中医健康管理系统的构建与应用
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摘要
研究背景
健康管理是指对个体或群体的健康进行全面监测、分析、评估,提供健康咨询和指导以及对健康危险因素进行干预的全过程。健康管理为个体和群体提供有针对性的科学健康信息并创造条件采取行动,有效地利用有限的资源来达到最大的健康效果。
目前亚健康和各种慢性病已成为威胁人类健康的主要问题。世界卫生组织(WHO)的一项全球性调查表明,真正健康的人约占5%左右,各种疾病患者人数约占20%,而75%的人处于亚健康状态。据统计,在美国每年有600万人被怀疑处于亚健康状态,年龄多在20～45岁之间。中国亚健康状态的城市发生率大约为10%～20%,知识分子、企业领导、领导干部发生率达70%。一项覆盖全国42个城市的亚健康大样本流行病学调查结果显示,在48960例被调查者中,27839人属于亚健康状态,占58.18%。在中国亚健康学术研讨会上,专家预测中国目前处于亚健康状态的人群占总人口的70%,亚健康已成为我国一个不容忽视的公共卫生问题。城市中,亚健康状态有低龄化倾向。随着人类医学科技的进步,发现造成亚健康与慢性病发生原因,除了遗传因素外,无不与人们的生活方式和欠科学的膳食结构以及缺少运动密切相关。
我国健康管理的理论研究与技术应用起步较晚,体检中心作为目前健康管理的主要研究与实施机构,在实际工作中,管理的重心大多放在控制疾病危险因素上,与真正意义上的健康管理还有相当差距。我国健康管理服务形式单一,盲目照搬西方发达国家健康管理经验和模式,健康管理市场存在无序竞争,目前应用于健康管理的软件主要由两大类组成：一类是用于辅助健康体检为主要目的的体检类信息管理系统,另一类是健康风险评估软件系统,在体检后通过风险评估模型形成健康报告与相关健康指导,该类软件具有较高的专业技术性,软件公司需联合医疗科研机构才能实现较好的产品开发。而具有中国特色的健康管理创新服务系统尚未建立。
中医药在亚健康与慢性病的防治上具有独特的优势已被大量的医学实践所证实。中医学历来重视运用天人合一的整体观、因时因地因人制宜的动态辩证观、中医“治未病”的预防观作为指导以维护人类的健康,具有中医特色的诊疗手段不仅弥补了现代健康管理手段的不足。同时,由于西医学指标只能对疾病状态进行判断,却不能区分健康与亚健康状态,而中医学的辩证论治思维则能客观描述和评估健康状态的变化过程,不单局限于疾病的危险因素进行评估,而是从整体上对个人的健康状态进行衡量,更符合真正意义上的健康管理。
虽然中医学对疾病的预防和控制有着丰富的临床实践经验,但却与现代西方医学的理论、诊治手段和思维上有较大的差异,并缺乏较具说服力的与现代生物医学相符的临床研究数据的支持,许多行之有效的中医诊疗措施难以得到国际的普遍认同和推广。
传统的手工处理方式不能满足现代健康管理规模化的要求,主要表现在随着受检人数的增加和大量的、形式多样的临床数据,如：有定性化的中医证候、体征症状和中医体质类型的信息,还有定量化的实验室指标数据以及影像功能检查信息和其他形式的数据的产生,若用原来传统的手工方式处理、分析健康信息,医生将会耗费大量的时间在手工查找健康档案信息上,且纸质储存信息的方式,难以保证临床数据不丢失。在这样的条件下,健康管理业务的质量与效率都得不到保证。本研究从我院治未病中心的临床实际需求出发,以中医理论为核心,在详细的需求分析基础上对系统的构建制定具体设计方案,并通过联合软件开发公司,采用先进的三层B／S架构的Microsoft.net开发工具结合大型数据库,实现有中医特色的计算机健康管理系统软件的研发,并在临床中试运行。
研究目的
本研究在中医健康管理理念为核心,通过对有关中医体质学、亚健康调治、健康管理及中医信息系统等文献进行研究,并对比分析市场上较为优秀的健康管理软件的特点、咨询专家教授中医临床实际需要,编制中医健康管理系统需求分析报告。在此基础上,制定系统构建的详细设计方案,运用现代计算机信息技术,研发一套系统化、智能化、网络化的中医健康管理系统。
设计方案
本研究分为三个部分,第一部分健康管理研究背景的概述,主要通过对健康管理相关的文献进行收集、整理、分析以及健康管理软件及相关网站的初步调研。第二部分以需求调查为主要手段,进行较为全面的中医健康管理系统需求分析与可行性分析,制定系统构建的总体需求与具体需求。第三部分以需求调查为依据,在中医理论的专业指导下对系统模块功能进行详细设计,并进行系统基本架构和系统开发工具设计,联合软件公司实现系统开发。
第一部分研究背景概述
研究方法：(1)文献研究资料搜集：全面收集健康管理类文献资料,包括理论型与实践型资料,与健康管理相关的中医体质学文献、亚健康文献等资料。(2)市场上现有健康管理软件及网站的收集与分析。
研究结果：(1)对我国健康管理研究概况进行总结,总体结论是我国健康管理基础性研究不足,健康管理研究工作主要集中在慢性疾病人群(如脑卒中、高血压、糖尿病等)的认知、态度和行为调查,以及健康教育及其效果评价。对我国民众健康水平监测等基础数据库的尚未建立,有关健康评估、健康需求、健康管理模式和系统的理论框架等研究也相对较少。(2)全面总结并归纳了中医健康管理的研究进展,包括：中医治未病思想与健康管理的理论研究,总体上呈现出治未病思想指导下进行有中医特色健康管理的理论研究与实践紧密结合的趋势；健康管理的中医评估手段与干预方法研究,分以下三方面分别进行归纳：针对亚健康人群的中医评估工具、中医干预研究、中医体质学说与健康管理,认为亚健康人群是健康管理的主要对象,运用中医理论和方法调治亚健康符合健康管理的要求,而中医体质学说的建立为健康信息分类提取、评估、有针对性地对各类体质人群的危险因素实施干预手段起到了积极作用,同时对建立中医健康管理模式的思维创造拓展空间。(3)通过对市面上的健康管理软件和网站经过归纳分析,得出以下结果一类是用于辅助健康体检为主要目的的体检类信息管理系统,该系统的前台开发工具一般选择visual basic, Powerbuilder等软件；而其后台数据库开发多采用Sqlserver与oracle等软件。在国内的代表性产品主要是深圳天方达公司的“杏林七贤”系列产品与北京中科恒业公司的一员体检管理系统。第二类是健康风险评估软件系统,在体检后通过风险评估模型形成健康报告与相关健康指导,该类软件具有较高的专业技术性,软件公司需联合医疗科研机构才能实现较好的产品开发。国内的主要产品有北京耀华康业公司的知己健康管理软件系统,爱健康管理公司研发的健康与疾病评估系统,上海勤方信息技术有限公司开发的勤方健康评估系统和北京博益美华公司的KYN健康风险评估管理系统等。许多软件开发公司通过联合医疗等科研机构,从而研发具有较高专业技术性的健康管理系统软件以满足市场的需求,并通过网络平台来拓宽健康管理服务模式的内涵和外延。
第二部分中医健康管理系统的需求分析与可行性分析
研究方法：(1)中医健康管理系统构建需求调查：调查对象为广东省中医院治未病中心和健康咨询门诊的医生、医学科研专家与软件设计专家共19人。调查工具是经过与多位专家讨论后,形成系统构建需求调查问卷一和问卷二(见附录)。调查方法：开调查会、专家访谈、发放调查问卷等形式进行。调查内容包括：系统模块的组成、各模块的具体功能需求、系统中医特色模块的功能需求、系统维护以及运行环境等。(2)对回收的问卷结果进行统计分析,归纳出系统构建的具体需求,制定需求分析文档并进行可行性分析。
研究结果：(1)回收有效问卷一,共12份,有效回收率是63.1%。回收有效问卷二,共10份,有效回收率是52.7%。(2)具体意见分布(按百分比描述)如下：①系统关键模块组成中,信息管理模块(58.3%)、数据统计分析模块(41.6%)、中医辨识干预模块(83.3%)、健康体检模块(41.6%)、系统设置管理模块(66.6%)。②个人基本信息模块内容中,选择个人基本资料、用户相关信息和个人医疗记录信息(83.3%)。③健康查询模块内容中,选择历史体检档案(58.3%)、门诊、住院记录(75.0%)、体检报告(50.0%)、医疗图像记录(58.3%)、个人日常检测记录(75.0%)、健康行为记录(66.7%)。④对医学图像功能中,选择能上传医学影像信息,并导出图像描述(58.3%)、存储功能(83.3%)。⑤健康查询方式中,选择系统网站(83.3%)、手机短信(75.0%)、电子邮件(91.7%)。⑥体检信息统计分析中,选择人群中病类、总检人数、流失率、年龄、性别分布(83.3%)、人群健康状态(健康、亚健康、疾病)各占总检人数百分率(75.0%)、中医四诊、体质分类与西医生化指标、日常生活方式以及各项体检信息的相关性统计分析(58.3%)、中医各体质人群与健康、各类亚健康转归的统计分析(83.3%)、环境因素(外环境：气候变化、地理特点、环境卫生等；内环境：人体正气、体质强弱、情志因素等)与健康状态的统计分析(33.3%)、膳食、睡眠、运动信息等生活方式统计分析(50.0%)、个人出生年月日,时辰信息与体质类型的统计(33.3%)、描述,展示个人中医证候变化的过程(按：干预前后,年度的总体趋势)(75.0%)。⑦体检数据管理中,选择导入功能(.txt、word、Excel) (83.3%)、导出功能(至word、Excel) (83.3%)、对比分析管理前后、个人与群体数据(91.7%)、个人体检数据趋势分析预测(75.0%)、按需制作各种统计报表(75.0%)。⑧体检数据图形描述中,选择饼图(83.3%)、条图(83.3%)、线型图(91.7%)。⑨图表内容分类(各项指标)中,选择个人、团体(按性别、年龄段等)健康状况综合分类图表(91.7%)、亚健康、中老年主要慢性病、妇科病专项统计图表(83.3%)、健康状况(好转、治愈、维持等)各阶段对比统计图表(91.7%)、个人、团体体检健康状况多年度对比图表(91.7%)。⑩远程健康维护模块中,选择提供网络用户自测问卷,为用户返回包括自测得分和健康指导等内容(75.0%)、经家庭终端设备采集的数据经网络传输数据,由医务人员反馈(33.3%)、通过本软件自带的视频,语音功能,在线进行中医初步诊疗(58.3%)、用户将健康档案更新,在线咨询工作人员(58.3%)。其余具体研究结果请看论文第二部分内容。(2)归纳总结出我国体检管理系统存在的问题、我院体检管理系统的不足,制定系统构建的总体需求、系统功能目标、系统性能目标,进行可行性分析。(3)总结出系统的健康体检模块的具体功能需求。(4)汇总出系统构建的68条具体需求。(5)进行可行性分析。
第三部分中医健康管理系统基本架构与模块功能的设计及实现
研究方法：(1)结合实际,设计合适的系统架构。(2)基于总体需求与系统设计原则,设计以下五大的功能模块。(3)在系统的具体需求调查结果基础上,结合临床实际需求,对系统各模块主要功能进行详细设计。(4)联合软件开发公司,实现系统的开发。(5)测试中医健康管理系统在临床科研中的运行情况,对系统测评的亚健康人群评估结果进行初步统计分析。
研究结果：(1)选择三层B／S结构为基础系统架构的Microsoft, net开发工具进行系统体系结构设计；以健康数据信息在系统运作中的流向为主线,对健康管理系统软件框架进行初步设计,数据采集与传输、健康监测、健康风险评估、自动制定干预方案和接口；系统构建方案设计,即系统架构主要是基于微软Win2000/2003 Server网络操作系统；在此结构上进行的开发工具主要选择Visual Studio. NET,目录管理基于Windows 2003Server的Active Directory;数据库系统基于SQL SERVER,利用Power Designer进行数据库建模；WWW服务器基于IIS6.0。(2)系统主要设计为六个主要的功能模块：信息管理模块、数据统计分析模块、健康体检模块、中医辨识模块和网络服务模块。(3)信息管理模块提供个人基本信息和健康信息两部分的录入、查询等管理功能。数据统计分析模块通过对后台数据进行统计分析,以图表(包括各时期健康指标的趋势展示)的形式为用户展现相应的统计分析结果。数据统计分析模块实现,数据处理后可提供图表类型包括饼图、条形图和线形图、柱状图等。并从健康、亚健康、患病三个维度结合中医体质分类与生化指标进行统计。网络服务模块对个人通过电子邮件、手机短信方式。中医辨识模块主要通过以下实现,辨识工具设计,中医健康信息采集方式设计,中医健康干预功能设计。健康体检模块实现结构化体检项目录入、健康检查项目的自定义、设置体检打印模板、一键式打印、系统自动提示异常检查指标、高效导出检查结果汇总以及预留其他数据接口等功能。(4)系统实现并试运行。(5)系统的在实践中能有效节省体检时间与保证高效体检质量。
研究结论
(1)中医药学经过漫长的历史进程,形成了特有的理论体系和对疾病的辨治方法,它的整体观、辨证论治、特色养生保健技术,在我国医疗卫生工作以健康为主导的今天,有着现代医学不可替代的对人群健康评估与干预的优势。
(2)目前健康管理软件主要以西医学为主导,而具有传统中医特色的健康管理软件很少。大部分软件的研发主要朝着智能化、网络化、多功能、操作简易方便的方向发展,并开始注重对健康信息评估、自助查询、互动功能的开发。此外,健康管理服务中的医疗技术、卫生临床科研人才及健康管理机构的实力影响着健康管理软件产品质量的高低。
(3)通过需求分析与框架设计将能为实现本系统的总体功能目标打下坚实的基础。
(4)中医健康管理系统软件的构建,在一定程度上实现了古今中医健康管理理念与现代健康管理思维的融合,是健康管理服务规模化、标准化的需求,是中医理论与现代多学科技术结合下有中医特色的健康管理工具,为维护人类健康提供了一个新方法。
Background:
The healthy management means to be to health of the individual or the community carry on monitoring completely, analysis, valuation, provide health consult with instruction and carry on the whole processeses of intervention to the healthily dangerous factor. The healthy management is individual and community to provide to have a science to aim at sex healthy information and create a condition to take action, availably make use of limited resources to attain the biggest healthy effect.
Second health and various chronic disease have become the key problem of threatenning mankind's health currently. A global survey of World Health Organization(WHO) expresses that the truely healthy person has 5% around or so, various disease sufferer's number has 20% around, while 75% people are placed in second healthy status. According to the statistics, there are 600 myriad people being doubted annually in the United States be placed in second healthy status, age much in the 20-45 years old. Incidence rate about 10%-20% in city of Chinese second healthy status, knowledge member, business enterprise leadership, leadership staff's incidence rate reach to 70%. A 42 cities in overlay whole country of second healthily big sample Epidemiology survey suggest as a result, at 48960 drive in the investigation,27839 people belong to second healthy status and have 58.18%.On second healthy seminar in China, expert predicts that the crowd that China is placed in second healthy status currently takes up 70% of the total population, second health has become an our country the public hygiene problem that allows of no and neglects. In the city, the second healthy status has a low age to turn tendency. Along with the progress of mankind medical science science and technology, discover to result in second health and chronic disease take place reason, in addition to inheritting a factor, all and people's life style and owe meal structure and want for of science to exercise closely related.
Our country theory research and technique of healthy management apply to start a little bit late, the check-up center is the main research and implementation organization that manage healthily currently, in the middle of physically working, the center of gravity managing mostly puts in controling a dangerous factor of disease and still has an equal margin with the healthy management of real meaning. Our country health management service form one, blindly shine on to move west flourishing national health management experience and mode, health management the market exist have no preface competition, the software that is applied to a healthy management currently mainly constitutes to°from two major types:1 type is the check-up information used for lending support to the healthy check-up as main purpose management system, another is a healthy risk to evaluate software system, pass risk valuation after check-up the model form healthy report and related health instruction, the type of software has a higher professional technique, and software company's needing to be united then medical research organization can carry out better product development. But have healthy management innovation service system of Chinese special feature haven't built up.
