| ObjectivesTo explore the characteristics of traditional Chinese medicine(TCM)constitution of stroke risk population,stroke risk development track and its characteristics,as well as the relationship between stroke risk development track and TCM constitution,so as to provide decision-making reference for formulating stroke risk management scheme based on TCM constitution.Methods(1)Based on the longitudinal data of the four national surveys in 2011,2013,2015 and 2018 in the CHALRS database,residents ≥45 years old with at least one stroke risk factor were selected and included in the study.A total of 6467 cases were included in the statistical analysis.Taking the stroke risk grade as the dependent variable,the potential category growth model was analyzed to evaluate the most explanatory stroke risk development track,and the change trend characteristics of different subgroups were analyzed;Finally,single factor chi square test and multivariate logistic regression analysis were used to explore the characteristics of each subgroup.(2)Through two cross-sectional studies,based on the health examination data of the elderly from 2019 to 2022 in one of three communities in Guangzhou,4685 cases with at least one stroke risk factor were selected as the research object,and finally included in the analysis sample(1607 cases in cross-sectional study 1 on basic constitution of traditional Chinese medicine,and 3078 cases in cross-sectional study 2 on combined constitution).Through descriptive statistics,describe the distribution of TCM constitution of elderly stroke risk population;Based on multiple logistic regression analysis,explore the impact of different TCM constitutions on stroke risk grade;Based on the association analysis of the Apriori algorithm(the minimum support threshold is 10%,the minimum confidence threshold is 60%,and the gain is>1),explore two kinds of biased constitution and double clip association rules.(3)A longitudinal study design was adopted,and the research data source was the same as that of the previous study.All the data were based on the health examination data of the elderly in four communities in Guangzhou from 2019 to 2021.1123 samples were included in the analysis of those who completed the physical examination in three years.Through statistical analysis,describe the changes in risk factors and grades of stroke and TCM constitution of the elderly in the community in 2019,2020 and 2021;With the stroke risk classification as the dependent variable,the potential category growth model was analyzed to screen the most explanatory stroke risk development trajectory classification,and analyze the change trend characteristics of different subgroups;Finally,single factor chi square test and latent variable transformation analysis were used to explore the relationship between TCM constitution and stroke risk development subgroup.Results(1)Based on the characteristics of stroke risk development trajectory of middle-aged and elderly people,it can be divided into middle high risk stable group(41.8%),low risk sudden rise middle high risk group(7.5%)and low risk stable group(50.7%).The incidence of stroke within 3 years in the low-risk stable group was significantly lower than that in the medium high risk stable group and low-risk sudden rise medium high risk group(all P<0.05),and there was no significant difference in the incidence rate of stroke in the next three years between the medium high risk stable group and low-risk sudden rise medium high risk group(P>0.05).In 2011 multiple logistic regression analysis showed that,the C1 was compared to the C2 group,non-drinkers were more likely to enter group C1(OR=1.444,P<0.05).Men,45 to 59 years old,and not lonely people were more likely to be divided into C2 groups(OR=0.402,0.464,and 0.720,all P<0.05).C3 compared to C2,men were more easily admitted to the C3 group(OR=1.323,P<0.05),60 to 74 years old were more likely to be included in group C2(OR=0.556,P<0.05).In 2013 multiple logistic regression analysis showed that,the C1 was compared to the C2 group,non-drinkers were more susceptible to group C1(OR=1.369,P<0.05).Men,45 to 59 years old,60 to 74 years old,and retirees were more likely to be divided into group C2(OR=0.398,0.481,0.602,and 0.662,all P<0.05).C3 compared to C2,men,agricultural,no disability,and no napping participants were more likely to be included in group C3(OR=1.441,1.382,1.449,and 1.392,all P<0.05).60 to 74 years old were more likely to be included in group C2(OR=0.588,P<0.05).In 2015 multiple logistic regression analysis showed that,the C1 was compared to the C2 group,men,45 to 59 years old,and 60 to 74 years old were more likely to be included in group C2(OR=0.372,0.522,and 0.698,all P<0.05).C3 compared to C2,men and those with no disabilities were more likely to enter group C3(OR=1.302 and 1.605,both P<0.05),and those aged 60 to 74 were more likely to enter group C2(OR=0.710,P<0.05).(2)In Guangzhou,12%～25%of the elderly at risk of stroke aged over 65 years old are of moderate constitution,and the proportion of biased constitution from high to low is of damp heat,yin deficiency and blood stasis.There are great differences between different genders,and the proportion of men’s peace quality is slightly higher than that of women;The most common distribution of male biased constitution is damp heat,accounting for 40.04%;Women are more balanced,with yin deficiency being the most common,followed by damp heat.Double clip constitution accounts for about half of the total,with the most of the two types.The strongest correlation is between qi deficiency and blood stasis,and between qi stagnation and blood stasis.Phlegm dampness is an independent risk factor for the high risk group of stroke(OR=2.584,P<0.05),and yin deficiency is an independent risk factor for the high risk group of female stroke(OR=2.104,P<0.05)and the medium risk group(OR=1.015,P<0.05).With the increase of stroke risk,the strong correlation item set gradually decreases,and the combination of Qi deficiency and Qi deficiency continuously decreases.The most prominent combination is phlegm dampness blood stasis;From the virtual reality of low-risk population to the real reality of high-risk population.Women are more in line with the essence of disease development from "invisible evil" to "visible evil"than men in terms of the relationship between dual constitution,which is based on qi deficiency and low risk to high risk.(3)During the three-year observation period,hypertension(63.04%,66.42%and 66.16%),atrial fibrillation(47.41%,54.14%and 57.88%)and dyslipidemia(44.70%,42.03%and 37.67%)were the highest risk factors of stroke in the elderly community in Guangzhou,and smoking(9.80%,9.17%and 8.64%)was the lowest risk factor.From the change trend of the proportion of risk factors in three years,atrial fibrillation has the largest overall increase(47.41%→57.88%);Except for the lack of exercise,the proportion decreased most(35.26%→24.40%);The proportion of residual risk factors changed steadily.The development of stroke risk in the elderly in Guangzhou community can be divided into four subgroups:C1 high risk down group(16%),C2 low risk up group(15%),C3 constant high risk group(39%),C4 constant low risk group(31%);The proportion of phlegm dampness,damp heat and other solid constitution showed an increasing trend;Compared with other groups,C3 constant high risk group has a lower proportion of virtual constitution in 2019 and a higher proportion of real constitution in 2021(P<0.05).Conclusions(1)The risk management of stroke in the middle-aged and elderly needs to monitor the risk development trend,and about 15%of the low-risk population will rise to medium high risk(mainly high risk)in the next 3 to 5 years;The risk prevention and control management of stroke especially needs to pay attention to the people aged 60～74,women and those who have too long naps.(2)At the same time,the risk of stroke in the elderly in Guangzhou has increased,and the constitution of traditional Chinese medicine has shown a trend of developing from a weak constitution to a solid constitution;The combination of traditional Chinese medicine and sandwich constitution tends to converge with the increase of stroke risk,showing a trend of "taking Qi deficiency as the basis" and the association rules of "sandwich Qi depression,damp heat,blood stasis and phlegm dampness" to "phlegm dampness blood stasis",with the characteristics of "deficiency of origin" to "standard reality". |
PDF Full Text Request