| Object:To provide an objective evaluation method for the identification of cold and thermal mass by detecting the rate of sweating dynamically.Method:1. Research Type:Exploratory research.2. Subjects:542 healthy college students (18-35 years old) were observed which were from Shandong University of Traditional Chinese Medicine and Binzhou Medical University during June to October of 2015. Ultimately, typical cold and hot constitution students were selected according to the cold and hot constitution questionnaire filled by the volunteers.3. Information collection:Collect the subjects’information by using Information Form and Cold and Hot Constitution Questionnaire including Name, Gender, Birthday, Height, Weight and other basic information, and the Physical Condition about cold and hot in recent years.4. Sample groups:According to the definition and diagnosis principle of Chinese medicine on the cold and hot state, this study screened 2 group of subjects who have typical cold and hot constitution. A. Cold Constitution:People who often feel cold, thermophilic, cold-intolerant, and have cold extremities. B. Hot Constitution:People who often feel hot, cold-resistant, hot-intolerant, and have a fever of hands and feet.5. Instruments:Sweating rate detector is used in this study. It’s developed by our research group, Beijing Guo hao institute of sensor technology and Hao Hua Science and Technology Co. Ltd. The instrument can detect the sweating rate dynamically and non-invasive with the accuracy of 0.01μg/(s·cm2).6. Testing method:(1)Testing condition:room temperature was (25±1)℃, humidity was 30%-70%, with no air flow. Subjects were all dressed on unlined clothes. Keep quiet and stable during the test period. (2)Testing position:2-5cm below the cubital crease on the forearm. (3)Testing time:8:30-11:30a. m, 2:00-6:00 p.m. (4)Testing process: ①Testers explained the testing purpose, procedures and related matters needing attention to subjects to eliminate their tension. ②Fix the probe to the corresponding testing position and tell participants to keep a comfortable sitting state during the process. ③Open the sweating rate detector and adjust the initial level of instrument. ④Click the "start test" and "start recording" buttons, and the machine began to test and record testing data. ⑤During the first 5 minutes, test and record the sweating rate of subjects in the resting state. In the second 5 minutes, participants need to do step test according to a certain speed rhythm from a metronome to induce sweating. There’re 10 minutes for rest after the step exercise. The three stages are called "rest period", "movement period", and "recovery period".⑥ After the completion of the test, the probe was removed, and the test data were obtained. Tell the subjects that test is over.7. Data processing and parameter extraction:Processing the raw data of sweating rate to extract arithmetic mean, standard deviation, coefficient of variation of the resting, movement and recovery period, the maximum sweating rate of the sweating and its time, sweat output per unit area, and the ratio of sweating rate between movement and resting period, recovery and resting period, recovery and movement period.8. Statistical analysis:a. Take normality test, chi square test, test or rank sum test for the temperature, humidity, season of test environment and the age, sex, body mass index (BMI) of subjects to confirm whether the influence factors of the two groups were the same. b. Choose matched individuals from the treatment group and control group respectively according to a propensity score instead of all known confounding factors. And then, study the relationship between outcome and research variables based on the subsample. c. Take normality test of the mean, standard deviation of sweating rate, sweating rate ratio of the three periods, sweating output, maximum sweating rate and it’s time to confirm the distribution characteristics of the data and find out the special indexes of sweating of the cold and hot constitution crowd through rank sum test.9. Model construction method:Special parameters can be regarded as a diagnostic index (such as mean of sweating rate during movement period). Using diagnostic test and ROC curve can divide subjects into different states (such as cold or hot state). The diagnostic value of each diagnostic index can be evaluated by comparing with the actual situation.Result:Among the 542 subjects in this study,167 subjects were diagnosed as cold constitution, and 163 subjects were diagnosed as hot constitution. The difference of the BMI and Gender Composition between the two groups was statistically significant (BMI:p<0.01; Gender Composition:x2=60.796, p=0.000). The propensity score method was used to balance the confounding factors, and finally,92 pairs of matching data were obtained. Because the data of the sweating rate does not conform to normal distribution, rank sum test was used to compare the sweat data of two groups. And "median (upper quartile, lower quartile)" is used for statistical description.