Since the mid 1980s, many scholars have devoted themselves to the study of sub-health. Sub health status in the economically developed, high
Since the mid 1980s, many scholars have devoted themselves to the study of sub-health. Sub health status in the economically developed, highly competitive countries and regions, and sub health population has increased year by year, has become one of the hot topics in the world. With the development of economy, people's health awareness is gradually improved. In the questionnaire survey and physical health consultation, sub-health is being eroded. Although each testing organization has its own set of sub health detection means, but the lack of a unified evaluation of the label, its research is still in its infancy, many problems remain to be solved. The following 20 years of research from the concept of sub-health, disease factors, epidemiological characteristics, evaluation criteria and other aspects of the review.
1 sub health concept
According to a survey of global WHO, really healthy people accounted for only 5% of people suffering from the disease accounted for 20%, while 75% of the people in between healthy and diseased state of over WHO, called "the third state (thethird - staus), often referred to as" domestic "sub healthy state (sub - healthstaus)". The sub-health term first appeared in the mid 1980s, the Soviet Union research scholar Professor Buchtmann found before, in addition to human health and disease, also there is an intermediate state between the health and disease, namely the sub-health state. This finding was confirmed by many scholars. At the seminar Chinese international health academic achievements on 2002: some scholars pointed out that China currently has 70% people in sub healthy state, 15% people in a disease state, only 15% of people in a state of health, sub-health showed a rising trend, and has two-way. Therefore, we should attach importance to it as an important issue to endanger human health.
1.1 sub health of medical concepts
Sub health is also known as gray state, intermediate state, sub disease state, sub health, etc.. Zhao Ruiqin, and so on, said the state of sub-health, also known as the third state, also known as gray state, before the disease state, preclinical, preclinical period, including no clinical symptoms or symptoms feel slightly, but there are potential pathological information. It has a wide range of meanings, which is a kind of low quality state of health and disease among the people. Sub health state is in a constantly changing development, can be healthy, but also to the state of disease.
To what extent, depends on the self health care measures and the level of their immunity. The transition to the state of illness is a spontaneous process of sub-health, and the need to take active preventive measures to strengthen the self health care, reasonable adjustment of dietary structure, etc.. Zhou Ying believes that health is a non between health and disease state of third, although not yet sick, but all have different degrees of risk factors, high risk tendency of a disease, is actually a psychosomatic disease or potential clinical disease state.
1.2 different types of sub health
Dong Yuzheng believes that the so-called sub health, refers to the health and disease between the low quality of health status and experience. Sub health is not only the sub health of the individual, but also the sub health and sub health, and there is an internal connection between the three. As far as the individual sub health is concerned, it is manifested in the following aspects: sub health of the body, psychological sub health, emotional sub health, sub health and sub health. Zhao Ruiqin will report the sub-health state can be divided into: the somatic symptoms of physical sub-health, psychological sub-health in mental symptoms, interpersonal sub-health symptoms in interpersonal relationships in the.
Lin Guizhen and other studies will be sub - health state performance is divided into sub - physical health, mental health, social adaptation sub - health.
1.3 sub-health and chronic fatigue syndrome"
Chronic fatigue syndrome (Chronic Fatigue Syndrome, CFS) is a new member of the sub health population. In 1988 the United States Centers for Disease Control and Prevention (CDC) by experts, a group of chronic persistent or recurrent mental and physical fatigue is the main characteristic of syndrome, the duration of at least 6 months, officially named the chronic fatigue syndrome, and to develop CFS diagnostic criteria and diagnostic criteria of CDC in 1994 and the CFS was revised. The Japanese Ministry of health on the basis of American Standard on the CFS standard. Other countries such as Australia in 1990 to develop the CFS standard, the United Kingdom in 1991 to develop the CFS standard.
