Fecal-associated microbiome differences between traditional Chinese medicine qi-deficiency and balanced constitutions

Objective:To explore the structural and functional characteristics of the fecal-associated microbiome(FAM)in a traditional Chinese medicine(TCM)qi-deficiency constitution(QDC)by comparing with balanced constitution(BC)and screen the related biomarkers.Methods:In this cross-sectional study,the TCM constitutions of subjects were determined based on published the Classification and Determination of constitution in TCM and further confirmed by a TCM clinician.Clinical characteristics were recorded,and fecal samples were collected for 16S rDNA sequencing using the Illumina Miseq platform.The FAM structure was described using alpha-diversity indexes,beta-diversity indexes,and the relative abundances of the dominant taxa.Differences in the FAM distribution and function were analyzed with a Wilcoxon rank-sum test,MetagenomeSeq,and LEfSe analysis,after which a receiver operating characteristic curve based on the specific operational taxonomic units(OTUs)was constructed to calculate the area under the curve.Results:Our study population was composed of 22 BCs and 9 QDCs.There were no significant differences between the two groups in the distribution of clinical characteristics or alpha-diversity indexes,except for the sweets preference and blood glucose level.In principal coordinate analysis and partial least squares discriminant analysis,the bacterial communities in the BC group samples and QDC group samples clustered separately.Notably,there were 214 OTUs significantly distributed between groups in the MetagenomeSeq analysis,200 OTUs identified by the Wilcoxon rank-sum test,and 6 OTUs found by the LEfSe analysis.Predicted function analysis revealed that six metabolic pathways were distinctly distributed between the two groups.The area under the curve for the receiver operating characteristic curve based on the four specific OTUs was 0.88.Conclusion:Unique FAM structural and related functional characteristics are displayed in individuals with a QDC,and four specific OTUs could be used as QDC biomarkers to assist in clinical diagnosis.

Correlation between tobacco and alcohol use and Traditional Chinese Medicine constitutions: an analysis based on a sample from general population of China

OBJECTIVE:To investigate the relationship between smoking and drinking and constitution types from Traditional Chinese Medicine(TCM)theory.METHODS:The Constitution in Chinese Medicine Questionnaire(CCMQ)was used.A sample of 8448subjects from nine provinces and municipalities was chosen from the database of the TCM constitution and health status survey.Constituent ratio and correspondence analysis were used to find the relationship between smoking and drinking and TCM constitution.RESULTS:There was an association between smokinganddrinkingandtheGentleness,phlegm-dampness,and dampness-heat type constitutions.People that did not smoke tobacco or drink alcohol tended to have Yang-deficiency,Yin-deficiency,Qi-depression,Qi-deficiency,special diathesis,orblood-stasis type constitutions.CONCLUSION:There was a significant correlation between tobacco and alcohol use and TCM constitutions.To improve patient health,more attention should be paid to tobacco and alcohol control.

A Study on the Correlation Between Cerebral Small Vascular Disease and Constitution Types of Traditional Chinese Medicine

Objective:To study the correlation between cerebral small vascular disease and constitution types of Traditional Chinese Medicine(TCM).Methods:The severity of lacunar infarction and leukoaraiosis were graded in 230 patients with cerebral small vascular disease,and they were divided into TCM constitution types.The survey of TCM constitution types was carried out by using standardized TCM constitution scale,and order multivariate Logistic regression was used to analyze the correlation between TCM constitution types with severity of lacunar infarction and leukoaraiosis.Results:Yang-deficiency(阳虚)constitution,blood-stasis constitution and phlegm-dampness constitution were the most common TCM constitution types in patients with lacunar infarction,accounting for 33.7%,12.5%,11.5%respectively.Yang-deficiency constitution,blood-stasis constitution and Yin-deficiency(阴虚)constitution were the most common TCM constitution types in patients with leukoaraiosis,accounting for 28.8%,18.5%,13.7%respectively.There were significant differences in lacunar infarction of Yang-deficiency constitution and blood stasis constitution(P<0.05),and there were significant differences in leukoaraiosis of phlegmdampness constitution and blood-stasis constitution(P<0.05).Single factor analysis showed that the main risk factors of lacunar infarction were age,smoking,alcohol consumption,Yang-deficiency constitution and blood-stasis constitution,and the main risk factors of leukoaraiosis were age,smoking,hypertensive disease,phlegm-dampness constitution and blood-stasis constitution.The ordered multivariate Logistic regression analysis found that the severity of lacunar infarction was closely related to age,and the severity of leukoplosis was closely related to age,smoking and hypertension disease.Conclusion:TCM constitution types of lacunar infarction in patients with small cerebral vascular disease is mainly Yang-deficiency constitution and blood-stasis constitution,and the risk factors include age,smoking,alcohol consumption,Yang-deficiency constitution and blood-stasis constitution.Age is closely related with lacunar infarction.TCM constitution types with leukoaraiosis are mainly phlegm-dampness constitution and blood-stasis constitution,and the risk factors are age,smoking,hypertension disease,phlegm-dampness constitution and blood-stasis constitution.Age,smoking and hypertension disease are closely related with leukoaraiosis.

