从大学生健康状况“四时八节”动态变化规律探讨“肝主疏泄”生理调节功能的研究
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摘要
肝主疏泄理论是肝藏象理论的主要内容。近年来,随着现代研究方法的不断引入,从生理角度探讨中医脏象功能的实质性研究逐步增多,其中,围绕肝主疏泄生理功能的研究尤其值得关注。
本研究正是基于生理角度全面评估与认识健康大学生的动态变化规律,通过对健康大学生被试的严格筛选,使用结合中医躯体健康状况调查问卷、西医健康状况量表、心理学量表的大学生健康状况调查问卷,分别于“四时八节”在北京中医药大学、山东中医药大学、山西中医学院对大学生被试进行问卷调查。在对大学生健康状况进行综合评估的同时,归纳在“四时八节”的变化规律,也通过对变化规律的分析,探寻中医肝主疏泄的生理调节功能。
目的
1.编制大学生“四时八节”健康状况调查表。
2.通过临床流行病学调查,对经过严格筛选的被试进行“四时八节”的动态追踪调查,通过总结、分析大学生健康状况的动态变化规律,分析“肝主疏泄”对大学生人群健康状况的调节作用。
方法
1.通过文献分析、专家论证,借鉴心理学量表的研制方法,编制中医躯体状况调查问卷；
2.通过制定严格的筛选标准、纳入标准、排除标准,对大学生被试进行筛选；
3.运用流行病学调查方法,对筛选的健康大学生被试展开“四时八节”的动态追踪
调查；
4.运用SPSS17.0软件包,对健康大学生被试“四时八节”的健康状况进行统计分析与分层分析。
结果
1.编制中医躯体健康调查问卷。问卷涵盖全身、饮食、睡眠、二便、妇科等方面的55个条目,其中涉及四级分级的条目44条,妇科条目11条。
2.大学生健康状况调查表中医躯体健康状况调查问卷,贝克焦虑自评量表BAI,贝克抑郁自评量表BDI,艾森克人格问卷简式量表中文版,青少年生活事件量表(ASLEC)。
3.健康被试的筛选
共发放问卷551份,回收546份,回收率98.5%。筛查后剩余364例,占初筛总人数的66.67%。三地参加体检者共有332人,体检合格者共312人,占体检总人数的93.98%。。
4.基于四时八节的大学生健康被试的动态变化规律
4.1BAI被试在四时八节的BAI得分有显著性差异。其中,立冬、冬至均显著高于其它节气,立春、立夏、夏至均显著高于立秋、秋分节气,春分、立秋间有显著性差异。(P<0.05)。四时八节的BAI得分有显著性差异。具体来说,立冬、冬至均显著高于其它节气,立春、立夏、夏至均显著高于立秋、秋分节气,春分显著高于立秋(P<0.05)。整体趋势为：冬季得分最高,春季、夏季次之,秋季最低。
4.2被试在四时八节的BDI得分有显著性差异。两两比较后发现,立冬显著高于其它节气,冬至显著高于春分、夏至、立秋、秋分(P<0.0.5),立春、立夏均显著高于立秋、秋分(P<0.05),夏至显著高于秋分(P<0.05)。四时八节的BDI得分表现出有显著性差异。整体趋势为：冬季得分最高,春季、夏季次之,秋季最低。
4.3情绪评分情况
四时八节的精神情绪得分有显著性差异。四时八节两两比较后发现,立冬、冬至得分均显著高于其它六个节气,立春、春分、立夏、夏至均显著高于立秋、秋分节气。整体趋势为：冬季得分最高,春季、夏季次之,秋季最低。
4.4躯体情况
被试在四时八节的躯体得分有显著性差异。其中,立冬、冬至均显著高于其它节气(立冬、冬至二者无显著差异),立春、立夏、夏至均显著高于立秋、秋分节气,春分显著高于立秋(P<0.05)。躯体条目除眼睛干涩、咽部不适、心慌、善太息、恶心、腹部不适、口干、头痛8个条目出现频率无节气间差异(P>0.05)外,其余条目均存在显著差异(P<0.05)。除耳鸣、胸部满闷、胁肋部胀满、恶心、呕吐、腰部不适、腿部不适、便秘、胁肋疼痛、腰痛等10个条目无显著节气间差异(P>0.05)外,其余条目均存在显著的节气间差异(P<0.05)。
从躯体条目的发生频率与严重程度综合来看,大致特点如下：
胃脘不适在立冬、冬至节气较显著,立春、春分、立夏、夏至节气则显著下降,而到立秋、秋分节气又较显著；
手足汗出立冬(频率)、冬至(程度)不显著,立春、春分、立夏、夏至又显著,立秋不显著,秋分显著；
睡眠问题(含睡眠差、多梦、入睡困难)仅在立秋节气不显著,其余节气均显著；
善太息立冬显著,冬至不显著,立春显著,春分不显著,立夏显著,夏至、立秋、秋分则不显著；
腹泻、便秘立春、春分、立夏节气便秘显著,立冬、冬至不显著,而夏至、立秋、秋分节气腹泻、便秘均显著,腹泻仅在夏至、立秋、秋分显著；
腰部不适仅在夏至、立秋、秋分显著,其余节气均不显著。
4.5大学生生活事件量表
四时的生活事件得分有显著性差异。除其它因子外,各因子得分均存在节气间有显著性差异。
