Characteristics and demographic factors of traditional Chinese medicine constitution types among elderly individuals in China:A national multistage cluster random study Author links open overlay panel

Objective:To reveal the distribution characteristics and demographic factors of traditional Chinese medicine(TCM)constitution among elderly individuals in China.Methods: Elderly individuals from seven regions in China were selected as samples in this study using a multistage cluster random sampling method.The basic information questionnaire and Constitution in Chinese Medicine Questionnaire(Elderly Edition)were used.Descriptive statistical analysis,chi-squared tests,and binary logistic regression analysis were used.Results: The single balanced constitution(BC)accounted for 23.9%.The results of the major TCM constitution types showed that BC(43.2%)accounted for the largest proportion and unbalanced constitutions ranged from 0.9%to 15.7%.East China region(odds ratio[OR]=2.097;95%confidence interval[CI],1.912 to 2.301),married status(OR=1.341;95%CI,1.235 to 1.457),and managers(OR=1.254;95%CI,1.044 to 1.505)were significantly associated with BC.Age>70 years was associated with qi-deficiency constitution and blood stasis constitution(BSC).Female sex was significantly associated with yang-deficiency constitution(OR=1.646;95%CI,1.52 to 1.782).Southwest region was significantly associated with phlegm-dampness constitution(OR=1.809;95%CI,1.569 to 2.086).North China region was significantly associated with inherited special constitution(OR=2.521;95%CI,1.569 to 4.05).South China region(OR=2.741;95%CI,1.997 to 1.3.763),Central China region(OR=8.889;95%CI,6.676 to 11.835),senior middle school education(OR=2.442;95%CI,1.932 to 3.088),and managers(OR=1.804;95%CI,1.21 to 2.69)were significantly associated with BSC.Conclusions: This study defined the distribution characteristics and demographic factors of TCM constitution in the elderly population.Adjusting and improving unbalanced constitutions,which are correlated with diseases,can help promote healthy aging through the scientific management of these demographic factors.

Revision and validation of the“Constitution in Chinese Medicine Questionnaire(Elderly Edition)”based on the Delphi process

Objective:This study aimed to revise the Constitution in Chinese Medicine Questionnaire(Elderly Edition)(CCMQ-EE),as well as evaluate its reliability and validity.The objective was to provide a more accurate Chinese medicine constitution identification tool for geriatric health management and help further research on the relationship between geriatric diseases and constitution type,etc.Methods:The Delphi method and a cross-sectional survey of the elderly population were used.From April to October 2021,experts in different fields were invited to participate in the questionnaire,and items were revised through the experts'ratings and feedback.From December 2021 to February 2022,the revised CCMQ-EE was validated in the elderly population.Results:The coefficients of variation of rationality and importance scores decreased to less than 0.25 in the third round of Delphi.The Kendall coordination coefficients of rationality and importance in the third round were 0.15 and 0.17(P=.031 and P=.007,respectively).The revised CCMQ-EE was established with 34 items.The factor loadings of subscales were between 0.39 and 0.92,and the fitting effects of other subscales were acceptable,except for the inherited special constitution.The Cronbach alpha and test-retest reliability coefficients of each subscale ranged from 0.65 to 0.83,and 0.66 to 0.96,respectively.The composite reliability and average variance extraction were between 0.66 and 0.84,and between 0.32 and 0.57,respectively.The reliability and validity of the revised CCMQ-EE were acceptable or satisfactory.Conclusion:The revised CCMQ-EE was developed through a three-round Delphi process and internal team discussion.After the verification in the elderly in Beijing area,its measurement performance was good.The updated questionnaire can probably replace the initial version to better promote health management and help healthy aging by identifying the constitution type of the elderly.

Translation, Adaptation and Validation of a Chinese Medicine Questionnaire to Brazilian Portuguese

The Constitution in Chinese Medicine Questionnaire [CCMQ] organizes 9 body constitutions according to Traditional Chinese Medicine [TCM]. The translation was realized by a Medical Doctor [MD] specialized in TCM and the back translation by an english-speaking MD. Comprehensibility assessment was performed (N = 40, main scores ranged from 4.20 to 4.95). On the test-retest reliability Cronbach’s alpha was 0.920 in the first application and 0.943 in the second, the intraclass correlation scores ranged between good and excellent (0.6 - >0.80). The results show that the adaptation of the CCMQ is valid and ready to be used.

