table 3 List of Self evaluation and Evaluation of Others of Shandong Modern Vocational College Students
Statistical items are high, high, generally poor, and poor
Self evaluation (%) 8 40 46 6 0
Evaluation of others (%) 2 56 36 2 4
Table 4 List of Social Environment Adaptation of Students in Shandong Modern Vocational College
The environment is well adapted, but generally not well adapted
Number of people 12 177 93 18 0 300
Percentage 4 59 31 6 0 100
2.1.4 Moral quality sub health
The main symptoms of college students with sub-health moral character are cognitive disorder, emotional disorder and behavioral disorder. Cognitive barriers mainly refer to psychological factors that are not conducive to moral development in the cognitive system of college students, including intellectual barriers and meaning barriers. People with intellectual disabilities often fall into a narrow circle of personal knowledge and experience, unable to comprehensively observe and analyze problems. They are often confused by superficial phenomena when thinking about problems, unable to grasp the essence of things through phenomena, and lack flexibility and logic in thinking. Meaning barrier refers to the psychological barrier caused by some internal psychological factors of college students that hinder their normal understanding of moral requirements. It is manifested by refusing the educator's education, forming a negative psychological pattern, and destroying the effect of any educational method. Emotional disorders are also common, easily emotional, and inappropriate passion. Behavioral disorders mainly refer to some abnormal bad habits, such as preferring leisure to work, coveting enjoyment, etc.
2.2 Causes of sub-health of college students
2.2.1 Season and climate: When the seasons change, people will feel uncomfortable. For example, in early spring, most people will feel tired. The change of weather can also lead to "sub health". If it rains for several consecutive days, you will feel depressed.
2.2.2 Interpersonal relationship: college students need more social interaction. It is easy to have feelings between classmates and fellow countrymen, but because of the age and experience of college students and the difference in personal feelings, conflicts often occur for a small matter, so students with poor psychological quality will feel depressed.
2.2.3 Learning pressure: because college students are admitted through the college entrance examination, their learning ability and academic performance are very close to each other, and their sense of superiority and superiority in middle school is gone. Once you do not work hard or other objective reasons cause you to fall behind with others in your academic performance, it will cause you great mental pressure.
2.2.4 Periodic low ebb period of human body: human emotions, mental agility, body responsiveness, and even intelligence are cyclical. When college students are at a low ebb, it is easy to enter the "sub-health" state.
2.3 Relationship between sub-health and sports
Scientific and effective sports can not only strengthen the body, cultivate the quality of perseverance and courage, good sports ethics, and the perseverance to overcome difficulties, but also stimulate the passion and ability of students, enhance self-confidence and self-esteem, increase social interaction, and improve social adaptability. Therefore, sports is the best means and method to prevent and eliminate college students' sub-health.
2.3.1 Sports can promote the development of self-consciousness
Sports can help college students understand themselves and educate themselves. Sports are mostly collective and competitive activities. Their ability, cultivation and charm will be clearly displayed, and they will have a more practical understanding of themselves. On the basis of self-awareness, students will consciously or unconsciously correct their own behavior, cultivate and improve the psychological quality and various abilities required by the society, increase opportunities for communication with others, enhance good sense of cooperation, and cultivate team spirit, so as to make themselves more suitable for social needs and society.
2.3.2 Sports can cultivate good will quality
Sports generally have the characteristics of hardship, fatigue, intense, tension, confrontation and strong competitiveness. Therefore, through sports, it is helpful to cultivate students' ideology of courage, perseverance, perseverance and overcoming difficulties, to cultivate their will qualities of calm, determination, modesty and prudence, and to maintain their positive and healthy mental state.
2.3.3 Sports are a driving force to promote psychological development
Compared with daily physical exercise, sports are different in content and form. Therefore, the original psychological level often cannot meet the needs of the learned sports. For example, sprinting requires fast reaction ability, good sense of distance and speed.
2.3.4 Sports can promote good mentality
A healthy mood will promote blood circulation, help the brain relax, thus promoting the formation of a good attitude, and gradually establish the spirit of contentment, helping others, and enjoying oneself, which is the most rare thing in a healthy life. The psychological changes in various situations during sports are a test for everyone. It is our college students' creed not to be conceited when winning or discouraged when losing. Good mental state is also a prerequisite for maintaining and improving our physical health.
3. Conclusions and countermeasures
3.1 Conclusion
3.1.1 "Sub healthy" people account for a high proportion of college students, which has a profound impact on students' physical, psychological and overall development, and should be given enough attention. However, the sub health types of students in Shandong Modern Vocational College are obviously different, and different methods should be taken to solve them.
3.1.2 The occurrence of "sub-health" phenomenon is closely related to factors such as the particularity of social environment and living environment, which leads to psychological disorder, bad habits, irregular diet and daily living, lack of persistent sports and low tide period in human biological cycle.
3.1.3 Sports can promote the improvement of students' self-consciousness, cultivate students' good will quality and good mentality, and promote students' physical and mental development to a healthy state.
3.2 Countermeasures
3.2.1 Strengthen health education and publicity, and establish the concept of "health first"
Strengthen publicity through various channels to make college students re understand health, understand various manifestations of "sub-health" status, and strengthen their awareness of guardianship.
3.2.2 Cultivate students' positive attitude towards life
Efforts should be made to create a campus cultural atmosphere suitable for the physical and mental characteristics of college students, so that college students can actively change their original bad lifestyle. They should study hard in a good campus environment, actively make progress, and prevent and eliminate sub-health.
3.2.3 Cultivate students' awareness of sports
Physical education is the best means to prevent and eliminate "sub-health". Regular physical education can exercise people's consciousness, cultivate sports behavior habits and sports concepts, and truly make sports a way of life for college students.
reference:
[1] Wang Yuxue. Sub health: a new concept of health in the 21st century [M]. Nanchang: Jiangxi Science and Technology Press, January 5, 2002
[2] Hong Jiayun Analysis and countermeasures of the current situation of "sub health" of college students in Hainan Province [J]. Journal of Physical Education, 2003 (5): 50-51
[3] Liu Xueyong. Investigation and Countermeasure Research on Sub health Status of College Students in Hunan Province [J]. Journal of Wuhan Institute of Physical Education, 2004, 12
Chapter 2: Model article on the relationship between health and sub-health
[Key words] Current situation and trend of sub-health industry
With the improvement of social economy, science and technology, and people's living standards, and the deepening of human understanding of the connotation of health, the modern concept of health has not only limited to the standard of health measurement, but also requires the understanding and understanding of health from the perspective of overall health (body, psychology, social adaptation and morality, etc.). Only in this way can people enjoy real health.
According to the health status of human body, people can generally be divided into healthy people, sick people, people in the process of transforming health into disease and people in the process of transforming disease into health. Professor Buchman, an expert from the former Soviet Union, proposed that the human body is neither healthy nor the intermediate state of illness, which can be called the third state or sub-health state. The people in the process of health to disease transformation and disease to health transformation and rehabilitation belong to the sub-health state. The survey of the World Health Organization shows that only 5% of the people are truly healthy, less than 20% are diagnosed with diseases, and more than 75% of the rest are in sub-health. Now, sub-health has been considered as the "No. 1 enemy" of human health by the medical community. In the 21st century, human health and medical work will implement preventive health strategies, with the focus on the prevention and treatment of sub-health. With the deepening of research on sub-health, human lifestyle and social medical system are undergoing tremendous changes, and sub-health industry has emerged as the times require and has great potential.
1、 Significance of the existence of sub-health industry
1. Scientific and technological progress is the realistic foundation for the birth of sub-health industry
In the medical field, not only the traditional basic disciplines have made significant progress, such as physiology, anatomy, cytology and microbiology have all entered the molecular level. Molecular biology and genetic engineering have been able to describe the map of human genes. Scientists have explored the mystery of life, birth, aging, disease and death from the genetic material. Moreover, with the development of the new medical model, relevant applied disciplines and products will continue to emerge and develop. The development of basic science and applied science has created a foundation for the birth of the sub-health industry, and the new medical model has given the sub-health industry a clear position in the entire medical industry system.
2. Human's pursuit of longevity is the internal driving force for the development of sub-health industry
Under the traditional medical model and medical system, medicine does not care about the desire of human longevity. Although medicine has successfully extended the average life span of human beings, it has always focused on "diseases", and in the new medical model, it will not only focus on human longevity aspirations, but also on the quality of human life. The new medical system will play an important role in the health industry. Subhealth treatment is to prevent and treat modern diseases before they occur or at the beginning. This medical model leads to the ultimate result of reducing or delaying chronic diseases, improving the quality of life, and prolonging life. This is the most important value point of the concept of sub-health and the strategic direction and significance of the development of the sub-health industry. No wealth, no power, no happiness is more important than life. In the strong desire of human beings to prolong life, the sub-health industry is not only born out of luck, but also develops rapidly.
3. Economic development and conceptual progress are important conditions for the growth of sub-health industry
Only people in economically developed countries and regions will pursue a higher quality of life and the prevention and treatment of sub-health. From this perspective, economic conditions determine demand and determine the success or failure of the sub-health industry. Compared with the developed countries in the world, China's economic development level is still very low, especially the level of medical and health expenditure. In China's high-income class, most people have high cultural literacy. Through the guidance of ideas, an absolute large number will soon be formed, and the effective service demand for the sub-health industry will provide a potential market for the emergence and development of the sub-health industry in China.