5.高、低神经质组指标比较发现,不同神经质人群的精神情绪、BAI、BDI方面均有显著差异(P<0.05),但躯体状况无显著差异(P>0.05)。低神经质组,各指标高低事件得分组间比较,BAI得分差异不显著P>0.05,其余指标均存在显著差异(P<0.05)四时高神经质低生活事件得分组的生活事件得分无显著差异(P>0.05),其余三组均存在显著季节间差异(P<0.05)。四时高神经质低生活事件组、低神经质高生活事件组的BAI得分无显著差异(P>0.05),其余二组均存在显著季节间差异(P<0.05)。四时各组BDI得分均存在显著差异(P<0.05)。四时各组情绪状况得分均存在显著差异(P<0.05)。四时高神经质低生活事件得分组的生活事件得分无显著差异(P>0.05),其余三组均存在显著季节间差异(P<0.05)。
结论
1.大学生健康被试在四时八节的躯体、心理、社会适应等方面状况有一定规律,大致趋势略为相似,即冬季健康状况不佳,春夏季次之,秋季最为理想。
2.本研究通过对不同神经质人群的躯体及情绪状况分析发现,高神经质人群的躯体及情绪状况较显著,而低神经质人群就比较平和。从中医理论角度分析,高神经质人群的特征性表现提示在生理状况下,其情志表现突出,躯体表现多样,而且变化幅度较大,程度较为剧烈,这可能与肝的疏泄气机及调畅全身气血、情志的功能有所不足的情况,故遇到同等强度的生活事件的应激刺激时,其感知以及收到的影响也较为显著；与之相应,低神经质人群的躯体以及情绪表现则相对缓和,其幅度的变化也较小,这可能与肝的疏泄功能较为平和,其调畅情志、调节气血的功能状态较为稳定,故躯体、情绪表现并不突出,在遇到同等强度的生活事件的应激刺激时,其感知以及收到的影响也较为轻微。
本研究通过对受试生活事件情况的调查分析,发现生活事件作为应激原,对被试的躯体、情绪以及BDI、BAI状况影响明显。
在四时变化中,对于机体在应对心理应激的过程中,由于不同个体调节能力的不同,而造成了这种差异。由此联系到中医藏象理论的肝主疏泄,其基本功能是调节气血,调畅情志,如果将之与心理应激反应相联系的话,恰恰说明了肝主疏泄的生理功能对于健康个体在心理应激过程中的发挥的调节功能。
The liver dispersion theory is the main content of the liver's function in TCM viscera manifestation theory. In recent years. with the constant introduction of modern research methods, more and more explore and research occurred from a physiological point to view TCM viscera function gradually and increasingly in which the liver dispersion theory-related evoked much attention to the field.
Based on a series of rigorous screening, selecting healthy students subjects in the study by College Students Health Status Questionnaire in four seasons and eight solar terms at Beijing University of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Shanxi College of Traditional Chinese Medicine respectively, a thorough dynamic tracking survey was carried out. From physiological point of a comprehensive assessment of the dynamic variation of the health of college students, summed up in a variation of the four seasons and eight solar terms, and also through the analysis of changes in the law to explore the regulatory mechanism of TCM liver dispersion physiological function.
Objective
1. Through literature analysis, preparation of TCM physical status questionnaire, to form a College Students Health Status Questionnaire initially, which could be used to evaluate the college students' health status.
2. Completing the test screening of healthy college students subjects in3TCM colleges in Beijing, Shandong, Shanxi province.
