Study of Zero-Inflated Regression Models in a Large-Scale Population Survey of Sub-Health Status and Its Influencing Factors

Objective Sub-health status has progressively gained more attention from both medical professionals and the publics. Treating the number of sub-health symptoms as count data rather than dichotomous data helps to completely and accurately analyze findings in sub-healthy population. This study aims to compare the goodness of fit for count outcome models to identify the optimum model for sub-health study.Methods The sample of the study derived from a large-scale population survey on physiological and psychological constants from 2007 to 2011 in 4 provinces and 2 autonomous regions in China. We constructed four count outcome models using SAS: Poisson model, negative binomial (NB) model, zero-inflated Poisson (ZIP) model and zero-inflated negative binomial (ZINB) model. The number of sub-health symptoms was used as the main outcome measure. The alpha dispersion parameter and O test were used to identify over-dispersed data, and Vuong test was used to evaluate the excessive zero count. The goodness of fit of regression models were determined by predictive probability curves and statistics of likelihood ratio test.Results Of all 78 307 respondents, 38.53% reported no sub-health symptoms. The mean number of sub-health symptoms was 2.98, and the standard deviation was 3.72. The statistic O in over-dispersion test was 720.995 (P<0.001); the estimated alpha was 0.618 (95% CI: 0.600-0.636) comparing ZINB model and ZIP model; Vuong test statistic Z was 45.487. These results indicated over-dispersion of the data and excessive zero counts in this sub-health study. ZINB model had the largest log likelihood (-167 519), the smallest Akaike’s Information Criterion coefficient (335 112) and the smallest Bayesian information criterion coefficient (335455),indicating its best goodness of fit. The predictive probabilities for most counts in ZINB model fitted the observed counts best. The logit section of ZINB model analysis showed that age, sex, occupation, smoking, alcohol drinking, ethnicity and obesity were determinants for presence of sub-health symptoms; the binomial negative section of ZINB model analysis showed that sex, occupation, smoking, alcohol drinking, ethnicity, marital status and obesity had significant effect on the severity of sub-health.Conclusions All tests for goodness of fit and the predictive probability curve produced the same finding that ZINB model was the optimum model for exploring the influencing factors of sub-health symptoms.

Concepts of body constitution, health and sub-health from traditional Chinese medicine perspective

This paper described and discussed the important literature and ideas about the concepts, types and measurement of body constitution, in terms of healthy,sub-healthy and disease status. In view of traditional Chinese medicine, ‘‘healthy" state is a status of relative balance of Yin and Yang to keep our bodily homeostasis. If there are significant physical and/or psychological stressors, such as loss of a beloved one and failure in study or work, the body can no longer keep its own bodily condition balanced and subsequently enter a state of ‘‘sub-health"(sub-optimal health).‘‘unhealthy" body constitution such as ‘‘Dampnessheat", ‘‘Cold-dampness" and ‘‘Heat- or Cold- dryness"with a subnormal body temperature and humidity and clinical manifestations such as insomnia, malaise and overweight will be presented. Immediate, appropriate strategies such as modification of life-style and seeking medical treatment can prevent evolution of an illness.Otherwise, the body will enter a disease status with a‘‘pathological" body constitution of ‘‘Yin or Yang deficiency'', ‘‘Blood-stasis" and/or ‘‘Phlegm-dampness". To be complimentary with health promotion and disease prevention in Western medicine, understanding about an individual's body constitution, together with itsdeterminants(e.g., healthy eating and lifestyle behaviors), can contribute to a more proactive, holistic and individualized healthcare.

Structural and functional characteristics of microbiota in oropharynx of sub-healthy children with gastrointestinal heat retention syndrome differentiated by traditional Chinese medicine

