疾病的流行病学..pptVIP

谢谢 * * The essentials of epidemiology noted by Hippocrates included observations on how diseases affected populations and how disease spread. He further addressed issues of diseases in relation to time and seasons, place, environmental conditions, and disease control, especially as it related to water and seasons. The broader contribution to epidemiology made by Hippocrates was that of epidemiological observation. His teachings about how to observe any and all contributing or causal factors to a disease are still sound epidemiological concepts. 《论气、水和地区》 《论瘟疫》，共7册，其中第一和第三册无疑是希伯克拉底的手笔 * * * * * * Sir Austin Bradford Hill and Sir Richard Doll More than anybody else Richard Doll has stopped doctors pontificating without any evidence. Together with the father of medical statistics, Austin Bradford Hill, he introduced the randomised controlled trial: a method of assessing a treatment or procedure that is one of the most important medical developments of the century. Doll and Hill were also the first to show the connection between cigarette smoking and many serious diseases, particularly lung cancer and heart disease. Austin Bradford-Hill. He was a professor of statistics at the London School of Hygiene and Tropical Medicine. * * * * * * 疾病的流行病学 流行病学简史 Hippocrates (460-377 BC) 第一个流行病学家 主要的流行病学著作： 《Epidemic Ⅰ》 《Epidemic Ⅲ》 《On Airs, Waters and Places》 中国： “疫” “时疫” “疫疠” 主要贡献： 流行病学观察 环境在疾病发生中起着很重要的作用 John Graunt (1620-1674) 利用死亡数据进行死亡分布及规律性研究 创制了第一张寿命表，计算期望寿命 用生存概率和死亡概率来概括死亡经历 提出设立比较组的思想 将统计学引入流行病学领域 《Natural and Political Observations Made Upon the Bills of Mortality》 James Lind (1716-1794) VitC缺乏 – 坏血病 (1747)开创了流行病学临床试验的先河 William Farr (1807-1883) 在英国首创人口和死亡的常规资料收集 提出许多流行病学的重要概念：标化死亡率、人年、剂量反应关系、患病率 患病率＝发病率×病程 现代流行病学的奠基人之一 公共卫生运动的领导者之一 John Snow (1813-1858) 伦敦宽街－霍乱爆发 标点地图法 霍乱是介水传播 流行病学现场调查、 分析与控制的经典实例 Robert Koch (1843-1910) 确定了结核杆菌和霍乱弧菌 1905年诺贝尔生理学或医学奖 确定了水净化在疾病预防过程中的重要性 确定微生物为致病因子时，Henle-Koch提出4条原则： 在相应疾病患者中总是能检出该病病原体(必要病因) 在其他疾病患者中不能检出该病原体(效应特异性) 能从相应疾病患者中分离到该病