3. Finishing the dynamic tracking survey through a cl inical epidemiology methods in three college students in four seasons and eight solar terms, to summarize, analyze the students' health status.
4. By stratified analysis, summarizing the representative of the health status of different populations of neurotic characteristics, and the dynamic changes of seasons, in order to analyze the important regulatory role in liver controlling dispersion in the process of psychological stress.
Methods
1. Through literature analysis, expert argumentation, according to psychology scale developed method, to draw up TCM physical health status questionnaire.
2.Through strict screening criteria, inclusion criteria, exclusion criteria, to select college students subjects.
3.By using epideraiological survey method, dynamic tracking investigation was carried out to healthy college students subjects in four seasons and eight solar terms.
Results
1. TCM physical health status questionnaire:The questionnaire covered58items in whole body, diet, sleep, stool and urine, gynecological aspects, which involves46four graded items and12gynecological items.
2. College Students Health Status Questionnaire:includes TCM physical health status questionnaire, Beck Self-Rating Anxiety Scale(BAI), Beck Depression self-rating scale (BDI), Eysenck Personality Questionnaire-Revised, Short Scale for Chinese (EPQ-RSC), Adolescent Self-Rat ing Life Events Check List (ASLEC). The quest ionnaire was designed for the health of col lege students in four seasons and eight solar terms dynamic investigation
3. Subjects screening:551questionnaires were distributed,546returned, which recovery rate was98.5%. After the screening,364subjects remained, which accounted for66.67%of the initial screening of the total number. Totally, there were332college students attended medical examination. Finally,312subjects passed physical examination, accounting for93.98percent of the total.
4. Dynamic survey of subjects in four seasons and eight solar terms.
4.1BAI
Significant difference in different four seasons and eight solar terms. Among them, the beginning of winter (Lidong), the winter solstice(Dongzhi) are significantly higher than other solar terms; the beginning of spring(Lichun), beginning of summer(Lixia), the summer solstice (Xiazhi) are significantly higher than the beginning of autumn(Liqiu); significant differences between the autumnal equinox (Qiufen) solar terms, the vernal equinox(Chunfen), the beginning of autumn (Liqiu)(P<0.05). The overall trend is the highest score in winter, followed by spring, summer, the lowest score in autumn.
4.2BDI
Significant difference in different four seasons and eight solar terms. Among them, beginning of winter(Lidong), the winter solstice (Dongzhi) significantly higher than the vernal equinox(Chunfen), summer sols t ice(Xiazhi), the beginning of autumn (Liqiu), autumnal equinox (Qiufen)(P<0.05); the beginning of spring(Lichun), beginning of summer (Lixia) significantly higher than the beginning of autumn(Liqiu), autumnal equinox (Qiufen)(P<0.05), the summer solstice (Xiazhi) significantly higher than Autumnal Equinox (Qiufen)(P<0.05). The overall trend is the highest score in winter, followed by spring, summer, the lowest score in autumn,.
4.3Mental or emotional status
The mood scores eight mental or emotional score showed a significant difference. Among them, the beginning of winter (Lidong), the winter solstice(Dongzhi) significantly higher than the other six solar terms (P<0.001), the beginning of spring (Lichun), the vernal equinox (Chunfen), the beginning of summer (Lixia), the summer solstice (Xiazhi) significantly higher than the beginning of autumn (Liqiu), autumnal equinox(Qiufen)(P<0.001). The overall trend:the highest score in winter, followed by spring, summer, the lowest score in autumn.