Development and evaluation of short form of constitution in Chinese medicine questionnaire:a national epidemiological survey data of 21948 cases

OBJECTIVE:To develop the best short form of constitution in Chinese medicine questionnaire(CCMQ)and evaluate its psychometric properties in Chinese population.METHODS:A total of 21948 subjects were used to refine the short form.Correlation coefficient,exploratory factor analysis(EFA)and Cronbach's alpha coefficient were used to analyze and select items to form the short form.Separate sample of 205 subjects were collected to further evaluate the short from.EFA,confirmatory factor analysis(CFA),item-scale correlation,discriminant validity,internal consistency reliability and split-half reliability were carried out to evaluate the short form.RESULTS:The short form CCMQ included 26 items.Seven common factors of characteristic root>1 were extracted to explain 58.488%of the total variation.Result of CFA was consistent with the 9-factors structure.The mean differences of Blood-stasis body constitution and Qi-stagnation body constitution had statistical significance in body mass index differentiation.Cronbach's alpha coefficient of short form CCMQ was 0.863.The split-half reliability of total scale was 0.813,and each scale was 0.568-0.770.The item-scale correlations ranged from 0.620-0.849.CONCLUSION:The short form CCMQ consisted of 26 items with good psychometric properties.The short form should be recommended for the measurement of health of Chinese population in any clinical trial.

Physical and mental health conditions of young college students with different Traditional Chinese Medicine constitutions in Zhejiang Province of China

OBJECTIVE: To investigate Traditional Chinese Medicine(TCM) constitutions of youths in colleges,and their physical and mental health conditions of different TCM constitutions, so as to provide a theoretical basis for the TCM way to improve young people's physical and mental health.METHODS: The Standard TCM Constitutions' Classification and Determination Questionnaire was used to measure the body health condition, and the Symptom Checklist 90 Questionnaire and the Questionnaire of the National Student Physical Health Standards were used to determine mental and physical health conditions respectively in 1421 young participants validly answering the questionnaires in Zhejiang Province.RESULTS: The participants had a mean age of 19.96years(SD = 0.95 years) with the majority of females(55.10%). One fourth of the 1421 participants were the Ping-he constitution and others were the tendency constitutions. Participants with Ping-he module(which has characteristics of moderate posture,rosy, energetic and is a healthy condition in TCM)were healthier than those with tendency constitutions in physical and mental health, with 65.81 ±7.83(men) and 77.99 ± 7.24(women) scores in the physical test and around 1.25 scores in the mental health test. College students with combined biased constitutions were more likely suffer force, sensitive, depression and anxiety.CONCLUSION: Most of college students have a tendency or biased constitution which could be more likely to suffer suboptimal health status and diseases. Youths in college themselves and health providers should pay more attention to their potential health issues and make proper healthcare plan according to their own TCM constitution.

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.

广西6所高校女大学生原发性痛经影响因素与体质调查研究

目的:调查分析广西6所高校女大学生原发性痛经的影响因素和中医体质类型。方法:对广西6所高校的女大学生发放网络问卷开展调查,调查内容包括基本资料、月经情况、痛经情况、痛经缓解措施、痛经影响因素及中医体质类型。结果:共收到734份调查问卷,剔除71份不符条件的问卷,得到有效问卷663份。调查人群中原发性痛经394人,占59.4%。痛经缓解措施选择上,大部分患者采用热敷腹部和服用止痛药。痛经患者与健康人群月经中血块量、情绪状况及饮食偏嗜情况比较,差异均有统计学意义(P<0.05)。痛经患者与健康人群月经初潮年龄、月经周期是否规律、月经量、月经颜色、月经质地、睡眠情况及运动情况比较,差异均无统计学意义(P>0.05)。Logistic二元回归分析结果显示,广西6所高校女大学生痛经的主要危险因素是月经中有少量和大量血块,情绪上多思、多虑、急躁易怒,饮食上喜食热食、热饮和喜爱冰品、冷饮。原发性痛经患者中,平和质、兼夹体质、气虚质、阳虚质占比较大;健康人群中,平和质、气虚质、兼夹体质占比较大。原发性痛经患者与健康人群兼夹体质、平和质与阳虚质占比比较,差异均有统计学意义(P<0.05)。结论:原发性痛经发病与中医体质类型息息相关,兼夹体质和阳虚质者原发性痛经发病风险大于健康人群,平素保持心情愉悦、少食生冷饮品,并根据自身体质类型选择科学的生活方式有利于防治痛经。

基于遗传算法与KNN融合的中医体质量表简化研究

目的针对中医体质量表在评估个人体质时条目多和填写时间久的问题,研究利用人工智能技术进行属性选择,帮助构建中医体质量表简短版本。方法分析由江苏省中医院体检科提供的中医体质数据,其中有特定的目标变量作为体质类型的分类。采用遗传算法的特征选择、交叉验证和KNN分类算法作为过滤器筛选问题,并通过问题子集规模、KNN分类准确率和填写时间评估效果。结果该方法选择出具有31个问题的中医体质量表简短版本,且在模型中的分类平均准确率为86.16%,时间提快了48.5%。结论该算法可以有效地找出较好的问题子集,实现降维并有一定的准确性,从而帮助简化中医体质量表。

