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.

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.

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.

Artificial intelligence meets traditional Chinese medicine: a bridge to opening the magic box of sphygmopalpation for pulse pattern recognition

Artificial intelligence(AI) aims to mimic human cognitive functions and execute intellectual activities like that performed by humans dealing with an uncertain environment. The rapid development of AI technology provides powerful tools to analyze massive amounts of data, facilitating physicians to make better clinical decisions or even replace human judgment in healthcare.Advanced AI technology also creates novel opportunities for exploring the scientific basis of traditional Chinese medicine(TCM) and developing the standardization and digitization of TCM pulse diagnostic methodology. In the present study, we review and discuss the potential application of AI technology in TCM pulse diagnosis. The major contents include the following aspects:(1) a brief introduction of the general concepts and knowledge of TCM pulse diagnosis or palpation,(2) landmark developments in AI technology and the applications of common AI deep learning algorithms in medical practice,(3) the current progress of AI technology in TCM pulse diagnosis,(4) challenges and perspectives of AI technology in TCM pulse diagnosis. In conclusion, the pairing of TCM with modern AI technology will bring novel insights into understanding the scientific principles underlying TCM pulse diagnosis and creating opportunities for the development of AI deep learning technology for the standardization and digitalization of TCM pulse diagnosis.

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.

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.

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.

A brief overview of traditional Chinese medicine prescription powered by artificial intelligence

Traditional Chinese medicine prescription is one of the treasures of traditional Chinese medicine(TCM).There are tens of thousands TCM prescriptions accumulated in the past thousands of years,corresponding to different diseases,symptoms and therapeutic goals.The correspondences are so complicated that there is an urgent need to leverage new technologies such as artificial intelligence(AI)to analyze,understand and utilize them effectively.In this paper,we present a brief overview of this direction,where current research progress on TCM prescription powered by AI is summarized.Our summarization focuses on three aspects,TCM prescription mining that aims at understanding the TCM prescription,TCM prescription or herb knowledge base construction that aims at extracting knowledge to support the TCM prescription-related study,and TCM prescription discovery that aims at utilizing AI technologies to further energize TCM.It is encouraging to see that steady progress in this direction has been made recently.Besides,a toy experiment on image-based TCM herb recognition by using convolutional neural networks is also conducted.It basically verifies that it is promising to use AI technologies to address challenging tasks in TCM.We also point out several research topics that could be cooperatively performed by researchers from the two disciplines.

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.

Understanding of Traditional Chinese Medicine and Western Medicine on Swimming Shoulder

Swimming shoulder refers to shoulder pain syndrome which is caused by repeated impinges on shoulder joints among swimmers.It is one of the most common causes of shoulder pain among swimmers with high incidence.Swimming shoulder can affect the systematization of swimmers’training and the improvement of their training level and performance,which is a difficult problem for many swimmers,coaches,medical staff and sports medical doctors.Therefore,attention should be paid to the treatment of swimming shoulder in daily diagnosis and treatment.

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.

Construction and optimization of traditional Chinese medicine constitution prediction models based on deep learning

Objective To cater to the demands for personalized health services from a deep learning per-spective by investigating the characteristics of traditional Chinese medicine(TCM)constitu-tion data and constructing models to explore new prediction methods.Methods Data from students at Chengdu University of Traditional Chinese Medicine were collected and organized according to the 24 solar terms from January 21,2020,to April 6,2022.The data were used to identify nine TCM constitutions,including balanced constitution,Qi deficiency constitution,Yang deficiency constitution,Yin deficiency constitution,phlegm dampness constitution,damp heat constitution,stagnant blood constitution,Qi stagnation constitution,and specific-inherited predisposition constitution.Deep learning algorithms were employed to construct multi-layer perceptron(MLP),long short-term memory(LSTM),and deep belief network(DBN)models for the prediction of TCM constitutions based on the nine constitution types.To optimize these TCM constitution prediction models,this study in-troduced the attention mechanism(AM),grey wolf optimizer(GWO),and particle swarm op-timization(PSO).The models’performance was evaluated before and after optimization us-ing the F1-score,accuracy,precision,and recall.Results The research analyzed a total of 31655 pieces of data.(i)Before optimization,the MLP model achieved more than 90%prediction accuracy for all constitution types except the balanced and Qi deficiency constitutions.The LSTM model's prediction accuracies exceeded 60%,indicating that their potential in TCM constitutional prediction may not have been fully realized due to the absence of pronounced temporal features in the data.Regarding the DBN model,the binary classification analysis showed that,apart from slightly underperforming in predicting the Qi deficiency constitution and damp heat constitution,with accuracies of 65%and 60%,respectively.The DBN model demonstrated considerable discriminative power for other constitution types,achieving prediction accuracy rates and area under the receiver op-erating characteristic(ROC)curve(AUC)values exceeding 70%and 0.78,respectively.This indicates that while the model possesses a certain level of constitutional differentiation abili-ty,it encounters limitations in processing specific constitutional features,leaving room for further improvement in its performance.For multi-class classification problem,the DBN model’s prediction accuracy rate fell short of 50%.(ii)After optimization,the LSTM model,enhanced with the AM,typically achieved a prediction accuracy rate above 75%,with lower performance for the Qi deficiency constitution,stagnant blood constitution,and Qi stagna-tion constitution.The GWO-optimized DBN model for multi-class classification showed an increased prediction accuracy rate of 56%,while the PSO-optimized model had a decreased accuracy rate to 37%.The GWO-PSO-DBN model,optimized with both algorithms,demon-strated an improved prediction accuracy rate of 54%.Conclusion This study constructed MLP,LSTM,and DBN models for predicting TCM consti-tution and improved them based on different optimisation algorithms.The results showed that the MLP model performs well,the LSTM and DBN models were effective in prediction but with certain limitations.This study also provided a new technology reference for the es-tablishment and optimisation strategies of TCM constitution prediction models,and a novel idea for the treatment of non-disease.