The population in sub-health state is the decisive factor of national macro health state, and its change determines the scale of healthy population and disease population. Only by effectively controlling the population in the sub-health state can we reduce the proportion of sick people and increase the proportion of healthy people, reduce the load of the medical system, ease the growing contradiction between medical supply and demand, improve the health quality of individual citizens, and thus improve the health quality of the whole nation.
2、 Current situation and existing problems of sub health industry in China
1. Development status of sub-health industry
At present, the sub-health industry has begun to emerge in China. Exploratory sub-health enterprises are mainly concentrated in cities with high per capita GDP and developed culture and education. On the one hand, because in economically developed areas, with people's increasing attention to their own health, there have been consumer groups; On the other hand, in these economically developed areas, the number of people with sub-health status is also increasing due to the increasing pressure from work and life. According to the survey on the sub-health rate of 16 cities with a population of one million in China, the highest sub-health rate is 75.31% in Beijing, 73.49% in Shanghai and 73.41% in Guangdong. People are more and more aware of the importance of sub-health prevention for health. Experts pointed out that entering the field of sub-health industry at this time, due to insufficient demand for effective consumption, there are certain risks for investors, but the competition is relatively not fierce, and the industry prospect is promising. If there is a correct business strategy, there should be a good return on investment.
A report from the organizing committee of the China Sub health Symposium pointed out that China's health problems are transforming, and a large number of chronic diseases are replacing infectious diseases as the main cause of death. The health problem of Chinese people in the transition period is serious. At the same time, the economic loss caused by diseases is up to more than 1.4 trillion yuan every year, which is equivalent to more than 14% of China's GDP every year. The authoritative survey of the Chinese Academy of Sciences shows that the average life span of intellectuals in China is only 58 years, which is about 10 years lower than the national average life span, and the phenomenon of early death of this class is increasing. Among people aged 25-59, the mortality rate of women is 10.4%, and that of men is 16.5%, which shows how serious their sub-health is. Experts warn that if sub-health cannot be effectively curbed, it will cause a heavier burden to the country and society.
At present, our country has only established a medical response system for people after the occurrence of individual diseases and a national fitness system that is not very scientific, has general effect and is not very popular. The health care and intervention for the sub-health population has basically not formed a system and scale. 80% of China's human health assets serve patients who account for 20% of the total population, while health services for healthy and sub-health people who account for 80% of the total population are in the embryonic stage from market development to industrial construction. There are few institutions that can systematically and comprehensively provide sub-health services, which are still in the initial stage, including health examination centers with physical examination as the core Leisure and vacation centers with leisure and entertainment as the core and sub health service institutions with TCM health conditioning as the core cannot meet people's demand for systematic solutions to sub health problems.
2. Problems in the development of sub-health industry
(1) The theoretical framework of sub-health has not been formed and lacks systematic and authoritative theoretical support. Since sub-health status is a dynamic process between health and disease, and its clinical symptoms are diverse, there is no unified standard for the evaluation of sub-health status at present, so how to evaluate and intervene sub-health status has become an urgent problem. Although in 2006 and 2007, the 863 Program of the Ministry of Science and Technology of the People's Republic of China (MOST) took the research on the theory and practice of sub-health as a key research project for two consecutive years, most of the project undertakers started from the theory of traditional Chinese medicine, and lack of biological theory research on sub-health. There is basically no national standard for sub-health assessment, identification and management, which results in confusion in the concept and publicity of sub-health consumption.
(2) The sub health service lacks technical equipment, means and talents, and the sub health service lacks systematic and humanistic operation. At present, the majority of domestic technical equipment for sub-health population is sub-health status detection equipment, but there are problems such as simple equipment and poor reproducibility of test results. The means of sub-health intervention and the lack of high-level service personnel are basically massage, acupuncture and other means based on the theory of traditional Chinese medicine. The above reasons lead to the lack of systematic and targeted sub-health services, leading to the lack of personalized services.
(3) Sub health business reputation is low, and there is no authoritative industry association or society to regulate sub health service institutions. Sub health industry is popular, but the market is chaotic. At present, many organizations and institutions, such as physical examination centers, fitness clubs, medical guidance institutions, health care product distributors, leisure and entertainment centers, all claim to be engaged in sub-health industry. This shows that the current domestic sub-health market is booming, but there is disorder, lack of authoritative industry associations or academic standards, and brand enterprises and product services have not yet been established.
(4) There is no unified standard and specification for sub-health information data management
With the rapid development of information technology, sub health information data management can collect the information of service objects through the information system, and conduct quantitative assessment on the sub health status of individuals and the risk of future illness or death, so as to encourage and help people to correct unhealthy behaviors and reduce risks. However, at present, the management and exchange of sub-health information data lack unified standards and norms, resulting in the lack of continuity and availability of personal information.
(5) It has not formed a good cooperative relationship with the insurance industry. Health insurance is a major aspect of the sub-health industry abroad. From the perspective of the business objectives of health insurance, it can meet the needs of customers for sub-health services by providing professional and personalized sub-health services; By implementing specialized sub-health diagnosis and treatment, the insurance company can reduce the compensation rate of diseases and expand the profit space.
3、 Development trend of China's sub-health industry
1. Closely integrate with community health services to build a sub health service platform
Sub health service targets not only sub healthy people, but also healthy people and patients. The experience of countries shows that more than 80% of diseases can be effectively prevented and treated in communities. For diseases that cannot be solved in the community, use the referral system to transfer patients to the designated hospital for treatment, and then return to the community for rehabilitation treatment after being cured. Therefore, the community should not only become a health education center and chronic disease prevention and treatment center, but also a platform for sub-health services. At present, China's sub-health industry is still in its infancy, and there are many deficiencies in the construction of community health services. The combination of the two will promote each other.
2. The content, scope and target of sub-health management services should be diversified and systematic
At present, China's sub-health industry mainly focuses on health examination service, which is a kind of service of "finding health problems, but not fully solving health problems", and most of the services are one-time and discontinuous, which has lagged behind the market demand. In addition, there are many problems in the medical examination industry, such as low entry threshold for service institutions, excess volume, uneven service quality, and so on. It has already faced a situation of declining demand, increasing bad competition, and some institutions are difficult to sustain. Therefore, sub-health service institutions must introduce correct management concepts, realize service upgrading, increase service content, expand service scope and attract more service objects. For example, increase physical fitness assessment, nutrition intervention, psychological counseling and other services.
3. Concurrently engaged in health insurance business
It is possible for the sub-health industry to concurrently operate health insurance business, and there are already examples to learn. The most typical representative, the American Health Maintenance Organization (HMO), provides health and disease management services for 8 million people in 17 states, including systematic sub-health insurance business. In addition, from the perspective of the development process of the international sub-health industry, the insurance industry is bound to enter the sub-health field for its own business safety and interests. While participating in the investment and operation of health management services, it will become one of the payment methods for insurance customers' personal non-medical health consumption. On the other hand, the concurrent operation of health insurance business also plays an important role in the sub-health industry itself, which will solve the "bottleneck" problem of sub-health service consumption payment and promote the rapid development of the sub-health management service industry.
4. Develop information and communication technology to realize interaction and win-win
The most obvious difference between the sub-health management service and other services is that it relies heavily on modern information and communication technology. It can even be said that without modern information and communication technology as its basic operation support platform, it is impossible to achieve market-oriented and large-scale sub-health management. Therefore, the emergence of sub health management will open up a new development direction and huge market space for the development of information and communication technology. At the same time, the progress of information and communication technology will also directly affect the service mode, service quality, service efficiency, service cost and service scale of sub-health management. With the establishment of national standards related to sub-health, sub-health data resources will become the most important core resources and shared resources of the country. It will promote the coordinated development of the sub-health industry, and guide the sub-health industry to operate in the direction of intensive management, decentralized operation, personal services, industrial integration, and standardized development.
4、 Prospects for China's sub-health industry
The World Health Organization (WHO) proposed to implement the "preventive health strategy", and to investigate and analyze the prevention and treatment of sub-health from the new medical model is a very complex system engineering. Therefore, the sub-health industry generated around the sub-health prevention and control work will also involve many fields: in education, there are health promotion, health promotion, health education, health manager training, etc; In terms of basic research, there are sub health theoretical research, bioengineering, and life science; Sub health diagnosis and treatment, TCM diagnosis and treatment of sub health research, ecological environment and sub health, social civilization and sub health, lifestyle and sub health; In the food industry, there are nutritional supplements, anti-aging and longevity foods, etc; In agriculture, there are pollution-free food, healthy food, green food, etc; In the pharmaceutical industry, there are chemical drugs, plant drugs, biological products, gene interference drugs, etc. to prevent and treat various sub-health conditions; In the leisure industry, there are sub health tourism, sports and fitness, health catering, etc; In the media industry, there are sub health websites, online consulting, books and magazines, audio and video products, etc; In the medical industry, there are sub health hospitals, sub health examination centers, sub health treatment centers, etc; In terms of equipment manufacturing, there are sub-health detection equipment, treatment equipment, household sub-health treatment equipment, etc.
