【作者】 王雪；

【导师】 王德斌；

【作者基本信息】 安徽医科大学 ， 社会医学与卫生事业管理， 2021， 硕士

【摘要】 目的(1)描述有上消化道症状个体在人群中的分布状况,发现上消化道症状的高危人群;(2)分析上消化道症状与饮食之间的关系,在饮食行为方面寻找影响上消化道症状发生的危险和保护因素;(3)为控制研究对象的上消化道症状设计合理饮食干预方案从而改善个体的生活质量。方法(1)以乡镇和社区为单位,采取整群和随机抽样,在安徽省合肥市、黄山市、六安市以及阜阳市抽取23704人。(2)调查工具包括:居民慢性病风险评估问卷和生活质量(EQ-5D)量表。(3)采用文献复习法和入户问卷调查。(4)运用SPSS16.0进行频数统计、卡方检验、t检验、二分类logistic回归和有序logistic回归分析上消化道症状患者流行现状与危害以及饮食和上消化道症状的关系。结果(1)本研究四个上消化道症状的报告率从高到低依次是经常感觉胃痛或胃部不适(22.8%)、经常食物反流或反酸(16.8%)、经常感觉胃口不好(7.0%)以及经常感觉吞咽轻度疼痛或不顺畅(3.6%)。研究对象经常出现上消化道症状女性高于男性、农村高于城市且大体上是随着文化程度的提高而减少,年龄段55-64岁是上消化道症状的高发期,其次是年龄组45-54岁。(2)研究对象自述有医生确诊的慢性胃炎患病率有上消化道症状的人群高于无上消化道症状的人群;黄山市有上消化道症状患者在行动能力、自我照顾、日常活动、疼痛/不舒服以及焦虑/抑郁这五个维度有任何困难/问题的损伤率高于无上消化道症状的人群,在垂直的视觉模拟刻度(VAS)得分低于无上消化道症状的人群,差异具有统计学意义。(3)研究对象经常食物反流或反酸的危险因素是经常吃腌晒食品、油炸食品、剩饭剩菜、大蒜、淡水鱼虾,平时饮食偏烫、口味重盐、油脂较低、进食速度偏快与偏慢、用餐时间较多与经常不规律以及用餐到睡觉时间经常小于2小时;经常感觉吞咽轻度疼痛或不顺畅的危险因素是经常吃腌晒食品、油炸食品、剩饭剩菜,平时饮食偏烫、偏稀、油脂较低、进食速度偏慢、用餐时间较多与经常不规律、用餐到睡觉时间经常小于2小时;经常感觉胃痛或胃部不适的危险因素是经常吃腌晒食品、油炸食品、剩饭剩菜、豆制品、淡水鱼虾,平时饮食偏烫、偏稀、油脂较高、进食速度偏快与偏、每次吃的六七成饱或更少、用餐时间较多与经常不规律、用餐到睡觉时间较多与经常小于2小时以及吸烟;经常感觉胃口不好的危险因素是经常吃油炸食品、喝牛奶,平时饮食偏烫、偏稀、口味重盐、油脂较低、进食速度偏慢、饱腹感八九成饱或更少、用餐时间较多与经常不规律、用餐到睡觉时间经常小于2小时以及吸烟。(4)以研究对象基线情况(一般人口学特征、经常出现的上消化道症状以及饮食行为)、饮食行为干预素材库(如减少腌晒和油炸食品摄入、多吃新鲜蔬菜和水果、辣椒要适量以及增加营养素供应等)和组合式干预方式(如短信、微信公众号以及宣传页等)初步设计饮食干预方案。结论安徽省女性、年龄组45-64岁、文化程度较低以及农村地区是上消化道症状的高危人群;有上消化道症状的人群慢性胃炎患病率以及生活质量损伤率更高;饮食是影响上消化道症状发生的重要因素,不同的上消化道症状在饮食行为方面既存在不同的危险和保护因素,又存在相同的危险和保护因素;初步设计了有上消化道症状个体的个性化饮食行为干预方案,以期控制上消化道症状进而改善个体生活质量。更多还原

