Association between metabolic syndrome and body constitution of traditional Chinese medicine:A systematic review and meta-analysis

Background:The constitution theory of traditional Chinese medicine(TCM)states that body constitution and disease are associated;therefore,the identification of body constitution can provide reference for disease prevention and treatment.A series of clinical studies evaluating the association between TCM constitution and metabolic syndrome(MetS)have been conducted in recent years.The aim of this systematic review is to summarize and evaluate the clinical evidence of the relationship between constitution and MetS.Methods:The PubMed,Embase,China National Knowledge Infrastructure(CNKI),Chongqing VIP,and Wanfang Data electronic databases were searched from April 2009 to July 2020.The search terms included“metabolic syndrome,”“constitution,”and“Chinese medicine.”Observational studies evaluating the relationship between body constitution of TCM and MetS were included.The primary outcome included the distribution of constitutional types in the MetS population,and odds ratio(OR)or relative risk(RR)between constitution and MetS.Effect size was expressed as proportion or OR with 95%confidence interval(CI).Methodological quality of included studies was evaluated by the NewcastleeOttawa Scale(NOS)or the American Agency for Healthcare Research and Quality(AHRQ)criteria.Results:Three caseecontrol and 26 cross-sectional studies involving 30435 cases were included.Phlegm-dampness,qi-deficiency,and damp-heat were the main constitution types in patients with MetS,accounting for 29%(22%e39%),18%(13%e24%),and 12%(9%e17%)of the population,respectively;the risk of MetS in people with phlegm-dampness and qi-deficiency constitution was 1.74[1.27,2.38]and 1.29[1.01,1.65]times higher than that in those with other constitutions.There were sex-and age-related differences in the distribution of TCM constitution in patients with MetS.Conclusion:Phlegm-dampness and qi-deficiency were associated with the occurrence of MetS.Welldesigned cohort and caseecontrol studies are needed to provide evidence for the use of TCM to prevent and treat MetS.

Concepts of body constitution, health and sub-health from traditional Chinese medicine perspective

This paper described and discussed the important literature and ideas about the concepts, types and measurement of body constitution, in terms of healthy,sub-healthy and disease status. In view of traditional Chinese medicine, ‘‘healthy" state is a status of relative balance of Yin and Yang to keep our bodily homeostasis. If there are significant physical and/or psychological stressors, such as loss of a beloved one and failure in study or work, the body can no longer keep its own bodily condition balanced and subsequently enter a state of ‘‘sub-health"(sub-optimal health).‘‘unhealthy" body constitution such as ‘‘Dampnessheat", ‘‘Cold-dampness" and ‘‘Heat- or Cold- dryness"with a subnormal body temperature and humidity and clinical manifestations such as insomnia, malaise and overweight will be presented. Immediate, appropriate strategies such as modification of life-style and seeking medical treatment can prevent evolution of an illness.Otherwise, the body will enter a disease status with a‘‘pathological" body constitution of ‘‘Yin or Yang deficiency'', ‘‘Blood-stasis" and/or ‘‘Phlegm-dampness". To be complimentary with health promotion and disease prevention in Western medicine, understanding about an individual's body constitution, together with itsdeterminants(e.g., healthy eating and lifestyle behaviors), can contribute to a more proactive, holistic and individualized healthcare.

Correlation between Tibetan and traditional Chinese medicine body constitutions: A cross-sectional study of Tibetan college students in the Tibet Autonomous Region