Chinese medicine medicine on the prevention and cure of second health and the chronic disease have special advantage have already been confirmed by a great deal of medical science fulfillment. Chinese medicine educational background to value to make use of the whole view that the nature and man unites as one, because of because of ground because the prevention view of person system proper dynamic state dialectical view, the Chinese medicine"curing don't disease" is instruction with support the mankind's health, having the diagnosis and treatment means of Chinese medicine special feature not only makes up the shortage of modern health management means. At the same time, because the doctor learns index sign to carry on judgment to the disease status, but cans not classifies healthy and second healthy status, but the Chinese medicine learn of the dialectical theory cure thinking then ability objective description and evaluate the variety process of healthy status, not only limit at a dangerous factor of paroxysm to carry on valuation, but from whole up carry on measuring to the healthy status of individual, more healthy management according to real meaning.
Although the Chinese medicine learns to prevent from and control to have abundant clinical fulfillment experience to the paroxysm, but with the theory of modern and western medical science, make a diagnosis and give treatment there is bigger difference on means and thinking, and lack more support of the clinical research data of having the agreeing with with modern biomedical science of conviction, many effective Chinese medicine diagnosis and treatment the measure is hard to get international of universal approbation and expansion.
Traditional handicraft treatment can not satisfy the request that modern health management scale turns, main performance at along with be subjected to the increment of checking the number and a great deal of of, diverse form clinical data, such as:Settled the Chinese medicine certificate that sex turns to wait, the body advertise for the information of symptom and Chinese medicine physical endowment type, there is also the creation of the data of the laboratory index sign data and image function check information and other forms that the fixed amount turns, if use an originally traditional handicraft method processing, analytical healthy information, the doctor will expend to check to seek a healthy file information in the handicraft for a great deal of time up, and paper quality storage the way of information, hard assurance the clinical data don't throw to lose. At under the condition like this, health manages quality and efficiencies of business to all can not get assurance. This research cures from my hospital don't the clinical actual need of the center of disease set out and take Chinese medicine theory as core, at detailed need analytical foundation the top concretely design a project to the setting up of system establishment, and pass to unite software development company, the adoption forerunner's 3 F B|S structure of Microsoft. net development the tool combine a large database, realization have the development of calculator health management system software of Chinese medicine special feature, and at clinical in try movement.
Objectives:
To objectively draw up a Chinese medicine health management system requirements analysis report. This research base on the Chinese medicine professional theory instruction, pass to relevant the Chinese medicine physical endowment learn, second health adjust to cure, healthy management and Chinese medicine information system etc. cultural heritage carry on a research, and contrast to analyze the characteristics of more excellent healthy management software on the market and consult an expert to teach at first the clinical effective demand, summary was systematic not perfect place and combined Chinese medicine Bian to cure a special feature. On this foundation, draw up the detailed design project that the system sets up, combine medium doctor professional techniques, such as knowledge and information network... etc., carried out to carry on to get stripe at first to the systematic function, develop a set of systematize, the intelligence turned, the network turned of Chinese medicine health manages system.
Des i gn:
There are three parts in the study. First, Healthy management theory and the research of fulfillment, mainly pass and manage related cultural heritage and carry on a collections, sorting and analysis to health and health management software and related website of initial investigation. Second, Take need survey as main means, carry on more overall Chinese medicine health management system need analysis, draw up the total need and concrete need that the system sets up, and carry on basic structure of system and system to develop a tool design. Third, Take need survey as a basis, under the professional instruction that Chinese medicine theoretical to system mold piece the function design in detail and unite software companies to carry out a system development.
Part one
Research method:
(1) The cultural heritage studies a data collection:Collect healthy management cultural heritage completely data, including theory type and fulfillment type data, with healthily manage related Chinese medicine physical endowment to learn datas, such as cultural heritage and second healthy cultural heritage... etc.. (2) Existing health manages the collections and analysis of software and website on the market.
Result:
(1)To our country the healthy management research general situation carry on summary, total conclusion is our country health management foundation research shortage, healthily manage a studying mainly concentration in cognition, attitude and behavior survey of chronic disease crowd(such as brain soldier win, the high blood pressure, glycouria is far-gone), and healthily education and it effect evaluation. To our country people the healthy level monitor an etc. foundation database of haven't built up, relevant health valuation, the theory frame of the healthy need, healthy management style and system etc. research also opposite less. (2)Is overall to tally up and induced Chinese medicine to healthily manage of research make progress, include:The Chinese medicine cures don't disease thought and healthily manage of theory research, total up present to cure don't the disease thought carry on the theory research with Chinese medicine special feature to healthily manage and practice allied trend under the instruction;Healthy management of Chinese medicine valuation means and intervention method research, divide following three aspectses to be respectively carry on inducing:Aim at the Chinese medicine of second healthy crowd valuation tool, Chinese medicine intervention research, Chinese medicine physical endowment theory and healthily management, think that the second healthy crowd is the main object of healthy management, make use of Chinese medicine theory and method to adjust to cure second health request according to healthy management, but the establishment of Chinese medicine physical endowment theory withdraw, evaluate, have for the healthy information classification aim at sex ground to each kind of physical endowment crowd of dangerous factor implementation intervention means since positive effect, expand space to the thinking creation that builds up a Chinese medicine healthy management style at the same time. (3)Pass the healthy management software to the market and website has been induced analysis and get as follows as a result 1 type is the check-up information used for lending support to the healthy check-up as main purpose management system, the stage of the system develops tool to generally choose visual basic, softwares like Powerbuilder, etc;But afterward set database developments adopt more softwares, such as Sqlserver and oracle... etc.. A member of the section Heng Ye company check-up manages system in"almond Lin Qi Xian" series product and Peking that is mainly sky square of Shenzhen to reach company in local representative's product. Category 2 is a healthy risk to evaluate software system, pass risk valuation after check-up the model form healthy report and related health instruction, the type of software has a higher professional technique, and software company's needing to be united then medical research organization can carry out better product development. The local main product has Peking shows off China Kang Ye company of the bosom friend healthily manage software system and love healthily manage the company develop of health and disease evaluate system, Shanghai frequently square information technique limited company development of frequently the square healthily evaluate healthy risk of KYN of system and Bo benefit in Peking American China company valuation management system etc.. Many software development the company pass to unite research organizations like medical treatment, etc, thus development have higher professional technical healthy management system software with the need that satisfies a market, and pass network platform to open widely the content of healthy management service mode and outside postpone.
