| Purpose:In the medical model transformation today, psychological factors,especially the emotional factors and disease and healthy relationship has become the medical and psychological circles on issues of common concern.Reveals how does emotions cause disease, further guidance on effective prevention and treatment is a serious demand in today’s society.Emotional calls qingzhi in traditional Chinese medicine. Seven emotions change injury the visceral qi movement is the TCM theory of internal injury due to seven emotions on their basic understanding of pathogenic patterns. This theory cannot explain today why increasingly frequent and emotional diseases, effective guidance for patients with different individual characteristics of emotional control of disease and syndrome. Therefore, there is an urgent need to propose a new theoretical basis for clinical treatment and research provides effective guidance of pathogenic model for emotional distress. For this, this research around national major needs and TCM important science problem, anger in and anger out as point, carried out emotional stimuli pathogenic mode research, put forward emotional stimuliation pathogenic five-stage model hypothesis and preliminary veritied it, aimed at explained the reason for the growing mumer of emotional diseases in today social, provided of theory guide for patients different individual features for effective control emotioal diseases, innovation internal injury due to seven emotions theory and the emotion pathogenesis theory, rich liver regulating emotions through governing smoothing flow of qi theory of TCM,and put forward a new theory-oriented for the development of Chinese and Western medical emotional disorders theories.Method:Adopted literature and epidemiological investigation to study.①Systematica-lly combing discourse of emotional stimulation pathogenic history of TCM, combined with our early team advances, and TCM,modern medicine and psychology-related awareness, put forward emotional stimuliating pathogenic five-stage mode hypothesis.②On the basis of cross section of workers, nurses, college students in early epidemiological investigation,carried out a case-control study of and an angry in and angry out sample as case group, no anger sample as control group to preliminary verify the hypothesis.③On the basis of the case-control study, carried out a prospective cohort study of angry in and angry out sample as exposed group, no anger sample as non-exposed group to further verify the hypothesis.Result:①Put forward emotional stimuliating pathogenic five-stage model hypothesis:life events are originating factors of formation emotional stimulation; individual psychological and physiological characteristics is key of formation emotional stimulation;changes of level and function of the relevant active substance of hormones and neurotransmitters in the body is the emotional stimulation caused the visceral qi movement turbulence and pathogenic micro-mechanism; personality characteristics is important factors of emotional stimulation caused what diseases and syndrome.②Case-control study results indicate:in today’s society, originating factors of anger out mainly:Group of college students "love or engagement"(OR=1.167,95%CI=1.023-1.330), nurses group "itself (lover) abortion"(OR=11.999,95%CI=1.560～92.271), groups of workers "love failure or rupture"(OR=3.954,95%CI=1.432～10.919)," Not satisfied with present job "(OR=4.098,95%CI=1.863～9.015). originating factors of anger in:groups of workers "and superior tension"(OR=32.596,95%CI=2.472～429.790),"their (lover) abortion"(OR=4.566,95%CI=1.461～14.268). Main body status of leading to anger out:College students "fatigue severity scale"(OR=1.502,95%CI=1.174～1.921), nurses group "used to sleep effect"(OR=2.707,95%CI=1.350～5.429),"effects of sleep problems"(OR=3.184,95%CI=1.535～6.602)," fatigue of environment specific table"(OR=1.363,95%CI=1.057～1.756). groups of workers "effects of sleep"(OR=1.887,95%CI=1.111～3.205),"day functions"(OR=1.674,95%CI=1.213～2.310),"results of fatigue"(OR=1.369,95%CI=1.110～1.689).Main body status of leading to anger in:College students "day functions"(OR=1.410,95%CI=1.143～1.739),"environmental specificity of fatigue"(OR=1.634,95%CI=1.236～2.161), nurses group "sleep time"(OR=1.470,95%CI=1.053～2.052),"day functions"(OR=1.540,95%CI=1.126～2.106),"results of fatigue"(OR=1.304,95%CI=1.056～1.611), groups of workers "function during the day"(OR=1.333,95%CI=0.928～1.916),"fatigue of environment-specific table" (OR=1.369,95%CI=1.110～1.689). Psychological characteristics of leading to anger out: College students both inside and outside to (OR=1.038,95%CI=1.201～1.478), negative (OR=1.062,95%C1=1.189～1.521) nurses groups both inside and outside to (OR=1.041,95%, CI=1.022～1.063), disguised OR=1.020,95%CI=1.001～1.109), groups of workers within and outside to (OR=1.093,95%CI=1.138～1.623), mental mass (OR=1.036,95%CI=1.138～1.623). Psychological characteristics of leading to anger in:College students in disguise (OR=1.051,95%CI=1.310～1.968), negative (OR=1.106,95%CI=1.201～1.496) nurses groups cover up (OR=1.039,95%CI=1.029～1.110)③Prospective cohort study results indicated that the incidence of emotional diseases:anger out group of college students incidence of11.11%, anger in group incidence of16.67%, anger out group of nursesincidence of7.89%, anger in group incidence of0.00%; anger out group of workers incidence of7.89%, anger in group incidence of10.09%; anger out group of three groups together incidence of9.43%, anger in group10.09%. Analysis emotional disorders of anger in and anger out group showed that the disease primarily included of chronic gastritis (29.37%), insomnia (13.51%), hyperthyroidism (8.11%)etc,the syndrome primarily included syndrome of liver-qi inversion syndrome (32.34%), the syndrome of stagnation of liver-Qi (29.73%),the syndrome of disharmony between liver and stomach (18.92%)etc.After Cox regression analysised, the angry out group of relative risk RR1.076(95%CI=0.490-1.201) to emotional disorders, anger in group relative risk RR1.767(95%CI=0.685-1.690)to emotional diseases. Angry out and anger in leading to emotional diseases attributable risk percentage (AR%) was7.06%and43.41%, respectively and percentage of population attributable risk (PAR%) was0.81%and9.68%, respectively. Microscopic pathogenic analysis showed that anger out and anger in can cause estradiol(E2),progesterone(P), testosterone (T), thyroid-stimulating hormone (TSH)content changes,may be caused further emotional risk factors for disease. The decision tree model analyses further showed:life events, individual State of the body, psychological characteristics were closely related to anger out and anger in,and further lead to emotional diseasese.Conclusions:Put forward emotional stimuliating pathogenic five-stage mode hypothesis:life events are originating factors of formation emotional stimulation; individual psychological and physiological characteristics is key of formation emotional stimulation;changes of level and function of the relevant active substance of hormones and neurotransmitters in the body is the emotional stimulation caused the visceral qi movement turbulence and pathogenic micro-mechanism; personality characteristics is important factors of emotional stimulation caused what diseases and syndrome.Preliminary veritied the hypothesis thourgh a case-control study and a prospective cohort study. Epidemiological research indicated that the hypothesis had evidence of epidemiological studies;consisted with the priniciple of scientific contact; after theory and logical argument,conformed logical reasoning.reached the level of scientific hypothesis. The hypothesis will be able to explain why today’s society increasingly frequent emotional diseases; provided of theory guide for patients different individual features for effective control emotioal diseases, rich liver regulating emotions through governing smoothing flow of qi theory of TCM,and put forward a new theory-oriented for the development of Chinese and Western medical emotional disorders theories. |
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