4.4Physical status
Significant difference in different four seasons and eight solar terms. Among them, the beginning of winter(Lidong), the winter solstice (Dongzhi) are significantly higher than other solar terms (no statistically significant d if ference between two solar terms), the beginning of spr ing (Lichun), beginning of summer (Lixia), the summer solst ice (Xiazhi) are significantly higher than the beginning of autumn(Liqiu), autumnal equinox(Qiufen) solar terms, the vernal equinox (Chunfen) was significantly higher than the beginning of autumn (Liqiu)(P<0.05).8items such as dry eyes, throat discomfort, palpitation, frequent sighing, nausea, abdominal discomfort, dry mouth, headache appear with no significant difference (P>0.05) among the solar terms in frequency (P<0.05).10items such as ringing in the ears, distension in chest, distension in lateral thorax, nausea, vomiting, back discomfort, leg discomfort, constipation, pains in lateral thorax, lumbago, with no significant difference (P>0.05) in severity among8solar terms. From a comprehensive view of the occurrence frequency and severity of physical items, following features occurred:
Epigastric discomfort is more serious at the beginning of winter(Lidong), the winter solstice(Dongzhi), the beginning of autumn (Liqiu), autumnal equinox (Qiufen)solar terms, but less serious at the beginning of spring(Lichun), the vernal equinox (Chunfen), the beginning of summer (Lixia), the summer solst ice (Xiazhi);
Sweating in palms and soles is more serious the beginning of spring (Lichun), the vernal equinox(Chunfen), the beginning of summer(Lixia), the summer solstice(Xiazhi) the autumnal equinox(Qiufen), but less serious at the beginning of winter(Lidong)(frequency), winter solstice(Dongzhi)(severity) and the beginning of autumn(Liqiu);
Sleep problems (including poor sleep, dreamy, difficulty falling asleep) only not serious at the beginning of autumn(Liqiu) solar terms, but more serious at the rest of the7solar terms;
Frequent sighing is more serious at the beginning of winter(Lidong), the beginning of spring (Lichun) the beginning of summer (Lixia), but less serious at the winter solstice(Dongzhi), the vernal equinox (Chunfen), the summer solstice(Xiazhi), the beginning of autumn (Liqiu) and the autumnal equinox(Qiufen);
Defecation problems (constipation, diarrhea) constipation is more serious at the beginning of spring(Lichun), the vernal equinox (Chunfen), the beginning of summer(Lixia), but both is more serious at the summer solstice(Xiazhi),the beginning of autumn(Liqiu), autumnal equinox(Qiufen) solar term;
Waist discomfort is more serious only at the summer solstice(Xiazhi),the beginning of autumn(Liqiu), autumnal equinox(Qiufen) solar term.
4.5ASLEC scores in significant difference. Except the other factor, the5ASLEC factors scores in significant differences (P<0.05).
5. The scores of mental or emotional, BAI, BDI scores exists with significantly different (P<0.05) between higher and lower neuroticism group, but physical status no significant difference (P>0.05). Low neuroticism group, the various indicators of the level of events to the inter-packet comparison of BAI score differences are not significant with P>0.05, remaining indicators are exist significant differences (P<0.05) high neuroticism low-life events have grouped1ife event score without significantly with differences (P>0.05), the remaining three groups, there were significant differences between seasons (P<0.05). Four o'clock high neuroticism and low life events group, the low neuroticism high1ife events group BAI score no s ignif icant difference (P>0.05), whi le the other two groups, there were significant differences between seasons (P<0.05). Seasons each group BDI score, there were significant differences (P<0.05). Seasons emotional condition score, there were significant differences (P<0.05). Four o'clock the high neuroticism low life events have grouped life events score no statistically significant difference (P>0.05), and the remaining three groups, there were significant differences between seasons (P<0.05)
Conclusion
1. College students healthy subjects in the physical, psychological, and social adaptation conditions of section four eight to certain rules, with the role of TCM Liver dispersion.
2. In this study, analysis of the body and the emotional state of the nervous crowd, the high neuroticism crowd body and emotional status is more significant, and the low neurot icism crowd relat ively mi Id. By comparison, the characteristic of these high neuroticism group entry significantly more than the low neuroticism group, there are significant performance both from a physical or emotional crowd of high neuroticism group. From the perspective of traditional Chinese medicine theory analysis, the high neuroticism crowd characteristic performance suggest that under physiological conditions, outstanding emotional, somatic manifestation liver catharsis gas machine, Regulating systemic blood inadequate function of emotions thus exhibiting the above characteristics; correspondingly, the the low neuroticism crowd catharsis function more significantly, regulating emotions, regulate the function of blood more stable state, it is physical, emotional performance is not prominent.
By subjects living circumstances of the incident investigation and analysis, this study found that life events as stressors on the body were obvious impact, emotional, and BDI, BAI status.
Analys is of the trends of level of neurot ic pm indicators, high neurot ici sm group in the four seasons of the indicators, such as physical, emotional fluctuations and differences are significant changes, the corresponding low neuroticism group indicators significantly more gentle. It is worth mentioning that the high, low neuroticism group life events crowd situation, although there are some changes, but overall, the crowd still high neuroticism group for the percept ion of life events more sensitive and dramatic. This suggests that, in the seasons change, for the body in a process to deal with the psychological stress due to the individual's ability to regulate and control the different result of this difference. Liver dispersion thus linked to the theory of TCM Viscera, its basic function is to regulate blood Regulating Emotions, if associated with psychological stress reaction, then, is precisely the physiological functions of the liver controlling dispers ion regulatory funct ions of heal thy ind iv iduals play in the process of psychological stress. Chinese medicine is not the concept of "psychological stress".