Part two
Research method:
(1) Through investigate the meeting and expert interviews of foundation up, combine currently me the shortage of check-up system in the hospital, carry on analysis, make sure the total need that system sets up. (2)The foundation analyzed in the total need up, pass to open to investigate colloquium, consult a clinical doctor, design personnel's interview with software and design to investigate form to invite the method that the related expert fills in, checks related professional technique cultural heritage, carry on comprehensive analysis, establish concrete of, more detailed need analysis result, and as to it's carry on inducing. (3)Combine physically, design suitable system structure.
Results:
(1)The shortage that induces the problem of tallying up the our country check-up management system existence, Is hospital check-up management system draws up the total need, system function target, system function target that the system sets up and carries on a viability assessment. (2)Tally up the concrete function request of the healthy check-up mold piece of a system. (3)68 concrete needs that sets up to the system carry on gathering. (4)Choose 3 F B|the S structure configuring for the foundation system of the Microsoft.net development tool carry on HER system structure to design. (5)With the healthy data information operate to mediumly fly to in the system for lord line, manage system software to health the frame carry on first step design, the data collects and delivers, health monitor, the healthy risk evaluate, the automatic establishment interfere a project and connect. (6)The system sets up a project design, namely the system configurings mainly is according to Microsoft Win 2000|2003 Server network operate system;The development tool carrying on on this structure mainly chooses Visual Studio. NET. The catalogue manages Directory according to Active of the Windows 2003 servers;Database system according to SQL SERVER, make use of Power Designer to carry on a database model;The WWW server is according to the IIS6.0.
Part three
Research method:
(1) Design a principle and design a following five greatest functions mold piece according to the total need and the system. (2)On the concrete need survey result foundation of system, combine a clinical actual need, carry on a detailed design to the each mold of system piece main function. (3)Unite software development company, carry out the development of system. Results:
(1)System mainly design for five main function mold piece:the information manage mold piece, healthy check-up mold piece, Chinese medicine of mold piece, data statistics analysis to recognize mold piece and network service mold piece. (2)The information manages a mold piece provide personal basic information and healthy information two parts of record to go into, search etc. management function. Data statistics analytical the mold piece pass to carry on a statistics to the backstage data analysis and take the form of chart(include the trend demonstration of each period healthy index sign) as a customer to make a show of a homologous statistics analytical result. Data statistics analytical mold piece realization, data processing behind can provide a chart type to include a round flat cake diagram and the form diagram and line form diagram, pillar-like in shape diagram etc. Combine from health, second health, fall ill three dimensions to combine Chinese medicine physical endowment classification and bio-chemical index sign to carry on a statistics. Network service mold piece passes an E-mail, cellular phone message method to the individual. The Chinese medicine recognizes a mold piece to mainly pass a following realization and recognizes a tool design, the Chinese medicine healthy information collects a way design, Chinese medicine health intervention function design. Healthy check-up mold piece carry out structure to turn check-up item to record to go into, health inspection item of from define, constitution the check-up print template, a key type to print, the system automatically hint excrescent check index sign, efficiently lead a check result to gather and reserve other datas to connect functions like a people, etc. (3)The system carries out and try movement.
Conclusion:
(1)The Chinese medicine pharmacy forms special theory system and cures a method to the paroxysm Bian after endless history progress, the its whole view, dialectics theory cures, special feature health health care technique, at our country medical and health the work take health as predominant today, having the modern medical science can not act for of healthily evaluate to the crowd with intervention of advantage. (2)Healthily manage software mainly currently with the doctor learn for predominance, but the healthy management software that has a traditional Chinese medicine special feature is few. The development of big parts of softwares mainly turns toward the intelligence, the network turn, multi-function, operate the direction development of simple convenience, and start paying attention to the development to the healthy information valuation, self-help search, interaction function. Healthily manage a clinical research talented person of the medical technique in service, health and healthily manage the real strenght of organization to influence a healthy management in addition the height of the software product quality. (3)Pass need analysis and frame design ability for realization originally the total function target of the system lay solid foundation. (4)Chinese medicine health manages setting up of system software and carried out a thou to some extent the fusion of Chinese medicine theory and modern health management thinking now, is health management service scale turn, standardize of the need is Chinese medicine theory and much more modern academics technique to combine next have the healthy management tool of Chinese medicine special feature, for supported mankind to healthily provide a new method.
健康管理是指对个体或群体的健康进行全面监测、分析、评估,提供健康咨询和指导以及对健康危险因素进行干预的全过程。健康管理为个体和群体提供有针对性的科学健康信息并创造条件采取行动,有效地利用有限的资源来达到最大的健康效果。
目前亚健康和各种慢性病已成为威胁人类健康的主要问题。世界卫生组织(WHO)的一项全球性调查表明,真正健康的人约占5%左右,各种疾病患者人数约占20%,而75%的人处于亚健康状态。据统计,在美国每年有600万人被怀疑处于亚健康状态,年龄多在20～45岁之间。中国亚健康状态的城市发生率大约为10%～20%,知识分子、企业领导、领导干部发生率达70%。一项覆盖全国42个城市的亚健康大样本流行病学调查结果显示,在48960例被调查者中,27839人属于亚健康状态,占58.18%。在中国亚健康学术研讨会上,专家预测中国目前处于亚健康状态的人群占总人口的70%,亚健康已成为我国一个不容忽视的公共卫生问题。城市中,亚健康状态有低龄化倾向。随着人类医学科技的进步,发现造成亚健康与慢性病发生原因,除了遗传因素外,无不与人们的生活方式和欠科学的膳食结构以及缺少运动密切相关。
我国健康管理的理论研究与技术应用起步较晚,体检中心作为目前健康管理的主要研究与实施机构,在实际工作中,管理的重心大多放在控制疾病危险因素上,与真正意义上的健康管理还有相当差距。我国健康管理服务形式单一,盲目照搬西方发达国家健康管理经验和模式,健康管理市场存在无序竞争,目前应用于健康管理的软件主要由两大类组成：一类是用于辅助健康体检为主要目的的体检类信息管理系统,另一类是健康风险评估软件系统,在体检后通过风险评估模型形成健康报告与相关健康指导,该类软件具有较高的专业技术性,软件公司需联合医疗科研机构才能实现较好的产品开发。而具有中国特色的健康管理创新服务系统尚未建立。
中医药在亚健康与慢性病的防治上具有独特的优势已被大量的医学实践所证实。中医学历来重视运用天人合一的整体观、因时因地因人制宜的动态辩证观、中医“治未病”的预防观作为指导以维护人类的健康,具有中医特色的诊疗手段不仅弥补了现代健康管理手段的不足。同时,由于西医学指标只能对疾病状态进行判断,却不能区分健康与亚健康状态,而中医学的辩证论治思维则能客观描述和评估健康状态的变化过程,不单局限于疾病的危险因素进行评估,而是从整体上对个人的健康状态进行衡量,更符合真正意义上的健康管理。
虽然中医学对疾病的预防和控制有着丰富的临床实践经验,但却与现代西方医学的理论、诊治手段和思维上有较大的差异,并缺乏较具说服力的与现代生物医学相符的临床研究数据的支持,许多行之有效的中医诊疗措施难以得到国际的普遍认同和推广。
传统的手工处理方式不能满足现代健康管理规模化的要求,主要表现在随着受检人数的增加和大量的、形式多样的临床数据,如：有定性化的中医证候、体征症状和中医体质类型的信息,还有定量化的实验室指标数据以及影像功能检查信息和其他形式的数据的产生,若用原来传统的手工方式处理、分析健康信息,医生将会耗费大量的时间在手工查找健康档案信息上,且纸质储存信息的方式,难以保证临床数据不丢失。在这样的条件下,健康管理业务的质量与效率都得不到保证。本研究从我院治未病中心的临床实际需求出发,以中医理论为核心,在详细的需求分析基础上对系统的构建制定具体设计方案,并通过联合软件开发公司,采用先进的三层B／S架构的Microsoft.net开发工具结合大型数据库,实现有中医特色的计算机健康管理系统软件的研发,并在临床中试运行。
研究目的
本研究在中医健康管理理念为核心,通过对有关中医体质学、亚健康调治、健康管理及中医信息系统等文献进行研究,并对比分析市场上较为优秀的健康管理软件的特点、咨询专家教授中医临床实际需要,编制中医健康管理系统需求分析报告。在此基础上,制定系统构建的详细设计方案,运用现代计算机信息技术,研发一套系统化、智能化、网络化的中医健康管理系统。
设计方案
本研究分为三个部分,第一部分健康管理研究背景的概述,主要通过对健康管理相关的文献进行收集、整理、分析以及健康管理软件及相关网站的初步调研。第二部分以需求调查为主要手段,进行较为全面的中医健康管理系统需求分析与可行性分析,制定系统构建的总体需求与具体需求。第三部分以需求调查为依据,在中医理论的专业指导下对系统模块功能进行详细设计,并进行系统基本架构和系统开发工具设计,联合软件公司实现系统开发。
第一部分研究背景概述
研究方法：(1)文献研究资料搜集：全面收集健康管理类文献资料,包括理论型与实践型资料,与健康管理相关的中医体质学文献、亚健康文献等资料。(2)市场上现有健康管理软件及网站的收集与分析。
