体质与情志致病研究
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摘要
目的:针对目前因怒导致的情志病证远比其他情志刺激所致病证常见的临床现状,遵循量表编制的规范程序,尝试编制易怒体质量表,从体质角度研究因怒引发的不同情志病证的体质特点及其形成的基本机制,有针对性地制定出因怒致病的预防措施。
方法:首先,以中医基础理论中的体质学、藏象学为基础,确立易怒体质的定义。第二,依据现存文献有关怒致病的论述,结合3家医院住院病历的回顾性调查,建立易怒体质量表的备选条目池,并采用频数法以P60为标准初选条目,参考、采纳专家的意见,建立初选条目池。第三,以济南市18～55岁人群为目标对象,采取多阶段分层整群抽样的方式抽取学生、工人、农民共520例,以初选量表为调查工具对其进行问卷调查,采用离散趋势法、区分度分析法、探索性因子分析法、Cronbach'sα系数法4种统计学方法筛选条目池,确立量表维度,保留条目最终形成初始易怒体质量表。第四,对初步确立的易怒体质量表进行可行性、信度及效度考评,所有统计方法的运算均采用SPSS13.0统计软件完成。
结果:①确立了易怒体质的含义,论证出易怒体质形成的基本过程:机体气血潜在不畅→易怒→气机失调→肝疏泄太过或不及→脏腑组织功能失常→精、血、津液的运行代谢失调→易怒体质。②文献中共查找与怒相关的文献4 602篇,有效文献1 017篇;相关住院病历共54 703份,筛选出情志致病病历506例,其中因怒致病病历130例,从中筛选出高频数条目86条,经专家论证及小范围预试后最后保留56个条目。③通过流行病学调查及统计处理后,形成了包含37个条目4个维度的易怒体质量表,分别从形态结构特征、怒伤肝、机体功能下降、心理特征方面描述易怒体质。④量表可行性考评显示:量表回收率99.2 %,有效率96.3 %,被调查者10～15 min可完成量表的填写。信度考评显示:易怒体质量表的重测信度在0.707～0.799,分半信度为0.900,同质性信度的Cronbach’sα系数是0.921。效度考评显示:结构效度使用探索性因子分析法,显示该量表符合逻辑关系,方差累计贡献率为56.068%,每个条目在其对应的公因子上的负荷都大于0.4,最小值为0.432,最大值为0.784。内部相关系数研究表明量表总分与各维度之间的相关在0.632～0.881之间,各维度之间的相关在0.401～0.692之间。区分度显示该量表可以有效地判别特质怒与非特质怒人群的体质特征,除形态结构特征维度外,两组怒伤肝维度、机体功能下降维度、心理特征维度及量表总分比较,有极显著性差异(P<0.0001)。
结论:易怒体质量表是灵敏、有效、可信的测量工具,能够较全面地反映易怒体质的特征,可以试用于人群的易怒体质评价。以此为依据可对易怒体质的形成环节实施有针对性地干预,修正体质偏颇,预防情志疾病的发生。
Objectives: In the current clinical settings, the diseases caused by anger were more common compared to other emotion-related syndromes. The aim of this study was to construct an angry constitution scale according to the standard scale establishment procedure. The scale could be used as a tool to study the constitution characteristics and mechanisms in various emotional diseases triggered by anger and thus it might contribute to the prevention of anger-related emotional diseases.
Methods: Firstly, defined the concept of angry constitution based on the Basic Theory of Traditional Chinese Medicine, specifically on its Constitution Theory and Zangxiang Theory. Secondly, all the possible candidates of the item pool were first listed by reviewing the literatures of angry related diseases and the retrospect studies of hospital records from three hospitals, and then the primary version of the scale was finalized by consulting the peers in this field, and by analyzing the item pool with frequency distribution and P60 standard. Thirdly, 520 people were sampled in the multistage stratified cluster sampling method and were tested by the primary scale of angry constitution, who lived in Jinan district with career variation of student, farmer and factory worker, aging from 18 to 55 years old. After further analysis of the survey data from valid 501 cases with four different statistic methods: tendency of dispersion method, distinction of analysis, exploratory factor analysis, Cronbach'sαcoefficient method, the item pool was filtered and the scale dimension was set up, and the prior test version of this scale was established. Fourthly, the feasibility, reliability and validity of the scale were tested. All statistic analysis was finished by SPSS13.0 if necessary.
Results: 1. Definition of angry constitution was established. The process of formation of angry constitution was demonstrated as :potentially disorder of Qi and blood→angry→disturbance of movement of Qi→the live loss of control of the maintenance of normal flow of Qi→functional decline of viscera and organs→movement and metabolism disorder of essencial substances,blood and body fluid→angry constitution. 2. There were total 4 602 literatures related to angry, 1 017 of which were related to this studies; 54 703 hospital records were reviewed, of which 506 were emotional related disease and 130 cases were angry induced diseases. From the literature and hospital record study, 86 high frequency encountered items were pooled out and 56 items were kept after peer consultation and small range test. 3. After epidemic research and statistic analysis, the scale of angry constitution was established with 37 items distributed in four dimensions of morphological characteristics, angry impairing liver, decreased function of the body and psychological characteristics. 4. The feasibility of this scale: 99.2% feed back, of which effective rate 96.3%; the tester could finish the scale in 10 to 15 min. The reliability of the scale: test-retest reliability 0.707~0.799; split-half reliability: 0.900; Cronbach’sα= 0.921. The validity of the scale: exploratory factor analysis revealed that the structure validity had logic relation with the cumulative variance of 56.068%. The common charges on each item were all larger than 4.0 (with min 0.432 and max 0.784, respectively). The interior correlation coefficient between the total scale score and its subdivision dimension score were 0.632~0.881, among each dimension was 0.401~0.962. The validity of the scale of angry constitution could effectively distinguish trait angry and none-trait angry population. Except the morphological characteristics dimension, all other dimension scores were statistically different (P<0.001), including two groups of angry impairing liver dimension, decreased function of the body dimension, psychological characteristics dimension and between the total score of the scale.