Objective:To evaluate the correlation between the body constitution types of Tibetan medicine and traditional Chinese medicine (TCM).Methods:The cluster sampling method was employed to recruit participants from a university in the Tibet Autonomous Region.Tibetan medicine and TCM questionnaires were respectively used to assess the participants' constitution information.Descriptive statistics were applied to analyze the baseline and constitution characteristics of the participants.Two-factor correlation analysis and the paired chi-square test were applied to analyze the correlation between Tibetan and TCM constitution types.Results:Data from 466 Tibetan students were analyzed.The mean scores of the rlung,mkhris pa,and bad kan constitution types in Tibetan medicine were 43.2 (11.1),42.1 (10.1),and 45.0 (8.0),respectively;participants with the three-factor convergence body constitution type accounted for 13.7% of the whole population.Among the TCM constitution types,qi stagnation was the most common (21.5%),followed by the balance type (16.5%);the other constitutions detected were qi deficiency,yin deficiency,and yang deficiency.The rate of consistency for the identification of the three-factor convergence constitution in Tibetan medicine and the balance constitution in TCM was 89.1%,with a Kappa coefficient of 0.57 (P >.05).The rlung constitution in Tibetan medicine was associated with the yin deficiency,yang deficiency,and blood stasis constitutions in TCM.The mkhhris pa constitution in Tibetan medicine was associated with the damp heat and yin deficiency constitutions in TCM.The bad kan constitution in Tibetan medicine was associated with the phlegm dampness,qi deficiency,and yin deficiency constitutions in TCM.Conclusion:There is a correlation between the body constitution types of Tibetan medicine and TCM.The reliability and validity of the Questionnaire for TibetanMedicine Constitution requires improvement,and more studies with larger sample sizes and more varied populations are warranted to verify the correlation between Tibetan medicine and TCM constitutions.

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.

The theory development of traditional Chinese medicine constitution: a review

Traditional Chinese medicine constitution (TCMC),as one of the most important parts of Chinese medicine theory,attracted the attention of more and more researchers and many research projects were conducted during past several decades in China's Mainland.This review provided a historic overview of TCMC theory and research progress in its classification,evaluation criteria and epidemiology,so as to give people through a different lens to understand human health.

Analysis of the Main Body the Object and their Relationship Concerning Research of Traditional Chinese Medicine

This paper is the analysis of the main body, the object and their relationship concerning research of traditional Chinese medicine. The result proved that the main body of research of traditional Chinese medicine is researchers who possessed the fundamentals of traditional Chinese medicine. It is the objects of research of traditional Chinese medicine that origin of a class of traditional Chinese medical literature consisting of herbals which focus on descriptions of individual drugs; the relationship of the technological process of preparing Chinese medicine, as by parching, roasting, baking, steaming, soaking, and simmering, etc.;and technology of separating, extracting and purifying for composition; traditional Chinese medicine dynamics of one of the 12 two-hour periods into which the day was formerly divided before the introduction of western chronology; compatibility of medicines in active compositions; patent, effectiveness for a given period of time and constantly changing of traditional Chinese medicine.The relationship between the main body and the objects was that the former depends on the latter ones and the main body has subjective initiative as fully as possible.

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.

A Brief Analysis of the Correlation Between Allergic Rhinitis and Traditional Chinese Medicine Constitution

Allergic rhinitis(AR)and is a type of allergic diseases caused by an inflammation of the nasal mucosa caused by allergens.Clinically,AR is a common allergic disease and is difficult to treat.Due to differences in individual constitutions also known as body type,the severity of the disease is also different and it may even affect the daily life of the patient if it is severe.The effective treatment of AR has become a hot topic in current allergic disease research.Traditional Chinese Medicine’s understanding of constitution is based on the“Yellow Emperor’s Internal Classic”book,and Professor Wang Qi put forward the“physical constitution theory of traditional Chinese medicine”.The constitution is a key internal factor of the occurrence and development of diseases.It is believed in Traditional Chinese medicine(TCM)that the constitution can be regulated,and rectifying the patient’s imbalanced constitution has a positive effect on the diagnosis,treatment,and prognosis of the disease.Therefore,based on the“physical constitution theory of TCM”,this study considers the idea of treating body differently applying TCM constitution in the treatment of AR as the breakthrough point,and explores the correlation between AR and TCM constitution.The results show that TCM constitution is an intrinsic factor affecting the pathogenesis of AR.The use of TCM constitution theory in the treatment of AR has a positive effect and should be popularized in application.

