支气管哮喘缓解期中医证候临床流行病学调查研究
|
摘要
目的:应用流行病学调查方法,建立支气管哮喘缓解期中医辨证规范,为支气管哮喘缓解期诊疗方案的确立提供可靠依据。
材料与方法:本研究采用多中心调查研究,据文献统计,考虑到地区发病情况,实际取400例。参加单位:辽宁中医药大学附属第二医院、本溪市中医院2家临床单位。每个中心分别承担200例。由两名主治医师以上医务人员同时对同一病人进行症状、体征和量表信息采集。对舌、脉象信息,两人分别采集并统一意见后记录。应用标准、易懂的医学术语询问采集,避免诱导和暗示;最后采用SPSS16.0统计软件进行数据分析,建立400例患者的个人基本信息及中医证候信息条目数据库。统计出符合五种传统支气管哮喘缓解期中医辨证分型的人数和比例。如果对应五种传统证型的比例不足100%,则对其余受试者的中医证候信息采用频数分析法分析临床中医证候、症状,舍去低频证候,再应用聚类分析,产生若干证候聚类。
结果:
肺气亏虚型41人,所占比例为10.25%;脾气亏虚型43人,所占比例为10.75%;肾气亏虚型48人,所占比例为12.00%;肺肾气虚型55人,所占比例为13.75%;肺脾气虚型35人,所占比例为8.75%,共计222人,所占比例为55.5%。仍有178人不完全符合上述证型,所占比例为44.5%。进一步的提取与总结,应用频数分析、聚类分析产生4种证候聚类。
结论:
1.推出支气管哮喘缓解期新的病因病机认识——“宿痰伏肺”。
2.初步确定4种新的中医证型。宿痰伏肺型、脾肾阳虚型、肺肾阴虚型、痰凝血瘀型。
Objective: Application, discusses epidemiological methods quickly disease pathogenesis, establish potential remission bronchial asthma standard for TCM syndrome differentiation of bronchial asthma diagnosis and the establishment of remission scheme to provide reliable basis.
Materials and methods: This study adopts multicenter study, according to document statistics, considering the area of disease, actual take 400 cases. Attend units: liaoning university of traditional Chinese medicine hospital 2nd affiliated hospitals, benxi two clinical units. Each center 200 patients with separate undertaking. More than two attending surgeon by medical staff also for the same patient symptoms, signs and scale information collection. Pulse of tongue, respectively, both information collection and unified opinions from the record. Use standard, easy-to-read medical terminology ask collection, avoid induction and hinted; Finally using SPSS16.0 statistical software data analysis, establish 400 patients personal basic information and syndromes information entries database. Statistics for the five kinds of traditional Chinese medicine of bronchial asthma syndrome differentiations remission of number and proportion. If corresponding five kinds of traditional syndrome types, the proportion of the rest is less than 100 per cent of the subjects of TCM syndrome information using frequency analysis to analyze clinical syndromes, symptoms, abandoned low-frequency syndrome, and using clustering analysis, produce several syndrome clustering.
Results:
Lung qi deficiency type, proportion of 41 for 10.25%; Temper deficiency type, proportion of 43 for 10.75%; By kidney deficiency type, proportion of 48 people for 12.00%; Pulmonary kidney empty type, proportion of 55 people for China; Lung on spleen-deficiency type, proportion of 35 people to 8.75%, totaling 222 people, the proportion is 55.5%. Still have 178 people don't fully comply with the above card type, proportion of 44.5% for. Further extraction and summary, applied frequency analysis, cluster analysis produces four syndrome clustering.
Conclusion:
1. Promoting the bronchus asthma remission new etiology known -- "lodge phlegm volts lung".
2. Four new preliminarily determined TCM syndrome type. Lodge phlegm volts lung type, spleen and kidney Yang type, lung kidney Yin deficiency type, TanNing blood stasis syndrome.
