Study On The TCM Constitution Distribution Of Patients With Anal Fistula

Objective: Through analyzing the distribution of TCM constitution of patients with anal fistula and its distribution in different gender,age,BMI,anal fistula classification,past history,and exploring the correlation between them,in order to provide the quantitative indicators of an objective guide to the individual treatment principles and patient's physical condition improvement,and improve the theoretical basis of the pathogenesis of TCM in anal fistula.Methods: Based on the "Classification and Determination of Constitution in TCM" standard,we designed a TCM constitution questionnaire.The questionnaire included dietary preferences,smoking and drinking history,defecation frequency and TCM constitution judgment.From June 2018 to February 2019,all anal fistula patients who were in accordance with the inclusion criteria and admitted to Shanghai Shuguang Hospital(East Branch)were investigated.The results of the questionnaire were assigned.General information such as gender,age,height and weight,and other indicators such as anal fistula classification and past history were recorded.After all the data were double checked and entered into the Excel database,the score was judged according to the "Classification and Determination of Constitution in TCM" standard.The statistical analysis was performed using SPSS24.0 statistical software.The count data was used to describe the statistics by frequency(or composition ratio),R×C chi-square test,or Fisher's exact test.The test standard = 0.05,the difference was statistically significant at P < 0.05.Results: A total of 552 patients with anal fistula were included in the study.(1)The TCM constitution distribution of patients with anal fistula in the order of frequency from high to low is: dampness-heat constitution(35.3%)> Yang-deficiency constitution(20.1%)> Phlegm-dampness constitution(14.3%)> Qi-deficiency constitution(10.3%)> Qi-depression constitution(6.9%)> gentleness constitution(6.5%)> Yin-deficiency constitution(4.7%)> Blood-stasis constitution(1.6%)> Special diathesis constitution(0.2%).The proportion of dampness-heat constitution,Yang-deficiency constitution and Phlegm-dampness constitution in patients with anal fistula is greater than that of the general population.(2)Male patients were accounted for 85.7% of the total.TCM constitution is mainly dampness-heat constitution,Yang-deficiency constitution,and Phlegm-dampness constitution.Female patients were accounted for 14.3% of the total.TCM constitution is mainly Yang-deficiency constitution,dampness-heat constitution,gentleness constitution,Qi-deficiency constitution,and Phlegm-dampness constitution.(3)The total number of patients aged 20-40 years was 63.2%.There was no significant difference in the distribution of TCM constitution among anal fistula patients of all ages.(4)Patients with underweight,normal and overweight had the highest proportion of dampness-heat constitution,and obesity patients had the highest proportion of Qi-deficiency constitution.It was not clear whether BMI was related to the constitution of anal fistula patients.(5)Patients with some eating preferences(like greasy,barbecue,spicy diet)have a higher proportion of dampness-heat constitution than other anal fistula patients.(6)Patients with anal fistula who had a history of smoking or drinking history had a higher proportion of dampness-heat constitution than other anal fistula patients.(7)The defecation frequency and character of patients in anal fistula are related to the distribution of TCM constitution.Yang-deficiency constitution is higher in anal fistula patients with higher defecation frequency or loose defecation character.(8)Patients with a history of anal fistula have more Yang-deficiency constitution.(9)There is a significant difference in the distribution of TCM constitution among patients with different anal fistulas classifications.Patients with low anal fistula have more dampness-heat constitution,and patients with high anal fistula have more Yang-deficiency constitution.(10)The proportion of high anal fistula is higher in an anal fistula patients who like greasy diet,eat barbecue,have higher defecation frequency,have loose stool character,and have an history of anal fistula.Conclusions:(1)The distribution of TCM constitution in patients with anal fistula is more common with dampness-heat constitution,Yang-deficiency constitution and Phlegm-dampness constitution.TCM constitution may be one of the risk factors for anal fistula.(2)Patients with high anal fistula are more common with Yang-deficiency constitution,while patients with low anal fistula are more common with dampness-heat constitution and Phlegm-dampness constitution.The TCM constitution of patients may affect the classification of anal fistula.(3)Factors,including gender,some eating habits(like barbecue,greasy,spicy diet),smoking and drinking history,defecation frequency and character,history of anal fistula may be risk factors affecting the distribution of TCM constitution in patients with anal fistula.