本研究正是基于生理角度全面评估与认识健康大学生的动态变化规律,通过对健康大学生被试的严格筛选,使用结合中医躯体健康状况调查问卷、西医健康状况量表、心理学量表的大学生健康状况调查问卷,分别于“四时八节”在北京中医药大学、山东中医药大学、山西中医学院对大学生被试进行问卷调查。在对大学生健康状况进行综合评估的同时,归纳在“四时八节”的变化规律,也通过对变化规律的分析,探寻中医肝主疏泄的生理调节功能。
目的
1.编制大学生“四时八节”健康状况调查表。
2.通过临床流行病学调查,对经过严格筛选的被试进行“四时八节”的动态追踪调查,通过总结、分析大学生健康状况的动态变化规律,分析“肝主疏泄”对大学生人群健康状况的调节作用。
方法
1.通过文献分析、专家论证,借鉴心理学量表的研制方法,编制中医躯体状况调查问卷；
2.通过制定严格的筛选标准、纳入标准、排除标准,对大学生被试进行筛选；
3.运用流行病学调查方法,对筛选的健康大学生被试展开“四时八节”的动态追踪
调查；
4.运用SPSS17.0软件包,对健康大学生被试“四时八节”的健康状况进行统计分析与分层分析。
结果
1.编制中医躯体健康调查问卷。问卷涵盖全身、饮食、睡眠、二便、妇科等方面的55个条目,其中涉及四级分级的条目44条,妇科条目11条。
2.大学生健康状况调查表中医躯体健康状况调查问卷,贝克焦虑自评量表BAI,贝克抑郁自评量表BDI,艾森克人格问卷简式量表中文版,青少年生活事件量表(ASLEC)。
3.健康被试的筛选
共发放问卷551份,回收546份,回收率98.5%。筛查后剩余364例,占初筛总人数的66.67%。三地参加体检者共有332人,体检合格者共312人,占体检总人数的93.98%。。
4.基于四时八节的大学生健康被试的动态变化规律
4.1BAI被试在四时八节的BAI得分有显著性差异。其中,立冬、冬至均显著高于其它节气,立春、立夏、夏至均显著高于立秋、秋分节气,春分、立秋间有显著性差异。(P<0.05)。四时八节的BAI得分有显著性差异。具体来说,立冬、冬至均显著高于其它节气,立春、立夏、夏至均显著高于立秋、秋分节气,春分显著高于立秋(P<0.05)。整体趋势为：冬季得分最高,春季、夏季次之,秋季最低。
4.2被试在四时八节的BDI得分有显著性差异。两两比较后发现,立冬显著高于其它节气,冬至显著高于春分、夏至、立秋、秋分(P<0.0.5),立春、立夏均显著高于立秋、秋分(P<0.05),夏至显著高于秋分(P<0.05)。四时八节的BDI得分表现出有显著性差异。整体趋势为：冬季得分最高,春季、夏季次之,秋季最低。
4.3情绪评分情况
四时八节的精神情绪得分有显著性差异。四时八节两两比较后发现,立冬、冬至得分均显著高于其它六个节气,立春、春分、立夏、夏至均显著高于立秋、秋分节气。整体趋势为：冬季得分最高,春季、夏季次之,秋季最低。
4.4躯体情况
被试在四时八节的躯体得分有显著性差异。其中,立冬、冬至均显著高于其它节气(立冬、冬至二者无显著差异),立春、立夏、夏至均显著高于立秋、秋分节气,春分显著高于立秋(P<0.05)。躯体条目除眼睛干涩、咽部不适、心慌、善太息、恶心、腹部不适、口干、头痛8个条目出现频率无节气间差异(P>0.05)外,其余条目均存在显著差异(P<0.05)。除耳鸣、胸部满闷、胁肋部胀满、恶心、呕吐、腰部不适、腿部不适、便秘、胁肋疼痛、腰痛等10个条目无显著节气间差异(P>0.05)外,其余条目均存在显著的节气间差异(P<0.05)。
从躯体条目的发生频率与严重程度综合来看,大致特点如下：
胃脘不适在立冬、冬至节气较显著,立春、春分、立夏、夏至节气则显著下降,而到立秋、秋分节气又较显著；
手足汗出立冬(频率)、冬至(程度)不显著,立春、春分、立夏、夏至又显著,立秋不显著,秋分显著；
睡眠问题(含睡眠差、多梦、入睡困难)仅在立秋节气不显著,其余节气均显著；
善太息立冬显著,冬至不显著,立春显著,春分不显著,立夏显著,夏至、立秋、秋分则不显著；
腹泻、便秘立春、春分、立夏节气便秘显著,立冬、冬至不显著,而夏至、立秋、秋分节气腹泻、便秘均显著,腹泻仅在夏至、立秋、秋分显著；
腰部不适仅在夏至、立秋、秋分显著,其余节气均不显著。
4.5大学生生活事件量表
四时的生活事件得分有显著性差异。除其它因子外,各因子得分均存在节气间有显著性差异。
5.高、低神经质组指标比较发现,不同神经质人群的精神情绪、BAI、BDI方面均有显著差异(P<0.05),但躯体状况无显著差异(P>0.05)。低神经质组,各指标高低事件得分组间比较,BAI得分差异不显著P>0.05,其余指标均存在显著差异(P<0.05)四时高神经质低生活事件得分组的生活事件得分无显著差异(P>0.05),其余三组均存在显著季节间差异(P<0.05)。四时高神经质低生活事件组、低神经质高生活事件组的BAI得分无显著差异(P>0.05),其余二组均存在显著季节间差异(P<0.05)。四时各组BDI得分均存在显著差异(P<0.05)。四时各组情绪状况得分均存在显著差异(P<0.05)。四时高神经质低生活事件得分组的生活事件得分无显著差异(P>0.05),其余三组均存在显著季节间差异(P<0.05)。
结论