Objective:To explore the structural and functional characteristics of microbiota in oropharynx of subhealthy children with gastrointestinal heat retention syndrome(GHRS)differentiated by traditional Chinese medicine,and screen the biometric operational taxonomic units(OTUs)to assist the clinical diagnosis.Methods:We recruited children according to the“GHRS diagnostic scale”,collected their oropharyngeal swabs,and sequenced the 16 SrDNA V4 region.We described the bacterial structure with alpha-indexes,beta-distances,and relative abundances;moreover,we screened the differential genera/OTUs with Wilcoxon rank-sum test,Metagenome Seq analysis,and linear discriminant analysis effect size(LEf Se)analysis,in which biometric OTUs were selected to construct the receiver operating characteristic curve to verify the diagnostic value.The bacterial function was predicted with Kyoto Encyclopedia of Genes and Genomes pathways according to 16S rDNA gene by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States.Results:The study population was composed of 10 children with GHRS and 10 healthy control children.GHRS children were more likely to overeat(gluttony,P=.033).Alpha-indexes,such as Sobs,abundancebased coverage estimator,Bootstrap,and Qstat,were significantly higher in the GHRS group,while betadistances did not exhibit any significant intergroup differences.There were 9 differently distributed nonpredominant genera between the groups in Wilcoxon rank-sum test,as well as 13 non-predominant genera in Metagenome Seq analysis and 3 non-predominant OTUs in LEfSe analysis.OTU44 and OTU196 were used to construct the receiver operating characteristic curve,and the area under curve was 0.92.Predicted functions showed that pathways related to oxidative phosphorylation and carbon metabolism were enriched in healthy control samples,while the pathway related to renin secretion was remarkably enriched in GHRS samples.Conclusion:Unique oropharyngeal microbial structure and function were identified in GHRS children.OTU44 and OTU196 were specific OTUs,which could be used as biomarkers of GHRS to assist clinical diagnosis.

Clinical Efficacy of Sedative Cataplasm for Insomnia Patients with Sub-health

[Objectives]This study aimed to observe the clinical efficacy of sedative cataplasm in the treatment of insomnia patients with sub-health.[Methods]A total of 90 insomnia patients with sub-health were randomly and evenly divided into treatment group and control group.The patients in the control group were given Bozi Yangxin pills orally,and those in the treatment group were treated with sedative cataplasm on Shenjue acupoint.The treatment duration was 4 weeks.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate clinical efficacy.[Results]The overall efficacy of the treatment group and control group was 91.1%and 77.1%,respectively,and the difference between the two was significant(P<0.05).After treatment,the PSQI scores of each group changed significantly(P<0.05).[Conclusions]Sedative cataplasm has a good clinical efficacy on sub-healthy insomnia patients.

Relationship Research between the Chinese Medicine Constitution and Sub-Health

With further development of the bio-psycho-social medical model, people began to re-examine the knowledge of disease and health. The concept of sub-health has also been proposed in western medicine. Because of the lack of a specific standard, it is difficult to make clinical diagnosis and treatments for sub-health. Chinese medicine constitution theory has been widely accepted in China, and has a set of executable standards. This paper puts forward a new research method that connects the sub-health in western medicine and Chinese medicine constitution theory together. The potential relationships and influences between Chinese medicine constitution theory and sub-health were analyzed and key content and research progress were discussed. The research method in this paper will provide new ideas for sub-health research.

A research on the composing of sub-health people’s hygienic gymnastics

according to statistics, 70 percent of Chinese people are in sub-health, so the health care for them should be payed more attention. In recent years, researches on sub-health people has increased and the classifi cation, diagnose for sub-health people’s current situation has entered an area of researching. Among them, the research of sub-health people’s infl uence on society stands out, because the occupational group is tightly related to the promotion of social economic development and stability. Hygienic gymnastics will help to improve sub-health situation and it still need to conduct relatively composing and completing. In this paper, questionnaire method and literature method are used to carry out investigation and analysis on sub-health people and therefore, the hygienic gymnastics for sub-health improving is composed and summarized.

Progress of research on massage therapy for sub-health conditions

Sub-health state is a kind of low-quality state between health and disease, and will lead to disease if not intervened in time. As one of the external treatment options in traditional Chinese medicine (TCM), massage therapy has achieved an ideal curative effect in the treatment of the sub-health state. This paper summarizes the articles on massage treatment for the treatment of patients in the sub-health state from the past decade. It mainly includes the current understanding of sub-health, treatment ideas and specific methods, as well as clinical classification of treatment modalities. From the perspective of treatment ideas and specific methods, most massage therapies are performed under the guidance of the holistic concept of TCM, and the concept of treatment based on syndrome differentiation (four diagnostic methods of TCM: inspection, auscultation, inquiry, and palpation). In this treatment, not only are the therapeutic functions of meridians and acupoints emphasized, but the selection of the therapeutic time is also performed according to the "Ziwuliuzhu" and the "Lingguibafa"(the acupuncture method based on time in ancient China). According to the different clinical symptoms of sub-health, it can be divided into three types: physical sub-health, psychological sub-health, and social adaptive sub-health. Massage therapy eliminates pain, relieves physical fatigue, and has a good therapeutic effect on physical sub-health. It can alleviate anxiety and depression, promote psychosomatic pleasure of patients, and has a satisfactory regulatory effect on the psychological sub-health symptoms. However, basic research on using modern medical theories and the means to explain its mechanism of action is relatively weak. Therefore, only constantly improving the quality of clinical observation and strengthening basic research can provide more and better evidence for the clinical application of massage therapy in treating the symptoms of the sub-health status.