2 sub health epidemiology study
2.1 foreign research status
The sub-health state exists in economic development, social competition of countries and regions, the number has been increasing year by year, has become one of the hot issues in the field of international medicine, sub-health concept is not accidental, it is the modern people focus on health, pay attention to prevent the occurrence and development of fully reflects the new thinking in health before the disease. According to statistics, there are 6 million people suspected in the sub-health state of the United States each year, at the age of 20-45 years old. 14% of adult men and 20% of women showed significant fatigue, of which 1/8 developed chronic fatigue syndrome. British survey shows that about 20% of men and women of the total fatigue, about 1/4 of which may be chronic fatigue syndrome (). At present, the incidence of chronic fatigue syndrome is increasing year by year, the incidence of America in higher socioeconomic status of young whites, the medical staff, especially nurses, the incidence rate was higher than that of general population. The National Institute of public health, the government of Japan, recently conducted the largest ever study on fatigue. In the country more than 5000 people aged 15-65, said he was feeling very tired, as high as 60%, which due to heavy workload, heavy housework, mental tension accounted for 44%, and there are no reasons for the 36%. Another survey of 130 thousand employees confirmed that the "fatigue commuters" seems more intense, 72% people claiming to work felt very tired, 75% people often feel weary or headache dizziness, but the main reason is "interpersonal relations", "promotion too slow" or "want to learn so many things such as . At present, Japan's suicide rate, divorce rate, and violent crime remains high, and the population is generally associated with continuing sub-health.
A global survey of WHO shows that only 5% of people are truly healthy, with the disease accounted for about 20%, while the number of people in sub-health status of 75%. Epidemiological studies have showed that the incidence rate of CFS at least in 0.2-0.4%; the most common age of onset was 20-45 years; the most common age of onset in children 13-15 years old, but also has lower incidence of children ages CFS in women; the incidence is 2 times that of men, CFS affects all ethnic groups.
2.2 domestic research status
According to the statistical data in April 8, 2002 twenty-first Century China sub-health market academic seminar "provided show that China has about 15% of the people are healthy, 15% people 70% people were non health, sub-health, health more than 900 million. Studies have shown that the proportion of the population in the developed economy in the sub healthy state in the total population is significantly higher than that in other regions, including Beijing 75.31%, Shanghai is 97.49%, Guangdong is 73.41%. Experts say this is mainly due to the economically developed provinces and cities life rhythm faster, people in the fierce competition, overload pressure tension, it is easy to form the sub-health state. Professor Wang Yuxue has done a survey of 50 thousand cases of the population, the normal distribution of sub-health reached 56.18%, most of them are young adults aged between 20 and 40. "White collar" is the main group of sub health, and more than 85% of the enterprise managers are in sub-health state. The intellectuals in China are the high incidence of sub healthy state, and their sub health is worrying. Beijing, Zhongguancun, where the elite of science and technology are brought together, the average life expectancy of intellectuals is only 53.4 years, less than the average life expectancy of the region around the age of about 20 years. In this paper, a unified questionnaire was used to investigate the sub-health of 19 teachers in Guangdong province. The results showed that the ages of 30 - and 40 years old were the risk factors of sub-health of College teachers. Li Xueying reported that the incidence of sub-health of primary and secondary school teachers in Tai'an city was 65.8%, of which the high school teachers were as high as 73.5%, the junior high school teachers was 66.2%, and the primary school teachers were as high as 45.2%. In April 2001, a survey conducted by the Beijing City: 1866 intellectuals received physical examination in the sub-health rate as high as 96%, and the title is proportional to the level of 95%, Professor, associate professor of 89.4%, of which 40 - 50 years old group "Yajiankang" rate as high as 90.4%. In July 2002, Fan Cunxin conducted a large-scale survey of 19 colleges and universities in Guangdong Province, nearly 10000 staffs health condition the results showed that there were 10.40% people in a state of health, 20.42% of people in various disease states, 69.17% of the people in sub-health state, there are 1/3 people in the severe sub-health state. Due to the physical advantages of young people, the proportion of people who are in a sub healthy state will not be very high, but the sub health problems of college students is worrying. Sub health state is the most prominent among the college students. 