In short, with the deepening and standardization of sub-health services in China, the implementation of sub-health intervention will be the main direction of the application of sub-health industry. As a new thing, sub health industry will have broad prospects for development.
reference:
[1] Ma Libin, Ma Aixia: Discussion on the Development of China's Health Management Industry [J]. Shanghai Pharmaceutical, 2007 (28) 1:12~15
[2] Zheng Lingqiao: Investing in the prevention and treatment of chronic diseases brings amazing benefits [N]. Health News, 2006
[3] Chen Yonghua: The investment prospect of sub-health industry is promising [J]. Medical and health care appliances, 2006
[4] Yu Yan: Look at both sides of a double-edged sword - unlimited business opportunities in the sub-health industry [J] Health Vision, 2007 (9): 93~95
Chapter 3: Model essay on the relationship between health and sub-health
Key words: TCM constitution; sub-health; Vocational college students
Sub health refers to a low quality state of health between health and disease. Higher vocational college students are faced with huge learning pressure and employment pressure after enrollment, and are prone to sub-health, which has a lot of negative effects on their study and life. If they do not deal with these problems in time, they will easily develop into diseases. TCM constitution is an objective life phenomenon, which is an inherent and relatively stable individual trait. There is a certain relationship between TCM constitution and sub-health. Therefore, the study of the relationship between the sub-health of vocational college students and the constitution of traditional Chinese medicine can provide a basis for scientific and reasonable intervention measures to improve the health level of students in the future.
1 Data and methods
1.1 Subjects: Baoshan College of Traditional Chinese Medicine, 1-2 grade junior college students, distributed 1256 test papers, 1215 valid test papers, and the response rate was 96.7%, including 390 male students, accounting for 32.1% of the total number; 825 women (67.9%).
1.2 Research methods
1.2.1 The sub health questionnaire is designed by referring to the Clinical Guide of Chinese Medicine for Sub health [1] and combining the physical and mental characteristics of college students. The content includes current medical history, physical symptoms, energy status, psychological status, and social environment.
1.2.2 Judgment standard of TCM constitution type: referring to the classification and judgment standard of TCM constitution of the Chinese Society of Traditional Chinese Medicine in 2009 [2], it can be divided into nine constitution types, namely, peaceful constitution, qi deficiency constitution, yang deficiency constitution, yin deficiency constitution, blood stasis constitution, phlegm dampness constitution, damp heat constitution, qi stagnation constitution, and characteristic constitution.
1.2.3 Statistical method All data were statistically processed by SPSS16.0 statistical software. Chi square test and correspondence analysis were used for counting data. The distribution of TCM constitution was statistically analyzed by frequency descriptive statistical analysis.
2 Results
2.1 The survey results show that the sub-health status of students: 497 are healthy, accounting for 40.9%; 718 people were sub healthy, accounting for 59.1%. Comparison of students with different health conditions: 385 healthy students, 77.5% of whom are of moderate quality, and 112 students, 22.5% of whom are of biased constitution; There were 82 people with moderate constitution, accounting for 11.4%, and 636 people with biased constitution, accounting for 88.6%. Chi square test showed that there was a significant difference in the distribution of bias quality between healthy students and sub healthy students (P
Table 1 Sub health status and biased qualitative distribution [n (%)]
2.2 Physique distribution of sub-health students: there are many physique types of male students, such as damp heat, phlegm and dampness, and qi deficiency; Female students have more yang deficiency, qi depression and qi deficiency. According to statistical analysis, the difference in constitution type distribution composition ratio between male and female students was statistically significant (P
Table 2 Physique distribution of sub-health students [n (%)]
3 Discussion
This study found that the incidence of sub-health among vocational and technical college students in our school was 59.1%, higher than the investigation result of the Ministry of Education on the prevalence of sub-health among college students (40%) [3], which may be related to medical specialty. Medical students face much more learning pressure and employment pressure than students of other majors, so students will be affected to a great extent both physically and psychologically, resulting in a sub-health state.
This study also found that there is a close relationship between TCM constitution and sub-health. The research results show that the proportion of biased physique in sub-health students is significantly higher than that in healthy students, indicating that there is an inseparable relationship between the change of physique and health, and the formation of biased physique plays an important role in the occurrence and development of sub-health. This fully shows that adjusting the state of physique, transforming biased physique into peaceful physique, may transform sub-health state into healthy state, thus reducing the probability of students' illness and improving their health level.
In addition, the survey results show that there are differences in the distribution of physique types between boys and girls among sub-health students, which may be related to the different physiological functions and psychological states of different sexes, as well as the different living habits and eating habits. The male students are mainly characterized by damp heat, phlegm dampness and qi deficiency, which may be related to the special geographical environment and climate characteristics of southwest China. In addition, age, diet preference, drinking and sports are also important influencing factors; The female students are mainly characterized by yang deficiency, qi depression and qi deficiency, which may be related to the environmental climate, lack of exercise, preference for cold drinks and emotional uncontrollability. These hints suggest that we can not generalize about the measures to intervene in physique, but should distinguish individual differences. Because the physical types of individuals are different, their sub-health performance is different, and the diseases formed in the future are also different, so we should give full play to the advantages of TCM syndrome differentiation, identify the physique of different students, and give targeted adjustment programs to achieve the goal of transforming biased physique into peaceful physique, and improve the overall health level of students.
reference:
[1] Zhu Rong Interpretation of Clinical Guidelines of Chinese Medicine for Subhealth [J]. Modern Distance Education of Chinese Medicine, 2009, 7 (2): 5-6
Chapter 4: Model article on the relationship between health and sub-health
1.1 General information
A random method was used to select 236 nurses from 8 hospitals at the grass-roots level in a district of Guangzhou. No age limit, female.
1.2 Survey method
The self-designed questionnaire (basic information+basic knowledge of sub-health+how to deal with sub-health) was used to distribute questionnaires to nursing staff, and after the investigators explained the questions and filling requirements in the questionnaire face to face, the respondents completed the questionnaire independently and took it back on the spot. Among the 300 proposed investigators, 290 were actually investigated, 290 questionnaires were issued, 260 were actually returned, and 236 were valid.
1.3 Evaluation criteria
In this study, nurses' cognition of sub-health was divided into three levels: "only heard of" was defined as having heard of sub-health, but the definition was vague, and how to deal with sub-health problems was unclear or poorly understood; "Preliminary understanding" is defined as knowing the definition of sub-health, having a preliminary understanding of the concept of sub-health and coping methods, but only a rough understanding, not comprehensive; "In depth understanding" is defined as a clear definition of sub-health, understanding that sub-health includes a low-quality state of health in three aspects of physiology, psychology and social adaptation, and being able to skillfully master the coping methods of patients with sub-health.
2 Results
Among 236 nursing staff, 17 had only heard of sub-health, accounting for 7.21%; 196 people had preliminary knowledge, accounting for 83.05%; 23 (9.75%) had a deep understanding of sub-health.
3 Discussion
The survey shows that the majority of nurses have a preliminary understanding of sub-health, accounting for 83.05%, while only 9.75% have a deep understanding of sub-health, and 7.21% of nurses have only heard of sub-health. There are many reasons for this phenomenon. ① It may be that the nursing staff did not seriously participate in continuing education and study after taking part in work, and did not keep pace with the pace of medical development; ② There are still quite a few older nurses in the township level basic level hospitals who have no professional nursing education, or who later participate in adult nursing learning, with insufficient learning intensity. ③ It is related to the relatively poor foundation of township level basic hospitals and the lack of serious continuing education. The cognition of nursing staff on sub-health is generally poor. It is suggested that health departments can take corresponding measures to improve the cognition of nursing staff on sub-health and health, so as to improve the health knowledge of nursing staff to promote health education of nursing staff. The author believes that the following measures can be taken: ① Regularly carry out health knowledge lectures: carry out some health knowledge of daily life to benefit the health of nursing staff more. Giving lectures can not only increase the health knowledge reserve of nursing staff, but also alert nursing staff to improve their health awareness first. ② To improve the basic knowledge of sub health of nurses in basic level hospitals. At present, there is a lot of education related to sub-health knowledge in the education of major nursing colleges in China, but nurses have less opportunities to participate in training on sub-health after work. Therefore, in order to improve the level of sub health knowledge of nurses in basic level hospitals as soon as possible, nursing societies at all levels should provide systematic sub health knowledge education courses for nurses in basic level hospitals, and the hospital nursing department should encourage nurses to participate in various forms of targeted academic lectures on sub health, so as to promote nurses to master sub health knowledge and management skills, In addition, compulsory or optional sub health courses were added for nursing students. ③ Nurses should actively participate in the sub-health management of patients. Most nurses believe that it is the responsibility of doctors to assess and diagnose patients' sub-health. Sub health management is a process of continuous quality improvement, which requires multidisciplinary cooperation. In clinical work, nurses have a lot of opportunities to contact patients. Nurses can timely find patients' sub-health in other aspects except the current symptoms. However, to give full play to the role of nurses in sub-health treatment, only by providing them with more opportunities to participate in "sub-health" learning, can they improve their knowledge of sub-health and better carry out health education for the masses. ④ To standardize the management and treatment practice of sub-health patients. To develop standardized, standardized and systematic work guidelines for sub-health practice, in order to improve nurses' ability to assess sub-health patients, establish a sub-health supervision and evaluation system, and strengthen the supervision and guidance of sub-health. Efforts should be made to train sub health specialist nurses, promote the development of sub health specialist, improve the level of sub health management, and effectively improve the quality of life of sub health patients. The survey on the cognition of sub-health among nurses in basic level hospitals shows that most nurses lack in-depth understanding of sub-health related knowledge, and the health education carried out in the daily holistic nursing work lacks substantive effect. They only stay in the preliminary understanding of sub-health knowledge, and cannot accurately and timely carry out sub-health education for sub-health patients.
