The Research On Measurement Method Of Three Types Of "Neijing" Obesity And The Correlativity With Syndrome Of Traditional Chinese Medicine

Objective:To explore the discriminating standard and the optimal tangent point for three types of "Neijing" obesity(oily,fat and fleshy),and reveal the correlativity with syndrome of traditional Chinese medicine,by designing the qualitative description (body configuration characteristic) of three fat types.To analyse the different prognosis developing,by investigating the related diseases of three types of "Neijing" obesity,remedying the theory of obesity.Method:Clinical data of 1267 obesity adults in Beijing Han population from the Beijing International Travel Health Care Center of Entry-exit Inspection and Quarantine Bureau and Guanganmen Hospital of China Academy of Chinese Medical Sciences during the period May-October 2008 were analyzed.The diagnostic criteria of BMI in the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults were applied.The diagnostic criteria of three types of "Neijing" obesity were worked out by consulting the relevance expert.The criteria of TCM syndrome differentiation were spleen-kidney qi deficiency,qi stagnation-phlegm stasis,and spleen hypofunction-dampness accumulation,the above not mentioned were others.To investigate the general information(gender,age,native place, occupation,fat occurrence age),main symptoms and signs,and condition happened in the relevance disease(diabetes mellitus and prediabetic state,hypertension,coronary heart disease,lipids disorder,osteoarthritis,gout,cerebrovascular disease,fatty liver, obstructive sleep apnea syndrome,obesity related glomerulopathy,cancer).To evaluate the discriminating standard for oily,fat and fleshy,measuring the anthropometric parameters(height,weight,upper arm circumference,wrist circumference,waist circumference,hip circumference,thigh circumference,calf circumference,the length of hands,the width of hands,shoulder width,hip width),The best spot is the highest positive likelihood ratio.Result:1.The investigation collects 1493 cases altogether,and the valid data material 1267 cases.The male 947 cases,account for 74.7%,the age(42.78±13.00) years old,and the female 320 cases,account for 25.3%,the age(53.27±13.89) years old.The overweight 884 cases,account for 69.8%,and the obesity 384 cases,account for 30.2%.The male overweight 661 cases(69.8%),and the male obesity 286 cases(30.2%). The female overweight 223 cases(69.7%),and the female obesity 97 cases(30.3%).2.The age range of respondents is 18-70 years,and the average age is(45.42±13.99) years,the average age of fat occurrence is(30.35±14.08) years.The male average age is(42.78±13.00) years,the peak age is 45 years old;the average age of fat occurrence is(29.57±13.60) years,the peak age is 30 years old.The female average age is (53.27±13.89) years,the peak age is 53 years old;the average age of fat occurrence is (32.82±15.15) years,the peak age is 30 years old.The overweight average age is (45.44±14.15) years,the peak age is 45 years old;the average age of fat occurrence is (31.08±13.78) years,the peak age is 30 years old.The obesity average age is (45.39±13.63) years,the peak age is 45 years old;the average age of fat occurrence is (28.76±14.55) years,the peak age is 0 and 30 years old.3.The oily 576 cases,account for 45.5%;the fat 351 cases,account for 27.7%;the fleshy 340 cases,account for 26.8%.The male oily 380 cases(40.1%),the male fat 247 cases(26.1%),and the male fleshy 320 cases(33.8%).The female oily 196 cases(61.2%),the female fat 104 cases(32.5%),and the female fleshy 20 cases(6.2%).The distribution of male oily,fat and fleshy is even;the female oily is in the majority,the female fleshy is few.4.The oily average age is(53.83±12.06) years,the peak age is 45 years old;the fat average age is(39.23±11.99) years,the peak age is 27 years old;the fleshy average age is(37.58±10.69) years,the peak age is 37 years old.The oily average age is bigger than the fat and fleshy obviously,approximately older 10-20 years old.The oily average age of fat occurrence is(36.97±13.03) years,the peak age is 30 years old;the fat average age of fat occurrence is(24.55±13.36) years,the peak age is 30 years old;the fleshy average age of fat occurrence is(25.51±11.55) years,the peak age is 25 years old.Moreover,in the fat and fleshy,the proportion of congenital obesity relatively to be also high. 5.In oily,spleen-kidney qi deficiency type 165 