| The physical classification of three yin and three yang was based on the clinical practice and put forward by my tutor professor Zhao Jinxi who researched the theory in Huangdi's Canon of Medicine and the method of three yin and three yang syndrome differentiation in Diseases Caused by Cold Factors. Distinguishing the type of constitution as a clinical thought can assist the differentiation of symptom-complexes and choosing drugs, judge susceptible diseases and development tendency of them, because constitution plays an important role in the process diseases. Besides, it can also guide health care. Because the three yin and three yang constitution is a valuable clinical classification method, the first thing is to establish an effective scale as measurement tools, this also is the premise of further studies. The study was divided into two parts, the purpose of the first part was to establish an early scale of three yin and three yang constitution, and tha of the second part was to analyze the correlation of constitution and type 2 diabetes. The abstract as follows:1 Literature review:The general situation of the study of classification of constitution in Chinese medicine and the process in correlation between constitution and diabetes and its complications were made a more systematic summary.2 Theory research:The connotation of three yin and three yang system theory and the physical theory were both relatively expounded according to the related content on Diseases Caused by Cold Factors. The physiological functions and pathological performance of each system of three yin and three yang were explained. The constitution type is formed because of the imbalance of the three yin and three yang system in human body. So the clinical manifestations of the corresponding system would be common in the pathologic state.3 The preliminary establishment of three yin and three yang constitution determination scale:Objective:Set up a preliminary determination scale based on the three yin and three yang physical classification method. The respondents are general population, and the purpose is to understand the individual type of constitution. It's a scale with universality.Methods:The research was done according to the step of the study of a homemade scale. The first step is to establish the concepts of three yin and three yang type of constitution, and collect items of the scale through literatures and discussion, and form an items pool. Weights of items in subscales were given. The standards of determination were decided, and the initial scale was formed; Items were filtered and modified preliminarily through the methods of interview, discussion and little scope of survey. Then a modified scale was formed; Then a survey 711 cases was been made, items were analyzed once again and the performance of the modified scale was evaluated.Results:(1) The items in the subscale were given weights and the proportion was 3:1 according to primary items and secondary ones. (2) Results of items screening:Items in 711 cases of sample were analyzed with many methods such as reaction degree of difficulty, reaction degree, sensitivity, concentrated trend analysis and exploratory factor analysis. A scale with 49 items including 4 areas and 17 facets was formed. (3) The test-retest reliability of the initial scale:20 cases did the scale twice, and the correlation coefficient r=0.787, p=0.007. The two scores were positively associated and the result has statistical significance which indicated that the test-retest reliability of the scale is good. (4) Content validity of the early scale:The types of constitution of 620 cases were judged by experience. The results were compared with that judged by the score. The anastomotic rate of the two methods was 80.3% taking the method of combining the qualitative and quantitative determination. Compared with the pure scores determination, the method of combining the qualitative and quantitative determination had higher validity.Conclusion:The early scale of three yin and three yang constitution which through items analysis and screening has good test-retest reliability. With the method of combining the qualitative and quantitative determination, the content validity is higher. The scale can be used preliminarily in judgement of the type of three yin and three yang constitution.4 The correlation between three yin and three yang constitution and type 2 diabetes:Objective:Through the case-control study with people with type 2 diabetes and the general population, introducing the scale method to analyze the distribution of three yin and three yang constitution characteristics, dietary habits and the present syndrome, physical and chemical examination, etc. To study the correlationship of constitution and many other factors by the mathematical statistic method. To explore the type of the susceptible constitution of diabetes and the characteristics of the risk factors of diabetes in different types of constitution. To provide the basis for the diagnosis and treatment model of the "trinity" including constitution, syndrome and disease differentiation in clinical practice.Methods:Both of 310 cases type 2 diabetes and general population were received according to the standard. The general information of the two groups was collected. Patients with type 2 diabetes were required to recall the state a long period before disease, fill the scale, and judgement of syndromes was done, and other clinical data were collected. General population filled the constitution scale based on their own feeling. The data were analyzed by SPSS18.0. Count material with the chi-square test, non-normal measurement data and grade material with rank sum test, and Logistic regression analysis was used in factors analysis.Results:(1) The frequency of yangming constitution and taiyin constitution of diabetic group was significant different from that of non-diabetic group. Yangming constitution of diabetic group was more than that of non-diabetic group (p<0.01), and taiyin constitution of diabetic group was less than that of non-diabetic group (p<0.01). Differences of the rest types of constitution had no statistically significance (p>0.05).(2) Compared with that of the non-diabetic group, people of thermal types of constitution was more than non-thermal types of constitution of diabetic group (p<0.01). There was no statistical significance between non-cold constitutions of the two groups (p>0.05). Compared with that of the diabetic group, the great constitution of diabetic group was more than the weak constitution (p<0.01).(3)BMI of diabetic group was higher than that of non-diabetic group (p<0.01); People who smoke in diabetic group were more than that of non-diabetic group (p<0.01); There was no significant difference between the two groups in drinking habits (p>0.05); in diabetic group, people who loved eating greasy, hot, salty, sweet food were more than that of non-diabetic group (p<0.01). There was no statistical differences between the two groups on bitter or light diet (p>0.05); People who have diabetes did less sports exercise than people who have no diabetes (p<0.01).(4) There were more women who had shaoyang constitution than men (p<0.01) and more women who had jueyin constitution than men (p<0.05).(5) Compared with people who had taiyang or yangming constitution, people who had shaoyang constitution had more chance to express as qi stagnation syndrome (both p<0.01). Compared with people who had taiyang or shaoyang constitution, people who had yangming constitution had more chance to express as heat and solid syndrome (both p<0.05).Conclusion:(1) Yangming constitution is a susceptible type of constitution for type 2 diabetes, and taiyin constitution is harder to suffer type 2 diabetes. (2) The type of constitution of people with type 2 diabetes is mostly thermal and solid constitution, which supports "hot injury yin" theory of diabetes from physical perspective. (3) Obesity, smoking, fat food of high calorie, and less movement are risk factors for diabetes. (4) There are obvious differences in frequency of shaoyang and jueyin constitution in sex. There are more women than men; There were more men of taiyang constitution than women but it is yet to be further study. (5) In diabetic people of shaoyang constitution, there are more qi stagnation syndrome than other people; In diabetic people of yang ming constitution, there are more heat and solid syndrome than other people. It is a preliminary evidence that syndrome and constitution have a trend of convergence.
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