4 Conclusion
Chapter 5: Model article on the relationship between health and sub-health
[Key words] Sub health; Influencing factors; Medical staff; Logistic regression analysis
[CLC No.] R19
[Document identification code] A
In today's era of rapid economic development and increasingly fierce competition, the pace of people's life and work is accelerating, and the factors affecting health have also undergone tremendous changes. Sub health refers to the intermediate state between health and disease. No disease is found through systematic inspection by medical institutions, and patients themselves feel various physical and psychological discomfort. Medical staff are the direct providers of medical services, and sub-health and illness status will seriously affect their work efficiency and service quality. If health problems of medical staff are found early, intervention measures can be taken as soon as possible to regulate and improve them, so as to prevent them from affecting the quality of work and life due to continued overdraft of health. The purpose of this study is to explore the influencing factors of sub-health status of medical personnel, and provide theoretical basis for comprehensive intervention methods to improve the health status of medical personnel.
1. Objects and Methods
1.1 From December 29, 2011 to January 21, 2012, the research subjects conducted a questionnaire survey on the in-service employees of Beijing Xuanwu Hospital who participated in the 2012 annual physical examination. The age of the in-service employees who received the physical examination this time was ≥ 40 years old. In 2012, the number of people in physical examination was 914, and 797 valid questionnaires were collected in this survey, with an effective response rate of 87.20%.
1.2 Research tools and methods
1.2.1 Suboptimal health status questionnaire (SHSQ-25)
SHSQ-25 was developed by our research group and has good reliability and validity, including five dimensions and 25 items of fatigue symptoms, cardiovascular symptoms, gastrointestinal symptoms, immune symptoms and mental symptoms. The subjects were asked about the frequency of each uncomfortable symptom in the last three months, and a 5-level scoring method was used. Firstly, according to the medical history and physical examination results, the research subjects suffering from hypertension, diabetes, coronary heart disease, metabolic syndrome, chronic kidney disease, chronic liver disease, blood disease, tuberculosis, respiratory system disease, digestive system disease, endocrine system disease, cerebrovascular disease, tumor and other chronic diseases were classified into the disease group (447 persons) by the deputy chief physician and above professionals; The remaining subjects, if the total score of the questionnaire is ≥ 35, are classified as sub health group (114 persons), with the total score
1.2.2 Copenhagen psychosocial questionnaire (COPSOQ) COPSOQ was prepared by Kristensen, etc. This study uses a total of 34 questions related to job stress in COPSOQ (short version), which is divided into five first-order factors: job requirements, personal influence and development, interpersonal relationship and leadership, job instability and job satisfaction. The higher the score of job requirements and job instability, the more likely occupational stress will occur, which is classified as a second-order factor "negative factor"; The higher the score of the other three factors, the less likely occupational stress will occur, and they are classified as the second order factor "positive factor". The factor score is calculated according to the standardized regression coefficient in the second-order factor model.
1.2.3 The Chinese version of the Family Stress Scale (FSS) was introduced by Xu Liying. It mainly reflects family stress from the aspects of relationship with family members, housework burden, family economic burden, and family responsibility, and has good reliability and validity. There are five items in total. The higher the score, the greater the life stress.
1.2.4 The simplified coping style question naire (SCSQ) SCSQ was prepared by Xie Yaning and used to evaluate the coping style of research subjects. It has good reliability and validity. There are 20 items in total, which are divided into two dimensions: positive coping style and negative coping style. The factor score is the average score of factor items.
1.2.5 Perceived social support scale, PSSS (PSSS) was prepared by Zimet et al., and revised into Chinese by Jiang Qianjin et al., to assess the degree of support of various social support sources perceived by individuals, with good reliability and validity. There are 12 items in total, which are divided into three scores: internal support, external support and social support. The factor score is the total score of factor items, and the higher the score, the higher the degree of social support.
1.3 Statistical methods: EpiData 3.1 software was used for double entry, IBM SPSS Amos v20.0 software was used to establish the second-order factor model and standard regression coefficient, and IBM SPSS Statistical v20.0 software was used for other statistical tests. The single factor analysis of different demographic characteristics and health status uses R × C contingency table X2 test (the test level is α=0.05), and the relationship between work stress, life stress, coping style and social support and different health status uses ANOVA, rank sum test (the test level is α=0.05), The influencing factors of sub-health status were analyzed by disordered multi classification Logistie stepwise regression analysis (stepwise forward method, sls=sle=0.05).
2. Results
2.1 The relationship between demographic characteristics and different health status There were statistically significant differences in the distribution of health status among people of different ages, genders, educational levels, job categories, physical exercise and smoking status (P
2.2 The relationship between work stress, life stress, coping style and social support and different health states There was a statistically significant difference in the scores of positive factors and negative factors in COPSOQ among people in different health states (P
2.3 The multi classification Logistie regression analysis of the influencing factors of sub-health status is to screen out the influencing factors of sub-health, with health status as the dependent variable (divided into health 1, sub-health 2 and illness 3), age, gender, education level, job category, physical exercise, smoking, COPSOQ first positive second order factor, COPSOQ first negative second order factor FSS life stress and SCSQ negative coping were taken as independent variables, and disorder multi classification Logistie stepwise regression analysis was conducted. The results show that gender, education level, COPSOQ negative second-order factor and FSS life stress are the main influencing factors of sub-health (see Table 3).
3. Discussion
The number of people in sub-health state is increasing year by year in many countries and regions, especially in countries and regions with developed economy and fierce social competition. It has become one of the hot spots in medical research. However, medical personnel need a high degree of concentration, careful thinking, good patience and a high sense of responsibility. They work long hours and are labor-intensive. They often suffer more pressure in physical strength and energy than other occupational groups. The results of this study show that the prevalence rate of chronic diseases among medical staff aged 40 years and above is as high as 56.09%, and the sub-health rate is 14.30%. The sub-health detection rate of medical staff aged 40 to 45 years is the highest (20.00%), which is consistent with the existing research.
Chapter 6: Model article on the relationship between health and sub-health
[Key words] Sub health status; Traditional Chinese medicine; Syndrome differentiation and treatment
current research on sub-health status for tcm syndrome differentiation
yan zhe-lin，liu tong-hua.beijing university of chinese traditional medicine，beijing 100029，china
[abstract] world health organization (who) made the definition of sub-health status as no organic lesion with some functional changes of the patient.modern traditional chinese medicine believes that sub-health is the critical state of both physical and pathological constitution.the syndrome differentiation method in traditional chinese medicine is an effective manner to intervene the sub-h ealth status.this review focuses on sub-health research progress combined with its clinical features.
[key words] sub-health status; traditional chinese medicine;syndrome differentiation
The World Health Organization calls the state in which there is no organic disease but some functional changes in the body "the third state", and China calls it "the sub-health state". Although there is no clear disease, this unhealthy condition is unstable, in which there is a great possibility of latent development into some pathological damage, which can be transformed into disease under certain conditions. Therefore, sub-health can be regarded as the precursor of a series of organic diseases, such as arteriosclerosis, cardiovascular and cerebrovascular diseases, hypertension, hyperlipidemia, diabetes, and cancer. However, if reasonable intervention is given in time, the body can return to a healthy state.
The main symptoms of sub-health state are fatigue, sleep disorders and mental disorders. The most basic reason for these symptoms is emotional imbalance and excessive psychological pressure, which exceeds the ability of the body to regulate. According to the sampling survey results in China, the sub-health population accounts for about 60% of the total population in China, of which more than 80% are aged 20-40 [1].
Modern Chinese medicine believes that sub-health is in the critical state of physical constitution and pathological constitution. Physiologically, the individual constitution has relative stability after formation. Although the double clip constitution contains the characteristics of pathological changes, the phenomenon of double clip constitution is not a pathological process after all, and can only be regarded as a sub-health state between health and disease at most. It can be seen that there is a close relationship between sub-health and physique. For example, those with deficiency of spleen qi in plain body have obvious symptoms of fatigue and fatigue, poor appetite and loose stools; However, those with excessive liver yang of vegetarian body are obviously irritable. The theory of traditional Chinese medicine believes that the sub-health state should be "prevented before it happens". Sun Simiao, a great medical expert in the Tang Dynasty, divided the disease into three levels: "not ill", "desire for disease" and "already ill", and put forward the idea of "the disease that is not ill in medical practice". TCM has three levels of "preventing disease", one is "preventing disease before disease", the other is "preventing disease from changing", and the third is "preventing disease before recovery", which respectively refers to "preventing disease when there is no disease", "preventing disease from further development and deterioration", and "taking appropriate measures to prevent recurrence after improvement or recovery" [2].
1. Syndrome distribution of sub-health population
1.1 Literature analysis The application of TCM treatment based on syndrome differentiation is an effective way to intervene in sub-health. In recent years, scholars have made fuzzy cluster analysis on the results of sub-health status. The sub-health group mainly belongs to the three major categories of depression syndrome, phlegm dampness syndrome and deficiency syndrome as mentioned in Chinese medicine. It can be seen from this that, in terms of the sub-health status of pathological constitution, it can be divided into: spleen, heart, lung, liver qi deficiency type, liver stagnation type, blood stasis type, phlegm dampness type, internal heat (excess heat and deficiency heat) type, spleen kidney yang deficiency type [3].