Fecal-associated microbiome differences between phlegm-dampness constitution and balanced constitution

Objective: This study aimed to explore the structural and functional characteristics of the fecalassociated microbiome(FAM) between the phlegm-dampness constitution(PDC) and balanced constitution(BC), and to screen the related specific operational taxonomic unit(OTU) biomarkers.Methods: This was a cross-sectional study. After strictly identifying the constitution of subjects, their clinical index was recorded and counted. Fecal samples were collected for 16S rDNA sequencing. Alpha diversity, beta diversity, and the relative abundance of dominant bacterial taxa were used to describe the FAM structure, and the Wilcoxon rank-sum test, Metagenome Seq, and linear discriminant analysis effect size(LEf Se) were used to screen specific bacterial taxa. Specific OTUs were screened to construct receiver operating characteristic(ROC) curves.Results: Thirty-two subjects were enrolled, including 22 subjects with BC and 10 subjects with PDC.There were significant differences in cold preference, levels of aspartate transaminase, β2-microglobulin,and creatine kinase MB, and alpha diversity indices(Shannon and Shannoneven) between the two groups. In principal coordinate analysis by abund-jaccard distance measure and partial least squares discriminant analysis, bacterial communities clustered separately between the two groups. Furthermore,based on Metagenome Seq, LEf Se, and the Wilcoxon rank-sum test, a total of 43, 18, and 130 OTUs were differentially distributed between BC group and PDC group, respectively, and OTU200, OTU133, and OTU353 were screened when P≤.01. The area under the ROC curve constructed from the 3 selected OTUs was 0.93.Conclusion: The FAM structure and related functional characteristics of the PDC group differed from those of the BC group. In particular, OTU200, OTU133, and OTU353 can be used as unique markers of PDC to assist clinical diagnosis.

Structure and function of the fecal-associated microbiome in qi stagnation constitution

Objective:To clarify the structural and functional characteristics of the gut microbiota in individuals with qi stagnation constitution(QSC)and identify the potential biomarkers related to QSC.Methods:This cross-sectional study involved individuals with QSC and balanced constitution(BC)confirmed by TCM clinicians.The clinical features were recorded,and fecal samples were collected for 16S rDNA sequencing.The structure of the fecal-associated microbiome(FAM)was described by the alpha-diversity indexes,beta-distances,and relative abundances of dominant taxa.The differences in FAM distribution were analyzed by the Wilcoxon rank-sum test,MetagenomeSeq,and LEfSe analysis.The 16S rDNA gene sequences were assigned to the KEGG dataset to predict the functional information of bacterial metabolic pathways by using PICRUSt.Differences in functional pathways between groups were assessed with the Wilcoxon rank-sum test.The ROC curve based on specific operational taxonomic units(OTUs)was constructed,and the AUC was calculated.Results:Twenty-two individuals with BC and 8 with QSC were recruited.Significant differences between the two groups were found in body mass index,health status,and low-density lipoprotein,etc.There was no significant difference in the alpha-diversity index.PCoA showed no evident clustering of bacterial communities according to constitutions.Bacteroidaceae,Lachnospiraceae,Ruminococcaceae,and Prevotellaceae were the four common bacteria with high abundances.Notably,MetagenomeSeq,LEfSe analysis,and the Wilcoxon rank-sum test identified significantly different distributions of 66,42,and 36 OTUs,respectively.Predictive function analysis showed that 13 metabolic pathways were significantly differentially distributed,including those related to fatty acid synthesis.Five specific OTUs were selected as potential biomarkers of a QSC,and the AUC was 0.94.Conclusion:Individuals with QSC have unique FAM structure and related functional characteristics.Five specific OTUs were identified to serve as potentially effective biomarkers related to QSC.