Conclusions: The scale establishment of angry constitution is a sensitive, effective and reliable test tool which can cover all the aspects of angry constitution and thus be used to evaluate the angry constitution of the population. It can also be used clinically as tool to adjust patient’s constitutional variation, thus it may have potential application in the prevention of emotion-related diseases.
方法:首先,以中医基础理论中的体质学、藏象学为基础,确立易怒体质的定义。第二,依据现存文献有关怒致病的论述,结合3家医院住院病历的回顾性调查,建立易怒体质量表的备选条目池,并采用频数法以P60为标准初选条目,参考、采纳专家的意见,建立初选条目池。第三,以济南市18～55岁人群为目标对象,采取多阶段分层整群抽样的方式抽取学生、工人、农民共520例,以初选量表为调查工具对其进行问卷调查,采用离散趋势法、区分度分析法、探索性因子分析法、Cronbach'sα系数法4种统计学方法筛选条目池,确立量表维度,保留条目最终形成初始易怒体质量表。第四,对初步确立的易怒体质量表进行可行性、信度及效度考评,所有统计方法的运算均采用SPSS13.0统计软件完成。
结果:①确立了易怒体质的含义,论证出易怒体质形成的基本过程:机体气血潜在不畅→易怒→气机失调→肝疏泄太过或不及→脏腑组织功能失常→精、血、津液的运行代谢失调→易怒体质。②文献中共查找与怒相关的文献4 602篇,有效文献1 017篇;相关住院病历共54 703份,筛选出情志致病病历506例,其中因怒致病病历130例,从中筛选出高频数条目86条,经专家论证及小范围预试后最后保留56个条目。③通过流行病学调查及统计处理后,形成了包含37个条目4个维度的易怒体质量表,分别从形态结构特征、怒伤肝、机体功能下降、心理特征方面描述易怒体质。④量表可行性考评显示:量表回收率99.2 %,有效率96.3 %,被调查者10～15 min可完成量表的填写。信度考评显示:易怒体质量表的重测信度在0.707～0.799,分半信度为0.900,同质性信度的Cronbach’sα系数是0.921。效度考评显示:结构效度使用探索性因子分析法,显示该量表符合逻辑关系,方差累计贡献率为56.068%,每个条目在其对应的公因子上的负荷都大于0.4,最小值为0.432,最大值为0.784。内部相关系数研究表明量表总分与各维度之间的相关在0.632～0.881之间,各维度之间的相关在0.401～0.692之间。区分度显示该量表可以有效地判别特质怒与非特质怒人群的体质特征,除形态结构特征维度外,两组怒伤肝维度、机体功能下降维度、心理特征维度及量表总分比较,有极显著性差异(P<0.0001)。
结论:易怒体质量表是灵敏、有效、可信的测量工具,能够较全面地反映易怒体质的特征,可以试用于人群的易怒体质评价。以此为依据可对易怒体质的形成环节实施有针对性地干预,修正体质偏颇,预防情志疾病的发生。
Objectives: In the current clinical settings, the diseases caused by anger were more common compared to other emotion-related syndromes. The aim of this study was to construct an angry constitution scale according to the standard scale establishment procedure. The scale could be used as a tool to study the constitution characteristics and mechanisms in various emotional diseases triggered by anger and thus it might contribute to the prevention of anger-related emotional diseases.
Methods: Firstly, defined the concept of angry constitution based on the Basic Theory of Traditional Chinese Medicine, specifically on its Constitution Theory and Zangxiang Theory. Secondly, all the possible candidates of the item pool were first listed by reviewing the literatures of angry related diseases and the retrospect studies of hospital records from three hospitals, and then the primary version of the scale was finalized by consulting the peers in this field, and by analyzing the item pool with frequency distribution and P60 standard. Thirdly, 520 people were sampled in the multistage stratified cluster sampling method and were tested by the primary scale of angry constitution, who lived in Jinan district with career variation of student, farmer and factory worker, aging from 18 to 55 years old. After further analysis of the survey data from valid 501 cases with four different statistic methods: tendency of dispersion method, distinction of analysis, exploratory factor analysis, Cronbach'sαcoefficient method, the item pool was filtered and the scale dimension was set up, and the prior test version of this scale was established. Fourthly, the feasibility, reliability and validity of the scale were tested. All statistic analysis was finished by SPSS13.0 if necessary.