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.

Quality Evaluation on Traditional Chinese Medicine Nursing Plan for Stroke in Acute and Recovery Phases

OBJECTIVE: To formulate the quality evaluation questionnaire of Traditional Chinese Medicine(TCM) nursing plan for stroke in acute and recovery phases, and to evaluate the quality of TCM nursing plan for stroke by clinical nurses. METHODS: The questionnaire was designed by referring to the Applicability Questionnaire of TCM Clinical Diagnosis and Treatment Guideline, and the expert consultation was used to assess the content validity. In addition, the results of the questionnaire were processed and analyzed with SPSS20.0 software. RESULTS: The content validity of the self-designed questionnaire was 0.94 for the S-CVI/Ave score. The results of the questionnaire demonstrated that the overall content of the plan was "better than the original routine nursing plan"(59.18%); the recognition degree of "common symptoms"(36.70%) and "syndrome classification"(36.70%) of the plan was the lowest. CONCLUSION: The plan is supposed to be further improved in the future in order to be coincident with clinical reality.

Holistic medicine: A new medical system based on body constitution and functional status

At present,modern medicine is a scientific system in the following sense:it uses observation of static states and analysis of single factors to determine the relationship between structure and function in the human body in states of health and disease.Physiology and pathology are based on observation from multiple perspectives and at multiple levels.The study of human body constitution and overall functional status is relatively unexplored territory in the field of modern medicine.This article discusses the possible confluences between traditional Chinese medicine (Chinese medicine) and the methods and concepts of complexity science.It also reveals that Chinese medicine,unlike biomedicine (Western medicine),uses a method of modeling to study the human body,and law and control methods from the perspective of functional state and viewpoint.To derive from there,in time of complexity science concept becoming the mainstream scientific idea of today,by adopting its methodsand techniques,and introduce Chinese medicine theoretical model,methods and experience,to develop a holistic medicine that can reveal human body constitution and functional state.It will be the main direction for the development of the 21st century modern medicine.

Study on traditional Chinese medicine syndrome of esophageal cancer based on Delphi method

Esophageal cancer is one of the common malignant tumors in humans.Traditional Chinese medicine(TCM)has unique advantages in the treatment of esophageal cancer.However,the TCM syndrome classification of esophageal cancer is not standardized.This Delphi survey aimed to explore the TCM syndrome classification and symptom characteristics of esophageal cancer.Methods:Based on literature research,an expert consultation questionnaire was developed for the study of the TCM syndrome rules of esophageal cancer.Two rounds of questionnaire surveys were conducted among 62 experts across the country.Statistical description and statistical analysis of the mean,coefficient of variation,grade sum,and unimportant percentage of the retrieved data.TCM syndrome rules and diagnostic indicators for esophageal cancer after screening and sorting out the questionnaire items,convening experts to demonstrate.Results:62 valid questionnaires were collected,and the expert positive coefficient was 100%.The Kendall's coefficient of concordance W of the first and second rounds are 0.232 and 0.2334 respectively.In addition,the Kendall's coefficient of concordance W of the second round has been improved compared with the first round,suggesting that experts have a better degree of coordination on the importance of indicators.The common TCM syndromes of esophageal cancer are obtained:"liver-stomach disharmony,phlegm and qi obstruction syndrome","liver and spleen disorders,phlegm accumulating with stagnation syndrome","deficiency of liver and kidney yin,stubborn blood syndrome","deficiency of spleen and kidney yang,stubborn blood syndrome".Conclusion:The TCM syndrome indicators of esophageal cancer has been established.It provides a basis for the standardized research of TCM syndrome diagnosis of esophageal cancer,which is of positive significance for improving the level of clinical diagnosis and treatment.