1.大学生健康被试在四时八节的躯体、心理、社会适应等方面状况有一定规律,大致趋势略为相似,即冬季健康状况不佳,春夏季次之,秋季最为理想。
2.本研究通过对不同神经质人群的躯体及情绪状况分析发现,高神经质人群的躯体及情绪状况较显著,而低神经质人群就比较平和。从中医理论角度分析,高神经质人群的特征性表现提示在生理状况下,其情志表现突出,躯体表现多样,而且变化幅度较大,程度较为剧烈,这可能与肝的疏泄气机及调畅全身气血、情志的功能有所不足的情况,故遇到同等强度的生活事件的应激刺激时,其感知以及收到的影响也较为显著；与之相应,低神经质人群的躯体以及情绪表现则相对缓和,其幅度的变化也较小,这可能与肝的疏泄功能较为平和,其调畅情志、调节气血的功能状态较为稳定,故躯体、情绪表现并不突出,在遇到同等强度的生活事件的应激刺激时,其感知以及收到的影响也较为轻微。
本研究通过对受试生活事件情况的调查分析,发现生活事件作为应激原,对被试的躯体、情绪以及BDI、BAI状况影响明显。
在四时变化中,对于机体在应对心理应激的过程中,由于不同个体调节能力的不同,而造成了这种差异。由此联系到中医藏象理论的肝主疏泄,其基本功能是调节气血,调畅情志,如果将之与心理应激反应相联系的话,恰恰说明了肝主疏泄的生理功能对于健康个体在心理应激过程中的发挥的调节功能。
The liver dispersion theory is the main content of the liver's function in TCM viscera manifestation theory. In recent years. with the constant introduction of modern research methods, more and more explore and research occurred from a physiological point to view TCM viscera function gradually and increasingly in which the liver dispersion theory-related evoked much attention to the field.
Based on a series of rigorous screening, selecting healthy students subjects in the study by College Students Health Status Questionnaire in four seasons and eight solar terms at Beijing University of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Shanxi College of Traditional Chinese Medicine respectively, a thorough dynamic tracking survey was carried out. From physiological point of a comprehensive assessment of the dynamic variation of the health of college students, summed up in a variation of the four seasons and eight solar terms, and also through the analysis of changes in the law to explore the regulatory mechanism of TCM liver dispersion physiological function.
Objective
1. Through literature analysis, preparation of TCM physical status questionnaire, to form a College Students Health Status Questionnaire initially, which could be used to evaluate the college students' health status.
2. Completing the test screening of healthy college students subjects in3TCM colleges in Beijing, Shandong, Shanxi province.
3. Finishing the dynamic tracking survey through a cl inical epidemiology methods in three college students in four seasons and eight solar terms, to summarize, analyze the students' health status.
