组态视角下中医体质与健康相关生命质量的关系研究

A configurations perspective on the impact of traditional Chinese medicine constitutions on health-related quality of life

目的对中医体质健康状态进行整体综合分析,探讨不同的兼夹体质组态对健康相关生命质量(HRQOL)的影响。方法采用方便抽样法,应用中医体质量表-41条目简短版、简明健康状况调查问卷中文版等工具对18~60岁无偿献血人群施测,运用模糊集定性比较分析探索影响HRQOL的中医体质组态。结果纳入分析的研究对象共2254名,平均年龄(30.72±9.78)岁。平和质占35.71%,3种以上偏颇体质兼夹占33.81%。负向影响生理领域HRQOL的中医体质组态有3类,一是以非平和质、气虚质、阳虚质、痰湿质、血瘀质为核心条件;二是以非平和质、气虚质、痰湿质、血瘀质、特禀质为核心条件;三是8种偏颇体质都为核心条件出现。负向影响心理领域HRQOL的中医体质组态有3类,一是以非平和质、气虚质、痰湿质、血瘀质、气郁质为核心条件;二是以非平和质、气虚质、阴虚质、湿热质、气郁质为核心条件;三是8种偏颇体质都为核心条件出现。结论本研究以组态视角的模糊定性比较分析方法,揭示了中医体质对HRQOL的影响是一种多要素组合的并发机制。本研究充分分析了兼夹体质的多样性及其与HRQOL关系的复杂性,为研究者更深入地挖掘体质调护、提升生命质量的干预路径提供参考方向。

Objective A holistic and comprehensive analysis of traditional Chinese medicine(TCM)constitutions health states was conducted to explore the impact of different concurrently clamped constitution histories on health-related quality of life(HRQOL).Methods Using the convenient sampling method,the Constitution in Chinese Medicine Questionnaire-41 entry short version,the Chinese verison of SF-36,and other tools were used to measure the unpaid blood donor population aged 18 to 60 years old,and the fuzzy set qualitative comparative analysis was used to explore configuration of the TCM constitution that affected HRQOL.Results The mean age of the 2254 study subjects included in the analysis was(30.72±9.78)years.The percentage of gentleness constitution was 35.71%,and 33.81%had a combination of more than 3 types biased constitutions.Three categories of TCM constitution groupings negatively influenced HRQOL in the physiological domain.First,non-gentleness constitution,qi-deficiency constitution,yang-deficiency constitution,phlegm-wetness constitution,and blood-stasis constitution were the core conditions;second,non-gentleness constitution,qi-deficiency constitution,phlegm-wetness constitution,blood-stasis constitution and special diathesis constitution were the core conditions;and third,all eight biased constitutions were present as core conditions.Three categories of TCM constitution groupings negatively influenced HRQOL in the psychological domain.First,non-gentleness constitution,qi-deficiency constitution,phlegm-wetness constitution,blood-stasis constitution,and qi-depression constitution were the core conditions;second,non-gentleness constitution,qi-deficiency constitution,yin-deficiency constitution,wetness-heat constitution,and qi-depression constitution were the core conditions;and third,all eight biased constitutions occurred as core conditions.Conclusion The fuzzyset qualitative comparative analysis method with a configuration perspective revealed the effect of TCM constitution on HRQOL as a multi-component combination of concurrent mechanisms.The diversity of concurrently clamped constitution and the complexity of its relationship with HRQOL were fully analyzed,and this results provide a reference direction for researchers to dig deeper into the intervention pathways of TCM constitution conditioning to enhance quality of life.