18805例中国成年人中医体质类型与超重和肥胖关系的Logistic回归分析

目的:探索中医体质类型与超重和肥胖的相关性,为调整体质偏颇、防治肥胖提供依据。方法:汇集我国9省市(江苏、安徽、甘肃、青海、福建、北京、吉林、江西、河南)中医体质横断面调查18岁以上人群的数据18 805例。中医体质调查采用标准化的中医体质量表,体质类型(平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质)的判定应用判别分析法。采用Logistic回归分析方法探索中医体质类型与超重和肥胖的关系。结果:与平和质相比,痰湿质者超重(OR,2.05;95%CI,1.79-2.35)和肥胖(OR,4.34;95%CI,3.52-5.36)的危险度均显著增高,气虚质者肥胖(OR,1.60;95%CI,1.30-1.98)危险度显著增高,而阳虚质、血瘀质、气郁质超重和肥胖的危险度显著降低。结论:痰湿质、气虚质是超重和肥胖的主要体质影响因素。

8448例一般人群的中医体质类型与健康状况关系的分层分析

目的:以性别或年龄为分层因素,探讨一般人群的中医体质类型与健康状况的关系。方法:从中国9省市(江苏、安徽、甘肃、青海、福建、北京、吉林、江西、河南)横断面中医体质和健康状况调查21948例数据库中,随机抽取性别和年龄结构与2005年中国15岁以上人口比例基本一致的8448例组成本研究样本。采用Nemenyi检验,研究不同性别或年龄人群的9种基本中医体质类型(平和质之外的气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质8种体质类型均为偏颇体质)与健康相关生命质量量表简明健康状况调查问卷(Medical Outcomes Study36-ItemShort-Form Health Survey,MOS SF-36)得分的关系。结果:不同性别或年龄人群的8种偏颇体质MOS SF-36得分显著低于平和质(P<0.05)。以性别为分层因素,男性气虚质(生理领域以及生理机能、生理职能、一般健康状况和精力4个维度)、气郁质(心理领域以及社会功能、情感职能和精神健康3个维度)、血瘀质(躯体疼痛维度)MOS SF-36得分最低,女性痰湿质(生理领域以及生理机能、生理职能、躯体疼痛、一般健康状况和社会功能5个维度)、气郁质(心理领域以及情感职能和精神健康2个维度)、气虚质(精力维度)MOS SF-36得分最低。以年龄分层,15～34岁年龄组特禀质(生理领域以及生理机能、生理职能和一般健康状况3个维度)、气郁质(心理领域以及精力、社会功能、情感职能和精神健康4个维度)、血瘀质(躯体疼痛维度)MOS SF-36得分最低,35～59岁年龄组气虚质(生理领域以及生理机能、生理职能和一般健康状况3个维度)、气郁质(心理领域以及精力、社会功能、情感职能和精神健康4个维度)、血瘀质(躯体疼痛维度)MOS SF-36得分最低,60岁以上年龄组气虚质(生理领域以及生理机能、生理职能和一般健康状况3个维度)、气郁质(心理领域以及精力、社会功能、情感职能和精神健康4个维度)、痰湿质(躯体疼痛维度)MOS SF-36得分最低。结论:不同性别或年龄人群的8种偏颇体质与平和质比较,MOS SF-36得分均显著降低,健康状况较差;不同中医体质类型的健康状况因性别或年龄呈现出不同的特点。

中医体质量表-41条目简短版的结构效度和反应度评价

目的分析中医体质量表-41条目简短版的结构效度和反应度,评价该量表辨识中医体质的应用价值。方法选取2013年2月—2014年7月于广东省中医院珠海医院自愿接受治未病并完成26周中医体质综合干预的509例受试者为调查对象。依据干预前的体质判定结果,调查对象均自行实施干预措施并记录,并由专业医生进行监督和指导。分别于干预前和干预26周后,调查对象自行填写中医体质量表。采用因子分析评价中医体质量表-41条目简短版的结构效度;通过比较干预前后各条目及各亚量表得分,并计算变化率(CR)、效应量(ES)、标准化反应均数(SRM)评价反应度。结果因子分析显示,提取的8个公因子解释的方差贡献率均≥4.00%,累积解释的方差贡献率53.57%;特征根均>1.00,主要支配的条目与8种偏颇体质基本对应,形成较好的解释。调查对象干预前后条目26、44、49、52得分比较,差异无统计学意义(P>0.05);其余条目干预后得分低于干预前(P<0.05)。各条目平均CR(绝对值)、ES(绝对值)、SRM(绝对值)分别为7.81%、0.16、0.20。调查对象干预后平和质亚量表得分高于干预前,气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质亚量表得分低于干预前(P<0.05)。各亚量表平均CR(绝对值)、ES(绝对值)、SRM(绝对值)分别为12.79%、0.25、0.35。结论中医体质量表-41条目简短版结构明确、反应度良好,具有较高的测量价值。