Modern research shows that sub-health is mostly caused by patients with physical and mental diseases, that is to say, emotional injury in traditional Chinese medicine. Continuous emotional anxiety, anger, depression, etc., will certainly cause a series of changes in the body's sympathetic nerve, autonomic nerve, endocrine and immune system, and then develop into a sub-health state. The sub-health state of people with such constitution mostly belongs to depression syndrome. The depression syndrome in sub-health is mostly caused by emotional distress and stagnation of qi. However, whether emotional factors lead to depression is closely related to the intensity and duration of mental stimulation as well as the condition of the body itself. The "weakness of visceral qi" in the body is the internal factor of depression syndrome. In the early stage of depression syndrome, qi stagnation is the main disease, often accompanied by blood stasis, fire, phlegm and food stagnation. If it does not heal after a long time, the pathological changes of deficiency of heart, liver, spleen and kidney will be formed according to the difference of the affected viscera and the loss of qi, blood, yin and yang. The clinical manifestations are diverse, and the repeated illness is closely related to emotional factors [4].
The causes of deficiency syndrome type in sub-health are complex: physiologically, congenital weakness or natural aging with age all show the decline of viscera function, deficiency of vital qi inside, weakness of defence outside, and reduction of body immunity and disease resistance; In terms of lifestyle, improper diet, abnormal living, overwork, emotional internal injury, and appetite are all important reasons for deficiency syndrome; Others can also be seen in the recovery stage of the later stage of the disease. The sub health deficiency syndrome formed by different causes acting on different constitutions, although the patient's main complaints are complex and diverse, its pathogenesis nature and transmission trend are nothing more than the deficiency of yin, yang, qi and blood.
It needs to be emphasized here that although the sub-health deficiency syndrome may originate from only one viscera, due to the close relationship between yin and yang, the same origin of qi and blood, and the restraint of the growth of viscera, they affect each other. If the sub-health state is not adjusted in time, it often evolves into the deficiency of multiple viscera, yin and yang, and qi and blood, and the clinical manifestations of the function of each viscera can be significantly reduced [5].
Phlegm dampness type in sub-health is mostly caused by exogenous cold dampness, improper diet, weak yang and other reasons, especially spleen yang dysfunction is the key to the disease. Qi deficiency cannot promote blood circulation. Hemorheology shows blood stasis and phlegm like changes of concentration, viscosity, coagulation and stagnation. Phlegm turbidity and blood stasis are pathological products of the body and pathogenic factors. The low function of zang fu organs and the accumulation of pathological products interact to accelerate the aging or disease process. If the phlegm obstructed sub-health patients are not controlled, they are likely to have cardiovascular diseases such as hypertension, coronary heart disease, stroke, obesity, diabetes and other metabolic disorders [6]. After a comprehensive review of various types of sub-health patients, the syndrome elements are arranged in the following order according to the proportion: stagnation of liver qi, stagnation of liver qi and deficiency of spleen, deficiency of spleen dampness, deficiency of liver and kidney yin, internal disturbance of phlegm and heat, and stagnation of liver qi transforming into fire.
1.2 Clinical medical investigation is an effective way to intervene in sub-health by using the method of TCM syndrome differentiation and treatment. At present, the Clinical Guidelines of Sub health Chinese Medicine issued by the Sub health Branch of the Chinese Society of Traditional Chinese Medicine classifies it into the following eight types [7]: (1) Stagnation of liver qi syndrome: some scholars [8] have discussed the differential treatment of liver dysfunction, and believe that liver dysfunction, weakened or excessive function are the main pathogenesis, and taking liver dysfunction as the main axis to relieve liver depression is one of the good strategies of traditional Chinese medicine for treating "sub-health". Some scholars believe that the sub-health state belongs to the imbalance of yin and yang in the human body, in which the deficiency and cold of liver wood and the loss of liver qi play an important role [9]. (2) Liver stagnation and spleen deficiency syndrome: A scholar [10] investigated that 208 of 317 hbv carriers were in sub-health state, with 22 main clinical symptoms, most of which were liver stagnation and spleen deficiency syndrome. Some scholars [11] reported the clinical efficacy observation of 50 cases of sub-health state of liver depression and qi stagnation with symptoms of depression or irritability, chest and hypochondriac fullness, upset and insomnia. Results: 20 cases were cured, 24 cases were markedly effective, 4 cases were effective, 2 cases were ineffective, and the total effective rate was 96.00%. (3) Deficiency of both heart and spleen: some scholars [12] used Guipi Decoction to treat 46 cases of sub-health patients with fatigue, memory decline, poor sleep and other symptoms, and achieved good results. Some scholars [13] used Guipi Decoction to treat 48 patients with excessive fatigue, and received obvious results. (4) Liver and kidney yin deficiency syndrome. (5) Deficiency of lung and spleen qi. (6) Spleen deficiency and dampness obstruction syndrome. (7) Syndrome of liver stagnation transforming into fire. (8) Phlegm heat internal disturbance syndrome.
2 Research status of clinical characteristics of sub-health
TCM theory believes that a healthy person should be a balanced and coordinated organism. The concept of "balance between yin and yang is health" in TCM theory points out the direction for the treatment of sub-health. Through the study of sub health syndrome combined with clinical characteristics, we can find out the syndrome differentiation rules of sub health TCM syndrome, and provide an important objective basis for TCM syndrome differentiation and treatment.
According to the definition of sub-health status, with reference to the Guiding Principles of Clinical Research in Traditional Chinese Medicine on Subhealth Status (Trial) and relevant research literature formulated by the Sub health Professional Committee of the Chinese Society of Traditional Chinese Medicine, a reference standard for judging sub-health status was formulated, including two aspects: (1) repeated discomfort or significant decline in adaptability lasting for more than three months, But there is no definite disease diagnosis; (2) Or although there is a clear diagnosis of disease, there is no causal link with the current discomfort or the decline of adaptability [14].
According to the above standards, non random sampling was carried out for some people who went to the physical examination center of a hospital for physical examination, and on-site investigation was adopted to distribute the epidemiological survey questionnaire of sub-health status to the personnel who participated in the physical examination. The questionnaire was filled out by the investigation object under the guidance and supervision of the investigators, and recovered on the spot.
The method of factor analysis is used to start from the original survey data, find the independent public factors smaller than the original data, and use the independent public factors to explain the internal relationship of the original data, so as to obtain the main clinical characteristics of kidney yin deficiency syndrome in sub-health. The research results show that the main clinical manifestations of the sub-health state are: pain in the back, fatigue, weakness in the legs and knees, dry throat, insomnia and dreaminess, hair loss, night sweat, dry stool, tinnitus, eye dryness, hot hands and feet, etc.; in addition, there are panic, poor memory, dizziness, hearing loss, blurred eyes, eye distension, slow reaction, short and red urine, loss of libido, numbness of hands and feet, fear of heat The frequency of symptoms such as lack of qi and lazy speech is low [10].
3. Research ideas and prospects of the combination of disease and syndrome with clinical characteristics of sub-health
Traditional Chinese medicine is an applied science that studies the physiological and pathological phenomena of human beings, the laws of the occurrence and development of diseases, and the prevention and treatment measures. There are many factors that affect the physiological and pathological changes of human beings and the process of the occurrence and development of diseases. The generation of syndromes is the result of the interaction of these factors, which is an organic combination of specific symptoms and signs (tongue, pulse, etc.) at the macro level, It is a high generalization of the essential attributes of a certain stage in the process of disease development, and is a set of unique symptoms. In terms of fuzzy mathematical language, "syndrome" can be seen as a fuzzy set composed of corresponding "symptoms". Different fuzzy sets of "symptoms" constitute different "syndromes". At present, the generation of macro standards of syndromes is rarely strictly mathematical statistical inference based on group survey. Multivariate analysis is a statistical analysis method to study multi factor and multi index problems. On the basis of group survey, using multivariate analysis to explore TCM syndromes is one of the means to achieve standardization and objectification of syndromes. Scholars around the world have conducted a lot of research on sub-health, and no specific pathogenic factors have been found so far. At present, it is generally believed that sub-health is caused by the imbalance and dysfunction of the overall coordination of the nervous system, endocrine system and immune system caused by psychological, physiological and social factors. In view of the current research status and shortcomings of sub health TCM syndromes, our further research work needs to address the following key issues: (1) Collect cases in strict accordance with the American cdc diagnostic standards to ensure the accuracy of case diagnosis, which is the premise to determine whether the research can produce results and whether the results are reliable. (2) The case sources should be scattered in different urban areas as far as possible to conduct large sample, multi center cooperative research, which is the premise of whether the results are representative and whether they can be popularized. (3) Select appropriate and scientific clinical epidemiological research methods, collect data according to the pre designed scheme, and select appropriate multivariate statistical methods for data processing and analysis. (4) The content of the survey data is reasonable and comprehensive, and it is necessary to solve the quantitative problem of TCM symptoms and formulate a unified quantitative standard of symptoms in advance. (5) The results need to be verified, modified and improved repeatedly in clinical practice. Therefore, the standardization, quantification and easy operation of syndrome differentiation criteria for sub-health are proposed, which is the need to improve the prevention and treatment level of sub-health, strengthen academic exchanges and accelerate the development of Chinese medicine.