Results: 1. Definition of angry constitution was established. The process of formation of angry constitution was demonstrated as :potentially disorder of Qi and blood→angry→disturbance of movement of Qi→the live loss of control of the maintenance of normal flow of Qi→functional decline of viscera and organs→movement and metabolism disorder of essencial substances,blood and body fluid→angry constitution. 2. There were total 4 602 literatures related to angry, 1 017 of which were related to this studies; 54 703 hospital records were reviewed, of which 506 were emotional related disease and 130 cases were angry induced diseases. From the literature and hospital record study, 86 high frequency encountered items were pooled out and 56 items were kept after peer consultation and small range test. 3. After epidemic research and statistic analysis, the scale of angry constitution was established with 37 items distributed in four dimensions of morphological characteristics, angry impairing liver, decreased function of the body and psychological characteristics. 4. The feasibility of this scale: 99.2% feed back, of which effective rate 96.3%; the tester could finish the scale in 10 to 15 min. The reliability of the scale: test-retest reliability 0.707~0.799; split-half reliability: 0.900; Cronbach’sα= 0.921. The validity of the scale: exploratory factor analysis revealed that the structure validity had logic relation with the cumulative variance of 56.068%. The common charges on each item were all larger than 4.0 (with min 0.432 and max 0.784, respectively). The interior correlation coefficient between the total scale score and its subdivision dimension score were 0.632~0.881, among each dimension was 0.401~0.962. The validity of the scale of angry constitution could effectively distinguish trait angry and none-trait angry population. Except the morphological characteristics dimension, all other dimension scores were statistically different (P<0.001), including two groups of angry impairing liver dimension, decreased function of the body dimension, psychological characteristics dimension and between the total score of the scale.
Conclusions: The scale establishment of angry constitution is a sensitive, effective and reliable test tool which can cover all the aspects of angry constitution and thus be used to evaluate the angry constitution of the population. It can also be used clinically as tool to adjust patient’s constitutional variation, thus it may have potential application in the prevention of emotion-related diseases.
引文
[1]赵志付.浅析心身疾病的刚柔辨证[J].中医杂志,2006,47(2):146.
[2]朱梅.现代心理学的对象与心身健康、中医七情病因学说关系探析[J].陕西中医,2006,27(2):206.
[3]胡随瑜.中医肝脏象情绪评估的研究思路与方法[J].中医文献杂志,2002: (1):15.
[4]王米渠.七情发病初探[J].四川中医,1986,(5):7.
[5]朱力.社会问题概论[M].北京:社会科学文献出版社,2002:175.
[6]汪士昌,陈瑞英,张凤娟,等.综合医院心理门诊1568例分析[J].中国心理卫生杂志,1999,(3):45.
[7]任昱,张虹.《内经》“怒”理论钩玄[J].浙江中医学院学报,2004,28(5):11.
[8]张沁园.怒致病的相关机理探讨[J].吉林中医药,2006,26(6):2.
[9]夏卫东,叶卉.内经对“怒”的认识[J].杭州医学高等专科学校学报,2002, 5(6):237.
[10]宋炜熙,胡随瑜.论情志与情绪的异同[J].山东中医药大学学报,2003,27(3):250.
[11]金光亮.论情志与情志病因[J].中国医药学报,1997,12(3):9.
[12]韩成仁.关于七情学说研究几个概念的阐释[J].山东中医药大学学报,1997,21(6):408.
[13]武刚.情志学说研究思路探析[J].安徽中医学院学报,2001,20(4):4.
[14]乔明琦,韩秀琴.情志概念与可能的定义[J].山东中医药大学学报,1997,21(4): 258.
[15]严灿.中西医学在精神心理领域的结合—情志学说中西医结合研究的思考[C].中西医结合实验医学创新与发展国际研讨会论文集,2007:113.
[16]吕直.解读中医情志疾病研究[J].中医药学刊,2004,22(9):1 601.
[17] Diamond, E L .The role of anger and hostility in essential hypertension and coronary heart disease[J]. Psychological Bulletin,1982,92(2):410.
[18] Siegel, JM. Anger and cardiovascular risk in adolescents[J]. Health Psychology,1984,3(4):293.
[19]张伯礼,宋其云,崔秀琼,等.天津地区中医中风病危险因素及证候调查研究[J].天津中医,2000:17(1):35.
[20]王米渠,邹义壮,曾倩,等.《名医类案》196例七情发病构成及男女特点分析[J].现代中西医结合杂志,2006,15(8):983.
[21]徐胤聪,张继伟,吴建林.情志伤肝头痛证治[J].山东中医杂志,2008,27(2):81.
[22]乔明琦,徐旭杰,韩秀琴,等.经前期综合征证候分布规律的流行病学调查研究[J].中国中医基础医学杂志,1997,3(3):31.
[23]乔明琦,张慧云,石忠峰,等.择时造模猕猴经前期“病证表现”及其评价[J].中国中医基础医学杂志,2002,8(7):59.
[24]王海苹,薛玲,张惠云,等.经前期综合征肝气逆证猕猴模型表情行为及递质水平的变化[J].中药药理与临床,2004,20(3):45.
[25]刘晓伟,曲宏达,张红梅,等.怒、恐应激大鼠脑内c-fos与CRHmRNA表达差异性分析[J].四川中医,2006,24(1):11.
[26]刘晓伟,曲宏达,张红梅,等.怒恐伤气大鼠血ACTH、CORT、IL-2、IL-8的含量变化的比较研究[J].辽宁中医杂志,2006,33(2):239.
[27]郭蕾.怒志的生理病理及实验研究[J].山东中医药大学学报,1995,19(5):290.
[28]高知勇.谈中医怒伤肝与癌症的关系[J].黑河科技,2001,(1):46.
[29]刘颖,姚丽,刘伟星.同病异治与室性早搏的治疗[J].山东中医杂志,2002,21(10):629.
[30] Williams JE,Nieto FJ,Sanford CP,etal.The association between trait anger and incident stroke risk: the atherosclerosis risk in communities (ARIC) study [J].Stroke,2002,33(1):9.