(Din the resting period, the mean of sweating rate of hot crowd isl.23(0.91,1.42)μg/(s·cm2), while the sweating rate mean of cold crowd is 1.20(0.88,1.44)μg/(s·cm2), and the difference is not statistically significant (p>0.05). During the movement period, the mean of sweating rate of hot crowd isl.71(1.27,2.29)μg/(s·cm2), while the sweating rate mean of cold crowd is 1.37(1.05,1.89)μg/(s·cm2), and the difference is statistically significant (p<0.05). During the recovery period, the mean of sweating rate of hot crowd is 2.06(1.45,3.05)μg/(s·cm2), significantly higher than the sweating rate mean of cold crowd of 1.60(1.17,2.20)μg/(s ·cm2). ②During the movement period, the coefficient of variation of hot crowd is26.03%(5.73%,43.84%), while the sweating rate coefficient of variation of cold crowd is 17.21%(2.90%,36.1%), the difference is statistically significant (p<0.05). ③The maximum of sweating rate of hot crowd is 3.86 (2.89,5.48) μg/(s·cm2), while the cold crowd’s is 3.07(1.91,4.81)μg/(s·cm2), the difference is statistically significant (p<0.05). ④During testing, the sweat output per square centimeter of a hot constitution person is 9.92(7.47,12.99)mg, and the cold is 8.05(6.12,11.05)mg, the difference is statistically significant (p<0.05).⑤The movement/resting ratio of mean of sweat rate in hot constitution group is 1.25(1.04,1.93), higher than 1.11(1.00,1.58) in cold constitution group, the difference has statistical significance (p<0.05). The recovery/resting ratio of mean of sweat rate in hot constitution group is 1.58(1.24,2.72), higher than 1.42(1.01,2.07) in cold constitution group, the difference has statistical significance (p<0.05). The recovery/movement ratio of mean of sweat rate in hot constitution group is 1.20(0.98,1.47), higher than 1.05(0.96,1.37) in cold constitution group, the difference has statistical significance (p<0.05).Diagnostic test results:The mean of sweating rate during recovery period is regarded as the diagnostic index. If it is less than or equal to 1.86μg/(s·cm2), the person will be diagnosed as cold constitution. Sensitivity is 71%, specificity is 58%, the correct rate of is 62.2%, diagnosis odds ratio is 3.38, positive likelihood ratio is 1.69, negative likelihood ratio is 0.5. If the mean of sweating rate during recovery period is more than or equal to 1.95μg/(s·cm2), the person will be diagnosed as hot constitution. Sensitivity is 67%, specificity is 62%, the correct rate of is 63.7%, diagnosis odds ratio is 3.33, positive likelihood ratio is 1.76, negative likelihood ratio is 0.53. Conclusion:The sweating rate detector with the accuracy of 0.01μg/(s ·cm2)can detect subjects’sweating rate dynamically, non-invasively. Sweating rate curve drawn by the sweating rate data can directly reflect the variation of sweating of subjects. According to the related indexes about sweating can classify the cold and hot constitution.2. Cold and hot constitutions have different characteristics about sweat. Statistical results show that the hot crowd is higher than the cold crowd in the following aspects:mean of sweating rate in the movement and recovery period, coefficient of variation of sweating rate in movement period, the maximum sweating rate and total amount of sweating. On the whole, People belonging to the hot constitution are easy to sweat. In the state of movement, the people of cold constitution sweating more smoothly than the hot.3. At the beginning of the recovery period, sweating rate is still on the rise after exercise. In other words, at the end of the exercise, the body is still cooling.4. After movement, the hot sweat longer than the cold. It means that the perspiring velocity of the hot is not easy to fade.5. The sweating mean of recovery period can be used as a diagnostic index to distinguish cold and hot constitution. It can diagnose cold constitution and heat constitution to some extent according the results of diagnosis test.6. The accuracy rate, sensitivity and specificity of the diagnostic model are low, and the model’s value is low. Constitution about cold or hot is closely related to the body’s gasification or energy metabolism level. And energy metabolism not only depends on the ability of heat dissipation, but also on heat production, the balance between them and body temperature set point. So, the testing and evaluation of constitutions need to combine with body temperature and other indicators which can reflect the metabolic level.7. Many factors can affect sweating rate, and individual difference is obvious. Even if in the same type of constitution, people’s state of sweating is not the same. So the sweating characteristics of a constitution is weaken, and the specificity of sweating is reduced. |
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