Characteristics of 240 randomized controlled trials for adjusting constitution in preventive treatment of disease:A bibliometric analysis

Background:A growing number of randomized controlled trials(RCTs)have explored the significance of adjusting constitution for preventive treatment of disease in traditional Chinese medicine(TCM).In this study,we sought to comprehensively analyze the characteristics of these RCTs.Methods:All RCTs related to constitutional adjustment and preventive treatment of disease were included in the study.Literature was screened searching seven databases,including Pubmed,Web of Science,Embase,SinoMed,CNKI,Chongqing VIP,and Wangfang Database,from inception to December 2018.Data pertaining to bibliometrics,participants,and interventions were extracted and analyzed.Results:Two hundred and forty papers were published between 2007 and 2018,involving 240 RCTs with 55977 total participants.Sample size in these RCTs ranged from 30 to 7800.Among them,59 RCTs addressed disease prevention prior to onset involving 11 healthy states of participants,mainly for general health or sub-health population(40.68%)using health care and non-drug therapy.In control the development of existing disease(n Z 174),59 diseases were involved.Based on the number of RCTs and sample sizes,diseases including type 2 diabetes mellitus,primary hypertension,nonalcoholic fatty liver disease,and hyperlipoproteinemia accounted for 51.15%of the total patients studied.Drug therapy as an intervention was frequently used.In preventing recurrence after recovery(n Z 7),over 4 kinds of health status in participants were involved.Drug therapy combined with health care was mostly used.Most RCTs reported positive outcomes,with only one reporting negative findings(1/240).Conclusion:The number of RCTs of constitutional adjustment on preventive treatment of disease has gradually increased since 2012.Participants and intervention measures from the above-mentioned types of RCTs exhibit their own characteristics.Future systematic reviews or meta-analyses on constitutional adjustment for preventive treatment of disease are warranted.

Study on Sleep Quality and TCM Constitution of Patients with General Tonic-clonic Epilepsy

Objective:To explore the relationship between interseizure sleep quality and Traditional Chinese medicien(TCM)constitution in patients with generalized tonic-clonic epilepsy,and to provide theoretical and practical basis for improving sleep quality and better controlling epileptic seizures by adjusting biased constitution of epilepsy patients.Methods:Two hundred and thirty eight epilepsy patients who met the standard and went to the epilepsy clinic of Neurology Department of Shanxi Provincial People's Hospital were sampled conveniently.Collect basic information such as age,gender and course of disease,and test and fill out"TCM Body Mass Table"to judge TCM constitution type,"Pittsburgh Sleep Quality Index Scale"to judge sleep quality grade,and useχ^(2) test to infer whether there is any difference in sleep quality of patients with different ages,genders and course of disease;Rank sum test was used to infer whether there were differences in sleep quality among different constitutions.Results:There was no significant difference in sleep quality among patients with different age,sex and course of disease(P>0.05).There were significant differences in sleep quality among patients with different constitutions(P<0.001).Among them,the number of peaceful quality groups accounted for 44.31%,and the number of biased quality groups accounted for 55.69%;There were statistically significant differences in sleep quality between calming and qi deficiency,yang deficiency,blood stasis,damp-heat,qi stagnation and yin deficiency(P<0.05);There was a significant difference between phlegm-dampness quality and qi stagnation quality in sleep quality(P<0.05).Conclusion:The sleep quality of patients with epilepsy with mild constitution is significantly higher than that of patients with biased constitution such as qi deficiency,yang deficiency,yin deficiency,damp-heat,blood stasis and qi stagnation.In addition to phlegmdampness quality and Qi stagnation quality of patients sleep quality comparison,the biased constitution of patients sleep quality were not statistically significant.Therefore,in the long-term process of drug treatment of epilepsy,we can adjust the biased constitution of most patients,improve sleep,and then better control the seizure.

Logistics Regression Analysis between TCM Constitution Types of Patients with Hypertension,Insomnia and ABPM,PSQI

[Objectives]The research aimed to explore the distribution characteristics of TCM constitution types of patients with hypertension and insomnia,and study the clinical characteristics of patients with different constitutions,in order to provide new ideas for the treatment of patients with hypertension and insomnia.[Methods]Cross sectional observation method was used,and 420 patients with hypertension and insomnia were selected.Required information was collected,and the constitution type of traditional Chinese medicine was determined,and relevant data were recorded.SPSS and Logistic regression analysis method were used to explore the correlation between the distribution of TCM constitution types and gender,age,24 h-SBP,24 h-DBP,24 h-BPV,PSQI score,etc.[Results]Among 420 patients,the proportion of gentleness constitution was the most,and others in turn were Qi deficiency constitution>Yang deficiency constitution>phlegm dampness constitution>Qi stagnation constitution>Yin deficiency constitution>blood stasis constitution>damp heat constitution>special constitution.Among male patients,the proportion of gentleness constitution was the most.Among female patients,the proportion of Qi deficiency constitution was the most.In each constitution,the proportion of men and women was different,and the difference in gentleness constitution,Qi deficiency constitution and Yin deficiency constitution had statistical significance(P<0.05).The proportion of gentleness constitution for young and middle-aged patients was the most,while elderly patients with Qi deficiency constitution was the most.There was difference in the distribution of TCM constitution in different age groups,and the difference had statistical significance(P<0.05).Compared with the patients with gentleness constitution,the patients with Qi deficiency constitution,Yang deficiency constitution,Yin deficiency constitution,damp heat constitution,blood stasis constitution and Qi stagnation constitution had different differences in terms of age,24 h-SBP,24 h-DBP,24 h-BPV and PSQI score,and there was statistical significance(P<0.05).Except damp heat constitution,blood stasis constitution and special constitution,other constitutions had certain correlation with age,24 h-SBP,24 h-DBP,24 h-BPV and PSQI score.[Conclusions]TCM constitution types of patients with hypertension and insomnia were dominant by gentleness constitution,Qi deficiency constitution and Yang deficiency constitution.The distribution of TCM constitution in different gender and age groups was different,and different TCM constitution was related to ABPM and PSQI.