4. By stratified analysis, summarizing the representative of the health status of different populations of neurotic characteristics, and the dynamic changes of seasons, in order to analyze the important regulatory role in liver controlling dispersion in the process of psychological stress.
Methods
1. Through literature analysis, expert argumentation, according to psychology scale developed method, to draw up TCM physical health status questionnaire.
2.Through strict screening criteria, inclusion criteria, exclusion criteria, to select college students subjects.
3.By using epideraiological survey method, dynamic tracking investigation was carried out to healthy college students subjects in four seasons and eight solar terms.
Results
1. TCM physical health status questionnaire:The questionnaire covered58items in whole body, diet, sleep, stool and urine, gynecological aspects, which involves46four graded items and12gynecological items.
2. College Students Health Status Questionnaire:includes TCM physical health status questionnaire, Beck Self-Rating Anxiety Scale(BAI), Beck Depression self-rating scale (BDI), Eysenck Personality Questionnaire-Revised, Short Scale for Chinese (EPQ-RSC), Adolescent Self-Rat ing Life Events Check List (ASLEC). The quest ionnaire was designed for the health of col lege students in four seasons and eight solar terms dynamic investigation
3. Subjects screening:551questionnaires were distributed,546returned, which recovery rate was98.5%. After the screening,364subjects remained, which accounted for66.67%of the initial screening of the total number. Totally, there were332college students attended medical examination. Finally,312subjects passed physical examination, accounting for93.98percent of the total.
4. Dynamic survey of subjects in four seasons and eight solar terms.
4.1BAI
Significant difference in different four seasons and eight solar terms. Among them, the beginning of winter (Lidong), the winter solstice(Dongzhi) are significantly higher than other solar terms; the beginning of spring(Lichun), beginning of summer(Lixia), the summer solstice (Xiazhi) are significantly higher than the beginning of autumn(Liqiu); significant differences between the autumnal equinox (Qiufen) solar terms, the vernal equinox(Chunfen), the beginning of autumn (Liqiu)(P<0.05). The overall trend is the highest score in winter, followed by spring, summer, the lowest score in autumn.
4.2BDI
Significant difference in different four seasons and eight solar terms. Among them, beginning of winter(Lidong), the winter solstice (Dongzhi) significantly higher than the vernal equinox(Chunfen), summer sols t ice(Xiazhi), the beginning of autumn (Liqiu), autumnal equinox (Qiufen)(P<0.05); the beginning of spring(Lichun), beginning of summer (Lixia) significantly higher than the beginning of autumn(Liqiu), autumnal equinox (Qiufen)(P<0.05), the summer solstice (Xiazhi) significantly higher than Autumnal Equinox (Qiufen)(P<0.05). The overall trend is the highest score in winter, followed by spring, summer, the lowest score in autumn,.
4.3Mental or emotional status
The mood scores eight mental or emotional score showed a significant difference. Among them, the beginning of winter (Lidong), the winter solstice(Dongzhi) significantly higher than the other six solar terms (P<0.001), the beginning of spring (Lichun), the vernal equinox (Chunfen), the beginning of summer (Lixia), the summer solstice (Xiazhi) significantly higher than the beginning of autumn (Liqiu), autumnal equinox(Qiufen)(P<0.001). The overall trend:the highest score in winter, followed by spring, summer, the lowest score in autumn.