材料与方法:本研究采用多中心调查研究,据文献统计,考虑到地区发病情况,实际取400例。参加单位:辽宁中医药大学附属第二医院、本溪市中医院2家临床单位。每个中心分别承担200例。由两名主治医师以上医务人员同时对同一病人进行症状、体征和量表信息采集。对舌、脉象信息,两人分别采集并统一意见后记录。应用标准、易懂的医学术语询问采集,避免诱导和暗示;最后采用SPSS16.0统计软件进行数据分析,建立400例患者的个人基本信息及中医证候信息条目数据库。统计出符合五种传统支气管哮喘缓解期中医辨证分型的人数和比例。如果对应五种传统证型的比例不足100%,则对其余受试者的中医证候信息采用频数分析法分析临床中医证候、症状,舍去低频证候,再应用聚类分析,产生若干证候聚类。
结果:
肺气亏虚型41人,所占比例为10.25%;脾气亏虚型43人,所占比例为10.75%;肾气亏虚型48人,所占比例为12.00%;肺肾气虚型55人,所占比例为13.75%;肺脾气虚型35人,所占比例为8.75%,共计222人,所占比例为55.5%。仍有178人不完全符合上述证型,所占比例为44.5%。进一步的提取与总结,应用频数分析、聚类分析产生4种证候聚类。
结论:
1.推出支气管哮喘缓解期新的病因病机认识——“宿痰伏肺”。
2.初步确定4种新的中医证型。宿痰伏肺型、脾肾阳虚型、肺肾阴虚型、痰凝血瘀型。
Objective: Application, discusses epidemiological methods quickly disease pathogenesis, establish potential remission bronchial asthma standard for TCM syndrome differentiation of bronchial asthma diagnosis and the establishment of remission scheme to provide reliable basis.
Materials and methods: This study adopts multicenter study, according to document statistics, considering the area of disease, actual take 400 cases. Attend units: liaoning university of traditional Chinese medicine hospital 2nd affiliated hospitals, benxi two clinical units. Each center 200 patients with separate undertaking. More than two attending surgeon by medical staff also for the same patient symptoms, signs and scale information collection. Pulse of tongue, respectively, both information collection and unified opinions from the record. Use standard, easy-to-read medical terminology ask collection, avoid induction and hinted; Finally using SPSS16.0 statistical software data analysis, establish 400 patients personal basic information and syndromes information entries database. Statistics for the five kinds of traditional Chinese medicine of bronchial asthma syndrome differentiations remission of number and proportion. If corresponding five kinds of traditional syndrome types, the proportion of the rest is less than 100 per cent of the subjects of TCM syndrome information using frequency analysis to analyze clinical syndromes, symptoms, abandoned low-frequency syndrome, and using clustering analysis, produce several syndrome clustering.
Results:
Lung qi deficiency type, proportion of 41 for 10.25%; Temper deficiency type, proportion of 43 for 10.75%; By kidney deficiency type, proportion of 48 people for 12.00%; Pulmonary kidney empty type, proportion of 55 people for China; Lung on spleen-deficiency type, proportion of 35 people to 8.75%, totaling 222 people, the proportion is 55.5%. Still have 178 people don't fully comply with the above card type, proportion of 44.5% for. Further extraction and summary, applied frequency analysis, cluster analysis produces four syndrome clustering.
Conclusion:
1. Promoting the bronchus asthma remission new etiology known -- "lodge phlegm volts lung".
2. Four new preliminarily determined TCM syndrome type. Lodge phlegm volts lung type, spleen and kidney Yang type, lung kidney Yin deficiency type, TanNing blood stasis syndrome.
引文
[1]黎敬,朱文锋.辩证规范化的难点和途径.医学与哲学[J] 1995,16(12):33-38
[2]刘玉良,关于中医学定量辩证理论研究的反思.中医杂志[J]2010.,21(8):16-17
[3]王雪峰,董丹中医辨证规范所需解决的基本问题.辽宁中医杂志[J]2007(3):2
[4]周文泉,于向东.中医临床疗效评价的关键问题及证的量化.第三次全国中西医结合养生学与康复学术研讨会[C].昆明,2002,8
[5]郭蕾,张启明,王永炎等.证候规范化研究思路和方法探讨[J].国家重点基础研究发展计划(973)资助项目(WO.2005CB517101)
[6]刘凤斌,方积乾.中医药临床疗效评价的探讨.中华中医药学刊[J],20(2):266-267
[7]朱立明,卢健,段立强.中药新药研发中证候规范化及其临床疗效评价[J].中国中医基础医学杂志,2006,12(7):
[8]郑筱萸,任德权,主编.中药新药临床研究指导原则(试行)[M]第一版.北京:中国医药科技出版社,2002.2.169
[9]张洁承.支气管哮喘.山东中医杂志[J],1994,13(1):28-30.