1712 undergraduate students from 5 universities in Guangzhou City, Fan Cunxin conducted a sample survey found that more than 60% of the students in the sub healthy state, the main manifestation of psychological and somatic symptoms in attention, learning efficiency, immunity, fatigue and digestive system, show that college students sub-health population is an important health the problems are common and can not be ignored. Ling Huang, through the investigation of the sub health status of 500 students of two universities in Nanning grade two or three, real health accounted for 7%, accounted for 14% of health has sounded the alarm, sit down, to reflect the life state of their own, exercise and pay attention to the reasonable collocation diet accounted for 61%, taking the money to see a doctor in time and need to adjust their body and mind accounted for 18%. The results of sub-health state survey of 2005 College Students in Zhengzhou City, Li Yuliang, the sub-health incidence rate was 62.44%, the frequency of occurrence of sub-health state and college students of different majors, gender, grade, whether the one-child and so on. Li Jun through the survey of 1520 college students in the fourth grade the Xinjiang Uygur Autonomous Region, Shaanxi Province, Jiangsu province six colleges and universities in the sub-health state, in 96 kinds of sub-health symptoms listed, with 16 or more symptoms of 61.02% students; 64.19% of the students think that Ya Jian Kang symptoms, and affects their social function; 20.87% of the students of general suspicion of having had a disease.
3 sub health factors
Many countries in the world have done a lot of research on "sub health", but there is no unified and specific pathogenic factor. One study suggests that sub-health status may be due to the fast pace of social life, many of the social information to stimulate the sympathetic nervous system, make people long-term in the excited state due to autonomic nervous system dysfunction caused by. Some people think that the causes of sub-health include psychological, physiological and social disorder three factors lead to the body of the nervous system, endocrine system and immune system dysfunction caused by imbalance, overall coordination, and living conditions, environmental pollution and working pressure due to the influence caused by. Although the understanding of the medical profession is not the same, but there are several reasons summarized.
3.1 psychological factors
Fan Cunxin research shows that university teachers' Sub-health with high relative risk factors and psychological problems such as work pressure, work, work is not smooth, unpleasant work ability not to be recognized, feel the life is dull, unpleasant things, not happy, not satisfied with the status quo of life etc.. Certain personality traits can be an important risk factor for disease. Some experts believe that the essence of sub-health is psychosomatic problems, mainly lead to the psychosocial factors of psychological stress, emotional irritability, abnormal behavior caused at the same time, personality, personality defects, personality quirks are closely related. They are the relationship, interaction and reciprocal causation of dialectical development.
3.2 social factors
The pressure of modern society is everywhere, tension has become a common feature of modern people. Social competition, work, learning burden, life pressure; social complex interpersonal relations, tensions between the upper and lower layer or colleagues; life events, such as divorce, widowed, unemployed, involved in legal disputes and economic burden; mechanization, the formulation of the life, work and study, accounted for most of the time people, the emotional communication between people is becoming less and less, loneliness has become a notable feature of people's life. All of these factors can lead to negative emotions, which are the important risk factors of sub-health.
3.3 habits and behavior factors
Along with the acceleration of modernization, social competition is becoming increasingly fierce, tough, heavy work career and life rhythm speeding up, more and more people load increase, not the law of life, work overtime has led to a severe lack of rest and sleep, often this down, prone to fatigue, and the fatigue is an important factor of health hazards at present. There are long-term smoking, excessive drinking, desk work for a long time, lack of physical exercise, the indiscriminate use of drugs and health care products, such as unhealthy lifestyle, which is an important factor in sub-health state. According to the WHO report, the cause of death in the world due to bad lifestyle caused by diseases accounted for 60%, of which up to 70-80% in developed countries, developing countries also reached 50 - 60%. Found in the top three causes of death analysis of China published, in the cardiovascular disease unhealthy lifestyle and biological factors of the ratio of 45.7%:29% to 43.3%:36%, cerebrovascular disease, malignant tumor is 43.6%:45.9, the three diseases accounted for 67.6% of all causes of death. In other words, at present, 2/3 of people die from diseases related to unhealthy lifestyles.
