疫学からみた高齢者の胃病変

An Epidemiological Approach to Gastric Diseases in the Aged Person

　臨床医学はいわばcase studyの集積を中心にした，経験からの治療を主体とする学問であるのに対し，疫学は人間集団を対象として人間の健康および異常の原因を宿主，病因，環墳の各面から包括的に考究し，その増進と予防をはかる学問である¹⁾．ある意味では集団病理学あるいは社会病理学といわれることもある．

　したがって疫学は人間の集団のなかで疾病を含む健康事象がどのような頻度で分布し，それが時間的にどのように変動するかを測定し，そのような分布に対してどのような要因が働いているかを異なった条件下での事象の発現と比較することによって明らかにする．その意味では疫学は決して基礎医学のなかで扱われるべき内容ではなく臨床医を含めた社会医学のなかでこそ問題にされるべきものであろう．

　Gastric diseases including cancer, peptic ulcer, polyps and atrophic gastritis are common among Japanese. Until now, however, their etiology has been discussed mainly from clinical and rarely from epidemiological points of view. At present, the evaluation for these diseases are demanded from the standpoint of people's health preservation or preventive medicine.

　In this paper, in order to characterize the gastric diseases in the aged person, we have performed a comparative study of their mortality and morbidity rates with reference to sex and age of patients. Furthermore, the evaluation of the features of gastric diseases compared with foreign countries was done from the following two points; the mortality rates of Japanese in USA, and the incidence of diseases on the endoscopical examinations in Japan and in West Germany by the same doctor.

　As a result, it was proved to be important that the diagnostic levels of a disease should be as equal as possible in all countries. If not so, the international comparison of the morbidity rates of a disease would be almost impossible. Therefore, it is desirable that not only fundamental but also clinical medicine pay a great attention to the epidemiology.