[10]包培蓉.吕同杰哮证论治经验.中国中医急症[J],1995,4(1),29-30
[11]何忠莲.支气管哮喘中医治疗近况.四川中医[J],1992,10(7),16-17
[12]宾学森,曾庆弊.“宣、降、纳”为曾庆弊常用的哮喘疗法.江西中医药[J],1994(4):3
[13]戴克敏,姜春华.治疗哮喘的经验.安徽中医学院学报[J],1990,9(13):17-19
[14]胡国俊.胡翘武治疗支气管哮喘的经验.中国医药学报[J],1993,8(6):56.
[15]邵英国.哮喘临证当议.中医函授通讯[J],1989,8(3):19.
[16]杨柏灿.徐辉光治疗哮喘持续发作的用药特色.上海中医药杂志[J],1992(12):22
[17]李美珠,钟伟新,朱莉芬.益气平喘丸的药理研究.中成药[J],1992,14(11):28.
[18]邵长荣,傅继勋,唐忆星等.支气管哮喘缓解期补虚后气道反应性测验.上海中医药杂志[J],1988,(10):21.
[19]武维平,贺福田.肝与咳、喘、哮.北京中医学院学报[J],1990,(13):11-13.
[20]李智华.抗敏煎治疗过敏性哮喘48例.湖南中医杂志[J],1988,4(3):43-44
[21]武维平.调肝理肺法治疗哮喘174例小结.北京中医学院学报[J],1990,13(4):19-20
[22]陈超,刘彦荣,李宁.补肾益肺法治疗哮喘300例.中医函授通讯[J],1993,12(6):14-16·
[23]崔文成,刘漠梧.论哮证治肝.山东中医杂志[J],1995,14(1):4.
[24]吴业华.支气管哮喘从湿论治的体会.黑龙江中医药杂志[J]1990,(2):32-33
[25]纪秀兰.哮喘灵治疗外源性支气管哮喘55例临床观察.天津中医[J]1991,(5):23.
[26]张建民.治哮莫忘和胃祛湿.吉林中医药[J],1993,(4):15.
[27]武维平.支气管哮喘临床研究述评.北京中医学院学报[J],1992,15(4):2-8.
[28]姜勇,刘丽军.下法在喘证中的应用.黑龙江中医药杂志[J],2990,(1),31-35
[29]史宇广,单书健主编.当代名医临证精华小儿咳喘专辑[C].第1版.北京:中医古籍出版社,1992,119.
[30]Masoli M, Fabian D, Holt S, Beasley R. The global burdenof asthma: executive summary of the GINA DisseminationCommittee report[J]. Allergy, 2004, 59(5): 469.
[31]Gerritsen J. Follow-up studies of asthma from childhood toadulthood[J]. Paediatr Respir Rev, 2002, 3(3): 184.
[32]Blumenthal M N, Langefeld C D, Beaty T H, etral. Agenome-wide search for allergic response (atopy) genes inthree ethnic groups: Collaborative Study on the Genetics of Asthma[J]. Hum Genet, 2004, 114(2): 157.
[33]Miller R L, Ho S M. Environmental epigenetics and asthma:current concepts and call for studies[J]. Am J Respir Crit Care Med, 2008, 177(6): 567.
[34]Beuther D A, Weiss S T, Sutherland E R. Obesity and asthma[J]. Am J Respir Crit Care Med, 2006, 174 (2): 112.
[35]Shore S A. Obesity and asthma: possible mechanisms[J]. JAllergy Clin Immunol, 2008, 121(5): 1087.
[36]Shore S A, Schwartzman I N, Mellema M S, etal. Effect of leptin on allergic airway responses in mice[J]. JAllergy ClinImmunol, 2005, 115: 103.
[37]Shore S A, Terry R D, Flynt Letal. Adiponectin attenuates allergen-induced airway inflammation and hyperrespon-siveness in mice[J]. J Allergy Clin Immunol, 2006, 118:389.
[38]全国儿科哮喘协作组.2000年与1990年儿童支气管哮喘患病率的调查比较.中华结核和呼吸杂志[J], 2004, 27(2): 112.
[39]Chinn S, Downs S H, Anto J M, et al. Incidence of asthmaand net change in symptoms in relation to changes in obesity[J]. Eur Respir J, 2006, 28(4): 763.
[40]Almqvist C, Egmar A C, van Hage-Hamsten Metal.Heredity, pet ownership, and confounding control in a popu-lation - based birth cohort[J]. J Allergy Clin Immunol,2003, 111 (4): 800.