cases(account for 28.6%),qi stagnation-phlegm stasis type 90 cases(account for 15.6%),and spleen hypofunction-dampness accumulation type 279 cases(account for 48.4%),the others 42 cases(account for 7.3%).In fat,spleen-kidney qi deficiency type 80 cases(account for 22.8%),qi stagnation-phlegm stasis type 87 cases(account for 24.8%),and spleen hypofunction-dampness accumulation type 116 cases(account for 33.0%),the others 68 cases(account for 19.4%).In fleshy,spleen-kidney qi deficiency type 59 cases(account for 17.4%),qi stagnation-phlegm stasis type 103 cases(account for 30.3%),and spleen hypofunction-dampness accumulation type 100 cases(account for 29.4%),the others 78 cases(account for 22.9%).And more pleen hypofunction-dampness accumulation type in oily and fat,the proportion of qi stagnation-phlegm stasis type is highest in fleshy,next is pleen hypofunction-dampness accumulation type.According to occurrence frequency high-low sorting,the top five symptoms are in turn the happy food of fat gan strong taste,easy weary,impetuosity or repression,soreness of waist and body tired heavy in oily;the top five symptoms are in turn the happy food of fat gan strong taste,easy weary,the impetuosity or repression,body tired heavy and much appetite in fat;the top five symptoms are in turn the happy food of fat gan strong taste,much appetite,easy weary,profuse sputum and soreness of waist in fleshy.The most remarkable symptom is the happy food of fat gan strong taste in oily,fat and fleshy.According to occurrence frequency,the prominent tongue picture is pale-dark tongue in oily,fat-big tongue in fat and fleshy,tooth-marked tongue in oily and fat.The frequency of the happy food of fat gan strong taste is high in spleen hypofunction-dampness accumulation type of oily,fat and fleshy.More easy weary and body tired heavy in pleen hypofunction-dampness accumulation type of oily and fat.The highest occurrence frequency of the tongue picture is pale-dark tongue, tooth-marked tongue and reddened tongue in oily,fat and fleshy correspondingly.The frequency of the happy food of fat gan strong taste,much appetite,impetuosity and profuse sputum is high in qi stagnation-phlegm stasis type of fleshy;and the frequency of fat-big tongue and reddened tongue is high in qi stagnation-phlegm stasis type of fleshy.6.Prevalence of fatty liver,lipids disorder,hypertension,diabetes mellitus and prediabetic state,coronary heart disease,cerebrovascular disease,osteoarthritis,gout, obesity related glomerulopathy in oily is higher than that in fat and fleshy.Prevalence of metabolic disease,such as fatty liver,lipids disorder,hypertension,diabetes mellitus and prediabetic state,coronary heart disease,cerebrovascular disease in oily is higher 10%or above than that in fat and fleshy.Prevalence of lipids disorder in fat is higher 10%than that in fleshy,and prevalence of obstructive sleep apnea syndrome in fleshy is higher 10%than that in fat,prevalence of other relevance disease is close.The results through chi-square test show:diabetes mellitus and prediabetic state, hypertension,coronary heart disease,obesity related glomerulopathy,fatty liver,lipids disorder,and osteoarthritis between oily and fat,the difference has statistical significance(P<0.05);diabetes mellitus and prediabetic state,hypertension,coronary heart disease,obesity related glomerulopathy,fatty liver,lipids disorder, cerebrovascular disease,and gout between oily and fleshy,the difference has statistical significance(P<0.05),Specially metabolic disease,such as diabetes mellitus and prediabetic state,lipids disorder,hypertension,coronary heart disease and cerebrovascular disease between oily and fat,fleshy,the difference has statistical significance(P<0.05).Diabetes mellitus and prediabetic state,lipids disorder, cerebrovascular disease and osteoarthritis between fat and fleshy,the difference has statistical significance(P<0.05);prevalence of diabetes mellitus and prediabetic state,lipids disorder and cerebrovascular disease in fat is higher than that in fleshy. Prevalence of hypertension,coronary heart disease,fatty liver,obstructive sleep apnea syndrome,gout and obesity related glomerulopathy in fat and fleshy has no obvious difference(P>0.05).The results about prevalence of three-high(blood pressure,blood sugar,blood fats) in oily,fat and fleshy through chi-square test show.The distribution of relevance disease in oily,fat and fleshy is different(P<0.07).The distribution