【Abstract】 Objectives(1)Describe the distribution of individuals with upper gastrointestinal symptoms in the population,and find high-risk groups of upper gastrointestinal symptoms;(2)Analyze the relationship between upper gastrointestinal symptoms and diet,and look for eating behaviors that affect the upper gastrointestinal tract The risk and protective factors for the occurrence of symptoms;(3)Design a reasonable diet intervention plan to control the upper gastrointestinal symptoms of the study subjects to improve the quality of life of the individual.Methods(1)Taking towns and communities as the unit,cluster and random sampling was adopted,and 23704 people were selected from Hefei,Huangshan,Lu’an and Fuyang in Anhui Province.(2)Survey tools include:Resident Chronic Disease Risk Assessment Questionnaire and Quality of Life(EQ-5D)Scale.(3)Adopt literature review method and household questionnaire survey.(4)Use SPSS16.0 to perform frequency statistics,chi-square test,t-test,binary logistic regression and ordered logistic regression to analyze the epidemic status and harm of patients with upper gastrointestinal symptoms,as well as the relationship between diet and upper gastrointestinal symptoms.Results(1)The reporting rates of the four upper gastrointestinal symptoms in this study,from high to low,are: frequent stomach pain or upset stomach(22.8%),frequent food reflux or acid reflux(16.8%),and frequent feeling of poor appetite(7.0%)and often feel mild pain or unsmooth swallowing(3.6%).Research subjects often have upper gastrointestinal symptoms in women than in men,rural areas are higher than in cities,and generally decrease with the increase of education level.The age group of 55-64 years is the high-incidence period of upper gastrointestinal symptoms,followed by the age group 45-54 years old.(2)The research subjects reported that the prevalence of chronic gastritis diagnosed by a doctor was higher than that of people with upper gastrointestinal symptoms than those without upper gastrointestinal symptoms;Huangshan City,patients with upper gastrointestinal symptoms were in mobility,self-care,daily activities,The injury rate of pain/discomfort and anxiety/depression with any difficulty/problem in the five dimensions is higher than that of people without upper gastrointestinal symptoms,and the score on the vertical visual analog scale(VAS)is lower than that of people without upper gastrointestinal symptoms.The difference is statistically significant.(3)The risk factors for frequent food reflux or acid reflux of the research subjects are the frequent eating of pickled and sun-dried foods,fried foods,leftovers,garlic,freshwater fish and shrimps,and their usual hot diet,heavy salt in taste,and low oil and fat.Fast and slow eating speed,frequent and irregular meal times,and the time from meal to bedtime is often less than 2 hours;the risk factors for frequent pain or difficulty in swallowing are frequent eating of pickled and sun-dried food,fried food,and leftovers.Food leftovers,usually hot,thinner,low fat,slow eating speed,frequent and irregular meal times,and the time between meal and bed is often less than 2 hours;the risk factors for frequent stomach pain or stomach discomfort are Often eat pickled sundried foods,fried foods,leftovers,soy products,freshwater fish and shrimps.The usual diet is hot,thin,high in fat,fast and partial,and 60% to 70% of the food is full or full each time.Less,more meal times and often irregularities,more time from meal to bedtime and often less than 2 hours,and smoking;the risk factors for often feeling bad appetite are frequent eating fried foods,drinking milk,and normal eating hot and partial Thin,heavy salt,low fat,slow eating speed,80 to 90% fullness or less,more and often irregular meal times,often less than 2 hours from meal to bed,and smoking.(4)Based on the baseline situation of the research object(general demographic characteristics,frequent upper gastrointestinal symptoms and eating behavior),dietary behavior intervention material library(such as reducing the intake of pickled and fried foods,eating more fresh vegetables and fruits,The amount of chili peppers should be appropriate and the supply of nutrients should be increased)and combined intervention methods(such as text messages,We Chat public accounts,and leaflets,etc.)to initially design dietary intervention programs.Conclusion Women in Anhui Province,45-64 years old,less educated,and rural areas are at high risk of upper gastrointestinal symptoms;people with upper gastrointestinal symptoms have a higher prevalence of chronic gastritis and quality of life impairment;diet is an influence An important factor in the occurrence of upper gastrointestinal symptoms,different upper gastrointestinal symptoms have different risk and protective factors in eating behavior,but also the same risk and protective factors;a personalized diet for individuals with upper gastrointestinal symptoms has been initially designed Behavioral intervention programs to control upper gastrointestinal symptoms and improve the quality of life of individuals.更多还原