Postmenopausal Osteoporosis And Its Influencing Factors, And Constitution Of Tcm-related Research

Modern studies have shown that an increaced incidence rate of postmenopausal osteoporosis(PMOP) is on going.With the high disability rate,lethality,high financial burden and low quality of life,the desease has aroused general concern of the medical profession,especially for research on the prevention and treatment.The Traditional Chinese Medicine (TCM) theory of constitution has long been playing an important part on the stage of history for the prevention and treatment of deseases.At present,there has not been any research on the relationship between PMO and TCM constitution,and this study aims to implement a preliminary research on the correlation of PMOP and TCM constitution to provide new ideas for the prevention and treatment of to the desease.PurposeIn this study,to explore the relevance of TCM constitution and PMOP and its impact factors by further research and clinical study based on the overview of TCM constitution and PMOP epidemiology research,as well as PMOP systematic review of risk factors,on one hand,to supplement the study of Osteoporosis Etiology and Pathogenesis;on the other hand,to provide new ideas for economic,effective TCM constitution tertiary prevention for the prevention of the desease.MethodsLiterature Study:A Review of the traditional form of TCM constitution and PMOP of the current situation,development trends and problems.Based on the form of a systematic review to evaluate PMOP risk factors,specific methods:â‘ Search Strategy:Studies were obtained from computerized searches of multiple electronic bibliographic databases,supplemented by hand searches of selected journals,and consultation with experts in the research field of PMOP.â‘¡Selection Criteria:All relevant case-control study and cohort study about PMOP were included.â‘¢Data Collection and Analysis:Two independent reviewers were responsible for data extraction and assessment,and quality of assessement.The original data of each trial were analyzed with software Revman 5.0.Theoretical research:based on the theory of TCM constitution,to discuss the TCM didease name of PMOP and the understanding of pathogenesis and the bibliometric analysis on the problem of the research field of TCM in the current understanding of PMOP.Clinical Research:â‘ The compilation of PMOP questionnaire on factors and pre-investigation.â‘¡Clinical epidemiological investigation:the use of hospital-based case-control study,researchers from the application of a unified questionnaire(The Constitution in Chinese Medicine Qnestionnaire and PMOP questionnaire on factors) of 224 cases and 238 control group carried out surveys to collect epidemiological data,and then used logistic regression method to explore the type of TCM constitution of PMOP and its impact on factors related to each other.In the process of Logistic-related statistics,therewas a need to carry out the diagnosis of multi-collinearity,influential point analysis,goodness of fit test. Finally,to make three-grade prevention system of TCM constitution on PMOP.ResultsLiterature Study:The Summary showed that prevalence of PMOP at home and abroad was severe,PMOP study on TCM constitution remained blank; Meta analysis on risk factors of results showed that:13 trails were identifed,the family history of fractures:WMD 2.57,95%CI[1.31,5.04]; case-control study of the personal history of fracture:WMD 2.27,95 %CI[1.76,2.92],cohort study of the personal history of fractures: WMD 1.76,95%CI[1.32,2.35];years since menopause:WMD 2.34,95%CL [1.71,3.21];BMI:WMD 0.53,95%CL[0.29,0.97];HRT:WMD 0.54,95%CL [0.31,0.97];added calcium:WMD 0.41,95%CL[0.28,0.59];regular smokers: WMD 1.41,95%CL[1.11,1.78];regular exercise:WMD 0.30,95%CL [0.14,0.64];regular tea:WMD 1.20,95%CL[0.34,4.29];the low level of education:WMD 2.30,95%CL[1.36,3.89];a little alcohol:WMD 0.38, 95%CL[0.26,0.57]TCM Theoretical research:PMOP among postmenopausal women is a bone atrophy;summed up for the essence of its pathogenesis is deficiency of the kidney essence,dysfunction of the spleen in transportation,deficiency of liver yin,bloodstasis,thecharacteristic of pathogenesis is deficiency and stagnation;PMOP problems in the TCM field have re-treatment,light Prevention,Diagnosis and Treatment of the lack of norms,theoretical research is lagging behind,the lack of empirical research of TCM.It is urgent and necessary to study prevention and treatment of PMOP according to TCM constitution.Clinical Research:â‘ through the questionnaire reliability and validity analysis,questionnaire items have been adjusted.