[41]Braun-Fahrlander C. Environmental exposure to endotoxinand other microbial products and the decreased risk of child-hood atopy: Evaluating developments since April 2002[J].Curr Opin Allergy Clin Immunol, 2003, 3(5): 325.
[42]Gem J E, Busse W W. Relationship of viral infections towheezing illnesses and asthma[J]. N at Rev Immunol, 2002,2 (2): 132.
[43]Zambrano J C, Carper HT, Rakes G P, et al. Experimentalrhinovirus challenges in adults with mild asthma: Response toinfection in relation to IgE[J]. J Allergy Clin Immunol,2003, 111 (5): 1008.
[44]Gauderman W J, Avol E, Gilliland F, et al. The effect of airpollution on lung development from 10 to 18 years of age[J].N Engle J M ed, 2004, 351(11): 1057.
[45]Jackkola J J, Kosheleva A A, Katsnelson B A, et al. Prenatal and postnatal tobacco smoke exposure and respiratoryhealth in Russian children[J]. Respir Res, 2006, 7: 48.
[46]Hamad A M, Sutcliffe A M, Knox AJ. Aspirin-inducedasthma: clinical aspects, pathogenesis and management[J].Drugs, 2004, 64(21): 2417.
[47]Devereux G, SemonA. Diet as a risk factor for atopy andasthma[J]. J Allergy Clin Immunol, 2005, 115(6): 1109.
[48]Friedman N J, Zeiger R S. The role of breast-feeding in thedevelopment of allergies and asthma[J]. J Allergy Clin Immunol, 2005, 115(6): 1238.
[49]Milton B, Whitehead M, Holland P, The social and economic consequences of childhood asthma across the lifecourse: a systematic review[J]. Child Care Health Dev, 2004, (6):711.
[50]王建华.流行病学[M],第五版,北京:人民卫生出版社,2007:31-35
[51]蒋峰.中国贫困地区女性健康状况分析,见李宏规,主编,生殖健康社会科学研究进展:北京:中国人口出版社:1996.417-421
[52]Akim.JM.LC.The determination of infant and child mortality in Tanzania;Health policy and plainly[J];1995.4:384-394
[53]David AS,Elizabeth AW,Andrew SK,Material employment and reproductive risk fators,AM J epidemiol[J];1990,132:933-945
[54]刘民,李竹.流行病学研究方法在生殖健康研究的应用.中华流行病学杂志[J],2003,8,24(8):11-13
[55]夏愔愔，詹思延．队列研究.中国循证儿科杂志[J],2009,7(4):21
[56]梁戈玉,浦跃朴,尹立红.某种基因与某些环境因素在肿瘤发生中交互作用的单纯病例,环境与职业医学[J],2006.23(6):449-453
[57]易洪刚,陈峰.单纯病例研究.国外医学.流行病学传染病学分册[M],2004,31(1):60-62
[58]Piegorsch.WW,Weinberg.CK,Taylor.JA.Non-bierarchical-population-based case-control studies,stat.Med[J],1994.13(2):153-162
[59]梁万年,主编,医学科研方法学[M],第一版,北京:人民卫生出版社,2002:83-85
[60]李素梅,陈海婴,袁昆华等.不同浓度碘盐对人群碘营养状况的现场试验研究,中华流行病学杂志[J],2005,10,26(10):25-27
[61]赵仲堂.流行病学研究方法与应用[M],第二版,北京:科学出版社,2003:69-97
[62]胡浩,姜宝.高琦等流行病学研究进展,中国公共卫生[J],2008,7,24(7):19-20
[63]王滨有.社区干预试验及应用.中国地方病学杂志[J],2004,7,23(4):52-54
[64]邱泓,张茂鎔,沈岚等.昆明是社区居民糖尿病防治健康教育干预效果评估,中国初级卫生保健[J],2010,9,24(9):41-43
[2]刘玉良,关于中医学定量辩证理论研究的反思.中医杂志[J]2010.,21(8):16-17
[3]王雪峰,董丹中医辨证规范所需解决的基本问题.辽宁中医杂志[J]2007(3):2
[4]周文泉,于向东.中医临床疗效评价的关键问题及证的量化.第三次全国中西医结合养生学与康复学术研讨会[C].昆明,2002,8
[5]郭蕾,张启明,王永炎等.证候规范化研究思路和方法探讨[J].国家重点基础研究发展计划(973)资助项目(WO.2005CB517101)
[6]刘凤斌,方积乾.中医药临床疗效评价的探讨.中华中医药学刊[J],20(2):266-267
[7]朱立明,卢健,段立强.中药新药研发中证候规范化及其临床疗效评价[J].中国中医基础医学杂志,2006,12(7):
[8]郑筱萸,任德权,主编.中药新药临床研究指导原则(试行)[M]第一版.北京:中国医药科技出版社,2002.2.169
[9]张洁承.支气管哮喘.山东中医杂志[J],1994,13(1):28-30.