[31] Rujescu D, Giegling I, Bondy B,et al.Association of anger-related traits with SNPs in the TPH gene[J]. Molecular Psychiatry,2002,7(9): 1 023.
[32] Davidson R J, Putnam K M, Larson C L, Dysfunction in the neural circuitry of emotion regulation--a possible prelude to violence[J].Science,2000,289 (5479):591.
[33] Ronekleiv OK, Kelly MJ.Diversity of ovarian steroid signaling in the hypothalamus[J]. Front Neuroendocrinol,2005,26(2):65.
[34] Maguire J L, Stell B M, Rafizadeh M ,et al. Ovarian cycle–linked changes in GABAA receptors mediating tonic inhibition alter seizure susceptibility and anxiety[J]. Nature Neuroscience,2005,8(6):797.
[35]吴斌.大鼠杏仁核—下丘脑神经通路研究[J ].自然科学杂志, 2000, 201 (1) : 75～77.
[36] Kilts CD, Egan G, Gideon DA, et al. Dissociable neural pathways are involved in the recognition of emotion in static and dynamic facial expressions[J]. Neuroimage,2003,18(1):156.
[37] Kimbrell TA, George MS, Parekh PI, et al. Regional brain activity during transient self-induced anxiety and anger in healthy adults[J]. Biol Psychiatry. 1999,46(4):454.
[38] Esslen M, Pascual-Marqui RD, Kochi K, et al. Brain areas and time course of emotional processing[J].Neuroimage,2004, 21(4):1 189.
[39] Nomura M, Ohira H, Haneda K, et al. Functional association of the amygdala and ventral prefrontal cortex during cognitive evaluation of facial expressions primed by masked angry faces: an event-related fMRI study[J]. NeuroImage,2004,21(1):352.
[40] Eddie Harmonjones. Clarifying the emotive functions of asymmetrical frontalcortical activity[J]. Psychophysiology,2003, 40 (6): 838.
[41] Deffenbacher JL, Filetti LB, Lynch RS, etal. Oetting ER:cognitive- behavioral treatment of high anger drivers[J]. Behav.Res.Ther. 2002, 40(8):895.
[42]杨靖,邢彤,李春禄,等.中医体质学说现代研究进展[J].长春中医学院学报,2000,16(4):601.
[43]马晓慧.中医体质学说理论与方法研究进展[J].上海中医药杂志,2000,(5):47.
[44]朱伟,王丽华,欧阳钦.中医体质学说研究面临的问题[J].中国中医药信息杂志,2000,7(3):11.
[45]刘良倚.中医体质学说的研究现状[J].江西中医药,2000,31(6):55.
[46]钱会南.中医体质的现代研究方法分析[J].中国中医药信息杂志,2005,12 (5):1.
[47]王琦.中医体质学说研究现状与展望[J].中国中医基础医学杂志,2002,8(2): 86.
[48]金香淑,赵贤俊,韩福仁.中医体质学说与朝医四象人学说浅析[J].中国民族医药杂志,1999:5(1):26.
[49]赵霞.100例哮喘患儿体质调查及分型研究[J].成都中医药大学学报,2001,24(3):16.
[50]童家罗.200例慢性支气管炎病理性体质类型与发病关系的分析[J].上海中医药杂志,1998,(3):14.
[51]张洪钧.急性白血病易患体质研究及病因病机探讨[J].北京中医药大学学报,2002,25(1):46.
[52]钱岳晟,张伟忠,周怀发,等.原发性高血压患者表型与中医体质分类关系的研究[J].中国中医基础医学杂志,2002,8(2):49.
[53]丰田一.汉方一贯堂中解毒证体质按年龄选用方剂的变迁[J].国外医学·中医中药分册,1998,(1):8.
[54]王米渠.《内经》阴阳人格体质学说与艾森克人格维度的比较研究[J].贵阳中医学院学报,1996,(3):7.
[55]王琦,苏庆民.试析中日体质观中证与临床异同[J].吉林中医药,1992,(1):5.
[56]王东坡,王琦.论体质分类研究的源流及其科学意义[J].北京中医药大学学报, 2006,29(6):374.
[57]王琦.9种基本中医体质类型的分类及其诊断表述依据[J].北京中医药大学学报,2005,28(4):1.
[58]匡调元.中医病理研究[M].上海:上海科学技术出版社,1980:66.
[59]田代华.论体质与证候[J].山东中医学院学报,1983,7(1):6.
[60]母国成.中医体质学说及其异化[J].新中医,1983,15(9):9.
[61]龚海洋.略论中医体质分类[J].中医药学报,2003,31(6):1.
[62]刘国强.温病体质学说概论[J].陕西中医,1986,7(1):1.
[63]孟凡迅,马红萍,党瑞山,等.检测脂肪条带结构上的低阻抗线[J].中华国际医学杂志,2004,4(4):171.
[64]许建华,陆敏.鼓胀患者的抑郁自评量表—SDS测定分析[J].贵阳中医学院学报,1995,16(2):481.
[65]赵唯贤,刘建涛.阳痿中医分型与心理量表测评对照研究[J].河南职工医学院学报,2001,13(2):103.
[66]施和勋.肝气郁结患者症状日评量表(SCL-90)评定结果分析[J].浙江中西医结合杂志,1999,9(2):85.
[67]彭汉光,王萍,刘新月,等.清脑灵对血管性痴呆患者智力量表和血液流变学的影响[J].中国中医药科技,2001,8(3):781.
