| So far,most of the disease risk assessment(early warning)is based on the assessment of the health risk factors of moderm medicine;even with the physical factors of traditional Chinese medicine,there is still a lack of the syndrome element distribution of TCM diseases,which plays an important part in disease predisposing factors.Therefore,it is necessary to take the holistic concept of traditional Chinese medicine as the cornerstone to grasp the state of health as a whole and systematically,and to make the risk warning of diseases incorporate better into the advantages of the Chinese and Western medicine.In this way,the health management enterprise can be constantly served,while a more feasible and perfect technical support for people's health can also be provided.From the aspects of theoretical research,methodological research and clinical validation,based on the identification of health state of traditional Chinese medicine,this paper aims to explore the risk warning of chronic diseases and the method on how to establish the system concerned.PurposeThrough the integration of Chinese and Western medicine,taking traditional Chinese medicine as the main part,using the techniques of the risk assessment of disease based on epidemiology and health management in modern medicine,this research initially set up a risk warning index system,with Chinese characteristics and suitable for our country,which can identify,evaluate and intervene in time to minimize the risk of diseases,and to provide references for the establishment of risk warning system of chronic diseases in China.Methods1.Based on "syndrome element dialectics" and "physical identification",by applying the integration of "TCM diagnostics principle" and "methods of modern epidemiological study",this research studies the relationships between state factors and diseases,and based on the state elements of basic pathogenesis,it constructs the risk index system of chronic disease risk warning,which is exemplified in five kinds of chronic diseases(hereafter as "five chronic diseases"),i.e.essential hypertension(hereafter as hypertension),diabetes,lung cancer,gout and perimenopause syndrome.2.According to the results of literature searching and sorting,based on experts' suggestions,this research explores and determines the main(Western Medicine)disease risk factors and constitution of the five chronic diseases,and sorts out the distribution of syndrome patterns of various diseases.Also,it divides the common syndromes of each disease into syndrome elements,so that the most relevant syndrome elements of each disease(syndrome elements are essential factors of the syndrome,including the location and nature of disease)are obtained.Syndrome elements plus the degree of syndrome would constitute the "state elements" of a disease(state elements are the basic elements of a state,including location,nature and degree).Thus,by sorting out literature,this research would find out various state elements,physical factors and risk factors of diseases,together can be termed as the"predisposing factors of diseases".3.Based on literature research and the Delphi expert investigation method,this research builds three categories of risk warning predisposing factors(including characteristics of syndrome elements distribution,physical factors and risk factors of diseases),which cover the main parts of the risk warning of chronic diseases,and can be used as the basic index of disease risk warning.4.According to results of epidemiological survey,literature records and the frequency of literature,combined with clinical experience and other methods,this research aims to arrange and preliminarily sort out the predisposing factors of the five chronic diseases.Besides,by reviewing literature and consulting experts,this research makes questionnaires based on analysis and arrangement of the relationships and proportions among predisposing factors,as well as the correlation of each chronic disease.Also,it would filter and adjust results of the preliminary sorting through the application of Delphi expert consultation method,so that the index system can be further improved and perfected to form the final scale.5.This research carries out a retrospective study to conduct a confirmatory research on physical examination reports with complete physical examination information of Chinese and Western medicine from "The Center of Disease Preventive Treatment" data base.Results1.The terms "disease preventive treatment","chronic diseases","health risk factors","disease risk factors","health risk assessment," and "risk warning of disease in traditional Chinese medicine" are sorted out and explained;the theory of "disease predisposing factors"is created which includes "syndrome element distribution","physical factors" and "disease risk factors" into one index system.2.The impact of each disease predisposing factors index of the five chronic diseases are determined,and a model of disease risk warning assessment based on the five chronic diseases is built.The highly influential predisposing factors of the five chronic diseases are as follows.