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1、流行病学教学课件下载-样章.ppt 流 行 病 学 EPIDEMIOLOGY,第一章 绪论 Chapter One Introduction,2018/10/28,2,第一节 概述 Introduction,流行病学 Epidemiology 是一门发展十分迅速的学科。早期的流行病学重点是研究人类疾病尤其是传染病的分布和频率，以后扩展到研究疾病的分布和频率的决定因素。当代著名流行病学家Rothman认为：病因和预防是一个硬币的两面。现代流行病学则更强调了流行病学作为应用学科在预防中的应用，以及作为方法学在医学中所起的不可替代的作用。流行病学是公共卫生的核心科学。它不仅是预防医学中的主导学科，也
2、是现代医学的一门重要的基础学科。流行病学是扎根于生物学、逻辑学和哲学的一门科学。,2018/10/28,3,第一节 概述 Introduction,Definition The scientific study of epidemics and epidemic diseases, especially the factors that influence the incidence, distribution, and control of infectious diseases; the study of disease occurrence in human populations. T
3、he statistical study of the distribution and determinants of disease in populations. The study of a disease that deals with how many people have it, where they are, how many new cases develop, and how to control the disease.,2018/10/28,4,第一节 概述 Introduction,Definition Epidemiology is the science dev
4、oted to the statistical study of categories of persons and the patterns of diseases from which they suffer, with the aim of determining the events or circumstances causing these diseases. Study of the distribution of disease, or other health-related states and events in human populations, as related
5、 to age, sex, occupation, ethnicity, and economic status in order to identify and alleviate health problems and promote better health.,2018/10/28,5,第一节 概述 Introduction,Definition Epidemiology is the study of the distribution and determinants of health-related states or events in specified population
6、s, and the application of this study to control of health problems (Last 2001). Epidemiology is the scientific study of factors affecting the health and illness of individuals and populations, and, in this capacity, it serves as the foundation and logic of interventions made in the interest of the p
7、ublics health.,2018/10/28,6,第一节 概述 Introduction,流行病学定义为：“流行病学是研究疾病和健康状态在人群中的分布及影响因素，以及制订和评价预防、控制和消灭疾病及促进健康的策略与措施的科学”。 该定义的基本内涵有四点：研究对象是人群，是研究所关注的具有某种特征的人群； 它不仅研究各种疾病，而且研究健康状态；研究重点是疾病和健康状态的分布及其影响因素；最终目的是为控制和消灭疾病及促进健康提供科学的决策依据。,2018/10/28,7,第一节 概述 Introduction,目前国际上比较通用的流行病学定义为：“研究特定人群中疾病和健康状态的分布及其决定因
8、素，以及防制疾病和促进健康的策略与措施的科学”（JM Last, 1995）。“流行病学是公共卫生的基础学科，研究特定人群中与健康有关的状态的分布和决定因素，并将研究结果应用于卫生问题的控制中去。”该定义与国内的定义基本是一致的。 近年来，国内外有些人提出与人类健康相关的“公共卫生事件”（public health events）， 甚至超出卫生事件范畴的自然和社会问题，如全球气候变暖、厄尔尼诺与拉尼那现象、人口“爆炸”与人口老龄化等现象。所有这些均是不可忽视的影响疾病和健康状态及其分布的重要因素。,2018/10/28,8,第一节 概述 Introduction,二、流行病学简史 Devel
9、opment History of Epidemiology 流行病学是人类在与多种流行性疾病，特别是传染病做斗争的实践中逐渐形成和发展起来的。中外古代医学对疾病的流行均有朴素的描述。现在已难于追溯到是谁最先使用epidemiology一词了，1802年Madrid西班牙疾病流行史一书中首次出现了epidemiologia一词，而epidemic（流行）一词希腊著名医生Hippocrates就已曾用过。此后，流行病学主要经历了三个阶段。,2018/10/28,9,第一节 概述 Introduction,Hippocrates (hih POK ruh teez) lived 400 years
10、 before the birth of Christ. He is known as the father of medicine because many of the things he discovered are still practiced today.,2018/10/28,10,第一节 概述 Introduction,During the time when Hippocrates lived, people were very superstitious. * They believed there were four fluids in the body which ma
11、tched four elements; earth, air, fire and water. They would carry sick people to the temple because they thought the god of medicine, Aesculapius (es kyoo LAY pe us) could heal them. They would say magic words over the patient to try and heal them. Hippocrates taught that diseases came from natural
12、causes. He had observed many patients and carefully recorded their symptoms and the way their illnesses developed. He would look at the color of the skin, and how the eyes looked. He would look for fevers and chills. He described many illnesses including pneumonia, * tetanus, * tuberculosis, * arthr
13、itis, * mumps, * and malaria *.,2018/10/28,11,第一节 概述 Introduction,He told his students to carefully observe their patients and to learn from the things they had observed. He said the human body could heal itself and could return itself to good health. The patient was given something to relieve pain,
14、 but nothing else was done. He told his patients they should eat a moderate amount of food; not too much and not too little. A moderate amount of exercise was recommended. Patients were encouraged to walk for exercise. Doctors were told to make sure their hands were clean before they treated patient
15、s. He said the operating room should be well lighted and look cheerful. His thought patients in good spirits would heal faster. Physicians should be men of honor, according to Hippocrates. He encouraged them to work as hard as possible for the good of the sick.,2018/10/28,12,第一节 概述 Introduction,16世纪
16、中叶，1543年人体解剖学奠定，生理学（1628年）迅速发展，以及列文霍克（Leeuwenhoek A） 发明显微镜后，人们开始认识了病原，琴纳（Edward Jenna）发明牛痘接种法（smallpox vaccination），成为18世纪预防医学的一项重大成就。 第一阶段，19世纪中叶，流行病学学科开始形成。贫穷和饥荒造成的营养不良、恶劣的环境、瘟疫（天花smallpox、鼠疫plague、霍乱cholera、麻疹measles等）是当时的时代特点，这一时期流行病学研究主要以研究传染病的人群现象为主。以50年代认识了霍乱（cholera）的传播方式为标志，流行病学有了长足的发展。,201
17、8/10/28,13,2018/10/28,14,第一节 概述 Introduction,Leeuwenhoek, Antony van b. Oct. 24, 1632, Delft, Neth.-d. Aug. 26, 1723, Delft), Dutch microscopist who was the first to observe bacteria and protozoa. His researches on lower animals refuted the doctrine of spontaneous generation, and his observations helped lay the foundations for the sciences of bacteriology and protozoology.,