4.4Physical status
Significant difference in different four seasons and eight solar terms. Among them, the beginning of winter(Lidong), the winter solstice (Dongzhi) are significantly higher than other solar terms (no statistically significant d if ference between two solar terms), the beginning of spr ing (Lichun), beginning of summer (Lixia), the summer solst ice (Xiazhi) are significantly higher than the beginning of autumn(Liqiu), autumnal equinox(Qiufen) solar terms, the vernal equinox (Chunfen) was significantly higher than the beginning of autumn (Liqiu)(P<0.05).8items such as dry eyes, throat discomfort, palpitation, frequent sighing, nausea, abdominal discomfort, dry mouth, headache appear with no significant difference (P>0.05) among the solar terms in frequency (P<0.05).10items such as ringing in the ears, distension in chest, distension in lateral thorax, nausea, vomiting, back discomfort, leg discomfort, constipation, pains in lateral thorax, lumbago, with no significant difference (P>0.05) in severity among8solar terms. From a comprehensive view of the occurrence frequency and severity of physical items, following features occurred:
Epigastric discomfort is more serious at the beginning of winter(Lidong), the winter solstice(Dongzhi), the beginning of autumn (Liqiu), autumnal equinox (Qiufen)solar terms, but less serious at the beginning of spring(Lichun), the vernal equinox (Chunfen), the beginning of summer (Lixia), the summer solst ice (Xiazhi);
Sweating in palms and soles is more serious the beginning of spring (Lichun), the vernal equinox(Chunfen), the beginning of summer(Lixia), the summer solstice(Xiazhi) the autumnal equinox(Qiufen), but less serious at the beginning of winter(Lidong)(frequency), winter solstice(Dongzhi)(severity) and the beginning of autumn(Liqiu);
Sleep problems (including poor sleep, dreamy, difficulty falling asleep) only not serious at the beginning of autumn(Liqiu) solar terms, but more serious at the rest of the7solar terms;
Frequent sighing is more serious at the beginning of winter(Lidong), the beginning of spring (Lichun) the beginning of summer (Lixia), but less serious at the winter solstice(Dongzhi), the vernal equinox (Chunfen), the summer solstice(Xiazhi), the beginning of autumn (Liqiu) and the autumnal equinox(Qiufen);
Defecation problems (constipation, diarrhea) constipation is more serious at the beginning of spring(Lichun), the vernal equinox (Chunfen), the beginning of summer(Lixia), but both is more serious at the summer solstice(Xiazhi),the beginning of autumn(Liqiu), autumnal equinox(Qiufen) solar term;
Waist discomfort is more serious only at the summer solstice(Xiazhi),the beginning of autumn(Liqiu), autumnal equinox(Qiufen) solar term.
4.5ASLEC scores in significant difference. Except the other factor, the5ASLEC factors scores in significant differences (P<0.05).
5. The scores of mental or emotional, BAI, BDI scores exists with significantly different (P<0.05) between higher and lower neuroticism group, but physical status no significant difference (P>0.05). Low neuroticism group, the various indicators of the level of events to the inter-packet comparison of BAI score differences are not significant with P>0.05, remaining indicators are exist significant differences (P<0.05) high neuroticism low-life events have grouped1ife event score without significantly with differences (P>0.05), the remaining three groups, there were significant differences between seasons (P<0.05). Four o'clock high neuroticism and low life events group, the low neuroticism high1ife events group BAI score no s ignif icant difference (P>0.05), whi le the other two groups, there were significant differences between seasons (P<0.05). Seasons each group BDI score, there were significant differences (P<0.05). Seasons emotional condition score, there were significant differences (P<0.05). Four o'clock the high neuroticism low life events have grouped life events score no statistically significant difference (P>0.05), and the remaining three groups, there were significant differences between seasons (P<0.05)
Conclusion
1. College students healthy subjects in the physical, psychological, and social adaptation conditions of section four eight to certain rules, with the role of TCM Liver dispersion.
2. In this study, analysis of the body and the emotional state of the nervous crowd, the high neuroticism crowd body and emotional status is more significant, and the low neurot icism crowd relat ively mi Id. By comparison, the characteristic of these high neuroticism group entry significantly more than the low neuroticism group, there are significant performance both from a physical or emotional crowd of high neuroticism group. From the perspective of traditional Chinese medicine theory analysis, the high neuroticism crowd characteristic performance suggest that under physiological conditions, outstanding emotional, somatic manifestation liver catharsis gas machine, Regulating systemic blood inadequate function of emotions thus exhibiting the above characteristics; correspondingly, the the low neuroticism crowd catharsis function more significantly, regulating emotions, regulate the function of blood more stable state, it is physical, emotional performance is not prominent.
By subjects living circumstances of the incident investigation and analysis, this study found that life events as stressors on the body were obvious impact, emotional, and BDI, BAI status.
Analys is of the trends of level of neurot ic pm indicators, high neurot ici sm group in the four seasons of the indicators, such as physical, emotional fluctuations and differences are significant changes, the corresponding low neuroticism group indicators significantly more gentle. It is worth mentioning that the high, low neuroticism group life events crowd situation, although there are some changes, but overall, the crowd still high neuroticism group for the percept ion of life events more sensitive and dramatic. This suggests that, in the seasons change, for the body in a process to deal with the psychological stress due to the individual's ability to regulate and control the different result of this difference. Liver dispersion thus linked to the theory of TCM Viscera, its basic function is to regulate blood Regulating Emotions, if associated with psychological stress reaction, then, is precisely the physiological functions of the liver controlling dispers ion regulatory funct ions of heal thy ind iv iduals play in the process of psychological stress. Chinese medicine is not the concept of "psychological stress".
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