Deep learning-based recognition of stained tongue coating images

Objective To build a dataset encompassing a large number of stained tongue coating images and process it using deep learning to automatically recognize stained tongue coating images.Methods A total of 1001 images of stained tongue coating from healthy students at Hunan University of Chinese Medicine and 1007 images of pathological(non-stained)tongue coat-ing from hospitalized patients at The First Hospital of Hunan University of Chinese Medicine withlungcancer;diabetes;andhypertensionwerecollected.Thetongueimageswererandomi-zed into the training;validation;and testing datasets in a 7:2:1 ratio.A deep learning model was constructed using the ResNet50 for recognizing stained tongue coating in the training and validation datasets.The training period was 90 epochs.The model’s performance was evaluated by its accuracy;loss curve;recall;F1 score;confusion matrix;receiver operating characteristic(ROC)curve;and precision-recall(PR)curve in the tasks of predicting stained tongue coating images in the testing dataset.The accuracy of the deep learning model was compared with that of attending physicians of traditional Chinese medicine(TCM).Results The training results showed that after 90 epochs;the model presented an excellent classification performance.The loss curve and accuracy were stable;showing no signs of overfitting.The model achieved an accuracy;recall;and F1 score of 92%;91%;and 92%;re-spectively.The confusion matrix revealed an accuracy of 92%for the model and 69%for TCM practitioners.The areas under the ROC and PR curves were 0.97 and 0.95;respectively.Conclusion The deep learning model constructed using ResNet50 can effectively recognize stained coating images with greater accuracy than visual inspection of TCM practitioners.This model has the potential to assist doctors in identifying false tongue coating and prevent-ing misdiagnosis.

Research hotspots andfrontiersanalysisoftraditional Chinese medicine constitution identification:Avisual analysis of literature based on CiteSpaceand vosviewer

Objective:To explore the development and hotspots in the field of traditional Chinese medicine(TCM)constitution identification since the year 2000.Methods:Using CiteSpace and VOSviewer software,literature from five prominent databases including VIP,WanFang,China National Knowledge Infrastructure(CNKI),PubMed,and Web ofScience was analyzed.Visual methods were used to examine the annual publications,keywords,authors,and collaborative networks.Results:After deduplication with EndNotes,a total of 5,747 articles meeting the criteria were included.Since 2000,the publications of TCM constitution identification shown three major stages:a significant increasing trend with the year before 2016,a fluctuating trend from 2016 to 2021,and a decreasing trend with the year after 2021.The co-occurrence analysis ofkeywords revealed health management,hypertension,and constitution as hot directions in this field of research.CiteSpace was used for keyword clustering and burst analysis,health management,medical life,and constitution emerged as the latest hotspots in the past three years,which will be the main development directions in the future.Clusters such as hypertension,preventive treatment,and health management were identified,representing the main research themes at present.VOSviewer and CiteSpace were used for co-occurrence and clustering analysis of authors,revealing collaborative research networks,with prominent groups represented by WANG Qi,WANG Ji,LI Lingru,HOU Shujuan,ZHU Yanbo,etc.Conclusion:Research related to TCM constitution identification is developing rapidly,involving various aspects of medical care and daily life.However,there is still a need to build an extensive academic platform,strengthen the dissemination of Chinese medicine culture,standardize,intellectualize and universalize the identification of TCM constitution assessments,and construct a health service system with Chinese characteristics.

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.

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.

Discrimination of TCM constitutions by biochemical and routine urine indexes

Objective:To investigate whether the specific traditional Chinese medicine(TCM)constitution of individuals can be defined by certain biological indexes instead of answering the questionnaire,and to explore the possibility of discriminating nine TCM constitutions from each other simultaneously using biological indexes.Methods:Blood and urine samples from 152 individuals with nine TCM constitutions were collected,and the related biological indexes were analyzed combining ANOVA,multiple comparison,discriminant analysis,and support vector machine.Results:We found that 4 out of 24 blood routine indexes,7 out of 10 urine routine indexes,and 12 out of 32 biochemical indexes showed differences among the constitutions.High-sensitivity C-reactive protein,apolipoprotein A1,and alkaline phosphatase were potential candidates for screening out individuals with unbalanced constitutions.Combining uric acid,high-density lipoprotein,apolipoprotein A1,creatine kinase,total protein,aspartate aminotransferase,total bile acid,dehydrogenase,sodium,and calcium levels had the potential to directly distinguish the nine TCM constitutions from each other.Among these indexes,the highest ratio of discriminant analysis between two constitutions was 95.5%,while the lowest was 66.1%.Conclusion:Our results suggest that some biochemical and urine indexes are related to various TCM constitutions,and thus they have the potential to be used for TCM constitution classification.

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.