3.4 dietary factors
With the improvement of material living conditions, the intake of high calorie foods, high-fat foods gradually increased, leading to obesity, hyperlipidemia, fatty liver. At present, overweight and obesity in the world is increasing year by year, obesity has become a serious threat to human health killer, according to statistics, 40 years of age are overweight people under the age of 85%. Obesity leads to various diseases, such as heart disease, high blood pressure, diabetes and so on.
3.5 interpersonal factors
The social life of the increasingly complex and changeful, the feelings between people increasingly indifferent, lack of emotional communication increasingly, communication tends to be superficial and materialistic, emotional frustration more chances of the emotional life of the decline in confidence, loneliness people in prominent aspects of emotional experience. The lack of close social relationships and friendships can make people feel bored, helpless and upset. A large body of evidence shows that lack of social support is an important factor leading to mental and physical disorders.
3.6 environmental factors
With the over exploitation of resources, the emergence of a group, and the edifice of climate change, destruction of the ecological environment of human beings, all kinds of pollution is becoming increasingly serious, such as air pollution, vehicle exhaust pollution, water pollution, food pollution, noise pollution, electromagnetic interference and so lead to human living space becomes smaller, and the adverse effects on the human body each system the long-term in this environment, the cells of the body can not play a normal physiological function, and thus damage the balance of human body causes various diseases. Shatana et al. Research shows that the geographical environment factor is one of the important factors that affect the sub-health state, the geographical environment is different, people's sub healthy state is also different, so as to develop into different local diseases. Zhou Ying and so on, bad lifestyle and behavior habits, psychological and social factors and housing tension, traffic congestion, environmental pollution is the cause of sub-health. Fu Jianmin believes that the main reasons for the sub health status of medical students are academic pressure, competitive environment, employment pressure, cultural differences and lack of exercise. According to statistics, China's urban residents living in the room every day up to 21.53 hours, accounting for the total amount of all day time of 90%, long-term living in air pollution in the room will be in a state of sub-health.
Study on diagnostic criteria of sub-health in 4
Up to now, there is no uniform diagnostic standard of sub-health status in the world. In 1988, the Centers for Disease Control and Prevention (CDC) established diagnostic criteria for the most prevalent chronic fatigue syndrome (CFS). Later, the various countries on the basis of the development of the national diagnostic criteria. The study of sub-health in China started late, there is still a lack of uniform evaluation criteria. Zheng Heng et al think that the sub-health state may be caused by many factors, the main symptoms are often multiple, therefore, to determine the evaluation of sub-health status, need to consider a variety of possible symptoms, a comprehensive syndrome differentiation. Researchers at home and abroad have several kinds of sub health evaluation methods.
4.1 scale evaluation
Currently the most representative of the Connell Medical Index (Cornell Medical Index, CMI). CMI is a self-administered health questionnaire at the Cornell University Wolff HG.Brodman R. system. The questionnaire consists of 4 parts: somatic symptoms, family history and past history, general health and habits, mental symptoms. The questionnaire is divided into 18 parts, each part of the alphabetical order, a total of 195 questions, each item is a grade two answer: Yes or no. "Yes" 1 minutes, "no" record of 0 points. The total score of all items added to the total score of CMI. MR is divided into 10 points. The United States used the screening value of the total score of 30 points, M - R score of 15 points; female total score of 40 points, M - R score of 20 points. Chinese scholars use CMI to study the sub health of different groups, such as students, soldiers, teachers, nurses and so on. Chinese Academy of traditional Chinese medicine (TCM) from 2001 to 2005 developed and applied a self-made "sub-health status questionnaire" to investigate and study the health and sub-health population of nearly 4000 people in Beijing. They are in the exclusion of disease diagnosis, the main measure "ill state and diminished capacity", taking into account the people's health and the nature, environment (natural and social), so the increase in related field. This questionnaire established by the sub health domain measurement system includes 4 aspects of the discomfort, diminished capacity, resources, environment, and further divided into body status, emotional status, living conditions, mental status, endowment conditions, social environment of the 6 domain structure, a total of 124 entries. The questionnaire of quality of life scale WHO absorb all 29 items in an item, which enriches the related items, the two are also laid the foundation for the validation and control of sub health measurement, this part of the entries can be analyzed separately.