[68]王灿晖,刘涛,杨进,等.滋肾通窍法对血管性痴呆患者精神量表评定的观察[J].中国中西医结合杂志, 1999,19(7):405.
[69]王静怡,林海,王晓燕,等.心理测验与神经衰弱辨证分型关系的探讨[J].中医杂志,2001,42(3):176.
[70]姬道绪,王天芳,薛晓琳.抑郁症常见证候精神症状表现特点的初步研究[J].北京中医药大学学报,2003,26(6):72.
[71]何裕民,王莉,石凤亭,等.体质的聚类研究[J].中国中医基础医学杂志,1996, 2(5):7.
[72]严铁毅,张伟刚.模糊数学在体质健康评估中的应用研究[J].广西工学院学报,1995,6(4):68.
[73]王琦,朱燕波,薛禾生,等.中医体质量表的初步编制[J].中国临床康复,2006, 10(3):12.
[74]朱燕波,王琦,薛禾生,等.中医体质量表性能的初步评价[J].中国临床康复, 2006,10(3):15.
[75]陆昌勤.工作倦怠感研究及展望[J].中国心理卫生杂志,2004,18(3):206.
[76]唐昕辉,李君春,耿文秀.国外工作倦怠观的理论探索[J].心理科学, 2005,(5): 40.
[77]王晓春,甘怡群.国外关于工作倦怠研究的现状述评[J].心理科学进展,2003 11(5): 567.
[78]林丽.教师工作倦怠问题研究综述[J].比较教育研究,2006,189(2):87
[79]林妙艺,刘英.国内护士工作倦怠的研究现状[J].天津护理,2006,14(2):119.
[80] Lee WH, Kim CJ.The relationship between depression, perceived stress, fatigue and anger in clinical nurses [J].Taehan Kanho Hakhoe Chi, 2006,36(6): 925.
[81] T Ohira, H Iso, T Tanigawa,etal.Validity and reliability of the Japanese version of the selected anger expression scale and age, sex, occupation and regional differences in anger expression among Japanese[J].J Epidemiol, 2000, 10(2):118.
[82] Starner TM, Peters RM. Anger expression and blood pressure in adolescents[J]. J Sch Nurs,2004,20(6):335.
[83] Suarez EC, Saab PG, Llabre MM,et al. Ethnicity, gender, and age effects on adrenoceptors and physiological responses to emotional stress[J]. Psychophysiology, 2004,41(3):450.
[84]汉许慎撰,清段玉裁.说文解字注[M].上海:上海古籍出版社,1981:511.
[85]司马迁.史记·平津侯主父列传[M].北京:中华书局,1985:2 954.
[86]南京师范大学主编.心理学[M].南京:河海大学出版社,1991:174.
[87]孙广仁.中医基础理论[M].北京:中国中医药出版社,2004:91.
[88] Thomas SP. Gender differences in anger expression: health implications [J].Research in Nursing and Health,1989,(12):389.
[89] Horn R, Towl G. Anger management for women prisoners[J]. Issues in Criminological and Legal Psychology,1997,29(1):57.
[90]乔明琦,张珍玉.肝气逆、肝气郁两证客观指标实验研究[J].山东中医学院学报,1992,(3):11.
[91]王琦.中医体质学[M].北京:中国医药科技出版社,1995:32.
[92]匡调元.论辨证与辨体质[J].中国中医基础医学杂志,2002,8(2):1.
[93]何裕民.体质结构研究[J].中国医药学报,1989,4(6):33.
[94]母国成.体质学说及其异化[J].新中医,1983,9:1.
[95]宋红普.对中医体质调研的几点思考[J].上海中医药杂志,2007,41(3):50.
[96]孙振球.医学统计学[M].第2版.北京:人民卫生出版社,2005: 328.
[97]方积乾.生命质量测定方法及应用[M].北京:北京医科大学出版社, 2000: 11.
[98]郝元涛,孙希凤,方积乾,等.量表条目筛选的统计学方法研究[J].中国卫生统计,2004,21(4):209.
[99]秦浩,陈景武.医学量表条目的筛选考评方法及其应用[J].中国行为医学科学,2006,15(4):39.
[100]方积乾.生存质量测定方法及应用[M].北京:北京医科大学出版社,2000:55.
[101]方积乾.医学统计学与电脑试验[M].第2版.上海:上海科学技术出版社,2001:78.
[102]孙振球.医学统计学[M].第2版.北京:人民卫生出版社,2005:529.
[103]王洪图.黄帝内经研究大成[M].北京:北京出版社,1999:1 134.
[104]孙理军,张登本.中医体质的基本内涵[J].天津中医学院学报,2002,21(3):6.
[105]金秀年.《黄帝内经》与《东医寿世保元》体质内涵的研究及其比较[C].中国优秀硕士学位论文全文数据库,2006:21.
[106]陈启光,申春悌,张华强.因子分析在中医证候规范标准研究中的应用[J].中国中医基础医学杂志,2004,10(8):53.
[107]金瑜.心理测量[M].上海:华东师范大学出版社, 2001:106.
[108]方积乾.医学统计学与统计软件[M].北京:北京医科大学出版社,2000:246.
[109]吴汉荣.学习障碍儿童生活质量的研究[J].中国校医,2000,14(4):241.
[110]白介辰.略谈中医病因学[J].福建医药杂志,1980,(2):21.
[111]叶新苗.论中医病因学说的形成与发展[J].浙江中医学院学报, 1996, 20(1): 5.