â‘¡TCM constitution for PMOP of single-factor non-conditional Logistic analysis revealed that:normal constitution,yang deficiency constitution,yin deficiency constitution and blood-stasis constitution of their corresponding p values less than 0.05,the OR for normal constitution 0.221, OR for yang deficiency constitution 2.118,OR for yin deficiency constitution 1.790,OR for blood-stasis constitution 2.372;TCM constitution for PMOP of multi-factor analysis of non-conditional Logistic regression equation shows that:Logit(p)=ln(p/1-p)=-0.218-1.191x₁ (normal constitution)+0.801 x₃(yang deficiency constitution)+0.666 x₄ (yin deficiency constitution)+0.948 x₇(blood-stasis constitution); Normal constitution of non-conditional logistic model stepwise regression analysis showed that:on the education level(P=0.001),exercise(P= 0.011) and calcium supplement(P=0.008),compared with the education for primary schools and less,the education for specialized middle school and above had higher possibility of normal constitution(OR=5.282),Regular exercise had higher possibility of normal constitution than few movement (OR=6.862);yang deficiency constitution in the non-conditional logistic model stepwise regression analysis showed that:somatotype(P=0.002), salt(P=0.016),exercise(P=0.001),disease(P=0.022),menopausal age(P=0.006) entered the regression model,there is a positive correlation between salt(OR=3.375),disease(OR=1.923),menopausal age(OR=1.272) and the occurrence of yang deficiency constitution,there is a negative correlation between somatotype(OR=0.151),exercise(OR =0.244) and the occurrence of yang deficiency constitution.Yin deficiency constitution of non-conditional logistic model stepwise regression analysis showed that:alcohol(P=0.009),and diet combination(P= 0.005),BMI(P=0.000) entered the regression model,drinking(OR=3.689), diet combination(OR=2.868) and the occurrence of yin deficiency constitution was positively correlated,BMI(OR=0.787) and the occurrence of yin deficiency constitution showed a negative correlation.Blood-stasis constitution of non-conditional logistic model stepwise regression analysis showed that:smoking(P=0.003),disease(P=0.004) and the number of births(P=0.005) entered the regression model,smoking(OR= 4.030),disease(OR=2.962),the number of births(OR=4.503) and the occurrence of blood quality was positively correlated.Conclusion1.The systematic evaluation made the possibility that family history of fracture,personal fracture history,menopausal age(≥5 years),regular smoking,low education level can promote the occurrence of PMOP, while BMI(≥25),HRT,calcium supplement,alittle drinking,regular exercise can help prevent the occurrence of PMOP.2.By exploring relationship between TCM constitution and PMOP,for the first time the establishment of yang deficiency constitution,yin deficiency constitution and blood-stasis constitution were regarded as risk factors of PMOP,normal constitution was found to be a protective factor of PMOP,Which enriches the TCM pathogenesis theory of PMOP.3.By exploring the relationship between TCM constitution and impact factors of PMOP,the research drawed the conclusion that normal constitution-related factors included:cultural,sports,calcium;and blood-stasis constitution-related factors included:smoking,chronic diseases,reproductive number;and yang deficiency constitution-related factors:somatotype,salt,exercise,chronic disease,menopausal age,among them,salt,chronic disease,risk factors for post-menopausal age,size, movement for the protection factor;while yin deficiency constitution -related factors include the following as:drinking,diet,BMI,among them, drinking,eating together as risk factors,protective factors for BMI.4.A three-grade prevention system of TCM constitution on PMOP has been made:primary prevention aimed at early life,for food,spiritual,exercise and other aspects of prevention;secondary prevention aimed at postmenopausal women,to screening high-risk groups by PMOP personal health management,and promote health from the diet,lifestyle,sports,exercise,emotional adjustment,to prevent controllable risk factors of PMOP,to improve risk constitution and restore the body's yin and yang balance;tertiary prevention aimed at of PMOP patients,the main measures is to take on Treating by Differentiation of Individual,spirit conditioning,physical exercise and living environment to adjust,and active treatment of disease,to prevent the occurrence of fractures.