研究结果：(1)对我国健康管理研究概况进行总结,总体结论是我国健康管理基础性研究不足,健康管理研究工作主要集中在慢性疾病人群(如脑卒中、高血压、糖尿病等)的认知、态度和行为调查,以及健康教育及其效果评价。对我国民众健康水平监测等基础数据库的尚未建立,有关健康评估、健康需求、健康管理模式和系统的理论框架等研究也相对较少。(2)全面总结并归纳了中医健康管理的研究进展,包括：中医治未病思想与健康管理的理论研究,总体上呈现出治未病思想指导下进行有中医特色健康管理的理论研究与实践紧密结合的趋势；健康管理的中医评估手段与干预方法研究,分以下三方面分别进行归纳：针对亚健康人群的中医评估工具、中医干预研究、中医体质学说与健康管理,认为亚健康人群是健康管理的主要对象,运用中医理论和方法调治亚健康符合健康管理的要求,而中医体质学说的建立为健康信息分类提取、评估、有针对性地对各类体质人群的危险因素实施干预手段起到了积极作用,同时对建立中医健康管理模式的思维创造拓展空间。(3)通过对市面上的健康管理软件和网站经过归纳分析,得出以下结果一类是用于辅助健康体检为主要目的的体检类信息管理系统,该系统的前台开发工具一般选择visual basic, Powerbuilder等软件；而其后台数据库开发多采用Sqlserver与oracle等软件。在国内的代表性产品主要是深圳天方达公司的“杏林七贤”系列产品与北京中科恒业公司的一员体检管理系统。第二类是健康风险评估软件系统,在体检后通过风险评估模型形成健康报告与相关健康指导,该类软件具有较高的专业技术性,软件公司需联合医疗科研机构才能实现较好的产品开发。国内的主要产品有北京耀华康业公司的知己健康管理软件系统,爱健康管理公司研发的健康与疾病评估系统,上海勤方信息技术有限公司开发的勤方健康评估系统和北京博益美华公司的KYN健康风险评估管理系统等。许多软件开发公司通过联合医疗等科研机构,从而研发具有较高专业技术性的健康管理系统软件以满足市场的需求,并通过网络平台来拓宽健康管理服务模式的内涵和外延。
第二部分中医健康管理系统的需求分析与可行性分析
研究方法：(1)中医健康管理系统构建需求调查：调查对象为广东省中医院治未病中心和健康咨询门诊的医生、医学科研专家与软件设计专家共19人。调查工具是经过与多位专家讨论后,形成系统构建需求调查问卷一和问卷二(见附录)。调查方法：开调查会、专家访谈、发放调查问卷等形式进行。调查内容包括：系统模块的组成、各模块的具体功能需求、系统中医特色模块的功能需求、系统维护以及运行环境等。(2)对回收的问卷结果进行统计分析,归纳出系统构建的具体需求,制定需求分析文档并进行可行性分析。
研究结果：(1)回收有效问卷一,共12份,有效回收率是63.1%。回收有效问卷二,共10份,有效回收率是52.7%。(2)具体意见分布(按百分比描述)如下：①系统关键模块组成中,信息管理模块(58.3%)、数据统计分析模块(41.6%)、中医辨识干预模块(83.3%)、健康体检模块(41.6%)、系统设置管理模块(66.6%)。②个人基本信息模块内容中,选择个人基本资料、用户相关信息和个人医疗记录信息(83.3%)。③健康查询模块内容中,选择历史体检档案(58.3%)、门诊、住院记录(75.0%)、体检报告(50.0%)、医疗图像记录(58.3%)、个人日常检测记录(75.0%)、健康行为记录(66.7%)。④对医学图像功能中,选择能上传医学影像信息,并导出图像描述(58.3%)、存储功能(83.3%)。⑤健康查询方式中,选择系统网站(83.3%)、手机短信(75.0%)、电子邮件(91.7%)。⑥体检信息统计分析中,选择人群中病类、总检人数、流失率、年龄、性别分布(83.3%)、人群健康状态(健康、亚健康、疾病)各占总检人数百分率(75.0%)、中医四诊、体质分类与西医生化指标、日常生活方式以及各项体检信息的相关性统计分析(58.3%)、中医各体质人群与健康、各类亚健康转归的统计分析(83.3%)、环境因素(外环境：气候变化、地理特点、环境卫生等；内环境：人体正气、体质强弱、情志因素等)与健康状态的统计分析(33.3%)、膳食、睡眠、运动信息等生活方式统计分析(50.0%)、个人出生年月日,时辰信息与体质类型的统计(33.3%)、描述,展示个人中医证候变化的过程(按：干预前后,年度的总体趋势)(75.0%)。⑦体检数据管理中,选择导入功能(.txt、word、Excel) (83.3%)、导出功能(至word、Excel) (83.3%)、对比分析管理前后、个人与群体数据(91.7%)、个人体检数据趋势分析预测(75.0%)、按需制作各种统计报表(75.0%)。⑧体检数据图形描述中,选择饼图(83.3%)、条图(83.3%)、线型图(91.7%)。⑨图表内容分类(各项指标)中,选择个人、团体(按性别、年龄段等)健康状况综合分类图表(91.7%)、亚健康、中老年主要慢性病、妇科病专项统计图表(83.3%)、健康状况(好转、治愈、维持等)各阶段对比统计图表(91.7%)、个人、团体体检健康状况多年度对比图表(91.7%)。⑩远程健康维护模块中,选择提供网络用户自测问卷,为用户返回包括自测得分和健康指导等内容(75.0%)、经家庭终端设备采集的数据经网络传输数据,由医务人员反馈(33.3%)、通过本软件自带的视频,语音功能,在线进行中医初步诊疗(58.3%)、用户将健康档案更新,在线咨询工作人员(58.3%)。其余具体研究结果请看论文第二部分内容。(2)归纳总结出我国体检管理系统存在的问题、我院体检管理系统的不足,制定系统构建的总体需求、系统功能目标、系统性能目标,进行可行性分析。(3)总结出系统的健康体检模块的具体功能需求。(4)汇总出系统构建的68条具体需求。(5)进行可行性分析。
第三部分中医健康管理系统基本架构与模块功能的设计及实现
研究方法：(1)结合实际,设计合适的系统架构。(2)基于总体需求与系统设计原则,设计以下五大的功能模块。(3)在系统的具体需求调查结果基础上,结合临床实际需求,对系统各模块主要功能进行详细设计。(4)联合软件开发公司,实现系统的开发。(5)测试中医健康管理系统在临床科研中的运行情况,对系统测评的亚健康人群评估结果进行初步统计分析。
研究结果：(1)选择三层B／S结构为基础系统架构的Microsoft, net开发工具进行系统体系结构设计；以健康数据信息在系统运作中的流向为主线,对健康管理系统软件框架进行初步设计,数据采集与传输、健康监测、健康风险评估、自动制定干预方案和接口；系统构建方案设计,即系统架构主要是基于微软Win2000/2003 Server网络操作系统；在此结构上进行的开发工具主要选择Visual Studio. NET,目录管理基于Windows 2003Server的Active Directory;数据库系统基于SQL SERVER,利用Power Designer进行数据库建模；WWW服务器基于IIS6.0。(2)系统主要设计为六个主要的功能模块：信息管理模块、数据统计分析模块、健康体检模块、中医辨识模块和网络服务模块。(3)信息管理模块提供个人基本信息和健康信息两部分的录入、查询等管理功能。数据统计分析模块通过对后台数据进行统计分析,以图表(包括各时期健康指标的趋势展示)的形式为用户展现相应的统计分析结果。数据统计分析模块实现,数据处理后可提供图表类型包括饼图、条形图和线形图、柱状图等。并从健康、亚健康、患病三个维度结合中医体质分类与生化指标进行统计。网络服务模块对个人通过电子邮件、手机短信方式。中医辨识模块主要通过以下实现,辨识工具设计,中医健康信息采集方式设计,中医健康干预功能设计。健康体检模块实现结构化体检项目录入、健康检查项目的自定义、设置体检打印模板、一键式打印、系统自动提示异常检查指标、高效导出检查结果汇总以及预留其他数据接口等功能。(4)系统实现并试运行。(5)系统的在实践中能有效节省体检时间与保证高效体检质量。
研究结论
(1)中医药学经过漫长的历史进程,形成了特有的理论体系和对疾病的辨治方法,它的整体观、辨证论治、特色养生保健技术,在我国医疗卫生工作以健康为主导的今天,有着现代医学不可替代的对人群健康评估与干预的优势。
(2)目前健康管理软件主要以西医学为主导,而具有传统中医特色的健康管理软件很少。大部分软件的研发主要朝着智能化、网络化、多功能、操作简易方便的方向发展,并开始注重对健康信息评估、自助查询、互动功能的开发。此外,健康管理服务中的医疗技术、卫生临床科研人才及健康管理机构的实力影响着健康管理软件产品质量的高低。
(3)通过需求分析与框架设计将能为实现本系统的总体功能目标打下坚实的基础。
(4)中医健康管理系统软件的构建,在一定程度上实现了古今中医健康管理理念与现代健康管理思维的融合,是健康管理服务规模化、标准化的需求,是中医理论与现代多学科技术结合下有中医特色的健康管理工具,为维护人类健康提供了一个新方法。
Background:
The healthy management means to be to health of the individual or the community carry on monitoring completely, analysis, valuation, provide health consult with instruction and carry on the whole processeses of intervention to the healthily dangerous factor. The healthy management is individual and community to provide to have a science to aim at sex healthy information and create a condition to take action, availably make use of limited resources to attain the biggest healthy effect.
Second health and various chronic disease have become the key problem of threatenning mankind's health currently. A global survey of World Health Organization(WHO) expresses that the truely healthy person has 5% around or so, various disease sufferer's number has 20% around, while 75% people are placed in second healthy status. According to the statistics, there are 600 myriad people being doubted annually in the United States be placed in second healthy status, age much in the 20-45 years old. Incidence rate about 10%-20% in city of Chinese second healthy status, knowledge member, business enterprise leadership, leadership staff's incidence rate reach to 70%. A 42 cities in overlay whole country of second healthily big sample Epidemiology survey suggest as a result, at 48960 drive in the investigation,27839 people belong to second healthy status and have 58.18%.On second healthy seminar in China, expert predicts that the crowd that China is placed in second healthy status currently takes up 70% of the total population, second health has become an our country the public hygiene problem that allows of no and neglects. In the city, the second healthy status has a low age to turn tendency. Along with the progress of mankind medical science science and technology, discover to result in second health and chronic disease take place reason, in addition to inheritting a factor, all and people's life style and owe meal structure and want for of science to exercise closely related.
Our country theory research and technique of healthy management apply to start a little bit late, the check-up center is the main research and implementation organization that manage healthily currently, in the middle of physically working, the center of gravity managing mostly puts in controling a dangerous factor of disease and still has an equal margin with the healthy management of real meaning. Our country health management service form one, blindly shine on to move west flourishing national health management experience and mode, health management the market exist have no preface competition, the software that is applied to a healthy management currently mainly constitutes to°from two major types:1 type is the check-up information used for lending support to the healthy check-up as main purpose management system, another is a healthy risk to evaluate software system, pass risk valuation after check-up the model form healthy report and related health instruction, the type of software has a higher professional technique, and software company's needing to be united then medical research organization can carry out better product development. But have healthy management innovation service system of Chinese special feature haven't built up.
Chinese medicine medicine on the prevention and cure of second health and the chronic disease have special advantage have already been confirmed by a great deal of medical science fulfillment. Chinese medicine educational background to value to make use of the whole view that the nature and man unites as one, because of because of ground because the prevention view of person system proper dynamic state dialectical view, the Chinese medicine"curing don't disease" is instruction with support the mankind's health, having the diagnosis and treatment means of Chinese medicine special feature not only makes up the shortage of modern health management means. At the same time, because the doctor learns index sign to carry on judgment to the disease status, but cans not classifies healthy and second healthy status, but the Chinese medicine learn of the dialectical theory cure thinking then ability objective description and evaluate the variety process of healthy status, not only limit at a dangerous factor of paroxysm to carry on valuation, but from whole up carry on measuring to the healthy status of individual, more healthy management according to real meaning.
Although the Chinese medicine learns to prevent from and control to have abundant clinical fulfillment experience to the paroxysm, but with the theory of modern and western medical science, make a diagnosis and give treatment there is bigger difference on means and thinking, and lack more support of the clinical research data of having the agreeing with with modern biomedical science of conviction, many effective Chinese medicine diagnosis and treatment the measure is hard to get international of universal approbation and expansion.
