企业人群亚健康状态流行病学调查的初步研究

发布时间：2018-07-03 19:23

本文选题：亚健康状态 + 流行病学调查　；参考：《第一军医大学》2007年硕士论文

【摘要】： 研究背景 80年代中期，前苏联布赫曼教授通过研究发现，除了健康状态和疾病状态之外，人体还存在着一种非健康非患病的中间状态，称为亚健康(sub-health)状态。亚健康状态是机体在无器质性病变情况下发生了一些功能性改变，造成人体生理机能低下，严重影响人们的工作能力和生存质量。WHO的一项全球性调查表明，真正健康的人仅占5％，患有疾病的人占20％，而75％的人处于亚健康状态。处于亚健康状态的人口在许多国家和地区呈上升趋势。据有关文献分析，中国处于亚健康状态的人已经超过7亿，占全国总人口的60％～70％。亚健康已经成为当今危害人类健康的头号隐形杀手，也是现代医学难题之一。目前，对亚健康状态尚无一个公认统一的定义和判断，国内学者对此作了大量的研究和探讨。2006年在北京举行的“世界中医药学会联合会亚健康专业委员会成立暨首届世界亚健康学术大会”上中华中医药学会亚健康分会，亚健康中医临床研究指导原则起草小组提出了亚健康状态的最新概念。其概念为：亚健康是指人体处于健康和疾病之间的一种状态。处于亚健康状态者，不能达到健康的标准，表现为一定时间内的活力降低、功能和适应能力减退的症状，但不符合现代医学有关疾病的临床或亚临床的诊断标准。我们课题组在这一概念的基础上，参考相关研究文献，并经广东省中医药学会亚健康专业委员会研讨，制定了亚健康状态的判断参考标准。流行病学是一门研究人群中疾病与健康状况的分布及其影响因素，并研究防治疾病及促进健康的策略和措施的科学。近年来，国内学者已经运用流行病学横断面调查的方法对亚健康状态人群进行了不少的研究。文献研究提示，目前对亚健康状态的研究主要集中在脑力劳动者(包括教师、机关干部、医务人员、学生等)及军人群体，到目前为止，在我国还未发现专门针对企业人群亚健康状态的调查。而在现代社会中，企业人群所占人口的比重不断攀升，对社会经济、医疗等方面的影响也日渐彰显。企业人群由于繁重的工作任务、单调的工作环境、相对较低的工资、不完善的社会医疗保障、拥挤的住宿环境、缺乏的休闲娱乐，导致该群体亚健康状态的发生率持续攀升，严重影响了人们的工作能力和生存质量，这对于企业人群的个人身心健康，以及企业的正常运作都产生了巨大的影响。近年来，随着经济的快速发展，尤其在珠江三角洲地区，工厂企业迅速增多，企业人群的数量也快速膨胀，在当地人口中所占比例越来越高，其在社会建设中所起的作用也越来越大，该群体的身心健康也倍受重视。故了解这部分人群的亚健康状态，研究亚健康状态的影响因素，有针对性地防治企业人群的亚健康状态，保障其身心健康，对于促进企业及社会稳定发展有着重要的意义。而这一领域的研究目前尚是一片空白，，对企业人群的亚健康状况缺乏研究，也未见相关的文献报道，所以对这一人群进行流行病学调查有着非常重要的现实意义。研究目的本课题属于亚健康状态系列研究中的一个子课题，采用流行病学横断面研究方法，研制亚健康状态流行病学调查问卷，应用此问卷首次专门针对企业人群开展亚健康状态的大样本流行病学调查，了解企业人群中亚健康状态的流行病学情况，探讨该特定人群亚健康状态的现患率、临床表现、相关因素等。这不仅填补了国内企业人群亚健康状态流行病学调查的空白，为亚健康状态干预策略的制定提供客观、科学的依据，还将为今后进一步研究确定干预措施及治疗方案奠定基础，对提高该人群的整体健康水平、工作效率及生活质量等方面均具有非常重大的意义。研究方法我们南方医科大学南方医院亚健康流行病学调查课题组在课题开始之初就严格按照横断面流行病学调查的方法，遵循科学的研究程序，对调查中的各个环节进行精心的设计，制定了本研究的详细实施步骤，包括研究目的的确定，研究对象及研究方法的确定，亚健康状态流行病学调查问卷的制定及评价，资料的收集、整理、分析及结果的解释，流行病学调查的质量控制等步骤。流行病学调查步骤制定及亚健康状态流行病学调查问卷研制成功后，我们以两个企业为研究对象(其中一个为深圳宝安地区私营企业，另一个为东莞市外资企业)，利用我们课题组研制的亚健康状态流行病学调查问卷，按照预先制定的流行病学调查步骤对其所有员工进行流行病学调查，排除患有疾病的人群，建立亚健康状态人群资料库，内容包括年龄、性别、职业、学历、婚姻、亚健康状态症状及影响因素等；采用计算机技术及数理统计等现代科学方法进行亚健康状态的流行病学研究。结果 1研制成功适用的亚健康状态流行病学调查问卷，并经过现场试用及效度、信度等评价，证明该问卷能达到预期研究的目的；应用此问卷，在国内首次对企业人群开展亚健康状态流行病学调查。 2深圳私营企业总的亚健康状态现患率为62.1％。其中男性亚健康状态现患率为60.2％，女性为64.4％；年龄在20岁以下的人群亚健康状态现患率为62.3％，年龄在20～30岁之间的人群为65.6％，年龄在30岁以上的人群为46.3％；工人亚健康状态现患率为62.3％，行政人员为60.8％，其他职业人员为62.0％；学历在高中及高中以下的人员亚健康状态现患率为61.3％，学历为中专的人员为66.9％，学历为大专以上的人群为57.1％；未婚人员亚健康状态现患率为64.4％，已婚人员为51.3％。 