[References]
Wu Yueping, Liu Aihua, Zhou Junli "Prevention of disease" and sub-health. Guangming Traditional Chinese Medicine, 2009, 2 (24): 314
2 Ma Yunzhi. Subhealth and TCM prevention and treatment. Henan Journal of Traditional Chinese Medicine, 2001, 21 (3): 11-13
3 Yuan Lixia, Liu Gang. Evaluation of TCM syndrome and treatment of sub-health. Journal of Traditional Chinese Medicine, 2005, 23 (3): 494-495
4 Wu Tong, Ren Yixin, Wang Zhiguo. Overview of TCM prevention and treatment of sub-health. Journal of Traditional Chinese Medicine, 2004, 32 (1): 57-58
5 Yang Zhigang. Effective intervention of traditional Chinese medicine in sub-health status. Anhui Journal of Clinical Chinese Medicine, 2003, 15 (5): 426-427
6 Huang Chaolan. On the role of traditional medicine in the treatment and health care of sub-health. Traditional Chinese Medicine Information, 2003, 20 (4): 4-6
7 Ministry of Health of the People's Republic of China. Guiding Principles for Clinical Research of New Traditional Chinese Medicine. Beijing: China Medical Science and Technology Press, 2002, 68-73
8 He Yuanhao, Lv Junying, Wu Xingui. Discussion on the differentiation and treatment of sub-health from liver loss. Modern Distance Education of Chinese Traditional Medicine, 2008, 5:426-427
9 Li Shimao. Experience of applying Wumei Pill to treat sub-health. Shandong Journal of Traditional Chinese Medicine, 2004, 23 (5): 306-307
10 Yang Lisa, Wang Qiuping, Zhou Jingang, et al. Analysis of TCM syndromes of sub-health status of hbv carriers. Journal of Shanghai University of Traditional Chinese Medicine, 2008, 22 (3): 34-37
11 He Wenli. Treatment of 50 cases of sub-health with Xiaoyao Powder. New Chinese Medicine, 2008, 10:79
Chapter 7: Model article on the relationship between health and sub-health
[Key words] Mongolian medicine holistic view; sub-health; Regulation; prevention
[CLC No.] R2-0 [Document Identification Code] B [Article No.] 1005-0515 (2012) - 02-215-01
Sub health, different medicine, has different understanding and interpretation from different theoretical points of view, different angles, and different levels. Mongolian medicine believes that sub-health is a state, process and stage in the process of disease accumulation, which has not yet formed a disease and is not a disease. Disease accumulation can also be divided into small, medium and large accumulation for further quantitative research. Sub health: all the auxiliary equipment of modern medicine are normal or negative, but the symptoms may exist, and the symptoms have not yet formed a disease syndrome. Some symptoms may be combined with or overlapped with clinical disease symptoms, which can be identified by pulse, tongue, urine and disease diagnosis of Mongolian medicine.
From the perspective of Mongolian medicine as a whole, the balance between yin and yang, and the mechanism of disease, health, sub-health, and disease are dynamic, relatively balanced, and mutually convertible. The holistic view of Mongolian medicine believes that man and nature (including society and thinking) are both opposites and unified organic whole. This unity includes the unity of man and nature, the unity of the human body itself, the unity of man's mind and body, and the unity of man and society. Among them, the unity within the human body is the key factor of life and health, especially the unity of opposites between the three roots (Heyi, Xiri, Badagan) and the seven elements (the essence of food, blood, meat, fat, bone, marrow,) and the three dirties (two stools, sweat) is the basis of human life activities. Mongolian medicine believes that the overall function (or the relationship between various factors in a balanced state) is the inherent and spontaneous movement trend of human beings, the fundamental law of life, and the best state of various relationships inside and outside the body [1]. Once the four pathogenic factors (diet, daily life, climate and others) and the balance within the human body are unbalanced, the disease begins to accumulate and enter a sub-health state. If treatment is not found in time, it can develop into a disease. Disease is the result of the relative imbalance within the human body, and it is a manifestation of the maladjustment between human beings and the living environment. Mongolian medicine learning ability mainly understands the basic mechanism of health, sub-health and disease from the "balance", "imbalance" and "imbalance" of various relationships. Balance leads to health, imbalance leads to sub-health, and imbalance leads to disease. The convertible, dynamic and relative balance among health, sub-health and disease needs to be further theorized and quantified and tested through clinical practice.
Modern medicine believes that sub-health is a non disease and non health state, a kind of inferior health state, and a state without organic diseases. It is also called "sub health", "third state", "intermediate state", "wandering state", "gray state", etc. In traditional Chinese medicine, Central Asian health is called "not sick". "not sick" is not disease free, nor is it a visible disease. It is the imbalance of yin and yang, qi and blood, viscera and health. To cure "not getting sick" is to keep people from getting sick, and take conditioning measures in advance to prevent the occurrence, development and transmission of diseases before the onset of disease.
Prevention: Restoring the "balanced relationship" is the highest law of Mongolian medicine. Make use of, adapt to and stimulate the "self balance" mechanism of the human body to promote the transformation of various relationships from "imbalance" to "balance". Mongolian medicine believes that to treat sub-health, we should establish the ideological system of "prevention before disease", "prevention against disease", and "recovery after recovery", and follow the general principles of "seeking the root", "strengthening the right and dispelling the evil", "recuperating the three roots" and "three causes" (according to people, time, and local conditions) [2], from diet, living, and traditional Mongolian medicine therapy (mainly burning, bloodletting, oil, bathing) Nursing and other aspects of adjustment, so that the human body to maintain physical and mental health. It is recorded in the three classic works of Mongolian medicine - The Four Treatises of Mongolian Medicine - The Spring of Mongolian Medicine: the human body should pay attention to seasonal changes in disease prevention, living rules, organ functions, excessive, insufficient and incorrect dietary efficiency, and maintaining their balance can ensure good health. When the physical strength is weak, organ function is reduced, and the elderly and infirm, they should first use oil to treat and bathe the body, and at the same time, use drugs to eliminate diseases in the body, and specifically nourish the body, enhance physical strength and improve organ function, so as to make them healthy and long-lived [3]. It shows that Mongolian medical experts have mastered the treatment methods of regulating the body with oil, bath and other natural therapies as early as the 19th century, and accumulated rich experience.
To sum up, from the perspective of Mongolian medicine as a whole, sub-health does not belong to the category of disease, but is a state, process and stage in the process of disease accumulation. The prevention of sub-health is based on the general principles of "seeking the root", "strengthening the right and eliminating the evil", "regulating the three roots", and "three causes". The inner part of the human body, the mind and body of people, people and society, and people and nature are transformed from "imbalance" to "balance", and sub-health can be prevented and treated. Combining the research methods of modern medicine, we continue to inherit, explore and improve the theory of Mongolian medicine in the treatment of sub-health, so that the diagnosis is more accurate, the treatment is more timely, and the development law of disease transmission, transformation, combination and combination is more clear, giving play to the advantages of traditional Mongolian medicine, so that Mongolian medicine can make greater contributions to human health.
reference
[1] Bao Long, Man Dula, et al. How to Understand the Holistic Thought of Mongolian Medicine [J]. Chinese Journal of Ethnic Medicine, 2002,4 (8): 52-53
Chapter 8: Model Essay on the Relationship between Health and Sub health
[CLC No.] R 179 G 478
[Article No.] 1000-9817 (2009) 04-0290-02
[Key words] Early diagnosis; sub-health; Intervention research; Student health services
With the change of human disease chart and the change of biomedical model, people no longer think that simply no disease is health, but pay more attention to the coordination and balance of their own physiology, psychology and society. In the 1980s, Chinese scholars put forward the concept of "subhealth status", that is, there is an intermediate state between health and disease, or called "the third state" or "gray state". Epidemiological investigation shows that sub-health problems are increasing year by year, and the trend is younger. However, the cause and diagnosis of sub-health are still unclear.
Bringing the early detection and intervention of adolescent sub-health into the field of school health services will help to find problems that harm health early, not only can it timely reverse the sub-health status of adolescents, but also has a decisive role in health protection in adulthood. This can not only expand the field of school health services, but also reduce the medical expenses borne by the transition from sub-health to disease, and promote the healthy growth of young people both physically and mentally.
The importance of early recognition of adolescent sub-health from the perspective of subliminal mental disorders
As we all know, traditional disease diagnosis needs a "threshold", which can be diagnosed as a disease only when it meets the criteria defined by different disease diagnosis systems (such as the international disease diagnosis system ICD-10); Corresponding to this is health, no physical weakness, effective and balanced psychological activities, and good social adaptation. With the deepening understanding of disease and health, the relationship between health and disease is called subliminal [1], which leads to subliminal mental disorders. Ignoring subliminal mental disorders, especially in the survey of the general population, will miss the opportunity of early detection of mental disorders [2]. The concept of sub-health and the practice of sub-health prevention and control that emerged in China in the 1980s should be consistent with the understanding of subliminal "disease". That is, a person has not found any abnormality of body structure and physiological function and identifiable mental disorder, but has physical discomfort, such as weakness, fatigue, etc., and no identifiable biological abnormality can be found; Or psychological discomfort or experience, as well as maladjustment in the sense of social survival, can be attributed to the sub health category [3].
In recent years, the research of subliminal mental disorders has received extensive attention from the academic community, mainly referring to the clinical symptoms of mental disorders, but it does not meet the criteria for clinical diagnosis of mental disorders. Subthreshold depression is the key content of research in this field, which mainly includes subsyndromic depression (SSD) [4], transient brief depression (RBD) [5-6] and minor depression (MinD) [7]. Epidemiological studies show that subliminal mental disorders exist at any age. An Italian study found that [8], the incidence of subthreshold depression was 2.2%~24.0% in community population and 5%~16% in primary care patients, which generally exceeded the incidence of depression diagnosed by ICD-10. The study of American scholar Fogel et al. [9] shows that the prevalence rate of mild depression in the general population is 2.0%~23.4%, and in patients in primary health care institutions and other medical institutions it accounts for 4.5%~17.0%, basically equivalent to the prevalence rate reported in Italy. However, the report in the United States may overestimate the prevalence rate of mild depression, which uses the diagnostic criteria of severe depression (MDD). When the severity of symptoms does not meet the diagnostic criteria of MDD, it is classified as mild depression. Therefore, it may include other subtypes of subliminal depression. The prevalence rate of SSD reported in China is about 9.2% [10] among the general population, which is somewhat different from that reported abroad, mainly because there is no unified diagnostic standard at present.
