中医偏颇体质与亚健康状态转化关系

Relationship between abnormal constitution and transformation of subhealth status: a prospective cohort study

目的 探讨中医偏颇体质与亚健康状态转化的关系。方法 采用前瞻性队列研究方法 ,将入选的2 980名亚健康者分为偏颇体质组（暴露组）及平和体质组（非暴露组）,分析中医偏颇体质对亚健康状态转化的相对危险度。结果 基线分析发现亚健康人群较易出现偏颇体质倾向（85.60%）;基线偏颇体质的亚健康者随访转化为健康者低于基线平和体质者（9.13%vs.32.87%,P=0.000）,而偏颇体质的亚健康者随访转化为疾病者明显高于平和体质者（26.03%vs.14.92%,P=0.000）;调整性别、年龄、婚姻状况、体质指数（BMI）等混杂因素后,基线偏颇体质的亚健康者转化为健康状态的RR值为0.197（95%CI=0.153~0.254,P=0.000）,而转化为疾病状态的危险度是平和体质者的2.508倍（95%CI=1.851~3.397,P=0.000）;进一步分析发现,调整基线得分后,偏颇体质者随访时亚健康总分,生理、心理、社会总分及其各维度得分均较平和体质者低（均P=0.000）。结论 中医偏颇体质是亚健康状态转化的重要危险因素之一,其较难实现健康的恢复,而更容易增加疾病的风险,调理偏颇体质显得格外重要。

Objective To explore the relationship between traditional Chinese medicine （TCM）-defined abnormal constitution and the transformation of sub-health status. Methods Prospective cohort design and the ＂Sub-Health and TCM Constitutions Measurement Scale＂ were adopted in the study. Totally 2 980 residents with sub-health conditions were recruited with random cluster sampling from 7 cities in Guangdong province. Based on the results of a baseline ques- tionnaire survey and physical examination, the participants were categorized as abnormal constitution（ experiment group） and normal constitution （control group）according TCM criteria. All the participants were followed-up from May 2012 through October 2014 and the difference in the transformation from sub-health to health status between the two groups was analyzed by the end of the follow-up. Results The prevalence rate of abnormal constitution was 85.60% among the participants at the baseline survey. Compared with the participants with normal constitution at the baseline survey, those with abnormal constitution showed a significantly lower ratio of transformation from sub-health to health（9.13% versus 32.87% ,P =0. 000） ,but a significantly higher ratio from sub-health to disease（26. 03% versus 14. 92% ,P = 0. 000） at the end of the follow-up, with the relative risk （RR） of 0. 197 （ 95% confidence interval [ 95% CI] ： 0. 153 - 0. 254, P =0. 000） for sub-health to health and 2. 508（95% CI= 1. 851 -3.397,P =0. 000） for sub-health to disease after adjus- ting for gender, age, marital status, and body mass index; in addition, at the the end of the follow-up, the participants with abnormal constitution had significantly lower mean scores for overall sub-health and physiological,psychological, and so- ciological domains after adjusting the scores at baseline survey （ all P = 0. 000）. Conclusion Abnormal constitution is one of the risk factors associated with the change in sub-health status and the persons with abnormal constitution have a higher risk for the transformation from sub-health to disease and are less likely to recover to healthy status, suggesting the importance of manipulating abnormal constitution in the people with sub-health.