大学生睡眠质量与体质类型相关性的研究

目的探讨大学生睡眠质量状况与体质类型分布特点及二者相关性。方法采用匹兹堡睡眠质量指数(PSQI)量表与中医体质评定量表,对5 202例大学生的PSQI各因子及总分与中医体质分布情况进行统计描述与分析。结果大学生睡眠问题检出率为44.4%(2 309/5 202)。存在睡眠质量问题大学生偏颇体质占98.5%(2 275/2 309),其中偏颇体质以阳虚体质最多。2 309例存在睡眠质量问题的大学生PSQI量表睡眠时间与阳虚质、阴虚质呈正相关;睡眠效率、睡眠障碍与阴虚质、湿热质呈正相关;入睡时间、睡眠时间、睡眠效率与痰湿体质呈负相关;睡眠质量各指标均与平和质呈负相关。结论大学生睡眠质量较差,睡眠质量与其体质类型存在内在相关性。

中医体质量表的信度和效度评价

目的对开发的60个条目构成的、包含9个亚量表的中医体质量表进行信度、效度评价。方法2005年6月～2006年3月，以我国东西南北中5个地域的自然人群和体检中心15岁以上、获得知情同意的2500人为调查对象（包括健康者和患病者）实施调查。通过量表的回答时间和量表的各个条目的回答率评价其实用性。在对各个亚量表用相关系数评价再现性的基础上，进一步用Cronbaeh’s α系数评价亚量表内条目的一致性。以中医体质量表与健康状况调查问卷SF-36的相关系数评价其效标效度。结果量表的回答时间平均为12min，60个条目回答率都很高（99％～100％）。9个亚量表得分的再现性相关系数为0．76～0．90，9个亚量表的内部一致性系数为0．72～0．80。与健康状况调查问卷的效标效度的评价结果显示，平和质呈显著正相关（r=0．58，P〈0．01），而各个偏颇体质类型呈显著负相关（r=-0．38～-0．54，P〈0．01）。依据BMI分组，以t检验进行分析的结果，中医体质量表痰湿质、气虚质、阳虚质3个亚量表得分存在显著差异（P〈0．01或P〈0．05）。结论中医体质量表具有较好的信度和效度，可以认为中医体质量表是一个性能良好的测评工具。

中医阳虚质相关影响因素的研究

目的探索中医阳虚质的主要相关影响因素。方法以我国东西南北中5个地域的自然人群和体检中心15岁以上、获得知情同意的2230人为调查对象(包括健康者和患者)实施横断面现场调查。采用标准化的中医体质量表测评阳虚质得分,应用单因素分析和多元逐步回归分析法分析主要影响因素。结果根据多元逐步回归分析入选了7个因素,按影响程度大小依次是:患有慢性疾病、女性、不喜运动、喜热饮食、体型偏瘦、喜清淡饮食、出生后非母乳喂养。结论疾病因素、性别差异、运动习惯、饮食因素、体型因素是阳虚质的主要相关影响因素。

简短版中医体质量表的初步设置与考评

目的设置简短版中医体质量表,并进行初步考评。方法本研究总样本量为4 940例,由6部分方便抽样法获得数据组成,分别为:2007年9月—2008年5月选取的河南省开封市体检人员1 632例,2012年7—10月选取的江西省瑞金市体检人员466例,2012年9月—2013年8月选取的安徽省合肥市体检人员519例,2013年2月—2014年1月选取的广东省珠海市体检人员595例,2015年1—12月选取的北京市体检人员1 044例,2015年7—12月选取的北京市无偿献血人员684例。采用随机数字表法,抽取2/3样本量为训练组(n=3 293),余1/3样本量为考核组(n=1 647)。采用中医体质量表进行调查,基于训练组对原量表条目进行分析和筛选,基于考核组对简短版中医体质量表进行考评。结果最终形成的简短版中医体质量表包含平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质及特禀质9个亚量表,共41个条目,与原量表相比条目数减少了约1/3。其中,28个条目的标准差>1.000,40个条目的相关系数≥0.300,各亚量表的克朗巴赫系数均>0.600;各条目区分度参数均>0.80,21个条目的难度参数为-3.00~3.00。结论 41条目简短版中医体质量表的考核结果较好,有利于提高中医体质辨识效率、促进中医体质辨识推广。后续工作应围绕量表的试用、调适及评价展开。