Traditional handicraft treatment can not satisfy the request that modern health management scale turns, main performance at along with be subjected to the increment of checking the number and a great deal of of, diverse form clinical data, such as:Settled the Chinese medicine certificate that sex turns to wait, the body advertise for the information of symptom and Chinese medicine physical endowment type, there is also the creation of the data of the laboratory index sign data and image function check information and other forms that the fixed amount turns, if use an originally traditional handicraft method processing, analytical healthy information, the doctor will expend to check to seek a healthy file information in the handicraft for a great deal of time up, and paper quality storage the way of information, hard assurance the clinical data don't throw to lose. At under the condition like this, health manages quality and efficiencies of business to all can not get assurance. This research cures from my hospital don't the clinical actual need of the center of disease set out and take Chinese medicine theory as core, at detailed need analytical foundation the top concretely design a project to the setting up of system establishment, and pass to unite software development company, the adoption forerunner's 3 F B|S structure of Microsoft. net development the tool combine a large database, realization have the development of calculator health management system software of Chinese medicine special feature, and at clinical in try movement.
Objectives:
To objectively draw up a Chinese medicine health management system requirements analysis report. This research base on the Chinese medicine professional theory instruction, pass to relevant the Chinese medicine physical endowment learn, second health adjust to cure, healthy management and Chinese medicine information system etc. cultural heritage carry on a research, and contrast to analyze the characteristics of more excellent healthy management software on the market and consult an expert to teach at first the clinical effective demand, summary was systematic not perfect place and combined Chinese medicine Bian to cure a special feature. On this foundation, draw up the detailed design project that the system sets up, combine medium doctor professional techniques, such as knowledge and information network... etc., carried out to carry on to get stripe at first to the systematic function, develop a set of systematize, the intelligence turned, the network turned of Chinese medicine health manages system.
Des i gn:
There are three parts in the study. First, Healthy management theory and the research of fulfillment, mainly pass and manage related cultural heritage and carry on a collections, sorting and analysis to health and health management software and related website of initial investigation. Second, Take need survey as main means, carry on more overall Chinese medicine health management system need analysis, draw up the total need and concrete need that the system sets up, and carry on basic structure of system and system to develop a tool design. Third, Take need survey as a basis, under the professional instruction that Chinese medicine theoretical to system mold piece the function design in detail and unite software companies to carry out a system development.
Part one
Research method:
(1) The cultural heritage studies a data collection:Collect healthy management cultural heritage completely data, including theory type and fulfillment type data, with healthily manage related Chinese medicine physical endowment to learn datas, such as cultural heritage and second healthy cultural heritage... etc.. (2) Existing health manages the collections and analysis of software and website on the market.
Result:
(1)To our country the healthy management research general situation carry on summary, total conclusion is our country health management foundation research shortage, healthily manage a studying mainly concentration in cognition, attitude and behavior survey of chronic disease crowd(such as brain soldier win, the high blood pressure, glycouria is far-gone), and healthily education and it effect evaluation. To our country people the healthy level monitor an etc. foundation database of haven't built up, relevant health valuation, the theory frame of the healthy need, healthy management style and system etc. research also opposite less. (2)Is overall to tally up and induced Chinese medicine to healthily manage of research make progress, include:The Chinese medicine cures don't disease thought and healthily manage of theory research, total up present to cure don't the disease thought carry on the theory research with Chinese medicine special feature to healthily manage and practice allied trend under the instruction;Healthy management of Chinese medicine valuation means and intervention method research, divide following three aspectses to be respectively carry on inducing:Aim at the Chinese medicine of second healthy crowd valuation tool, Chinese medicine intervention research, Chinese medicine physical endowment theory and healthily management, think that the second healthy crowd is the main object of healthy management, make use of Chinese medicine theory and method to adjust to cure second health request according to healthy management, but the establishment of Chinese medicine physical endowment theory withdraw, evaluate, have for the healthy information classification aim at sex ground to each kind of physical endowment crowd of dangerous factor implementation intervention means since positive effect, expand space to the thinking creation that builds up a Chinese medicine healthy management style at the same time. (3)Pass the healthy management software to the market and website has been induced analysis and get as follows as a result 1 type is the check-up information used for lending support to the healthy check-up as main purpose management system, the stage of the system develops tool to generally choose visual basic, softwares like Powerbuilder, etc;But afterward set database developments adopt more softwares, such as Sqlserver and oracle... etc.. A member of the section Heng Ye company check-up manages system in"almond Lin Qi Xian" series product and Peking that is mainly sky square of Shenzhen to reach company in local representative's product. Category 2 is a healthy risk to evaluate software system, pass risk valuation after check-up the model form healthy report and related health instruction, the type of software has a higher professional technique, and software company's needing to be united then medical research organization can carry out better product development. The local main product has Peking shows off China Kang Ye company of the bosom friend healthily manage software system and love healthily manage the company develop of health and disease evaluate system, Shanghai frequently square information technique limited company development of frequently the square healthily evaluate healthy risk of KYN of system and Bo benefit in Peking American China company valuation management system etc.. Many software development the company pass to unite research organizations like medical treatment, etc, thus development have higher professional technical healthy management system software with the need that satisfies a market, and pass network platform to open widely the content of healthy management service mode and outside postpone.
Part two
Research method:
(1) Through investigate the meeting and expert interviews of foundation up, combine currently me the shortage of check-up system in the hospital, carry on analysis, make sure the total need that system sets up. (2)The foundation analyzed in the total need up, pass to open to investigate colloquium, consult a clinical doctor, design personnel's interview with software and design to investigate form to invite the method that the related expert fills in, checks related professional technique cultural heritage, carry on comprehensive analysis, establish concrete of, more detailed need analysis result, and as to it's carry on inducing. (3)Combine physically, design suitable system structure.
Results:
(1)The shortage that induces the problem of tallying up the our country check-up management system existence, Is hospital check-up management system draws up the total need, system function target, system function target that the system sets up and carries on a viability assessment. (2)Tally up the concrete function request of the healthy check-up mold piece of a system. (3)68 concrete needs that sets up to the system carry on gathering. (4)Choose 3 F B|the S structure configuring for the foundation system of the Microsoft.net development tool carry on HER system structure to design. (5)With the healthy data information operate to mediumly fly to in the system for lord line, manage system software to health the frame carry on first step design, the data collects and delivers, health monitor, the healthy risk evaluate, the automatic establishment interfere a project and connect. (6)The system sets up a project design, namely the system configurings mainly is according to Microsoft Win 2000|2003 Server network operate system;The development tool carrying on on this structure mainly chooses Visual Studio. NET. The catalogue manages Directory according to Active of the Windows 2003 servers;Database system according to SQL SERVER, make use of Power Designer to carry on a database model;The WWW server is according to the IIS6.0.
Part three
Research method:
(1) Design a principle and design a following five greatest functions mold piece according to the total need and the system. (2)On the concrete need survey result foundation of system, combine a clinical actual need, carry on a detailed design to the each mold of system piece main function. (3)Unite software development company, carry out the development of system. Results:
(1)System mainly design for five main function mold piece:the information manage mold piece, healthy check-up mold piece, Chinese medicine of mold piece, data statistics analysis to recognize mold piece and network service mold piece. (2)The information manages a mold piece provide personal basic information and healthy information two parts of record to go into, search etc. management function. Data statistics analytical the mold piece pass to carry on a statistics to the backstage data analysis and take the form of chart(include the trend demonstration of each period healthy index sign) as a customer to make a show of a homologous statistics analytical result. Data statistics analytical mold piece realization, data processing behind can provide a chart type to include a round flat cake diagram and the form diagram and line form diagram, pillar-like in shape diagram etc. Combine from health, second health, fall ill three dimensions to combine Chinese medicine physical endowment classification and bio-chemical index sign to carry on a statistics. Network service mold piece passes an E-mail, cellular phone message method to the individual. The Chinese medicine recognizes a mold piece to mainly pass a following realization and recognizes a tool design, the Chinese medicine healthy information collects a way design, Chinese medicine health intervention function design. Healthy check-up mold piece carry out structure to turn check-up item to record to go into, health inspection item of from define, constitution the check-up print template, a key type to print, the system automatically hint excrescent check index sign, efficiently lead a check result to gather and reserve other datas to connect functions like a people, etc. (3)The system carries out and try movement.
Conclusion:
(1)The Chinese medicine pharmacy forms special theory system and cures a method to the paroxysm Bian after endless history progress, the its whole view, dialectics theory cures, special feature health health care technique, at our country medical and health the work take health as predominant today, having the modern medical science can not act for of healthily evaluate to the crowd with intervention of advantage. (2)Healthily manage software mainly currently with the doctor learn for predominance, but the healthy management software that has a traditional Chinese medicine special feature is few. The development of big parts of softwares mainly turns toward the intelligence, the network turn, multi-function, operate the direction development of simple convenience, and start paying attention to the development to the healthy information valuation, self-help search, interaction function. Healthily manage a clinical research talented person of the medical technique in service, health and healthily manage the real strenght of organization to influence a healthy management in addition the height of the software product quality. (3)Pass need analysis and frame design ability for realization originally the total function target of the system lay solid foundation. (4)Chinese medicine health manages setting up of system software and carried out a thou to some extent the fusion of Chinese medicine theory and modern health management thinking now, is health management service scale turn, standardize of the need is Chinese medicine theory and much more modern academics technique to combine next have the healthy management tool of Chinese medicine special feature, for supported mankind to healthily provide a new method.
引文
[1]Bernard Sullivan, Washington Business Journal, Aug.29,1997.
[2]陈君石,黄建始.健康管理师[M].第一版.北京：中国协和医科大学出版杜,2007：11.
[3]黄建始,陈君石.健康管理在中国的历史、现状和挑战[J].中华全科医师志,2007,6(1)：45—47.
[4]吴静娜.卢建华,王福影,等.论健康管理的历史和现实[J].医学与社会,2008,21(7)：31—32
[5]黄建始.美国的全民健康管理[J].中国医疗前沿,2007,(2)：16.
[6]李元元.健康惹祸员工出工不出力健康管理提高忠诚度,重庆日报,2009. http://www. sciencenet. cn/m/user_content. aspx?id=219770
[7]王晓鸥.与健康有约成黄金职业—健康管理师呼之欲出2006. http://www. ccw. com. cn.
[8]EdingtondW, LouisY, KuKuI I, etal. Recent trends in the devel-opment of health management[J]. HealthManagementResearch,2001,76(103):140-147.
[9]Kongstvedt PR. Essentials of managed health care. Gatihersburg Maryland: Aspen publishers, Inc,1997.3-16.
[10]胡哈力,方俊岚,关世延,等.社区卫生服务计算机三级网络化建设的体会[J].中国初级卫生保健,2003,17(6)：42.
[11]陶再平,陈奇,俞瑞钊.三层结构模型应用的研究[J].电脑与信息技术,1999,7(6)：5-6.
[12]黄建始,王煜,张娴.健康管理还处在胚胎期——中国健康管理相关服务机构现状调查[J].中国卫生,2009,(1)：21.
[13]胡镜清,彭锦,陈勇,等.健康管理与中医药学优势[J].国际中医中药杂志,2006,28(4)：217-220.