Some studies have shown that subliminal mental disorders may be the prelude to the development of mental disorders, which can predict the occurrence of mental disorders, and may cause more comprehensive diseases of subliminal mental disorders; Patients often show low self health awareness, impairment of daily activity function, impairment of body function, decline in quality of life, and even lead to schizophrenia and suicidal behavior. Subthreshold mental disorder is one of the important research contents in the field of mental sub-health, CDI) and other assessments of depressive symptoms indicate that depressive symptoms have a high prevalence rate among children and adolescents [13-15]. With the intensification of social competition, teenagers are facing enormous pressure to enter schools and/or obtain employment. However, because adolescents are in a special life stage, the socialized prevention mechanism is not perfect, and their response resources are insufficient, it is likely to lead to more serious consequences. Therefore, the early identification of adolescent sub-health is particularly important.
2. Establishing the assessment method of adolescent sub-health is the basic work of early identification
Sub health has become a major hidden danger to the health of adolescents. At present, there is no unified diagnostic standard at home and abroad, which has become the main bottleneck restricting the study of sub health. Chronic fatigue syndrome (CFS) The research on subliminal mental disorders [16-17] has given people a good enlightenment, that is, establishing a set of systematic multidimensional assessment methods is the first step of sub-health research, and on this basis, large-scale epidemiological investigation is carried out to understand the current situation of adolescent sub-health in China and take effective intervention measures.
Some scholars believe that sub-health mainly refers to a low quality state of health and its experience that people are between health and disease in terms of physical, mental and emotional aspects [18]. However, this concept has rich connotation and extensive extension, and different scholars have different understanding and understanding of it. Zhao Ruiqin et al. [19] believed that sub-health status refers to no clinical symptoms or mild symptoms, but there is potential pathological information, and this status is constantly changing and developing, which can be transformed into health status or disease status. It can be seen from this that sub-health is a transitional state between health and disease. Most people in sub-health have no positive physical signs in physical examination, while most laboratory tests are negative, which brings great challenges to the diagnosis of sub-health. At present, the operability of the existing traditional disease classification diagnostic criteria (such as ICD-10, DSM-IV) for related non-specific physical diseases and mental disorders needs to be further strengthened.
At this stage, the time for the classification and typing of sub-health is not yet ripe. To develop a unified and holistic screening method for adolescent sub-health is the first step to carry out epidemiological research on sub-health. At present, an effective and sensitive sub-health self-assessment questionnaire can be developed as one of the standardized research tools of sub-health from the perspective of symptomatology and multi-dimensional evaluation. Self assessment of health is one of the methods of health assessment. It is widely used in the field of social science and health research. It is an independent predictor of disease and death in community population [20-21]. For this reason, the research group led by the author compiled the Multidimensional Sub health Questionnaire of Adolescents (MSQA) [22], and systematically evaluated the reliability, validity and responsiveness of the questionnaire [23-24]. In order to evaluate the predictive validity of the questionnaire, the MSQA was popularized and applied in 9 cities nationwide (Beijing, Harbin, Bengbu, Ezhou, Shaoxing, Taiyuan, Guangzhou, Chongqing, Guiyang). One provincial university and one urban and rural ordinary middle school (junior high school and senior high school) were selected from each city, and a national 22325 people queue was established with students in junior high school, junior high school, senior high school, senior high school, junior high school, senior high school, junior high school and junior high school as the target population. While conducting MSQA measurement, collect their physiological indicators, including height, weight, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, squat test, etc., and follow the principle of informed consent, About 30% of the subjects were selected for the detection of biochemical indicators (including cholesterol, triacylglycerol, high-density lipoprotein, low-density lipoprotein, fasting blood glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, direct bilirubin, etc.). In addition, the cohort was followed up for 9 months, and the information mainly collected included medical treatment due to illness, absenteeism due to illness, behavior endangering health, cardiovascular disease and metabolic syndrome related symptoms, and detection of mental disorders (including emotional disorders, mental disorders, and serious mental diseases). To observe the influence of illness and injury on learning time, the incidence of injury, the incidence of suicidal psychology and behavior, the rate of outpatient visits, the diagnostic rate of psychological disorders, and the incidence of cardiovascular disease and metabolic syndrome related symptoms every three months, so as to evaluate the predictive validity of MSQA. It was found that the detection rate of sub-health symptoms was 46.4% for boys and 46.1% for girls; Teenagers' sub-health status is not only related to a variety of health risk behaviors, suicide, self injurious behaviors, and life satisfaction, but also can predict the rate of absenteeism due to illness, suicidal ideation, suicide plans, attempted suicide, and various self injurious behaviors; Sub health needs attention.
3. Integrating adolescent sub-health intervention into school health service
In May 2007, the Central Committee of the Communist Party of China issued the Opinions of the Central Committee of the Communist Party of China and the State Council on Strengthening Teenager Sports and Enhancing Teenager Physique (i.e. the 7th Document of the Central Committee of the CPC) [25], and formulated a series of measures to enhance the physique of teenagers. The document puts forward a series of measures and requirements to strengthen school health work in view of the prominent problems existing in the physical health of adolescents. It is an extremely important programmatic document for carrying out school health work at present and in the future. The document emphasizes the need to "establish and improve the student health examination system so that young students can have a health examination once a year", carry out serious statistical analysis of the results of the health examination, and take practical measures to solve the outstanding problems of students' health status; At the same time, the document emphasizes that "the system of monitoring students' physical health should be improved, and students' physical health should be regularly monitored and announced". At the same time of social and economic development, the inclusion of sub-health adolescents between disease and health into school health services is not only in line with the spirit of the Central Document No. 7, but also to meet social needs, which is an inevitable requirement to comprehensively improve the health quality of students.
Students with sub-health symptoms should be identified early to expand the field of school health services. Carry out health education by means of life skills education for sub-health adolescents, advocate healthy lifestyle, strengthen physical exercise, achieve balanced diet, train the ability of psychological response to frustration and pressure effectively, and have a universal impact on the physical and mental health of adolescents, thus promoting the transition of sub-health population to health; At the same time, we should monitor the adverse outcomes of sub-health adolescents, timely refer them to doctors, and obtain the help of specialists, so as to effectively avoid the transformation of sub-health into disease, reduce the huge medical costs borne by families and society, and implement school health services.
The research on the causes and prognosis of adolescent sub-health is not only a challenge for school workers, but also a new research field for school health workers. In this way, it will further provide information and theoretical support for sub-health prevention and control research, especially for sub-health school intervention; At the same time, these basic studies also accumulate data for the classification and typing of adolescent sub-health.
4 References
［1］ HELMCHEN H, LINDEN M. Subthreshold disorders in psychiatry: Clinical reality, methodological artifact, and the double-threshold problem. Compr Psychiatry, 2000, 41(2 Suppl 1):1-7.
［2］ FERGUSSON DM, HORWOOD LJ, RIDDER EM, et al. Subthreshold depression in adolescence and mental health outcomes in adulthood. Arch Gen Psychiatry, 2005 , 62(1):66-72.
[3] He Yumin, Shen Hongyi, Ni Hongmei, etc Research on the category of sub-health Medicine and Philosophy: Humanities and Social Medicine Edition, 2008, 29 (1): 2-4
［4］ FORSELL Y. A three-year follow-up of major depression, dysthymia, minor depression and subsyndromal depression: Results from a population-based study. Depress Anxiety，2007, 24(1):62-65.
［5］ L? VDAHL H, ANDERSSON S, HYNNEKLEIV T, et al. The phenomenology of recurrent brief depression with and without hypomanic features. J Affect Disord，2009, 112(1-3):151-164.
［6］ PEZAWAS L, ANGST J, KASPER S. Recurrent brief depression revisited. Int Rev Psychiatry，2005, 17(1):63-70.
［7］ CUIJPERS P, DE GRAAF R, VAN DORSSELAER S. Minor depression: risk profiles, functional disability, health care use and risk of developing major depression. J Affect Disord，2004, 79(1-3):71-79.
［8］ RUCCI P, GHERARDI S, TANSELLA M, et al. Subthreshold psychiatric disorders in primary care: Prevalence and associated characteristics. J Affect Disord, 2003 , 76(1-3):171-181.
［9］ FOGEL J, EATON WW, FORD DE. Minor depression as a predictor of the first onset of major depressive disorder over a 15-year follow-up. Acta Psychiatr Scand，2006 ,113(1):36-43.
[10] Li Yiyun, Fan Jie, Shi Yongcheng, etc The depressive subsyndrome (SSD) was followed up two years later Chinese Journal of Health Psychology, 2004, 12 (4): 275-276
［11］CUIJPERS P, SMIT F. Subthreshold depression as a risk indicator for major depressive disorder: A systematic review of prospective studies. Acta Psychiatr Scand, 2004 , 109(5):325-331.
［12］BORGMANN-WINTER K, CALKINS ME, KNIELE K,et al. Assessment of adolescents at risk for psychosis. Curr Psychiatry Rep, 2006, 8(4): 313-321.
