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.

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.

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.

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

Objective： To evaluate the effect of different training methods of Tai Chi on Chinese medicine constitution of international students with depression or depression tendency. Methods： Thirty-eight Africa international students were randomly divided into the physical exercise group who receiving the simple physical exercise of simplified 24-form Tai Chi （physical exercise group） and the breathing group who receiving both deep breathing method plus simple physical exercise （breathing group）. The average scores of Chinese medicine gentleness and various biased constitutional types in the two groups were compared. Results： The average score of thirty-eight students with biased constitution in both groups decreased significantly compared with that before training （P 〈 0.05）. Compared with that before training, the average scores of biased constitutional types in the breathing group, including Qi deficiency, Yang deficiency, phlegm-dampness and Qi stagnation, were significantly decreased （P 〈 0.05）. The average scores of Yang deficiency, blood stasis and Qi stagnation constitutional types of students in simple physical group after training were also significantly decreased after training （P 〈 0.05）. Moreover, the average scores of biased constitutional types, including Qi deficiency, Yang deficiency, Yin deficiency, phlegm and dampness, Qi-stagnation, in the breathing group were significantly lower than those of the simple exercise group, suggesting the superior therapeutic effect of breathing training method （P 〈 0.01）. Conclusion： When combines with the deep breathing method, Tai Chi training achieves better effect on improving the biased constitutional types which may be related to depression or depression tendency, including Qi deficiency, Yang deficiency, Yin deficiency, phlegm and dampness, Qi-stagnation.

Constitution of the Chinese Association for International Understanding

正(Approved by the Third Plenary Sessionof the Tenth Executive Council on May 11, 2012)Chapter I General Rules Article 1 The Chinese Association for International Understanding is a national non-governmental organization(NGO) in the People’s Republic of China.

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.

A DELIBERATION ON SCIENCE DEVELOPMENT IN CHINA AND ON THE READJUSTMENT OF CONSTITUTIONAL DISCIPLINES IN THE CHINESE ACADEMY OF SCIENCES

The CAS, as a national comprehensive research and development (R&D) center for natural science and high technology with numerous researchers of a high quality in almost all disciplines, plays a decisive role in the development of this country’s science and technology. Based on the trend of China’s development in the period of its Ninth Five-Year Plan and in the next century, this article analyzes the trends of science and technology of China in combination with the current readjustment in the constitution of science disciplines in the CAS.

Classifying Chinese Medicine Constitution Using Multimodal Deep-Learning Model

Objective:To develop a multimodal deep-learning model for classifying Chinese medicine constitution,i.e.,the balanced and unbalanced constitutions,based on inspection of tongue and face images,pulse waves from palpation,and health information from a total of 540 subjects.Methods:This study data consisted of tongue and face images,pulse waves obtained by palpation,and health information,including personal information,life habits,medical history,and current symptoms,from 540 subjects(202 males and 338 females).Convolutional neural networks,recurrent neural networks,and fully connected neural networks were used to extract deep features from the data.Feature fusion and decision fusion models were constructed for the multimodal data.Results:The optimal models for tongue and face images,pulse waves and health information were ResNet18,Gate Recurrent Unit,and entity embedding,respectively.Feature fusion was superior to decision fusion.The multimodal analysis revealed that multimodal data compensated for the loss of information from a single mode,resulting in improved classification performance.Conclusions:Multimodal data fusion can supplement single model information and improve classification performance.Our research underscores the effectiveness of multimodal deep learning technology to identify body constitution for modernizing and improving the intelligent application of Chinese medicine.

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.

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.

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.

Association of Chinese Medicine Constitution Susceptibility to Diabetic Nephropathy and Transforming Growth Factor-β1(T869C)Gene Polymorphism

Objective：To explore the association of Chinese medicine constitution susceptibility to diabetic nephropathy（DN） and transforming growth factor（TGF）-β1（T869C） gene polymorphism.Methods：TGF-β1 gene polymorphism detected with polymerase chain reaction-restriction fragment length polymorphism（PCRRFLP） was screened for 180 DN cases and 180 type 2 diabetic mellitus（T2DM） cases without combined DN. Patients with DN were surveyed epidemiologically with constitution in the Chinese medicine questionnaire （CCMQ）.Binary logistic regression analysis was utilized to study the correlation between nine types of Chinese medicine constitution and TGF-β1（T869C） gene polymorphisms.Results：The DN group has a higher frequency of TGF-β1（T869C） gene polymorphism than the T2DM group,and CC/CT genotypes than the T2DM group[CC,CT,TT（DN group）：88,87,5（cases） versus（T2DM group） 71,73,36（cases）,P0.05].The phlegm-dampness constitution,damp-heat constitution,and blood stasis constitution have correlations with TGF-β1 （T869C） gene polymorphism.Conclusion：Chinese medicine constitutions were associated with TGF-β1（T869C） gene polymorphism,a potential predictor of susceptibility to DN in T2DM patients.

Research on Constitution of Chinese Medicine and Implementation of Translational Medicine

Translational medicine is a new concept presented in recent decades, the core of which is to build a bridge between basic medical research and clinical application. From the beginning of constitution of Chinese medicine, clinical application has been given priority. Therefore, the idea of translational medicine is fully demonstrated in the research into the three key scientific problems of ＂classification of constitution of Chinese medicine＂, ＂relationship between constitution and disease＂ and ＂adjustment of constitution＂. Under its guidance, not only was the systematic theory of constitution of Chinese medicine established, but also the Constitution of Chinese Medicine Scale and the Standards of Classification and determination of Constitution of Chinese Medicine were developed, which translates methods of classifying the nine constitutional types into guidance for prevention of disease, management of health and clinical application. The research findings of constitution of Chinese medicine have been applied in clinical practice and public health, establishing the diagnosis and treatment model of constitution-disease-syndrome differentiation. The nationwide application of constitution differentiation has shown good effect. In the future, constitution of Chinese medicine should strengthen the evidence-based research and multi-disciplinary cooperation, and establish a research team on comprehensive constitution of Chinese medicine and translational medicine, to translate the findings into clinical practice and public health more accurately and quickly.

Individualized medicine,health medicine,and constitutional theory in Chinese medicine

The patterns of modern science and changes in the medical model can result in the transformation of the current state of individualized and health medicines into being the primary trend in medical development.Chinese and Western medical systems are dissimilar in terms of value orientations,thinking style,and research directions because of their different historical and cultural backgrounds.Individualized treatment in modern medicine is mainly established based on individual genome information and the differences in mononucleotide polymorphisms.However,such treatment method is expensive,creates an uncertain genetic marker,and leads to different result interpretations,among other problems.The Chinese constitutional theory developed in the 1970s expresses the principle behind Chinese health medicine and individual treatment and provides the corresponding methods.The Chinese constitutional theory divides the constitution of the Chinese population into nine categories based on established classification criteria.It promotes the study of the relationship of each constitution to diseases and Chinese medicine preparation toward adjusting the constitution and preventing diseases.The theory also provides methods and tools for individualized treatment.Constitution identification shows the direction and provides the core technology for the evaluation of the health status.By combining the developments in modern biotechnology,new diagnostic techniques and treatment models of constitution-differentiation,disease-differentiation,and syndrome-differentiation can be established for the development of individualized Chinese medicine treatment and health medicine for the international medical community.