[14]孟春英,郭颖,曹爽,等.“知己”健康管理模式在社区慢性病管理中的应用[J].护理学杂志,2008,(8)：59-61.
[15]朱俊峰.46例慢性病病人健康管理疗效的观察[J].中国医药导,2009,(11)：330—331.
[16]张宏伟,李晓莹.某银行105名职工慢性病健康管理[J].中华健康管理学杂志,2008,2(1)：36—38.
[17]冯超,吴琴琴,马继红,等.健康管理中心的慢性病管理[J].现代预防医学2008,35(8)：1517—1518.
[18]李星明,黄建始.健康管理和社区卫生整合对慢性病防治的意义与服务模式探 讨[J].疾病控制杂志,2008,12(1)：53—57.
[19]周军,李详成.慢性病健康管理非药物干预模式的研究初探[J].中国公共卫生管理,2008,24(3)：289—290.
[20]翟俊霞,明兰真,李小艳,等.石家庄地区周边6县健康管理的需求调查[J].河北医药,2009,31(10)：1255.
[21]杨珺,赵雅丽,刘向红,等.社区合同式健康管理需求调查及影响因素研究[J].中国全科医学,2006,9(19)：1642-1644,1647.
[22]刘森.健康管理信息化的需求和定位及层次描述[J].中华健康管理学杂志,2008,2(5)：261-263.
[23]李明,关志强.健康管理师——健康风险评估和风险管理[M].第一版.北京：中国协和医科大学出版杜,2007：33—51.
[24]孙胜男,李峥,等.2型糖尿病风险评估工具的研究进展[J].中华护理杂志,2009(9)：861-864.
[25]窦丽萍.高血压病10年心脑血管病风险风险评估及预防[J].浙江医学200931(6)：821-822.
[26]陈玲,王桦,袁胜,等.2型糖尿病及其高危人群的风险评估与健康管理[J].中华健康管理学杂志,2008,2(4)：252-253.
[27]王浩彦.动态体检在风险评估与健康管理中的应用[J].中华健康管理学杂志,2008,2(3)：138-139.
[28]曹东平,张坚,谭福彬,等.体检机构健康风险评估的实施与思考[J].中华健康管理学杂志,2008,2(3)：132-133.
[29]王利玲.心理评估在健康管理中的应用模式初探[J].中华健康管理学杂志,2008,2(3)：134—137.
[30]张斓,王煜,黄建始.健康评估在健康管理中的应用[J].中华健康管理学杂志,2008,2(3)：168—171.
[31]蒋业政,覃月秋.我国1994—2003年亚健康研究文献的统计分析[J].中华医学图书情报,2004,(6)：60—63.
[32]陈君石,黄建始.健康管理师[M].第一版.北京：中国协和医科大学出版杜,2007：47-48.
[33]祝恒琛,谢成.亚健康[M].第一版.北京：中国医药科技出版社2002.10：455-543.
[34]黄喜顺,邱耀辉,苏洪,等.对当前健康管理产业的现状分析和发展方向的探索[J].中华现代医院管理杂志,2009,7(6)：266—267.
[35]杨光华,王汉亮,等。从源头上阻断“慢病”自然进程的《健康管理模式》[J].中国公共卫生管理,2007,(23)：123—127.
[36]董冬.中国健康管理模式研究[J].科学之友,2007,(11B)：73—74.
[37]李再强,林枫.医疗保险制度下的慢性病健康管理模式[J].中国卫生经济,2005,24(1)：45—46.
[38]向月应,王庆林,易秀英,等.军队医院建立为部队全程服务保障模式的研究与实践[J].中国医院,2007,11(1)：52—54.
[39]陈雁,胡云.社区糖尿病患者健康管理模式的建立和探讨[J].解放军护理杂志.2007,24(10B)：63-64.
[40]刘勇,濮欣,王伟英,等.中山市社区中老年人个体化健康管理模式的研究[J].中国全科医学.2007,10(5)：405-406.
[41]李瑜,王媛媛.综合性医院体检中心实施健康管理的探讨[J].中华健康管理学杂志.2008,2(5)：274-274.
[42]骆华伟.慢性心脑血管病的健康管理模式探讨[J].浙江预防医学杂志.2006,18(9)：56-57.
[43]钱文红,韩殉,杜兵,等.北京市某地区农民健康体检情况分析与健康管理模式初探[J].中华健康管理学杂志.2008,2(6)：343-346.
[44]周颖.以“治未病”理念推进自我健康管理第五届中国健康产业论坛高擎“治未病”旗帜[J].中医药管理杂志,2008,16(2)：157-157.
[45]陈希,吴伯平.中医“治未病”与健康管理[J].人人健康,2009,(14)：20-21.
[46]孙涛,武留信.中医未病思想与“慢病后备军”健康管理[J].世界中西医结合杂志,2007,(2)：252-253.
[47]王琦,董静,等.发挥中医药“治未病”的特色优势实践健康促进[J].中医药通报,2006,(5)：1-4.
[48]牛潞芳,谢雁呜,王永炎,等.中医“治未病”理论对建立慢病风险评估模型的指导作用[J].时珍国医国药,2008,(19)：2976—2978.
[49]黄文秀.“治未病”思想对大学生心理健康管理的意义[J].北京中医药,2008,27(3)：237-239.
[50]赵金铎.中医症状鉴别诊断学[M].北京：人民卫生出版社,1987.
[51]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京：中国医药科技出版社,1993.
[52]季绍良.中医诊断学[M].北京：人民卫生出版社,2002.
[53]中华中医药学会.亚健康中医临床指南[M].北京：中国中医药出版社,2006：1.
[54]王秀云,刘公望,李积胜.亚健康在中医学的理论渊源与源流发展[J].天津中医学院学报,2006,(1)：7-9.
[55]刘保延,谢雁鸣,于嘉,等.亚健康中医基本证候调查问卷的信度和效度分析[J].中国中医基础医学杂志,2006,12(2)：145—149.
[56]韦玉科,汪仁煌,黎敬波.一种亚健康诊断推理的新方法[J].针算机应用研究,2006,(3)：70-72.
[57]Volpato S. The inverse association between ago and cholesterol level Among older patients:the role of poor health states [J]. Gerontology,2001,47 (1) :36-40.
[58]李海峰,陈晓,金如锋.亚健康证候测试量表的编制和信效度分析[J].陕西中医,2007,(28)：565-567.
[59]吴大嵘,赖世隆.中医健康量表测量特性的初步评价[J].《中西医结合学报》,2008,(6)：682-689.
[60]刘凤斌,郎建英,等.中医健康状况量表的研制[J].《中山大学学报：医学科学版》2008(29)332-336.
[61]王琦.调治亚健康状态是中医学在21世纪对人类的新贡献[J].北京中医药大学学报,2001,24(2)：1-4.
[62]张孝娟,严灿,高敏.中医药与心理应激亚健康状态的调节[J].中医杂志,2002,43(9)：647—648.
[63]安丽萍,陈雅民,李燕,等.组合针刺法对躯体性亚健康状态干预作用的对比观察[J].四川中医,2006,24(12)：104-105.
[64]赵珏,杨红,齐志勤.针刺治疗亚健康[J].针灸临床杂志,2003,19(7)：16-17.
[65]林晓天,李元林.推拿治疗亚健康状态探析[J].辽宁中医杂志,2001,28(11),687—688.
[66]李爽姿态,王勤明.浅谈养心与食疗防治亚健康状态[J].中国中医基础医学杂志,2005,11(12),929—915.
[67]王琦,叶加农,朱燕波.中医痰湿体质的判定标准研究[J].中华中医药杂志2006,21(2)：73-75.
[68]于春泉,张伯礼,马寰,等.亚健康状态常见病因及其干预措施[J].天津中医药,2005,22(5)：439-440.
[69]薛晓琳,王天芳,张雅静,等.亚健康中医药干预效果评价体系的构建思路[J].中西医结合学报,2009,(7)：201—204.
[70]张早华,苏大明,等.亚健康中医干预数据库数据结构的探讨[J].中国中医药信息杂志2009,(16)：94—96.
[71]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—14.
[72]马晓峰王琦.论体质辨识在健康管理中的应用和意义[J].中华中医药学刊,2007,25(11)：2265—2266.
[73]王琦.中医体质学[M].北京：人民卫生出版社,2009.
[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—17.
[75]任小娟,王琦.应用《中医体质分类判定标准》进行个体化健康管理研究初探[J].中国卫生事业管理,2007,(9)：580—581.
[76]靳琦,王琦.辨体—辨病—辨证诊疗模式——中医体质理论的临床应用[M].北京：中国中医药出版社,2006.
[77]来跃文.计算机软件在我国健康管理服务中的应用分析[J].科技咨询,2008,2008,34(131)：150.
[78]成福春,尹岭,朱抗美,等.中医临床数据分析模型构建[J].中国中医基础医学杂志,2009,15(6)：449—451.
[79]胡广芹,陆小左.中医药科学在健康管理中的特色和优势[J].中医药管理杂志,2008,16(5)：332—333.
[80]罗爱静主编.卫生信息管理概论[M].第一版.北京：人民卫生出版杜,2009.2第1版；206.
[81]罗爱静主编.卫生信息管理概论[M].第一版.北京：人民卫生出版杜,2009.2第1版；207.
[82]马里奥,麦克莱伦著,王析,符莹莹译.医疗机构信息管理(第1版).北京：北京大学医学出版社,2004.6第1版；53.
[83]明李杰,翟金德,王磊.有关电子病历的几个重要概念.中国新医药.2004,3(7)：126.
[84]李晴辉.个人健康管理信息系统技术研究[J].中国数字医学,2009,4(3)：1673-7571.
[85]Dave Gaets著,王虹译.应用电子健康记录达到数字化医院的更高阶段[J].中国医院,2007,11(5)：38—39.
[86]罗爱静主编.卫生信息管理概论[M].第一版.北京：人民卫生出版杜,2009.2第1版；213.
[87]周元哲,周明全,耿国华一个基于J2EE体系结构的电子病历子系统[J].西北大学学报：自然科学版.2003,33(6)：659-661.
[88]王灿钰,赵家骜.网络时代的电子病历[J].医学信息：医学与计算机应用,2001,14(8)：453-455.
[89]黄梯云主编.管理信息系统修订版[M].第一版.北京：高等教育出版社.1999；17.
[90]黄梯云主编.管理信息系统修订版[M].第一版.北京：高等教育出版社.1999；18-19.
[91]黄梯云主编.管理信息系统修订版[M].第一版.北京：高等教育出版社.1999；27.
[92](Visual Studio 2008, http://baike. baidu. com/view/1811041.htm)
[93]Visual J#.NET中的设计工具2004-08-08 01：56作者：微软来源：eNet论坛,http://www. enet. com. cn/article/2004/0808/A20040808331658. shtml
[94]白尚旺等著.数据库建模工具PowerDesigner 11.0 [M].第一版.北京：电子工业出版杜,2004.7第1版：
[95]郑昊,徐一平,刑沈阳.电子健康记录的发展及其在我国的应用[J].护理研究.2008,22(10)：2633-2634.