of relevance disease in fat and fleshy is the same(P>0.05).Compare Whether to have no three-high,Whether to have one three-high,Whether to have two three-high,and Whether to have three three-high in oily and fat,fleshy,the difference in Whether to have two three-high has statistical significance(P<0.01 ),namely the proportion of Whether to have two three-high in oily is higher than that in fat and fleshy.Whether to have no three-high,Whether to have one three-high,Whether to have two three-high, and Whether to have three three-high in fat and fleshy has no obvious difference(P> 0.05).7.The oily index is waist circumference,the waist hip ratio,waist circumference -height ratio,upper arm circumference-waist circumference ratio,waist circumference-thigh circumference ratio and waist circumference-calf circumference ratio.The optimal tangent point is 110.0,1.0,0.6,44.0,2.0 and 3.0 correspondingly.The index of fat and fleshy is the length of hands-height ratio,the width of hands-the length of hands ratio and shoulder width-hip width ratio.The optimal tangent point is 12.7,52.5and 1.4 correspondingly.The prevalence of diabetes mellitus and prediabetic state and coronary heart disease increased with the index of upper arm circumference-waist circumference ratio decreased.The prevalence of diabetes mellitus and prediabetic state,coronary heart disease and cerebrovascular disease increased with the index of waist circumference-thigh circumference ratio increased and the index of shoulder width-hip width ratio decreased.Conclusion:1.As a result of the difference between human body fat distribution proportion and degree,obesity have these types of oily,fat and fleshy.The oily accounts for the maximum proportion,explained that the abdomen fat metabolism is more active than other spots,that conforms to the Asian fat distributed characteristic.2.The influencing factors of the oily,fat and fleshy mainly have the age and the gender.The oily average age is bigger than the fat and fleshy obviously, approximately older 10-20 years.Many young people are fleshy or fat,then oily with age increases.The distribution of male oily,fat and fleshy is even;young female is fat, oily is in the majority of older female.the peak age of fat occurrence is 30 years old in oily and fat,and the peak age of fat occurrence is 25 years old in fleshy.Moreover,the proportion of congenital obesity relatively to be also high in the fat and fleshy.The age of three types of "Neijing" obesity is youth oriented day by day;obesity together with the obvious tendency of low age,appears in the middle-aged stage especially. 3.The Chinese medicine clinical dialectical for obesity may take deficiency and excess syndrome as a general outline.TCM syndrome-typing based therapy from spleen-kidney qi deficiency,qi stagnation-phlegm stasis,and spleen hypofunction-dampness accumulation.Spleen and stomach is the main disease location of obesity,which pathogenesis is abdominal fullness.Oily has primary asthenia syndrome or insufficiency and excess syndrome,fat and fleshy have insufficiency and excess syndrome or excess syndrome.More are spleen hypofunction-dampness accumulation and spleen-kidney qi deficiency in oily,and more are spleen hypofunction-dampness accumulation in fat and fleshy.Oily has the stasis,fat has phlegm and wet,fleshy has phlegm and hot.4.The hazard factor's frequency and degree of many kinds of disease in oily are higher than that in fat and fleshy,speeially metabolic disease,such as diabetes mellitus and prediabetic state,lipids disorder,hypertension,coronary heart disease,cerebrovascular disease and blood pressure,blood sugar,blood fats-important metabolism target.The abdomen fat stack degree is the good forecast target which the metabolic disease develops,which should be given the early intervention.5.The oily index is waist circumference,waist hip ratio,waist circumference -height ratio,upper arm circumference-waist circumference ratio,waist circumference-thigh circumference ratio and waist circumference-calf circumference ratio.The index of fat and fleshy is the length of hands-height ratio,the width of hands-the length of hands ratio and shoulder width-hip width ratio.The above index may become discriminating standard of oily,fat and fleshy.And the measurement method is easy and feasible, which is an objective and thorough annotation on three types of "Neijing" obesity, perhaps its results may be used in clinic as evaluating indicator.