4.1.2 Delphi self testing table
Many scholars in China have adopted the self-made scale to study the sub-health state. Chen Qingshan used the Delphi method to evaluate the sub-health diagnosis standard, the scale includes: (1) physical symptoms: fatigue, headache or dizziness, tinnitus, shoulder or leg numbness stiff, pharyngeal foreign body sensation 5; (2) psychological symptoms: loneliness, confused in mind, inattention, anxiety and insomnia the rest is not good, poor memory 6; (3): vitality loss, not interested in the things around, the bad mood of 3; (4) social adaptability: work difficulty, the tense relationship between colleagues and other 2; (5) immunity: colds or suffering from a disease which he (; 6) to the hospital: I feel sick but not confirmed a total of 6 level indicators, 18 symptom. Chen Qingshan et al. Application of this standard, the sub health survey and evaluation of the 19 universities of Guangdong Province, 9600 staff members of University Teachers' Sub-Health incidence rate was 69.18%. In addition, there are "fatigue scale", "fatigue scale and SCL-90 scale of sub-health detection. Zhao Yongguang SCL - 90 scale and health survey, the border defense soldier sampling results show that compared to soldiers of frontier defense soldiers and other regions have higher psychological pressure and there are more people in sub healthy state.
4.2 hematology and instrumentation
4.2.1 ultra high magnification microscopy (MDI) sub health assessment
MDI health check (commonly known as a drop of blood) is the Stanford University Dr. Dradford launched a health assessment and disease diagnosis method, through the "blood test" and "blood", without staining can be observed in the blood visible component morphology and vitality, so as to obtain the original information of the cell level based on the free radical, track inspection, make an important cue for the early diagnosis of disease. Compared with the blood biochemistry test, blood rheology and life quality measurement, measured the comprehensive evaluation according to percentile, above 85 points for health, below 70 points for the disease state, 70 to 85 points for the sub-health state. The king of Jiangsu, equal application of MDI 5 in Zhejiang at the age of 100 - more than 20 thousand people were sub healthy blood survey, the experimental results show that MDI in the sub health survey has a unique "overall evaluation value. The deficiency of MDI is that it can not be used for quantitative and qualitative detection of specific organs.
4.2.2 multimedia Microscopy Diagnostic Instrument (THMMDI)
THMMDI is a kind of detection method based on the improved design of Tsinghua University in MDI. This method preserves the health check of the "one drop", compared with MDI, improve the magnification of 20000 times, increasing the number of pathogens and cytology. Qian Jinkang and so on, THMMDI can be found in the sub health status of the population, the positive rate of diagnosis was 90%.
The determination of the project are: the whole blood viscosity, plasma viscosity, whole blood high (low) reduced viscosity, erythrocyte deformation index, erythrocyte aggregation index, erythrocyte sedimentation rate, hematocrit etc.. Many studies have shown that elevated blood viscosity often occur in early sub-health or disease, is one of the distinctive features of the indexes of blood rheology.
4.2.4 blood cell impedance measurement
Chen Anyu believes that the sub health state may cause changes in the nature of blood red cell membrane, and this change will affect the impedance of the blood changes, but did not put forward specific criteria for judgment.
4.2.5 other blood indicators
Zhong Yukun believes that the content of trace elements in the body can be measured to reveal the sub-health status. Study on 2486 elderly people in Italy found that low serum protein and low serum iron may be a marker of sub-health, age - cholesterol negative correlation in male is significant for the elderly, low cholesterol may be a marker of sub-health ". Wu Weiping proposed that there are two kinds of sub-health: the critical state of specific disease and the critical state of nonspecific disease. The people in sub-health consciously have many symptoms, changes of laboratory examination may have some indexes, but has not yet reached the diagnostic criteria of corresponding diseases, such as blood sugar is often higher than the reference value, but has not yet reached the diagnostic criteria for diabetes mellitus.