Effect of moxibustion on the nailfold microcirculation of young and middle-aged people in sub-health status

Objective To explore the mechanism of moxibustion for people in sub-health status. Methods Thirty-nine young and middle-aged sub-health volunteers were enrolled, including 13 males and 26 females. Mild moxibustion was adopted, and Shenque （神阙 CV 8）, Guanyuan （关元 CV 4）, Zusanli （足三里 ST 36, bilateral）, Pish0 （脾俞 BL 20, bilateral） and Shenshu （肾俞 BL 23, bilateral） were selected. The moxibustion was performed once every other day, 20 min at each time, and moxibustion for ten times was needed. The changes in morphology, flow velocity and pefiloop of nailfold microcirculation were detected by adopting microcirculation detector before moxibustion, after moxibustion for three times, six times, ten times, and on the 15th day after moxibustion, respectively. Results After moxibustion, the abnormal blood capillary morphology of microcirculation gradually turned into normal pattern along with the increase of the number of times of moxibustion, according to the comparison of the number of capillary loop, the diameter of input limb, the diameter of output limb/the diameter of input limb, flow pattern integral, pefiloop integral and total integral with those before moxibustion, the differences were all statistically significant （all P〈0.01）. Conclusion Moxibustion changs the microcirculation of nailfold of body, improves the blood flow pattern, makes the pefiloop status clear, accelerats the blood flow and increases the microcirculation perfusion amount, thus regulating the sub- health status of human body.

Evaluation on Effectiveness and Safety of Chinese Herbs inTreatment of Sub-health: A Systematic Review andMeta-Analysis of Randomized Controlled Trials

Objective: To evaluate the effectiveness and safety of Chinese herbs in the treatment of sub-health systematical y. Methods: Nine databases were systematicaly and extensively searched to col ect randomized control ed trials(RCTs) about Chinese herbs in the treatment of sub-health. The outcomes included overal effective rate, main symptoms, quality of life, etc. Literature screening, data extraction and quality assessment were conducted according to Cochrane Handbook 5.1. Meta-analysis was conducted to the included literature with Review Manager Software.Results: Seventy-two studies involving 9,296 patients with sub-health were included with 4,908 patients in experimental groups and 4,387 patients in control groups. The overal quality of included clinical research was not high. In the aspect of improving overall effective rate, relieving main symptoms, Pittsburgh sleep quality index(PSQI) score, Athens Insomnia Scale(AIS) score, Fatigue Scale-14(FS-14), Cornel Medical Index(CMI) score and discontinuation rate, the effects of experimental groups were better than that of control groups. According to available research reports, adverse reactions in Chinese herb groups were mainly mild gastrointestinal symptoms, which did not affect the treatment.Conclusion: Chinese herbs have a curative effect in the treatment of sub-health. However, there are no clear criteria for diagnosis and curative effectiveness judgment global y, which would affect the accuracy of curative effect evaluation.

Correlation between women's sub-health and reproductive diseases with pregnancies and labors

OBJECTIVE: To investigate whether female sub-health conditions and reproductive diseases areassociated with pregnancies and labors.METHODS: A cross-sectional survey was performed by using a structured questionnaire. A total of 1343 women aged 35 years or younger in six urban areas of Chengdu were included in the study.According to the Screening Criteria of sub-health conditions, these women were categorized into three groups: postpartum healthy group,sub-healthy group, and reproductive disease group. Data were double-entered using EpiData and the nanalyzed by SPSS.RESULTS: Pregnancy and labor were correlated with postpartum sub-health conditions. The number of pregnancies was negatively correlated with women's postnatal health but was positively correlated with the incidence of postpartum reproductive diseases.CONCLUSION: The number of pregnancies and labors is probably an important factor leading to sub-health conditions and the occurrence of reproductive diseases in women. Avoiding or reducing unwanted pregnancies and labors, enhancing the awareness of health among child bearing-age women are effective measures for preventing sub-health conditions.