[13] Luo Yingzi, Wang Xiang, Zhu Xiongzhao, etc A survey on depression level of high school students and its influencing factors Chinese Journal of Clinical Psychology, 2008, 16 (3): 274-277
[14] Li Tong A survey of depression and related factors among college students Social Psychological Science, 2008, 23 (6): 547-553
[15] Xu Juan, Lin Denan, Wang Jianjie, et al Comparison of depressive symptoms and its influencing factors between primary school students in Hefei and Shenzhen Chinese Journal of Mental Health, 2008, 22 (4): 246-248
［16］WOLBEEK MT, VAN DOORNEN LJP, COFFENG LE, et al. Cortisol and severe fatigue: A longitudinal study in adolescent girl. Psychoneuroendocrinology, 2007, 32: 171-182.
［17］GEORGIADES K, LEWINSOHN PM, MONROE SM, et al. Major depressive disorder in adolescence: The role of subthreshold symptoms. J Am Acad Child Adolesc Psychiatry, 2006, 45(8):936-944.
[18] Dong Yuzhen Sub health and its three main causes Chinese Journal of Epidemiology, 2003, 24 (9): 758-759
[19] Zhao Ruiqin, Song Zhenfeng Research progress on sub-health Foreign Medicine: Social Medicine, 2002, 19 (1): 11-13
［20］HWANG JW, HAHM BJ, KWON ST,et al. Impact of lifetime subthreshold depression and major depression before internship on psychopathology and quality of life in Korean interns: 6 month follow-up study. Aust N Z J Psychiatry, 2008, 42(4): 301-308.
［21］LEWINSOHN PM, SHANKMAN SA, GAU JM, et al. The prevalence and co-morbidity of subthreshold psychiatric conditions. Psychol Med, 2004, 34(4): 613-622.
[22] Qi Xiuyu, Tao Fangbiao, Hu Chuanlai, etc Development of multidimensional questionnaire on sub-health of Chinese adolescents China Public Health, 2008, 24 (9): 1025-1028
[23] Xing Chao, Tao Fangbiao, Yuan Changjiang, etc The reliability and validity of the multidimensional assessment questionnaire for adolescent sub-health China Public Health, 2008, 24 (9): 1031-1033
[24] Wan Yuhui, Hu Chuanlai, Tao Fangbiao, etc Responsiveness analysis of multidimensional assessment questionnaire for adolescent sub-health China Public Health, 2008, 24 (9): 1035-1036
Chapter 9: Model essay on the relationship between health and sub-health
Key words: sub health; diagnosis; overview
CLC No.: R2-03
Document ID: A
Article No.: 1673-7717 (2008) 06-1324-03
A global survey conducted by the World Health Organization (WHO) shows that only 5% of the world's truly healthy people (the first state), 20% of the people who have been checked and diagnosed by doctors (the second state), and 75% of the people are in the transitional state between health and disease. WHO calls it the "third state", and China often calls it the "sub-health state". Sub health is becoming a century disease threatening the whole world, and research upsurge has been set off at home and abroad. Because of the macro concept of sub-health, various clinical manifestations, and no abnormality in laboratory indicators, the diagnosis of sub-health status has become one of the difficulties in academic research. The research status of sub-health diagnosis and assessment is summarized as follows.
1 Definition of sub-health status
At present, domestic experts have proposed several different standards for the definition of sub-health, including the following aspects of research.
1.1 Liu Baoyan and other expert groups proposed diagnostic criteria for sub-health
① Repeated discomfort or adaptability that lasts for more than 3 months is significantly reduced, but can maintain normal work; ② No major organic diseases and mental and psychological diseases; ③ Although there is a clear diagnosis of non major organ organic disease or psychosocial disease, it does not need to be maintained with drugs, and there is no causal link with the current discomfort or decline in adaptability. These three diagnostic criteria are proposed according to the concept of sub-health. It is widely used and authoritative.
1.2 Diagnostic criteria for sub-health in the Clinical Guidelines of Chinese Medicine for Subhealth (ZYYXH/T2-2006) issued by the Chinese Society of Traditional Chinese Medicine
① The main physical symptoms are fatigue, sleep disorder, or pain; ② It is characterized by depression, anxiety, irritability, fear and timidity, or short-term memory decline, inability to concentrate and other psychological symptoms; ③ It is mainly manifested by the decrease of interpersonal communication frequency, or the decline of social adaptability such as interpersonal tension. Any of the above three items has lasted for more than 3 months, and the disease that may cause the above symptoms is excluded through systematic examination, can be judged as physical sub-health, mental sub-health, and social interaction sub-health respectively.
1.3 Sub health diagnostic criteria formulated by Shi Hefeng and other expert groups
In addition to all the contents in 1.1 above, the sub health diagnostic criteria formulated by Shi Hefeng and others have expanded and deepened the contents of "repeated discomfort or significant decline in adaptability lasting more than 3 months", including: ① somatic discomfort syndrome; ② Subclinical state syndrome; ③ Syndrome of unknown cause (such as climacteric syndrome and neurasthenia syndrome); ④ Pathogen carrier syndrome; ⑤ Check the critical state of high and low values; ⑥ Physical health is in a state of high pathogenic risk factors (such as overweight, smoking).
The above sub health diagnostic criteria are based on the concept of sub health, accurate and authoritative, but they do not list specific symptom indicators. They can only make qualitative judgments on sub health, and cannot make quantitative measurements.
2 Scale (questionnaire) evaluation method
2.1 Questionnaire on basic syndromes of TCM in sub-health state
Liu Baoyan and others designed a questionnaire on the characteristics of basic syndromes of TCM in sub-health state, including six parts: physical condition, living condition, emotional condition, energy condition, endowment condition, and social environment condition. There are 124 question items in total. With a 5-level score, the score of each item ranges from 1 to 5, and the meaning ranges from good to bad. The questionnaire is comprehensive and accurate, which can judge the health status of the population to a certain extent and reveal the distribution law of TCM syndromes of sub-health. Using the questionnaire, the research group has conducted a large number of epidemiological investigations and TCM syndrome studies, which are quite representative in the field of domestic sub-health research. However, the items involved are many, the content is complex, and the research is partial to TCM syndrome, so it is difficult to operate and promote. On this basis, Wang Xueliang and others developed a TCM syndrome questionnaire for sub-health status, which includes three aspects: physical symptoms, psychological symptoms, and social symptoms. There are 72 items in total. The content is greatly simplified and easy to operate. The research group used the questionnaire to carry out many epidemiological investigations in universities and hospitals in Guangdong Province.
The above two TCM basic syndrome questionnaires for sub-health status can comprehensively reflect the characteristics of sub-health status, but can not make qualitative and quantitative judgments on sub-health. They are suitable for the study of symptom and TCM syndrome analysis of people who have been diagnosed as sub-health.
2.2 Cornell Medical Index (CMI)
The CMI questionnaire compiled by Cornell University consists of four parts: somatic symptoms, family history and past history, general health and habits, and mental symptoms. It is divided into 18 parts, with 195 entries in total. The person who answers "Yes" to each item will be scored 1 point; Those who answer "No" will be scored 0, and the total score of CMI will be obtained by adding all items. Among them, 51 items are emotional, emotional and behavioral problems related to mental activities, called the M R part. CMI also determined the screening criteria. In China, the screening criteria are: total score of men ≥ 935, M-R ≥ 15; The total score of female is ≥ 40, and M-R is ≥ 20. Those who reach this standard are those with physical and mental disorders. Zhou Lingling et al. conducted a sub-health survey of 372 primary and secondary school teachers by combining the scale with the self-made scale, and found that the incidence of sub-health among primary and secondary school teachers was 55.11%.
2.3 SCL-90 Self assessment Scale
SCL-90 is widely used in foreign countries. It has 90 questions, including feelings, thinking, emotions, consciousness, behavior, living habits, interpersonal relationships, diet, sleep and other psychological and psychiatric symptoms. Each question is assigned 1-5 points according to the degree of "no, very light, medium, heavy and serious". The statistical indicators include total score, total average score, number of positive items, average score of positive symptoms, factor score, etc., which can reflect the mental health problems of individuals or a group. SCL-90 is an effective tool for testing the mental health status of sub-health people, and its self-evaluation results can be used as the criteria for judging the clinical mental status of sub-health people. Yang Pingting et al. used SCL-90 to evaluate 820 cases of sub healthy people. The results showed that the total average score and seven factor scores of somatization, compulsion, interpersonal sensitivity, depression, anxiety, paranoia and psychosis of sub healthy people were higher than the norm (P
2.4 MDI health assessment method
Many scholars use the world's popular MDI health assessment method to carry out quantitative research on sub-health status. It was originally used by WHO to measure various indicators suggested by the disease with the greatest risk of human death. According to the actual detection status of the tested, score them item by item (using the percentage system, the full score is 100 points), and make a comprehensive evaluation corresponding to the WHO health definition, The criteria are as follows: above 85 points is a healthy state, below 70 points is a disease state, and 70-85 points is a sub healthy state (the third state). The indications on which MDI is based include the physical indicators such as cardiovascular and cerebrovascular disease monitoring and stroke prediction, malignant tumor signs, organ diseases, blood and allergic diseases, determination of internal pollution, endocrine system examination, limb damage detection, drug taking effect detection, and the MDI health assessment scale, an indicator of psychological and social disorders, which has been added in recent years.