[112]李成卫,王庆国.对七情病因概念的形成分析[J].北京中医药大学学报,2005,28(1):17.
[113]刘洋,潘桂娟.情志成为中医学病因的理论依据与致病形式[J].中国中医基础医学杂,2007,13(12):892.
[114]郑红斌,张光霁,陈诚.中医病因古今演变的研究之一—七情内伤病因概论[J].浙江中医学院学报,1998,(2):5.
[115]孙理军.情志致病的藏象学基础及其与免疫的相关性[J].中国中医基础医学杂志,2001,10(7):18.
[116]魏盛,乔明琦.经前期综合征肝气逆肝气郁证动物模型改进及肝失疏泄微观机制研究[J].山东中医药大学学报,2007,(5):25.
[2]朱梅.现代心理学的对象与心身健康、中医七情病因学说关系探析[J].陕西中医,2006,27(2):206.
[3]胡随瑜.中医肝脏象情绪评估的研究思路与方法[J].中医文献杂志,2002: (1):15.
[4]王米渠.七情发病初探[J].四川中医,1986,(5):7.
[5]朱力.社会问题概论[M].北京:社会科学文献出版社,2002:175.
[6]汪士昌,陈瑞英,张凤娟,等.综合医院心理门诊1568例分析[J].中国心理卫生杂志,1999,(3):45.
[7]任昱,张虹.《内经》“怒”理论钩玄[J].浙江中医学院学报,2004,28(5):11.
[8]张沁园.怒致病的相关机理探讨[J].吉林中医药,2006,26(6):2.
[9]夏卫东,叶卉.内经对“怒”的认识[J].杭州医学高等专科学校学报,2002, 5(6):237.
[10]宋炜熙,胡随瑜.论情志与情绪的异同[J].山东中医药大学学报,2003,27(3):250.
[11]金光亮.论情志与情志病因[J].中国医药学报,1997,12(3):9.
[12]韩成仁.关于七情学说研究几个概念的阐释[J].山东中医药大学学报,1997,21(6):408.
[13]武刚.情志学说研究思路探析[J].安徽中医学院学报,2001,20(4):4.
[14]乔明琦,韩秀琴.情志概念与可能的定义[J].山东中医药大学学报,1997,21(4): 258.
[15]严灿.中西医学在精神心理领域的结合—情志学说中西医结合研究的思考[C].中西医结合实验医学创新与发展国际研讨会论文集,2007:113.
[16]吕直.解读中医情志疾病研究[J].中医药学刊,2004,22(9):1 601.
[17] Diamond, E L .The role of anger and hostility in essential hypertension and coronary heart disease[J]. Psychological Bulletin,1982,92(2):410.
[18] Siegel, JM. Anger and cardiovascular risk in adolescents[J]. Health Psychology,1984,3(4):293.
[19]张伯礼,宋其云,崔秀琼,等.天津地区中医中风病危险因素及证候调查研究[J].天津中医,2000:17(1):35.
[20]王米渠,邹义壮,曾倩,等.《名医类案》196例七情发病构成及男女特点分析[J].现代中西医结合杂志,2006,15(8):983.
[21]徐胤聪,张继伟,吴建林.情志伤肝头痛证治[J].山东中医杂志,2008,27(2):81.
[22]乔明琦,徐旭杰,韩秀琴,等.经前期综合征证候分布规律的流行病学调查研究[J].中国中医基础医学杂志,1997,3(3):31.
[23]乔明琦,张慧云,石忠峰,等.择时造模猕猴经前期“病证表现”及其评价[J].中国中医基础医学杂志,2002,8(7):59.
[24]王海苹,薛玲,张惠云,等.经前期综合征肝气逆证猕猴模型表情行为及递质水平的变化[J].中药药理与临床,2004,20(3):45.
[25]刘晓伟,曲宏达,张红梅,等.怒、恐应激大鼠脑内c-fos与CRHmRNA表达差异性分析[J].四川中医,2006,24(1):11.
[26]刘晓伟,曲宏达,张红梅,等.怒恐伤气大鼠血ACTH、CORT、IL-2、IL-8的含量变化的比较研究[J].辽宁中医杂志,2006,33(2):239.
[27]郭蕾.怒志的生理病理及实验研究[J].山东中医药大学学报,1995,19(5):290.
[28]高知勇.谈中医怒伤肝与癌症的关系[J].黑河科技,2001,(1):46.
[29]刘颖,姚丽,刘伟星.同病异治与室性早搏的治疗[J].山东中医杂志,2002,21(10):629.
[30] Williams JE,Nieto FJ,Sanford CP,etal.The association between trait anger and incident stroke risk: the atherosclerosis risk in communities (ARIC) study [J].Stroke,2002,33(1):9.
[31] Rujescu D, Giegling I, Bondy B,et al.Association of anger-related traits with SNPs in the TPH gene[J]. Molecular Psychiatry,2002,7(9): 1 023.
[32] Davidson R J, Putnam K M, Larson C L, Dysfunction in the neural circuitry of emotion regulation--a possible prelude to violence[J].Science,2000,289 (5479):591.
[33] Ronekleiv OK, Kelly MJ.Diversity of ovarian steroid signaling in the hypothalamus[J]. Front Neuroendocrinol,2005,26(2):65.
[34] Maguire J L, Stell B M, Rafizadeh M ,et al. Ovarian cycle–linked changes in GABAA receptors mediating tonic inhibition alter seizure susceptibility and anxiety[J]. Nature Neuroscience,2005,8(6):797.