Optimal exercise intensity and volume to impact rats with Traditional Chinese Medicine phlegm-dampness constitution

Objective:We aim to investigate the effects of different exercise intensities and volumes on Phlegm-dampness constitution(PDC).Methods:The rats were fed with high-fat food and lived in 75%–85%humidity for 6 weeks to establish the model of PDC.Then PDC rats were screened and intervened by varying exercise intensities for 8 weeks.Weight,constitution scores,blood and liver tissues were collected to detect the concentration of serum total cholesterol(Tch),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),homocysteine(Hcy),blood glucose(GLU),alanine transaminase(ALT)and percentage of lipid droplet area in liver tissue(PLDA).Results:The weight,Tch,TG,HDL-C,LDL-C,Hcy,GLU,and ALT of rats in moderate-intensity exercise group returned to normal.The rats with high-intensity or low-intensity exercise did not recover as well as moderate-intensity.Conclusion:Different exercise intensities and volumes have different effects on PDC,moderate-intensity exercise over an 8-week intervention is most appropriate.

Expression profiling-based clustering of healthy subjects recapitulates classifications defined by clinical observation in Chinese medicine

Differences between healthy subjects and associated disease risks are of substantial interest in clinical medicine. Based on clinical presentations, Traditional Chinese Medicine （TCM） classifies healthy people into nine constitutions： Balanced, Qi, Yang or Yin deficiency, Phlegm-dampness, Damp-heat, Blood stasis, Qi stagnation, and Inherited special constitutions. In particular, Yang and Yin deficiency constitutions exhibit cold and heat aversion, respectively. However, the intrinsic molecular characteristics of unbal- anced phenotypes remain unclear. To determine whether gene expression-based clustering can reca- pitulate TCM-based classification, peripheral blood mononudear cells （PBMCs） were collected from Chinese Han individuals with Yang/Yin deficiency （n = 12 each） and Balanced （n = 8） constitutions, and global gene expression profiles were determined using the Affymetrix HC-UI33A Plus 2.0 array. Notably, we found that gene expression-based classifications reflected distinct TCM-based subtypes. Consistent with the clinical observation that subjects with Yang deficiency tend toward obesity, series-clustering analysis detected several key lipid metabolic genes （diacylglycerol acyltransferase （DGAT2）, acyl-CoA synthetase （ACSL1）, and ATP-hinding cassette subfamily A member 1 （ABCAI）） to be down- and up- regulated in Yin and Yang deficiency constitutions, respectively. Our findings suggest that Yin]Yang deficiency and Balanced constitutions are unique entities in their mRNA expression profiles. Moreover, the distinct physical and clinical characteristics of each unbalanced constitution can be explained, in part, by specific gene expression signatures.

Distributions of Sasang constitutions and six syndromes in patients with functional dyspepsia and healthy subjects

OBJECTIVE:To investigated the characteristics of patients with functional dyspepsia(FD)in terms of Sasang constitutional medicine.METHODS:A total of 116 patients with FD were recruited based on diagnosis by gastroscopy and symptomatic measurements.The distributions of Sasang constitutions and six syndromes in terms of TKM theory in the patients was compared with those from 1423 healthy subjects.RESULTS:The distribution of Sasang constitutions for the patients with FD significantly differed from that for healthy subjects,especially among women;36.7%vs 45.6%for Taeumin,28.9%vs 33.9%for Soumin,and 34.4%vs 20.4%for Soyangin.Our results assumed a high prevalence in Soyangin women(around 1.7 folds),and Soumin(45.2%),inparticular,had a high prevalence of"deficiency and coldness of spleen and stomach"compared with Taeumin(14.9%)and Soyangin types(15.7%).CONCLUSION:This study identified a trend for the frequency of FD and the Sasang constitutions.The findings may provide new ideas for the study of prevention and management of FD.