疏肝健脾汤联合刮痧治疗亚健康失眠临床观察

目的 观察疏肝健脾汤联合刮痧治疗亚健康失眠的临床效果。方法 将90例亚健康失眠患者随机分为治疗组和对照组,每组45例。治疗组采用疏肝健脾汤联合刮痧治疗,对照组口服艾司唑仑片。2组均连续治疗3周,观察2组患者的临床疗效。结果 治疗组总有效率92.86%(39/42)高于对照组的78.57%(33/42),差异有显著统计学意义(P<0.01)。治疗后,治疗组匹兹堡睡眠质量指数(PSQI)及中医证候积分均明显低于对照组(P<0.01)。结论 疏肝健脾汤联合刮痧治疗可有效改善亚健康失眠患者的失眠状态,提高其生活质量,值得临床进一步推广。

国内亚健康状态中医临床试验的文献计量学研究

[目的]探讨国内亚健康状态中医临床试验方法、干预措施及目前研究热点分布领域,为日后临床研究及干预提供参考。[方法]采用循证医学定性系统综述研究方法,检索中国知网(CNKI)、维普(VIP)及万方数据库(WANFANG DATA)文献,应用Note Express 3.2.0软件结合人工阅读文章的方式对检索的文献进行筛选,分别从文献研究方法、干预措施、有效率、受试人群、发表时间、核心作者、期刊分布、基金分布等方面进行定性系统综述分析。[结果]纳入141篇文献,近5年发文量明显降低,可见近几年国内对亚健康状态中医临床试验的关注度呈下降趋势;临床试验研究方法以随机对照试验居多,占总文献的78.72%,但阐明随机化方法的仅占32.43%,且样本含量普遍较低,以致文章可信度低;共有38种结局指标,累计频次279次,说明中医临床试验已有较成熟体系;涉及作者389位,根据普赖斯定律尚未形成核心作者群;涉及期刊67种,尚未形成核心期刊;省级基金项目最多,国家级次之;高频关键词分析,亚健康仍为热点词,其次为亚健康状态,临床疗效;受试人群有25种,较为广泛。干预措施以中药治疗者居多,其次为中医综合疗法、中医推拿法,由此可见,中药在本研究所提及的众多干预措施中是认可度最高的。[结论]研究表明,亚健康状态中医临床试验研究热度有所降低,但受试人群比较广,相对具有代表性,现亚健康人群较多,应重视亚健康状态临床试验的研究及研究的严谨性。

中医护理模式对亚健康患者的影响

目的分析基于中医体质辨识学说的中医护理模式对亚健康患者的影响。方法本研究为随机对照试验。前瞻性选取2021年4月至2023年4月连云港市中医院治未病中心收治的100例处于亚健康状态患者作为研究对象。采用随机数字表法,将患者分为对照组(50例)和观察组(50例)。对照组男29例,女21例;年龄(40.20±2.01)岁;疲劳症状持续时间(6.45±1.43)个月。观察组男31例,女19例;年龄(39.98±2.40)岁;疲劳症状持续时间(6.37±1.40)个月。对照组采用常规护理,观察组在对照组基础上采用基于中医体质辨识学说的中医护理模式。两组均连续干预30 d。比较两组干预前后中医症候积分、生活质量[欧洲五维生存质量量表(EQ-5D)]。采用独立样本t检验、配对t检验和χ^(2)检验。结果干预后,观察组中医症候积分中的体倦乏力、神疲懒言、口淡不渴、食少纳呆评分均低于对照组[(1.01±0.30)分比(1.25±0.69)分、(1.43±0.22)分比(1.66±0.59)分、(1.00±0.35)分比(1.29±0.46)分、(0.73±0.22)分比(1.04±0.41)分](均P<0.05)。观察组EQ-5D中的行动能力、自我管理能力、活动能力、疼痛或不适、焦虑或抑郁评分均高于对照组[(2.01±0.64)分比(1.78±0.14)分、(1.95±0.43)分比(1.72±0.34)分、(1.82±0.26)分比(1.67±0.27)分、(2.01±0.27)分比(1.90±0.12)分、(1.92±0.14)分比(1.78±0.30)分](均P<0.05)。结论基于中医体质辨识学说的中医护理模式可改善亚健康患者中医症候积分,提高生活质量。