[10]包培蓉.吕同杰哮证论治经验.中国中医急症[J],1995,4(1),29-30
[11]何忠莲.支气管哮喘中医治疗近况.四川中医[J],1992,10(7),16-17
[12]宾学森,曾庆弊.“宣、降、纳”为曾庆弊常用的哮喘疗法.江西中医药[J],1994(4):3
[13]戴克敏,姜春华.治疗哮喘的经验.安徽中医学院学报[J],1990,9(13):17-19
[14]胡国俊.胡翘武治疗支气管哮喘的经验.中国医药学报[J],1993,8(6):56.
[15]邵英国.哮喘临证当议.中医函授通讯[J],1989,8(3):19.
[16]杨柏灿.徐辉光治疗哮喘持续发作的用药特色.上海中医药杂志[J],1992(12):22
[17]李美珠,钟伟新,朱莉芬.益气平喘丸的药理研究.中成药[J],1992,14(11):28.
[18]邵长荣,傅继勋,唐忆星等.支气管哮喘缓解期补虚后气道反应性测验.上海中医药杂志[J],1988,(10):21.
[19]武维平,贺福田.肝与咳、喘、哮.北京中医学院学报[J],1990,(13):11-13.
[20]李智华.抗敏煎治疗过敏性哮喘48例.湖南中医杂志[J],1988,4(3):43-44
[21]武维平.调肝理肺法治疗哮喘174例小结.北京中医学院学报[J],1990,13(4):19-20
[22]陈超,刘彦荣,李宁.补肾益肺法治疗哮喘300例.中医函授通讯[J],1993,12(6):14-16·
[23]崔文成,刘漠梧.论哮证治肝.山东中医杂志[J],1995,14(1):4.
[24]吴业华.支气管哮喘从湿论治的体会.黑龙江中医药杂志[J]1990,(2):32-33
[25]纪秀兰.哮喘灵治疗外源性支气管哮喘55例临床观察.天津中医[J]1991,(5):23.
[26]张建民.治哮莫忘和胃祛湿.吉林中医药[J],1993,(4):15.
[27]武维平.支气管哮喘临床研究述评.北京中医学院学报[J],1992,15(4):2-8.
[28]姜勇,刘丽军.下法在喘证中的应用.黑龙江中医药杂志[J],2990,(1),31-35
[29]史宇广,单书健主编.当代名医临证精华小儿咳喘专辑[C].第1版.北京:中医古籍出版社,1992,119.
[30]Masoli M, Fabian D, Holt S, Beasley R. The global burdenof asthma: executive summary of the GINA DisseminationCommittee report[J]. Allergy, 2004, 59(5): 469.
[31]Gerritsen J. Follow-up studies of asthma from childhood toadulthood[J]. Paediatr Respir Rev, 2002, 3(3): 184.
[32]Blumenthal M N, Langefeld C D, Beaty T H, etral. Agenome-wide search for allergic response (atopy) genes inthree ethnic groups: Collaborative Study on the Genetics of Asthma[J]. Hum Genet, 2004, 114(2): 157.
[33]Miller R L, Ho S M. Environmental epigenetics and asthma:current concepts and call for studies[J]. Am J Respir Crit Care Med, 2008, 177(6): 567.
[34]Beuther D A, Weiss S T, Sutherland E R. Obesity and asthma[J]. Am J Respir Crit Care Med, 2006, 174 (2): 112.
[35]Shore S A. Obesity and asthma: possible mechanisms[J]. JAllergy Clin Immunol, 2008, 121(5): 1087.
[36]Shore S A, Schwartzman I N, Mellema M S, etal. Effect of leptin on allergic airway responses in mice[J]. JAllergy ClinImmunol, 2005, 115: 103.
[37]Shore S A, Terry R D, Flynt Letal. Adiponectin attenuates allergen-induced airway inflammation and hyperrespon-siveness in mice[J]. J Allergy Clin Immunol, 2006, 118:389.