A New Page for Women's Reproductive Health in Integrated Traditional Chinese and Western Medicine

The integrated traditional Chinese and western medicine (ICWM) of obstetrics and gynecology (OBS/GYN) emerged eventually with more than 40 years’ hard struggle, and one of the most promising articles is the integration of the masterpieces of menstrual disorder and infertility in TCM and the virtual explosion of new knowledge and methods in

Evaluating the confidence level of Traditional Chinese Medicine in nursing undergraduates at Chinese medical university

Objective:To observe the confidence level prevailing with regard to the practice of Traditional Chinese Medicine(TCM)among undergraduate nursing students who have undertaken TCM courses at Shanxi Medical University.Methods:This cross-sectional study was conducted at Shanxi University of Chinese Medicine.A questionnaire survey was administered through the Questionnaire Star website(https://www.questionstar.com/).The confidence level was examined from 6 aspects,namely cognition of TCM culture and theory,advantages and characteristics of TCM diagnosis and treatment,feelings about TCM achievements,personal behaviors related to TCM,attitudes toward Western medicine,and the future of TCM.The mean score of the observed items was calculated,and was found to be positively related to the confidence level concerning TCM(the score was between 1 and 5).Results:A total of 120 participants voluntarily enrolled themselves in the study.The results showed that the mean score of observed items were generally about 4.A relatively strong confidence was shown in understating TCM advantages and characteristics in diagnosis and treatment,and also in feelings toward TCM achievements.Conclusions:The majority of nursing undergraduates had confidence in TCM.However,some aspects such as the understanding of TCM culture and the correlation between TCM and Western medicine may need to be improved through education.

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.

Clinical Research on the Treatment of Simple Obesity by Oral Chinese Medicine Combined with Health Education to Improve Phlegm Dampness Constitution

OBJECTIVE: To observe the clinical effect of oral traditional Chinese medicine granules combined with health education to regulate phlegm constitution and treat simple obesity. METHODS: According to the method of constitution evaluation in TCM Constitution Classification and Evaluation(Chinese Association of Chinese Medicine), the TCM classification of Chinese medicine was performed on patients who came to the outpatient department of the Traditional Chinese Medicine Hospital of Pinggu District of Beijing and met the diagnostic criteria of simple obesity. One hundred patients with phlegm constitution were selected and those in accordance with the standards, were randomly divided into group with oral TCM granules combined with health education(refer to as treatment group) and health education group(refer to as control group) according to 1:1 ratio. The control group was given health education including diet and exercise instruction. Treatment group:(1) Health education includes diet and exercise instruction.(2) Oral Chinese medicine granules: ingredients: atractylodes rhizome 15g, raw barley 30g, Folium Nelumbinis 10g, Chinese hawthorn fruit 10g, Chinese waxgourd peel 15g, milk-vetch root;15g, kudzuvine root 15g, danshen root10g, 2 times/d. The two groups were intervened for 12 weeks each time, and obesity evaluation indicators such as body weight, body fat, waist circumference, hip circumference, weight index, and score table of TCM constitutional were observed before and after the intervention. Statistical software was used for statistical analysis. RESULTS: The total curative effect of the treatment group was better than that of the control group(P<0.001). The weight index, body weight, waist and hip circumference decreased significantly after treatment(P <0.01). Compared with the two groups, the treatment group is better than the control group in terms of dampness constitution improvement, weight and fat losing and waist and hip circumference reducing.(P<0.01). CONCLUSION: Oral Chinese medicine granules Jiangzhuo Fang(combined with health education) and simple health education can improve phlegm constitution, and improve the body weight, body fat percentage and other indicators of the patients, but oral granules combined with health education to improve the physical fitness of phlegm is better than simple health education. The thoughts and methods of Chinese medicine granules combined with health education to regulate phlegm constitution is effective for weight losing and is worthy of further research and promotion.