沈阳居民身体健康现状的实证研究

《“健康中国”2030规划纲要》明确指出:到2030年,人民身体素质明显增强,主要健康危险因素得到有效控制。目前,健康中国战略已取得显著成果,但在微观角度上,尚且缺乏有关于人民身体健康现状的实证研究。本文基于沈阳市国民体质监测活动,运用SPSS26.0软件,统计1616份沈阳居民健康数据,分析沈阳居民心肺功能、亚健康以及骨密度现状,丰富健康中国背景下有关人民身体素质的实证基料。研究发现:(1)目前心肺功能呈现“差、较差、一般、良好、优秀”状态的沈阳居民分别占0.9%、5.1%、20.3%、36.6%、37.1%。(2)目前亚健康呈现“亚健康、健康”状态的沈阳居民分别占22.1%、77.9%。(3)目前骨密度呈现“骨质疏松、低骨密度、骨质正常”的沈阳居民分别占0.4%、21.1%、78.5%。可见,目前沈阳居民整体身体健康水平较高,但仍然存在一部分居民身体健康水平较低。

髓过氧化物酶预警健康及亚健康人群发生急性冠状动脉综合征的应用研究

目的:探讨髓过氧化物酶(MPO)预警健康及亚健康人群发生急性冠状动脉综合征(ACS)的应用价值。方法:回顾性分析2021年5月—2023年5月于赣州市人民医院进行体检的90例体检者资料,将健康人群作为对照组,亚健康人群为研究组,各45例。测量并分析两组的MPO、肌酸激酶同工酶和肌酸激酶水平,使用ROC曲线分析MPO、肌酸激酶同工酶和肌酸激酶水平对亚健康人群发生ACS的预测价值。结果:研究组的MPO、肌酸激酶同工酶、肌酸激酶水平均高于对照组,差异均有统计学意义(P<0.05)。ROC曲线分析,MPO水平的曲线下面积为0.92、灵敏度为0.93、特异度为0.88,其预测价值高于肌酸激酶同工酶和肌酸激酶水平。结论:相比较健康人群,亚健康人群的MPO水平会异常升高,对亚健康人群发生ACS具有重要的预测价值。通过检测MPO水平,可以发现亚健康人群潜在的心血管问题,为早期预防和治疗提供诊断依据,降低ACS的发生风险。

针刀五脏夹脊穴配合拔罐调理亚健康临床观察

目的在针刀医学理论的指导下,运用中医脏腑、经络理论结合脊柱相关源性亚健康的调理机制,观察针刀五脏夹脊穴配合拔罐调理亚健康的临床效果。方法60例亚健康状态者随机分为两组,针刀组(观察组)与针刺组(对照组),两组均采用五脏夹脊穴调理。观察组用针刀刺松穴位后,分别向督脉及膀胱经透刺,然后选取五脏夹脊穴进行拔罐;对照组取五脏夹脊穴针刺,得气后运用平补平泻的手法,留针20 min,出针后进行拔罐。21 d后观察两组的调理效果。结果调理后显示观察组总有效率为96.4%(27/28),高于对照组的77.8%(21/27)(P<0.05);观察组痊愈率为39.3%(11/28),高于对照组的22.2%(6/27)(P<0.01)。结论针刀五脏夹脊穴配合拔罐调理亚健康效果显著,并具有很好的发展前景,值得在临床上推广。

初中生校园欺凌与心理亚健康的关系

目的:探究初中生校园欺凌与心理亚健康的关系及心理韧性在其中的调节作用。方法:以武汉市2所初中10~14岁792名学生为研究对象。采用中文版Olweus欺凌问卷、青少年亚健康多维评定问卷及青少年心理韧性量表来测量学生的校园欺凌、心理亚健康和心理韧性水平。结果:受欺凌得分与心理亚健康得分正向关联(β=1.88);心理韧性得分在受欺凌得分与心理亚健康得分之间的调节作用有统计学意义(β=-0.07)。结论:初中生心理亚健康问题可能与受欺凌经历有关,心理韧性在受欺凌与心理亚健康的关系间可能有调节作用。

