| OBJECTIVE:To explore the basic status and characteristics of Chinese adult population's combined constitution,and to analyze the relationship between combined constitution and health outcomes,so as to empirically supplements the separable and disease-related issue about traditional Chinese medicine(TCM)constitution,and provide some thoughts for the health management related to adjustable issue about TCM constitution.METHODS:From 2005 to 2017,the cross-sectional survey was conducted in 11 provinces(or municipalities directly under the central government)of China on the TCM constitution and health status.Samples aged over 18 years were included and divided into subgroups according to the gender and age(18-40 years,41-60 years,61-years)of the subjects.Based on the filling-in of constitution of Chinese medicine questionnaire,the constitution types of the subjects were identified,and then the judgment of whether the constitution type was combined or not and the specific constitution type was made.The sample number and composition ratio of each combination of two kind of constitution combined and three kind of constitution combined were counted.Simple correlation analysis,factor analysis and cluster analysis were all used to analyze the tendency of combination of constitution.Obesity,hypertension,diabetes and hyperlipidemia were taken as disease indicators to investigate whether there were differences in prevalence among samples with different combined constitution status.Correspondence analysis was used to describe the relationship between the number of biased constitutions and the number of diseases.Taking the SF-36 score as the quality of life(QOL)index,examined whether there were differences in the QOL score among samples with different combined constitution status.Canonical correlation analysis was used to analyze the correlation between eight biased constitution scores and eight dimensions of QOL.RESULTS:A total of 23671 samples were included in the study,including 7008 young males,8700 young females,2853 middle-aged males,3312 middle-aged females,944 elderly males and 853 elderly females.?Combined constitution status:The overall incidence of combined constitution in all subjects was 54.3%.The most common constitution status was the combined constitution formed by four or more kinds of biased constitution,and the least was the status of unjudgmental constitution.The incidences of combined constitution in female and elderly groups were higher.Qi Deficiency constitution was the most likely to form the combined constitution,while Special Diathesis constitution was the least likely to form the combined constitution.'Qi Deficiency-Qi Depression'and'Qi Deficiency-Yang Deficiency'were the most common types of two kind of biased constitutions combined,while'Phlegm Dampness-Specific Diathesis' and'Phlegm Dampness-Blood Stasis' were the most rare types of two kind of biased constitutions combined,and'Qi Deficiency-Yang Deficiency-Qi Depression'and'Qi Deficiency-Yin Deficiency-Blood Stasis' were the most common types of three kind of biased constitutions combined.The results of correlation analysis,factor analysis and cluster analysis not only supported the above conclusions,but also suggested that'Yin deficiency-Blood stasis,and 'Phlegm Dampness-Dampness Heat,had a strong tendency of form the combined constitution.The results of subgroup analysis were in good agreement with those of the whole population,but at the same time,we could see the specific constitution characteristics of the subgroups,such as the Phlegm Dampness constitution easily formed combined constitution in the male population.?Researches on the relationship between constitution and diseases:In the whole population,the combined constitution status in patients with hypertension,diabetes and hyperlipidemia was more common.Compared with the people of Gentleness constitution,the prevalence of those with more than three kinds of biased constitution combined was higher,and the difference was statistically significant(P<0.05).In some subgroups,the prevalence of obesity was also significantly higher among those with more than three biased constitutions.The corresponding analysis results of the whole population and each subgroup showed that the increase of biased constitution species had a relatively synchronous trend with the increase of the number of diseases,and there was a correlation between the situation of complex constitution and the agglomeration of diseases.?The relationship between combined constitution and QOL:With the gradual deepening of biased constitution and the complexity of combined constitution,the scores of eight dimensions,two fields and total scores of SF-36 showed the gradual downward trend,and the difference was statistically significant in the whole population and some subgroups(P<0.05).Canonical correlation analysis showed that in the whole population and young or middle-aged population,the combination of 'Qi Deficiency-Blood Stasis-Qi Depression' constitution had significant impairment on the body pain dimension,general health dimension,vitality dimension and mental health dimension of QOL;in the elderly male population,the combination of 'Qi Deficiency-Phlegm Dampness-Qi Depression'constitution had significant impairment on the vitality dimension and mental health dimension of QOL;in the elderly female population,the combination of 'Qi Deficiency-Qi Depression' constitution had significant impairment on the physical pain dimension,vitality dimension and mental health dimension of QOL.CONCLUSIONS:Combined status of constitution in Chinese adult population has the characteristics of universality and complexity.Some biased constitutions have strong correlation and are easy to form the specific types of combined constitution.The condition about combined constitution is associated with higher morbidity and lower quality of life.The more complex the combined constitution condition is,the worse the outcome of disease and quality of life will be.It is of positive significance to carry out constitution intervention and improve the condition of both physical and mental health. |
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