论《中医体质量表》的修订

《中医体质分类与判定》标准及《中医体质量表》自正式颁布以来,已被广泛应用于科研、临床和健康管理。然而在多年的使用过程中,不少学者发现体质判定标准及体质量表自身存在一定问题,给体质辨识造成困惑。通过梳理目前体质量表的应用现状及有关体质量表应用中存在的问题,发现《中医体质量表》及《中医体质分类与判定》标准的修订具有可行性和必要性。

924例军事飞行人员中医体质类型调查分析

目的:探讨军事飞行人员中医体质类型的分布特点。方法:采用《中医体质分类与判定》标准对924例军事飞行人员进行问卷调查,数据结果采用SPSS 17.0软件进行统计描述与分析。结果:(1)正常体质515例(55.7%),偏颇体质409例(44.3%),比例占前5位的体质类型是:平和质、湿热质、痰湿质、气虚质、阳虚质;(2)各年龄段偏颇体质类型分布不同。结论:为从中医体质学着手了解军事飞行人员健康信息及给予中医药保健服务提供依据。

400例健康青年男性中医体质特点研究

目的:通过对400例健康男性进行中医体质流行病学调查,初步了解健康青年男性体质差异。方法:从2006年11月—2007年12月,对400例18～32岁健康男性开展问卷调查。根据中国人体质问卷量表测评各体质类型(气滞质、气虚质、血瘀质、阴虚质、阳虚质、内热质、津亏质、精亏质、紧张质、协调质)得分;应用判别分析法判定个体体质类型,分析健康青年男性体质差异。结果:400例健康男性中,协调质占38.75%,9种偏颇体质占61.25%;9种偏颇体质中居于前4位的体质类型是津亏质、内热质、气虚质、精亏质,分别占10.50%、9.50%、9.00%和9.00%。结论:健康青年男性存在不同的体质特点。

长沙地区男性不育患者精索静脉宽度与中医体质类型相关性探讨

目的通过对长沙地区男性不育患者进行中医体质的问卷调查,得出男性不育患者体质分布的特点及精索静脉宽度与中医体质的关系,分析常见病因对中医体质的影响,探讨中医药防治男性不育的新思路。方法根据《中医体质分类与判定》(ZYYXH/T157-2009)对长沙地区344例不育男性进行中医体质判定,并分析精索静脉宽度与中医体质的相关性。结果男性不育患者中平和体质占17.4%,单一偏颇体质占25.6%,混合偏颇体质占57.0%。总体体质类型前10位依次为平和质(17.4%),湿热痰湿质(14.2%),阳虚气虚质(9.59%),湿热质(8.43%),阳虚痰湿质(6.69%),痰湿质(5.81%)、气虚湿热质(5.81%),气虚质(4.94%),阳虚质(4.36%),气郁气虚质(3.49%)。男性不育患者双侧精索静脉宽度与中医体质分布差异有统计学意义(P<0.01)。湿热质、痰湿质在精索静脉曲张所致男性不育患者中分布比例较高。结论男性不育患者中,平和质、湿热质和气虚质是主要单一体质类型;复合类型中各型相对分散,但仍然表现以湿热复合类为主要特征,而阳虚、气虚、痰湿复合类次之的分布特征。湿热质、痰湿质与精索静脉曲张所致男性不育存在一定联系。

317例腹股沟疝患者中医体质类型分析

目的:探讨腹股沟疝患者的中医体质分布特征。方法:采用《中医体质分类与判定》标准,对317例腹股沟疝患者(病例组)和80例健康者(对照组)进行问卷调查,分析中医体质与腹股沟疝的相关性。结果:两组间性别、年龄差异无统计学意义(P>0.05),具有可比性。与对照组相比,病例组患者的中医体质类型以气虚质和平和质为主(气虚质:8人VS 84人,P<0.05;平和质:33人VS 82人,P<0.05;)。进一步分析不同腹股沟疝类型与中医体质的分布发现,斜疝患者中以气虚质和平和质为主,分别为45人和43人;直疝患者以气虚质、平和质、和湿热质为主,分别为27人、25人和17人;而复合疝患者则以气虚质、阳虚质为主,分别为12人和18人。结论:腹股沟疝患者的中医体质类型以气虚质为主,气虚质可能是腹股沟疝的易感因素。