Randomized control study in the influence of different training methods of Tai Chi on Chinese medicine constitution of international students with depression or depression tendency

目的：探讨太极拳不同训练方式对留学生抑郁或抑郁倾向的影响.方法：38名留学生被随机分为太极拳单纯动作练习组（简称单纯动作组）和太极拳动作练习配合呼吸吐纳组（简称呼吸吐纳组）,并比较两组实验前后中医体质的均分变化.结果：与训练前相比,38名留学生中偏颇体质的平均得分明显下降（P〈0.05）.与训练前相比,呼吸吐纳组中气虚型、阳虚型、痰湿型、气滞型的偏颇体质的平均得分显著降低（P〈0.05）.单纯动作组的阳虚型、血瘀型、气滞型的偏颇体质的平均得分也显著下降（P〈0.05）.另外,气虚型、阳虚型、阴虚型、痰湿型、气滞型的偏颇体质的平均得分均显著低于单纯运动组中这些体质的得分,提示太极拳动作练习配合呼吸吐纳的方法优于太极拳单纯动作练习（P〈0.01）.结论：与呼吸吐纳法结合,太极拳动作练习对改善与抑郁或抑郁倾向相关的偏颇体质有更好的效果.

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.

Constitution identification model in traditional Chinese medicine based on multiple features

Objective To construct a precise model for identifying traditional Chinese medicine(TCM)constitutions;thereby offering optimized guidance for clinical diagnosis and treatment plan-ning;and ultimately enhancing medical efficiency and treatment outcomes.Methods First;TCM full-body inspection data acquisition equipment was employed to col-lect full-body standing images of healthy people;from which the constitutions were labelled and defined in accordance with the Constitution in Chinese Medicine Questionnaire(CCMQ);and a dataset encompassing labelled constitutions was constructed.Second;heat-suppres-sion valve(HSV)color space and improved local binary patterns(LBP)algorithm were lever-aged for the extraction of features such as facial complexion and body shape.In addition;a dual-branch deep network was employed to collect deep features from the full-body standing images.Last;the random forest(RF)algorithm was utilized to learn the extracted multifea-tures;which were subsequently employed to establish a TCM constitution identification mod-el.Accuracy;precision;and F1 score were the three measures selected to assess the perfor-mance of the model.Results It was found that the accuracy;precision;and F1 score of the proposed model based on multifeatures for identifying TCM constitutions were 0.842;0.868;and 0.790;respectively.In comparison with the identification models that encompass a single feature;either a single facial complexion feature;a body shape feature;or deep features;the accuracy of the model that incorporating all the aforementioned features was elevated by 0.105;0.105;and 0.079;the precision increased by 0.164;0.164;and 0.211;and the F1 score rose by 0.071;0.071;and 0.084;respectively.Conclusion The research findings affirmed the viability of the proposed model;which incor-porated multifeatures;including the facial complexion feature;the body shape feature;and the deep feature.In addition;by employing the proposed model;the objectification and intel-ligence of identifying constitutions in TCM practices could be optimized.

Literature review and analysis of the application of health outcome assessment instruments in Chinese medicine

OBJECTIVE： To evaluate the application of health assessment instruments in Chinese medicine. METHODS： According to a pre-defined search strategy, a comprehensive literature search for all articles published in China National Knowledge Infrastructure databases was conducted. The resulting articles that met the defined inclusion and exclusion criteria were used for analysis. RESULTS： A total of 97 instruments for health outcome assessment in Chinese medicine have been used in fundamental and theoretical research, and 14 of these were also used in 29 clinical trials that were randomized controlled trials, or descriptive or cross-sectional studies. In 2 152 Chinese medicine-based studies that used instruments in their methodology, more than 150 questionnaires were identified. Among the identified questionnaires, 51 were used in more than 10 articles （0.5%）. Most of these instruments were developed in Western countries and few studies （4%） used the instrument as the primary evidence for their conclusions. CONCLUSION： Usage of instruments for health outcome assessment in Chinese medicine is increasing rapidly; however, current limitations include selection rationale, result interpretation and standardization, which must be addressed accordingly.