[96]上海市卫生局·关于进一步完善本市社区居民健康档案工作的通知[Z].泸卫妇基(2004)11号,2004.
[97]Dougherty M. EHR development steps in long-termcare [J]. Journal of American Health InformationManagement Association,2005,76 (1):54-55,59.
[98]H. U. Prokosch. Community Health Information Net-works:Steps Towards an Electronic Patient Record [J]. World Congress of High-Tech Medicine,2000, 12.
[99]沈韬,马宁.从HIMSS2005看卫生信息技术的发展趋势[J].中国医院.2005,9(7)：8-11.
[100]Gary Dickinson, Linda Fischetti, Sam Heard. HL7EHR System Functional Model Draft Standard for TrialUse [J]. Health Level Seven, July,2004.
[101]Institute of Health Information and Statistics. HealthStatistics Yearbook of the Slovak Republic, Bratislava[C].1994.
[102]About us, the Australian Institute of Health and Welfare.2009. http://www. aihw. gov. au/aboutus/.
[103]Liptak L. A History of Slovakia and the Slovaks, Ministry of Foreign Affairs of the Slovak Republic[R].1994.
[104]Makovicky E. et al. Organization of Health Care[M]. Osveta, Martin, 1974
[105]Ministry of Health of the Slovak Republic. The Re-form of Structure, Management.and Financing of the Health Sector of the Slovak Republic, Vestn k MZ SR[R].1990.
[106]陈兵. 电子健康档案在国外的一些实践[EB/OL]. http://bbs. chinaunix.net/thread-1481998-1-1. html.
[107]国家卫生部.全国卫生信息化工作会议文件汇编[R].2002,10：73-81,307-308.
[108]卫生部基层卫生与妇幼保健司.社区卫生服务论文选编[M].北京：中国矿业大学出版社,2001.1.
[109]张开金,荆瑞巍,李森,等.居民健康档案软件开发与应用探讨[J].中国全科医 学杂志,2000,3(5)：371-372.
[110]胡建平. 我国居民电子健康档案亟待规范[EB/OL]. http://cnii. com. cn/20080623/ca537308. htm.
[111]建宇,李杨.中医电子病历将规范[J].光明中医,2009,24(11)：2164.
[112]刘保延,张红,倪皖东.试论中医电子病历系统及其特殊性[J].医学信息：医学与计算机应用,2004,17(1)：9-11.
[113]董建成,周董,胡新平.我国医学信息标准化建设存在的主要问题及建议[J].中国医院管理,2007,27(2)：59-60.
[114]范为宇,国际传统医学信息标准化工作进展[J].国际中医药杂志杂志,2006,28(3)：136-140.
[115]吕孟涛,吴静,饶克勤,等.电子健康档案现状分析与展望[J].医学与社会,2006,19(7)：60-61.
[116]胡建平,吴静,饶克勤,等.标准化个人健康档案架构研究[J].中国卫生事业管理,2009,(6)：422-424.
[117]健康档案基本架构与数据标准.中华人民共和国卫生部(试行),2009.www. moh. gov. cn (2009-05-19)
[118]Schloeffel P. Open EHR archetypes:Putting the clinician back in the driver's seat[R]. HIC(Health Informatics Conference Australia), Sydney,2003.
[119]刘保延,张红,倪皖东.试论中医电子病历系统及其特殊性[J].医学信息：医学与计算机应用,2004,17(1)：9-11.
[120]BERG M, LANGENBERG C, BERGI, etal. Considerations for sociotechnical design:experiences with an electronic patient record in a clinical context. International Journal of Medical Informatics,1998,52(1-3):243-51.
[121]TANGE HJ, SCHOUTEN HC, KESTER AD, et al. The granularity of medical narra-fivesan dits effect onthe speedan d complete-ness of information retrieval[J]. The Journal of the American M edical InformaticSAssociation, 1998,5(6):571-582
[122]姜兆顺.结构化糖尿病临床信息采集系统的构建与应用研究[J].现代中西医结合杂志,2007,16(26).
[123]张继先.电子病历特征及其设计方法探讨[J].中国医院管理杂志,2003,23(5)：44-45.
[124]赖世隆.中西医结合临床科研方法学(第2版)[M].科学出版社,2008,1：8.
[125]王映辉,姜在呖,闫英杰,等.基于信息和数据挖掘技术的名老中医临床经验研究思路[J].世界科学技术——中医药现代化,2005,7(1)：98—105.
[126]刘顺松.建立全国医疗电子病历档案信息化、网络化的重要性[J].中国口腔医学信息,2005,14(6)：126-127.
[127]FRIEDMAN C, HRIPCSAK G. Evaluat-ing natural language processors in the clinicaldomain. Methods of information in Medicine,1998,37(4-5):334-344.
[128]马玉宝,朱新宁,杨惠萍.中医特色与优势的思考[J].中国医药学报,2003,18(4)： 228.
[2]陈君石,黄建始.健康管理师[M].第一版.北京：中国协和医科大学出版杜,2007：11.
[3]黄建始,陈君石.健康管理在中国的历史、现状和挑战[J].中华全科医师志,2007,6(1)：45—47.
[4]吴静娜.卢建华,王福影,等.论健康管理的历史和现实[J].医学与社会,2008,21(7)：31—32
[5]黄建始.美国的全民健康管理[J].中国医疗前沿,2007,(2)：16.
[6]李元元.健康惹祸员工出工不出力健康管理提高忠诚度,重庆日报,2009. http://www. sciencenet. cn/m/user_content. aspx?id=219770
[7]王晓鸥.与健康有约成黄金职业—健康管理师呼之欲出2006. http://www. ccw. com. cn.
[8]EdingtondW, LouisY, KuKuI I, etal. Recent trends in the devel-opment of health management[J]. HealthManagementResearch,2001,76(103):140-147.
[9]Kongstvedt PR. Essentials of managed health care. Gatihersburg Maryland: Aspen publishers, Inc,1997.3-16.
[10]胡哈力,方俊岚,关世延,等.社区卫生服务计算机三级网络化建设的体会[J].中国初级卫生保健,2003,17(6)：42.
[11]陶再平,陈奇,俞瑞钊.三层结构模型应用的研究[J].电脑与信息技术,1999,7(6)：5-6.
[12]黄建始,王煜,张娴.健康管理还处在胚胎期——中国健康管理相关服务机构现状调查[J].中国卫生,2009,(1)：21.
[13]胡镜清,彭锦,陈勇,等.健康管理与中医药学优势[J].国际中医中药杂志,2006,28(4)：217-220.
[14]孟春英,郭颖,曹爽,等.“知己”健康管理模式在社区慢性病管理中的应用[J].护理学杂志,2008,(8)：59-61.
[15]朱俊峰.46例慢性病病人健康管理疗效的观察[J].中国医药导,2009,(11)：330—331.
[16]张宏伟,李晓莹.某银行105名职工慢性病健康管理[J].中华健康管理学杂志,2008,2(1)：36—38.
[17]冯超,吴琴琴,马继红,等.健康管理中心的慢性病管理[J].现代预防医学2008,35(8)：1517—1518.
[18]李星明,黄建始.健康管理和社区卫生整合对慢性病防治的意义与服务模式探 讨[J].疾病控制杂志,2008,12(1)：53—57.
[19]周军,李详成.慢性病健康管理非药物干预模式的研究初探[J].中国公共卫生管理,2008,24(3)：289—290.
[20]翟俊霞,明兰真,李小艳,等.石家庄地区周边6县健康管理的需求调查[J].河北医药,2009,31(10)：1255.
[21]杨珺,赵雅丽,刘向红,等.社区合同式健康管理需求调查及影响因素研究[J].中国全科医学,2006,9(19)：1642-1644,1647.
[22]刘森.健康管理信息化的需求和定位及层次描述[J].中华健康管理学杂志,2008,2(5)：261-263.
[23]李明,关志强.健康管理师——健康风险评估和风险管理[M].第一版.北京：中国协和医科大学出版杜,2007：33—51.
[24]孙胜男,李峥,等.2型糖尿病风险评估工具的研究进展[J].中华护理杂志,2009(9)：861-864.
[25]窦丽萍.高血压病10年心脑血管病风险风险评估及预防[J].浙江医学200931(6)：821-822.
[26]陈玲,王桦,袁胜,等.2型糖尿病及其高危人群的风险评估与健康管理[J].中华健康管理学杂志,2008,2(4)：252-253.
[27]王浩彦.动态体检在风险评估与健康管理中的应用[J].中华健康管理学杂志,2008,2(3)：138-139.
[28]曹东平,张坚,谭福彬,等.体检机构健康风险评估的实施与思考[J].中华健康管理学杂志,2008,2(3)：132-133.
[29]王利玲.心理评估在健康管理中的应用模式初探[J].中华健康管理学杂志,2008,2(3)：134—137.
[30]张斓,王煜,黄建始.健康评估在健康管理中的应用[J].中华健康管理学杂志,2008,2(3)：168—171.
[31]蒋业政,覃月秋.我国1994—2003年亚健康研究文献的统计分析[J].中华医学图书情报,2004,(6)：60—63.
[32]陈君石,黄建始.健康管理师[M].第一版.北京：中国协和医科大学出版杜,2007：47-48.
[33]祝恒琛,谢成.亚健康[M].第一版.北京：中国医药科技出版社2002.10：455-543.
[34]黄喜顺,邱耀辉,苏洪,等.对当前健康管理产业的现状分析和发展方向的探索[J].中华现代医院管理杂志,2009,7(6)：266—267.
[35]杨光华,王汉亮,等。从源头上阻断“慢病”自然进程的《健康管理模式》[J].中国公共卫生管理,2007,(23)：123—127.
[36]董冬.中国健康管理模式研究[J].科学之友,2007,(11B)：73—74.
[37]李再强,林枫.医疗保险制度下的慢性病健康管理模式[J].中国卫生经济,2005,24(1)：45—46.
[38]向月应,王庆林,易秀英,等.军队医院建立为部队全程服务保障模式的研究与实践[J].中国医院,2007,11(1)：52—54.
[39]陈雁,胡云.社区糖尿病患者健康管理模式的建立和探讨[J].解放军护理杂志.2007,24(10B)：63-64.
[40]刘勇,濮欣,王伟英,等.中山市社区中老年人个体化健康管理模式的研究[J].中国全科医学.2007,10(5)：405-406.
[41]李瑜,王媛媛.综合性医院体检中心实施健康管理的探讨[J].中华健康管理学杂志.2008,2(5)：274-274.
[42]骆华伟.慢性心脑血管病的健康管理模式探讨[J].浙江预防医学杂志.2006,18(9)：56-57.
[43]钱文红,韩殉,杜兵,等.北京市某地区农民健康体检情况分析与健康管理模式初探[J].中华健康管理学杂志.2008,2(6)：343-346.
[44]周颖.以“治未病”理念推进自我健康管理第五届中国健康产业论坛高擎“治未病”旗帜[J].中医药管理杂志,2008,16(2)：157-157.
[45]陈希,吴伯平.中医“治未病”与健康管理[J].人人健康,2009,(14)：20-21.
[46]孙涛,武留信.中医未病思想与“慢病后备军”健康管理[J].世界中西医结合杂志,2007,(2)：252-253.