[35]吴斌.大鼠杏仁核—下丘脑神经通路研究[J ].自然科学杂志, 2000, 201 (1) : 75～77.
[36] Kilts CD, Egan G, Gideon DA, et al. Dissociable neural pathways are involved in the recognition of emotion in static and dynamic facial expressions[J]. Neuroimage,2003,18(1):156.
[37] Kimbrell TA, George MS, Parekh PI, et al. Regional brain activity during transient self-induced anxiety and anger in healthy adults[J]. Biol Psychiatry. 1999,46(4):454.
[38] Esslen M, Pascual-Marqui RD, Kochi K, et al. Brain areas and time course of emotional processing[J].Neuroimage,2004, 21(4):1 189.
[39] Nomura M, Ohira H, Haneda K, et al. Functional association of the amygdala and ventral prefrontal cortex during cognitive evaluation of facial expressions primed by masked angry faces: an event-related fMRI study[J]. NeuroImage,2004,21(1):352.
[40] Eddie Harmonjones. Clarifying the emotive functions of asymmetrical frontalcortical activity[J]. Psychophysiology,2003, 40 (6): 838.
[41] Deffenbacher JL, Filetti LB, Lynch RS, etal. Oetting ER:cognitive- behavioral treatment of high anger drivers[J]. Behav.Res.Ther. 2002, 40(8):895.
[42]杨靖,邢彤,李春禄,等.中医体质学说现代研究进展[J].长春中医学院学报,2000,16(4):601.
[43]马晓慧.中医体质学说理论与方法研究进展[J].上海中医药杂志,2000,(5):47.
[44]朱伟,王丽华,欧阳钦.中医体质学说研究面临的问题[J].中国中医药信息杂志,2000,7(3):11.
[45]刘良倚.中医体质学说的研究现状[J].江西中医药,2000,31(6):55.
[46]钱会南.中医体质的现代研究方法分析[J].中国中医药信息杂志,2005,12 (5):1.
[47]王琦.中医体质学说研究现状与展望[J].中国中医基础医学杂志,2002,8(2): 86.
[48]金香淑,赵贤俊,韩福仁.中医体质学说与朝医四象人学说浅析[J].中国民族医药杂志,1999:5(1):26.
[49]赵霞.100例哮喘患儿体质调查及分型研究[J].成都中医药大学学报,2001,24(3):16.
[50]童家罗.200例慢性支气管炎病理性体质类型与发病关系的分析[J].上海中医药杂志,1998,(3):14.
[51]张洪钧.急性白血病易患体质研究及病因病机探讨[J].北京中医药大学学报,2002,25(1):46.
[52]钱岳晟,张伟忠,周怀发,等.原发性高血压患者表型与中医体质分类关系的研究[J].中国中医基础医学杂志,2002,8(2):49.
[53]丰田一.汉方一贯堂中解毒证体质按年龄选用方剂的变迁[J].国外医学·中医中药分册,1998,(1):8.
[54]王米渠.《内经》阴阳人格体质学说与艾森克人格维度的比较研究[J].贵阳中医学院学报,1996,(3):7.
[55]王琦,苏庆民.试析中日体质观中证与临床异同[J].吉林中医药,1992,(1):5.
[56]王东坡,王琦.论体质分类研究的源流及其科学意义[J].北京中医药大学学报, 2006,29(6):374.
[57]王琦.9种基本中医体质类型的分类及其诊断表述依据[J].北京中医药大学学报,2005,28(4):1.
[58]匡调元.中医病理研究[M].上海:上海科学技术出版社,1980:66.
[59]田代华.论体质与证候[J].山东中医学院学报,1983,7(1):6.
[60]母国成.中医体质学说及其异化[J].新中医,1983,15(9):9.
[61]龚海洋.略论中医体质分类[J].中医药学报,2003,31(6):1.
[62]刘国强.温病体质学说概论[J].陕西中医,1986,7(1):1.
[63]孟凡迅,马红萍,党瑞山,等.检测脂肪条带结构上的低阻抗线[J].中华国际医学杂志,2004,4(4):171.
[64]许建华,陆敏.鼓胀患者的抑郁自评量表—SDS测定分析[J].贵阳中医学院学报,1995,16(2):481.
[65]赵唯贤,刘建涛.阳痿中医分型与心理量表测评对照研究[J].河南职工医学院学报,2001,13(2):103.
[66]施和勋.肝气郁结患者症状日评量表(SCL-90)评定结果分析[J].浙江中西医结合杂志,1999,9(2):85.
[67]彭汉光,王萍,刘新月,等.清脑灵对血管性痴呆患者智力量表和血液流变学的影响[J].中国中医药科技,2001,8(3):781.
[68]王灿晖,刘涛,杨进,等.滋肾通窍法对血管性痴呆患者精神量表评定的观察[J].中国中西医结合杂志, 1999,19(7):405.
[69]王静怡,林海,王晓燕,等.心理测验与神经衰弱辨证分型关系的探讨[J].中医杂志,2001,42(3):176.
[70]姬道绪,王天芳,薛晓琳.抑郁症常见证候精神症状表现特点的初步研究[J].北京中医药大学学报,2003,26(6):72.
[71]何裕民,王莉,石凤亭,等.体质的聚类研究[J].中国中医基础医学杂志,1996, 2(5):7.
[72]严铁毅,张伟刚.模糊数学在体质健康评估中的应用研究[J].广西工学院学报,1995,6(4):68.