家庭与生活环境对青少年心理亚健康的影响研究

目的 探讨家庭与生活环境因素对青少年心理亚健康状态的影响,为制定青少年心理亚健康状态的干预措施提供参考依据。方法 于2021年5—6月,对重庆市主城某区的667名青少年进行心理亚健康调查。采用χ^(2)检验、二元Logistic回归模型分析家庭与生活环境因素对青少年心理亚健康状态及其各维度的影响。结果青少年心理亚健康状态的检出率为10.9%,情绪问题、品行问题和社会适应困难各维度的检出率分别为15.3%、23.2%和8.2%。二元Logistic回归分析显示,女生心理亚健康状态、情绪问题维度和品行问题维度检出率均高于男生,OR值分别为1.792(95%CI:1.037~3.095)、2.175(95%CI:1.331~3.554)和2.013(95%CI:1.297~3.125);自觉父母间关系不太好/很不好的青少年心理亚健康状态、情绪问题维度、品行问题维度和社会适应困难维度检出率均高于自觉父母间关系很好的青少年,OR值分别为4.706(95%CI:1.594~13.890)、3.642(95%CI:1.341~9.892)、3.436(95%CI:1.353~8.728)和4.103(95%CI:1.354~12.437);自觉家庭经济条件不好/很差的青少年品行问题维度检出率高于自觉家庭经济条件很好/比较好的青少年,OR值为2.923(95%CI:1.111~7.692);母亲在本地工作的青少年心理亚健康状态和情绪问题维度检出率低于母亲在外地工作的青少年,OR值为0.252(95%CI:0.081~0.779)和0.305(95%CI:0.101~0.921)。结论 性别、自觉父母间关系、自觉家庭经济情况和母亲是否外出务工是影响青少年心理亚健康状态及其各维度的重要因素。因此,应注重家庭环境对于保护青少年心理健康的重要性。

耳穴贴压联合五音疗法干预大学生肝郁化火型亚健康失眠临床研究

目的 探讨耳穴贴压联合五音疗法干预大学生亚健康失眠(肝郁化火型)的临床疗效。方法 将符合标准亚健康失眠(肝郁化火型)的62例大学生随机分为治疗组和对照组,每组各31例。治疗组采用耳穴贴压联合五音疗法进行干预治疗,7 d为一个疗程,共治疗2个疗程;对照组未采取任何干预措施。试验结果采用匹兹堡睡眠质量指数(pittsburgh sleep quality index, PSQI)、有效率、复发率以及患者反馈等指标进行综合评价,治疗结束后随访一个月的复发情况。结果 研究期间脱落5例视为无效病例,实际获得有效统计样本量57例,其中治疗组27例,对照组30例。治疗前,两组大学生PSQI评分无统计学差异(P>0.05);治疗后,治疗组大学生PSQI评分明显低于对照组(P<0.05),且治疗组的总有效率为92.60%(25/27),高于对照组40%(12/30)。两组治疗前后评分差值比较,治疗组评分下降的差值大于对照组(P<0.05)。治疗组经30 d随访复发率为18.18%(4/22)。结论 耳穴贴压联合五音疗法能有效缓解大学生亚健康失眠(肝郁化火型)的临床症状,提高睡眠质量,治愈后复发率较低,患者青睐度高,推荐临床选用。

父母教养方式与青少年心理亚健康的关系:挫商的中介效应

目的:探讨青少年群体中父母教养方式、心理亚健康、挫商三者间的关系,以及挫商在其中可能存在的中介效应,为早期预防青少年心理亚健康提供新的理论依据。方法:采用多阶段分层随机抽样,应用亚健康评定量表对我国广东省、黑龙江省、甘肃省、四川省和天津市5个省、直辖市1216名14~24岁“青少年”人群进行调查。对数据进行相关分析、偏相关分析以及类别变量的中介效应检验。结果:1父母教养方式与青少年心理亚健康得分(r=0.198,P<0.01)和挫商显著正相关(r=0.164,P<0.05),挫商与心理亚健康得分显著正相关(r=0.341,P<0.01);2与骄纵型管教方式相比,挫商在严厉型管教方式中起完全中介作用(a 1b=1.20),中介效应占比为38%;挫商在正面管教(相互尊重、共同制定规则)方式中起部分中介作用(a 2b=2.23),中介效应占比为28%。结论:积极、正面的父母教养方式有利于培养青少年的挫商,提升其应对逆境和抗挫折的能力,从而缓冲负性事件和压力带来的负面影响,有助于保持心理健康和个人发展。