3深圳私营企业亚健康状态人群中出现频率为60％以上的症状有：疲倦乏力、情绪低落；出现频率为50％以上的症状有：容易感冒、时常叹气、怕热、头痛、急躁易怒、腰背酸痛、注意力差、健忘、动则汗出、情绪不稳、失眠、工作效率低下及食欲不振；出现频率为40％以上的症状有：精神不振、孤独感、咽干、心慌、空虚寂寞、焦虑、精神紧张、难以承担相应的社会角色、脱发、反应迟钝、人际关系紧张、交往频率下降、恶风怕冷、眼花、腿膝酸软、逃避现实、手足麻木及苦闷等；另外痛经、月经量异常及白带过多等多见于女性亚健康状态。 4深圳私营企业亚健康状态的危险因素为超时工作、遇到挫折或事故，保护因素为个人收入、安全感、体育锻炼、生活环境。 5东莞外资企业亚健康状态总的现患率为72.0％。其中男性亚健康状态现患率为67.3％，女性为74.0％；年龄在20岁以下的人群亚健康状态现患率为77.6％，年龄在20～30岁之间的人群为74.8％，年龄在30岁以上的人群为44.6％；工人亚健康状态现患率为72.7％，行政人员为50.5％，其他职业人员为73.9％；学历在高中及高中以下的人群亚健康状态现患率为73.0％，学历为中专的人群为70.1％，学历为大专以上的人群为65.1％；未婚人员亚健康状态现患率为75.4％，已婚人员为59.8％。 6东莞外资企业亚健康状态人群中出现频率为60％以上的症状为疲倦乏力；出现频率为50％以上的症状有：情绪低落、怕热、头痛、头晕、容易感冒、时常叹气、腰背酸痛；出现频率为40％以上的症状有：失眠多梦、动则汗出、记忆力差、急躁易怒、食欲不振、注意力差、工作效率低下、情绪不稳、脱发、心慌、精神不振、腿膝酸软、咽干等；另外白带过多、痛经、月经量多、经期异常等多见于女性亚健康状态。 7东莞外资企业亚健康状态的危险因素为超时工作、遇到挫折或事故，保护因素为体育锻炼、生活环境、个人收入以及健康状况。 8东莞外资企业人群亚健康状态总的现患率、男性及女性现患率、工人现患率均高于深圳私营企业。结论 1深圳私营企业与东莞外资企业人群亚健康状态常见症状基本一致，现患率及影响因素不完全相同。 2企业人群亚健康状态现患率较高，其高发人群为30岁以下的青年。 3企业人群亚健康状态症状表现多样，涉及到躯体、心理、社会三方面。 4企业人群的健康状况不容乐观，应采取各种干预措施加以改善。
[Abstract]:Background of the study

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

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

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

Purpose of study

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

Research Methods

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

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

Results

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

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

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

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

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

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

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

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

Conclusion

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

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

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

4 . The health status of the enterprise population is not optimistic , and various intervention measures should be taken to improve .
【学位授予单位】：第一军医大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R181.3

【引证文献】