[47]王琦,董静,等.发挥中医药“治未病”的特色优势实践健康促进[J].中医药通报,2006,(5)：1-4.
[48]牛潞芳,谢雁呜,王永炎,等.中医“治未病”理论对建立慢病风险评估模型的指导作用[J].时珍国医国药,2008,(19)：2976—2978.
[49]黄文秀.“治未病”思想对大学生心理健康管理的意义[J].北京中医药,2008,27(3)：237-239.
[50]赵金铎.中医症状鉴别诊断学[M].北京：人民卫生出版社,1987.
[51]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京：中国医药科技出版社,1993.
[52]季绍良.中医诊断学[M].北京：人民卫生出版社,2002.
[53]中华中医药学会.亚健康中医临床指南[M].北京：中国中医药出版社,2006：1.
[54]王秀云,刘公望,李积胜.亚健康在中医学的理论渊源与源流发展[J].天津中医学院学报,2006,(1)：7-9.
[55]刘保延,谢雁鸣,于嘉,等.亚健康中医基本证候调查问卷的信度和效度分析[J].中国中医基础医学杂志,2006,12(2)：145—149.
[56]韦玉科,汪仁煌,黎敬波.一种亚健康诊断推理的新方法[J].针算机应用研究,2006,(3)：70-72.
[57]Volpato S. The inverse association between ago and cholesterol level Among older patients:the role of poor health states [J]. Gerontology,2001,47 (1) :36-40.
[58]李海峰,陈晓,金如锋.亚健康证候测试量表的编制和信效度分析[J].陕西中医,2007,(28)：565-567.
[59]吴大嵘,赖世隆.中医健康量表测量特性的初步评价[J].《中西医结合学报》,2008,(6)：682-689.
[60]刘凤斌,郎建英,等.中医健康状况量表的研制[J].《中山大学学报：医学科学版》2008(29)332-336.
[61]王琦.调治亚健康状态是中医学在21世纪对人类的新贡献[J].北京中医药大学学报,2001,24(2)：1-4.
[62]张孝娟,严灿,高敏.中医药与心理应激亚健康状态的调节[J].中医杂志,2002,43(9)：647—648.
[63]安丽萍,陈雅民,李燕,等.组合针刺法对躯体性亚健康状态干预作用的对比观察[J].四川中医,2006,24(12)：104-105.
[64]赵珏,杨红,齐志勤.针刺治疗亚健康[J].针灸临床杂志,2003,19(7)：16-17.
[65]林晓天,李元林.推拿治疗亚健康状态探析[J].辽宁中医杂志,2001,28(11),687—688.
[66]李爽姿态,王勤明.浅谈养心与食疗防治亚健康状态[J].中国中医基础医学杂志,2005,11(12),929—915.
[67]王琦,叶加农,朱燕波.中医痰湿体质的判定标准研究[J].中华中医药杂志2006,21(2)：73-75.
[68]于春泉,张伯礼,马寰,等.亚健康状态常见病因及其干预措施[J].天津中医药,2005,22(5)：439-440.
[69]薛晓琳,王天芳,张雅静,等.亚健康中医药干预效果评价体系的构建思路[J].中西医结合学报,2009,(7)：201—204.
[70]张早华,苏大明,等.亚健康中医干预数据库数据结构的探讨[J].中国中医药信息杂志2009,(16)：94—96.
[71]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—14.
[72]马晓峰王琦.论体质辨识在健康管理中的应用和意义[J].中华中医药学刊,2007,25(11)：2265—2266.
[73]王琦.中医体质学[M].北京：人民卫生出版社,2009.
[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—17.
[75]任小娟,王琦.应用《中医体质分类判定标准》进行个体化健康管理研究初探[J].中国卫生事业管理,2007,(9)：580—581.
[76]靳琦,王琦.辨体—辨病—辨证诊疗模式——中医体质理论的临床应用[M].北京：中国中医药出版社,2006.
[77]来跃文.计算机软件在我国健康管理服务中的应用分析[J].科技咨询,2008,2008,34(131)：150.
[78]成福春,尹岭,朱抗美,等.中医临床数据分析模型构建[J].中国中医基础医学杂志,2009,15(6)：449—451.
[79]胡广芹,陆小左.中医药科学在健康管理中的特色和优势[J].中医药管理杂志,2008,16(5)：332—333.
[80]罗爱静主编.卫生信息管理概论[M].第一版.北京：人民卫生出版杜,2009.2第1版；206.
[81]罗爱静主编.卫生信息管理概论[M].第一版.北京：人民卫生出版杜,2009.2第1版；207.
[82]马里奥,麦克莱伦著,王析,符莹莹译.医疗机构信息管理(第1版).北京：北京大学医学出版社,2004.6第1版；53.
[83]明李杰,翟金德,王磊.有关电子病历的几个重要概念.中国新医药.2004,3(7)：126.
[84]李晴辉.个人健康管理信息系统技术研究[J].中国数字医学,2009,4(3)：1673-7571.
[85]Dave Gaets著,王虹译.应用电子健康记录达到数字化医院的更高阶段[J].中国医院,2007,11(5)：38—39.
[86]罗爱静主编.卫生信息管理概论[M].第一版.北京：人民卫生出版杜,2009.2第1版；213.
[87]周元哲,周明全,耿国华一个基于J2EE体系结构的电子病历子系统[J].西北大学学报：自然科学版.2003,33(6)：659-661.
[88]王灿钰,赵家骜.网络时代的电子病历[J].医学信息：医学与计算机应用,2001,14(8)：453-455.
[89]黄梯云主编.管理信息系统修订版[M].第一版.北京：高等教育出版社.1999；17.
[90]黄梯云主编.管理信息系统修订版[M].第一版.北京：高等教育出版社.1999；18-19.
[91]黄梯云主编.管理信息系统修订版[M].第一版.北京：高等教育出版社.1999；27.
[92](Visual Studio 2008, http://baike. baidu. com/view/1811041.htm)
[93]Visual J#.NET中的设计工具2004-08-08 01：56作者：微软来源：eNet论坛,http://www. enet. com. cn/article/2004/0808/A20040808331658. shtml
[94]白尚旺等著.数据库建模工具PowerDesigner 11.0 [M].第一版.北京：电子工业出版杜,2004.7第1版：
[95]郑昊,徐一平,刑沈阳.电子健康记录的发展及其在我国的应用[J].护理研究.2008,22(10)：2633-2634.
[96]上海市卫生局·关于进一步完善本市社区居民健康档案工作的通知[Z].泸卫妇基(2004)11号,2004.
[97]Dougherty M. EHR development steps in long-termcare [J]. Journal of American Health InformationManagement Association,2005,76 (1):54-55,59.
[98]H. U. Prokosch. Community Health Information Net-works:Steps Towards an Electronic Patient Record [J]. World Congress of High-Tech Medicine,2000, 12.
[99]沈韬,马宁.从HIMSS2005看卫生信息技术的发展趋势[J].中国医院.2005,9(7)：8-11.
[100]Gary Dickinson, Linda Fischetti, Sam Heard. HL7EHR System Functional Model Draft Standard for TrialUse [J]. Health Level Seven, July,2004.
[101]Institute of Health Information and Statistics. HealthStatistics Yearbook of the Slovak Republic, Bratislava[C].1994.
[102]About us, the Australian Institute of Health and Welfare.2009. http://www. aihw. gov. au/aboutus/.
[103]Liptak L. A History of Slovakia and the Slovaks, Ministry of Foreign Affairs of the Slovak Republic[R].1994.
[104]Makovicky E. et al. Organization of Health Care[M]. Osveta, Martin, 1974
[105]Ministry of Health of the Slovak Republic. The Re-form of Structure, Management.and Financing of the Health Sector of the Slovak Republic, Vestn k MZ SR[R].1990.
[106]陈兵. 电子健康档案在国外的一些实践[EB/OL]. http://bbs. chinaunix.net/thread-1481998-1-1. html.
[107]国家卫生部.全国卫生信息化工作会议文件汇编[R].2002,10：73-81,307-308.
[108]卫生部基层卫生与妇幼保健司.社区卫生服务论文选编[M].北京：中国矿业大学出版社,2001.1.
[109]张开金,荆瑞巍,李森,等.居民健康档案软件开发与应用探讨[J].中国全科医 学杂志,2000,3(5)：371-372.
[110]胡建平. 我国居民电子健康档案亟待规范[EB/OL]. http://cnii. com. cn/20080623/ca537308. htm.
[111]建宇,李杨.中医电子病历将规范[J].光明中医,2009,24(11)：2164.
[112]刘保延,张红,倪皖东.试论中医电子病历系统及其特殊性[J].医学信息：医学与计算机应用,2004,17(1)：9-11.
[113]董建成,周董,胡新平.我国医学信息标准化建设存在的主要问题及建议[J].中国医院管理,2007,27(2)：59-60.
[114]范为宇,国际传统医学信息标准化工作进展[J].国际中医药杂志杂志,2006,28(3)：136-140.
[115]吕孟涛,吴静,饶克勤,等.电子健康档案现状分析与展望[J].医学与社会,2006,19(7)：60-61.
[116]胡建平,吴静,饶克勤,等.标准化个人健康档案架构研究[J].中国卫生事业管理,2009,(6)：422-424.
[117]健康档案基本架构与数据标准.中华人民共和国卫生部(试行),2009.www. moh. gov. cn (2009-05-19)
[118]Schloeffel P. Open EHR archetypes:Putting the clinician back in the driver's seat[R]. HIC(Health Informatics Conference Australia), Sydney,2003.
[119]刘保延,张红,倪皖东.试论中医电子病历系统及其特殊性[J].医学信息：医学与计算机应用,2004,17(1)：9-11.
[120]BERG M, LANGENBERG C, BERGI, etal. Considerations for sociotechnical design:experiences with an electronic patient record in a clinical context. International Journal of Medical Informatics,1998,52(1-3):243-51.
[121]TANGE HJ, SCHOUTEN HC, KESTER AD, et al. The granularity of medical narra-fivesan dits effect onthe speedan d complete-ness of information retrieval[J]. The Journal of the American M edical InformaticSAssociation, 1998,5(6):571-582
[122]姜兆顺.结构化糖尿病临床信息采集系统的构建与应用研究[J].现代中西医结合杂志,2007,16(26).
[123]张继先.电子病历特征及其设计方法探讨[J].中国医院管理杂志,2003,23(5)：44-45.
[124]赖世隆.中西医结合临床科研方法学(第2版)[M].科学出版社,2008,1：8.
[125]王映辉,姜在呖,闫英杰,等.基于信息和数据挖掘技术的名老中医临床经验研究思路[J].世界科学技术——中医药现代化,2005,7(1)：98—105.
[126]刘顺松.建立全国医疗电子病历档案信息化、网络化的重要性[J].中国口腔医学信息,2005,14(6)：126-127.
[127]FRIEDMAN C, HRIPCSAK G. Evaluat-ing natural language processors in the clinicaldomain. Methods of information in Medicine,1998,37(4-5):334-344.
[128]马玉宝,朱新宁,杨惠萍.中医特色与优势的思考[J].中国医药学报,2003,18(4)： 228.