[38]全国儿科哮喘协作组.2000年与1990年儿童支气管哮喘患病率的调查比较.中华结核和呼吸杂志[J], 2004, 27(2): 112.
[39]Chinn S, Downs S H, Anto J M, et al. Incidence of asthmaand net change in symptoms in relation to changes in obesity[J]. Eur Respir J, 2006, 28(4): 763.
[40]Almqvist C, Egmar A C, van Hage-Hamsten Metal.Heredity, pet ownership, and confounding control in a popu-lation - based birth cohort[J]. J Allergy Clin Immunol,2003, 111 (4): 800.
[41]Braun-Fahrlander C. Environmental exposure to endotoxinand other microbial products and the decreased risk of child-hood atopy: Evaluating developments since April 2002[J].Curr Opin Allergy Clin Immunol, 2003, 3(5): 325.
[42]Gem J E, Busse W W. Relationship of viral infections towheezing illnesses and asthma[J]. N at Rev Immunol, 2002,2 (2): 132.
[43]Zambrano J C, Carper HT, Rakes G P, et al. Experimentalrhinovirus challenges in adults with mild asthma: Response toinfection in relation to IgE[J]. J Allergy Clin Immunol,2003, 111 (5): 1008.
[44]Gauderman W J, Avol E, Gilliland F, et al. The effect of airpollution on lung development from 10 to 18 years of age[J].N Engle J M ed, 2004, 351(11): 1057.
[45]Jackkola J J, Kosheleva A A, Katsnelson B A, et al. Prenatal and postnatal tobacco smoke exposure and respiratoryhealth in Russian children[J]. Respir Res, 2006, 7: 48.
[46]Hamad A M, Sutcliffe A M, Knox AJ. Aspirin-inducedasthma: clinical aspects, pathogenesis and management[J].Drugs, 2004, 64(21): 2417.
[47]Devereux G, SemonA. Diet as a risk factor for atopy andasthma[J]. J Allergy Clin Immunol, 2005, 115(6): 1109.
[48]Friedman N J, Zeiger R S. The role of breast-feeding in thedevelopment of allergies and asthma[J]. J Allergy Clin Immunol, 2005, 115(6): 1238.
[49]Milton B, Whitehead M, Holland P, The social and economic consequences of childhood asthma across the lifecourse: a systematic review[J]. Child Care Health Dev, 2004, (6):711.
[50]王建华.流行病学[M],第五版,北京:人民卫生出版社,2007:31-35
[51]蒋峰.中国贫困地区女性健康状况分析,见李宏规,主编,生殖健康社会科学研究进展:北京:中国人口出版社:1996.417-421
[52]Akim.JM.LC.The determination of infant and child mortality in Tanzania;Health policy and plainly[J];1995.4:384-394
[53]David AS,Elizabeth AW,Andrew SK,Material employment and reproductive risk fators,AM J epidemiol[J];1990,132:933-945
[54]刘民,李竹.流行病学研究方法在生殖健康研究的应用.中华流行病学杂志[J],2003,8,24(8):11-13
[55]夏愔愔，詹思延．队列研究.中国循证儿科杂志[J],2009,7(4):21
[56]梁戈玉,浦跃朴,尹立红.某种基因与某些环境因素在肿瘤发生中交互作用的单纯病例,环境与职业医学[J],2006.23(6):449-453
[57]易洪刚,陈峰.单纯病例研究.国外医学.流行病学传染病学分册[M],2004,31(1):60-62
[58]Piegorsch.WW,Weinberg.CK,Taylor.JA.Non-bierarchical-population-based case-control studies,stat.Med[J],1994.13(2):153-162
[59]梁万年,主编,医学科研方法学[M],第一版,北京:人民卫生出版社,2002:83-85
[60]李素梅,陈海婴,袁昆华等.不同浓度碘盐对人群碘营养状况的现场试验研究,中华流行病学杂志[J],2005,10,26(10):25-27
[61]赵仲堂.流行病学研究方法与应用[M],第二版,北京:科学出版社,2003:69-97
[62]胡浩,姜宝.高琦等流行病学研究进展,中国公共卫生[J],2008,7,24(7):19-20
[63]王滨有.社区干预试验及应用.中国地方病学杂志[J],2004,7,23(4):52-54
[64]邱泓,张茂鎔,沈岚等.昆明是社区居民糖尿病防治健康教育干预效果评估,中国初级卫生保健[J],2010,9,24(9):41-43