(1)The highly influential predisposing factors of diabetes are:obesity/overweight[overweight(BMI>25kg/m2 and/or waistline male?85cm female?80cm),obesity(BMI BMI?28kg/m2,similarly hereinafter),phlegm,damp-heat,family history of diabetes,history of pregnancy diabetes,wet,fire(heat),blood stasis,spleen,phlegm-dampness constitution,yin asthenia constitution,kidney,qi asthenia constitution and "three-highs" diet in the long term(high fat,high sugar and high protein);(2)The highly influential predisposing factors of high blood pressure are:"three-highs" diet in the long term(high fat,high sugar and high protein),excessive drinking in the long term,high levels of mental stress,family history of hypertension,phlegm,blood stasis constitution,phlegm-dampness constitution,qi stagnation constitution,qi asthenia constitution,damp-heat constitution,age(>45 years old),wind symptom,qi stagnation,liver and yang hyperactivity;(3)The highly influential predisposing factors of perimenopausal syndrome are:age(45?55 years old),women,depression,liver,yin asthenia constitution,qi stagnation constitution,high levels of mental stress,anxiety,marital status(married,divorced,widowed,remarried),work pressure,qi stagnation,irritability,menstruation(natural menopause,menopause,hysterectomy),state of mind,phlegm-dampness constitution and phlegm;(4)The highly influential predisposing factors of gout are:high purine diet(frequent seafood intake,like shrimp,crab,etc.),suspected gout history/hyperuricemia(history),damp-heat constitution,family history of gout,wet,phlegm,blood stasis,kidney,excessive water drinking,obesity/overweight and phlegm-dampness constitution;(5)The highly influential predisposing factors of lung cancer are:smoking,lung,phlegm-dampness constitution,blood stasis constitution,sputum,family history of lung cancer,heat toxin and qi stagnation constitution.3.Among the test of 500 subjects,the numbers of high risk people of the five chronic diseases are:diabetes 25.6%(128),high blood pressure 22.4%(112),perimenopausal syndrome 18.6%(93),gout 14.4%(72)and lung cancer 3.4%(17).4.Among the test of 500 subjects,the top 10 predisposing factors of the five chronic diseases are as follows.(1)The top 10 predisposing factors of diabetes are:fire(heat),spleen,stomach,dampness,obesity/overweight,phlegm,kidney,phlegm-dampness constitution,deficiency of vital energy and qi asthenia constitution;(2)The top 10 predisposing factors of hypertension are:liver,blood stasis constitution,hyperactivity of yang,obesity/overweight,phlegm-dampness constitution,blood stasis,phlegm,state of mind,yin deficiency and kidney;(3)The top 10 predisposing factors of perimenopausal syndrome are:age,liver,state of mind,qi depression,qi stagnation constitution,yin deficiency,yin asthenia constitution,fire(heat),kidney and qi deficiency.(4)The top 10 predisposing factors of gout are:damp-heat constitution,fire(heat),high purine diet,blood stasis constitution,phlegm-dampness constitution,blood stasis,liver,spleen,obesity/overweight and kidney;(5)The top 10 predisposing factors of lung cancer are:lung,dampness,spleen,qi stagnation constitution,phlegm,qi depression,blood stasis,fire(heat),phlegm-dampness constitution and smoking.5.Among patients of the five chronic diseases,the influential frequencies of the predisposing factors of each disease are different.The distribution of physical factors mainly focus on phlegm-dampness constitution,damp-heat constitution,blood stasis constitution and qi asthenia constitution.Most of the disease risk factors are obesity,smoking,lack of physical activities and exercises,irrational diet,long-term drinking,psychological factors,etc.The distribution of related syndrome elements is scattering,mainly with liver,spleen,kidney,phlegm,blood stasis,damp,qi stagnation and yin deficiency.Conclusion:1.Through literature research,this study has elaborated the theory of disease risk warning based on TCM·health state identification,and initially built the theoretical system of disease risk warning.2.,Through literature research and Delphi expert consultation method,this study has constructed the methodology of disease risk warning based on TCM health state identification.3.The disease risk assessment scale based on the theory and methodology of disease risk warning can effectively predict and warn the risk of diseases. |
PDF Full Text Request