4.2.6 Forbes remote health monitoring system (TDS)
At the beginning of 2000, Forbes medical instrument development Co. Ltd. the research and development of remote health detector (TDS), it is a product of traditional Chinese meridian theory and modern high-tech electronic technology equipment with the noninvasive human health status detection, the use of electronic sensors to the human body meridian biological current was measured twelve. The physiological and pathological status of human organs and tissues was analyzed by case analysis database. TDS sub health population detection rate of 87.2%, Fujian province has been included in the civil service examination TDS detection.
4.2.7 other instrumentation
There are brain imaging examination (EEQG), quantum resonance detection, ECG QT dispersion, etc., to enrich the sub health diagnosis method, a certain degree of sub-health detection.
4.3 chronic fatigue syndrome
The diagnostic criteria for CFS were first developed by the US Centers for Disease Control and Prevention (CDC) in 1988 and revised in 1994. The standard by the international medical community recognized as the gold standard, its content includes the following 3 aspects: (1) chronic fatigue causes persistent or recurrent unexplained fatigue, this is new or clear at the beginning of the history of not less than 6 months; not sustained results; the rest can ease; at present all kinds of occupation ability, and the ability to accept the education, personal life and social activity ability was significantly decreased before the illness. (2) also have the following 8 items in 4 or 4 or more symptoms: short-term memory or concentration decreased significantly; the sore throat; the neck or axillary lymph node enlargement and tenderness; muscle pain; and no multiple joint pain and swelling; a new type of degree of weight the poor quality of sleep; headache; the fatigue after exercise lasted more than 24h. (3) chronic fatigue to exclude the following: the primary causes of chronic fatigue can be explained; the clinical diagnosis and treatment of some diseases but difficult in the existing medical conditions caused by persistent chronic fatigue.
4.4 traditional Chinese medicine evaluation
Chinese traditional medicine is a set of scientific sub health evaluation system, which is based on the comprehensive evaluation of nine health care. Wei Yuke developed the sub-health state of common clinical symptom diagnosis system used in the determination of human sub-health status, with the practical situation of Chinese medicine diagnosis was consistent with that of fuzzy neural network technology can play a better role in the development of the diagnosis system. In 2006, the Chinese Academy of traditional Chinese medicine (TCM) published the clinical guidelines for sub health Chinese medicine, which is the first document to guide and regulate the research and intervention of sub-health in china. It standardizes the scope, terms and definitions, sub-health sub-health category, sub-health common clinical manifestation, classification and differentiation of traditional Chinese medicine to provide reference and research related disciplines and intervention in sub-health status for TCM, combination of TCM and Western medicine, the diagnosis and intervention of sub-health of scientific and standardized management, provide the basis for seeking health management is feasible and health intervention measures.
A word of sub-health late, so far only 20 years of history, during the period of scholars dedicated to the study of sub-health causes, diagnostic criteria and intervention measures, but has not yet been found to cause specific pathogenic factors of sub-health, has not yet formed a unified standard in the world, the lack of objective and effective tool for the quantitative evaluation. Research on China's sub-health state started later, although a lot of research, but is still at the primary stage of self diagnostic criteria for local research, although there are some achievements, but there are many problems to be solved. We are currently working on sub-health diagnostic standard, mainly from the subjective and objective indicators index combining comprehensive evaluation system to evaluate the sub-health, the participation of experts in all aspects, develop sub-health questionnaire, evaluation of sub-health diagnostic criteria according to the results of blood biochemical indexes, immunological indexes, electrocardiogram, ultrasound and other detection equipment gene detection index, comprehensive detection, hope to develop the sub-health diagnostic criteria consistent with the Chinese in the near future, for more healthy people's health service.