[73]王琦,朱燕波,薛禾生,等.中医体质量表的初步编制[J].中国临床康复,2006, 10(3):12.
[74]朱燕波,王琦,薛禾生,等.中医体质量表性能的初步评价[J].中国临床康复, 2006,10(3):15.
[75]陆昌勤.工作倦怠感研究及展望[J].中国心理卫生杂志,2004,18(3):206.
[76]唐昕辉,李君春,耿文秀.国外工作倦怠观的理论探索[J].心理科学, 2005,(5): 40.
[77]王晓春,甘怡群.国外关于工作倦怠研究的现状述评[J].心理科学进展,2003 11(5): 567.
[78]林丽.教师工作倦怠问题研究综述[J].比较教育研究,2006,189(2):87
[79]林妙艺,刘英.国内护士工作倦怠的研究现状[J].天津护理,2006,14(2):119.
[80] Lee WH, Kim CJ.The relationship between depression, perceived stress, fatigue and anger in clinical nurses [J].Taehan Kanho Hakhoe Chi, 2006,36(6): 925.
[81] T Ohira, H Iso, T Tanigawa,etal.Validity and reliability of the Japanese version of the selected anger expression scale and age, sex, occupation and regional differences in anger expression among Japanese[J].J Epidemiol, 2000, 10(2):118.
[82] Starner TM, Peters RM. Anger expression and blood pressure in adolescents[J]. J Sch Nurs,2004,20(6):335.
[83] Suarez EC, Saab PG, Llabre MM,et al. Ethnicity, gender, and age effects on adrenoceptors and physiological responses to emotional stress[J]. Psychophysiology, 2004,41(3):450.
[84]汉许慎撰,清段玉裁.说文解字注[M].上海:上海古籍出版社,1981:511.
[85]司马迁.史记·平津侯主父列传[M].北京:中华书局,1985:2 954.
[86]南京师范大学主编.心理学[M].南京:河海大学出版社,1991:174.
[87]孙广仁.中医基础理论[M].北京:中国中医药出版社,2004:91.
[88] Thomas SP. Gender differences in anger expression: health implications [J].Research in Nursing and Health,1989,(12):389.
[89] Horn R, Towl G. Anger management for women prisoners[J]. Issues in Criminological and Legal Psychology,1997,29(1):57.
[90]乔明琦,张珍玉.肝气逆、肝气郁两证客观指标实验研究[J].山东中医学院学报,1992,(3):11.
[91]王琦.中医体质学[M].北京:中国医药科技出版社,1995:32.
[92]匡调元.论辨证与辨体质[J].中国中医基础医学杂志,2002,8(2):1.
[93]何裕民.体质结构研究[J].中国医药学报,1989,4(6):33.
[94]母国成.体质学说及其异化[J].新中医,1983,9:1.
[95]宋红普.对中医体质调研的几点思考[J].上海中医药杂志,2007,41(3):50.
[96]孙振球.医学统计学[M].第2版.北京:人民卫生出版社,2005: 328.
[97]方积乾.生命质量测定方法及应用[M].北京:北京医科大学出版社, 2000: 11.
[98]郝元涛,孙希凤,方积乾,等.量表条目筛选的统计学方法研究[J].中国卫生统计,2004,21(4):209.
[99]秦浩,陈景武.医学量表条目的筛选考评方法及其应用[J].中国行为医学科学,2006,15(4):39.
[100]方积乾.生存质量测定方法及应用[M].北京:北京医科大学出版社,2000:55.
[101]方积乾.医学统计学与电脑试验[M].第2版.上海:上海科学技术出版社,2001:78.
[102]孙振球.医学统计学[M].第2版.北京:人民卫生出版社,2005:529.
[103]王洪图.黄帝内经研究大成[M].北京:北京出版社,1999:1 134.
[104]孙理军,张登本.中医体质的基本内涵[J].天津中医学院学报,2002,21(3):6.
[105]金秀年.《黄帝内经》与《东医寿世保元》体质内涵的研究及其比较[C].中国优秀硕士学位论文全文数据库,2006:21.
[106]陈启光,申春悌,张华强.因子分析在中医证候规范标准研究中的应用[J].中国中医基础医学杂志,2004,10(8):53.
[107]金瑜.心理测量[M].上海:华东师范大学出版社, 2001:106.
[108]方积乾.医学统计学与统计软件[M].北京:北京医科大学出版社,2000:246.
[109]吴汉荣.学习障碍儿童生活质量的研究[J].中国校医,2000,14(4):241.
[110]白介辰.略谈中医病因学[J].福建医药杂志,1980,(2):21.
[111]叶新苗.论中医病因学说的形成与发展[J].浙江中医学院学报, 1996, 20(1): 5.
[112]李成卫,王庆国.对七情病因概念的形成分析[J].北京中医药大学学报,2005,28(1):17.
[113]刘洋,潘桂娟.情志成为中医学病因的理论依据与致病形式[J].中国中医基础医学杂,2007,13(12):892.
[114]郑红斌,张光霁,陈诚.中医病因古今演变的研究之一—七情内伤病因概论[J].浙江中医学院学报,1998,(2):5.
[115]孙理军.情志致病的藏象学基础及其与免疫的相关性[J].中国中医基础医学杂志,2001,10(7):18.
[116]魏盛,乔明琦.经前期综合征肝气逆肝气郁证动物模型改进及肝失疏泄微观机制研究[J].山东中医药大学学报,2007,(5):25.