| Purpose : This study aims to investigate the TCMBC of gout patients explore the correlation between dietary habits and prevailing TCMBC among gout patients in Singapore at Singapore Thong Chai Medical Institution(STCMI).A questionnaire designed based on TCMBC Scale developed by Wang et al will be used in data collection of lifestyle habits and general health information?Material and method:This is a questionnaire-based,cross-sectional study carried out at STCMI and Wong Yiu Nam Clinic.Patients with history of gout were recruited between December 2020 and July 2021.Questionnaire(refer to Annex)was designed based on the standard TCMBC Scale released by China Association of Chinese Medicine(CACM)in2009.The questionnaire will be completed by the patient or by interview with the key investigator.Results:1.There are a total of 76.1% males in the study,69% of the participants are above 50 years of age with the 60-69 years old having the highest proportion(25.7%)among all age groups,mean age is 57.28±14.28 years old;Mean BMI among participants is 26.45±3.71 with 82.3% in the unhealthy range.2.Among patients with gouty arthritis(GA),there are 37 cases(32.74%)of balanced BC and 76 cases(67.26%)of unbalanced BC.The unbalanced cases comprises 24 cases of qi-deficiency(21.24%);9 cases of yang-deficiency(7.96%);13 cases of yin-deficiency(11.50%);6 cases of phlegm-dampness(5.31%);12 cases of damp-heat(10.62%);8cases of blood-stasis(7.08%);4 cases of stagnant-qi(3.54%);There is no special inherited BC.3.The most common secondary BC tendencies are qi-deficiency(20 cases,25%)and blood-stasis(19 cases,23.75%).Among those with balanced BC as main constitution,12 cases have other BC tendencies,whereas in those with unbalanced BC,there are 68 cases with other BC tendencies,difference in concurrence is statistically significant(P<.05).4.Risk factors: There are 36.05% balanced BC among males and 22.22% among female,P=.029,difference is statistically significant(P<.05).However there is no significant difference between the unbalanced BC distribution of male and females.Balanced BC take up 25% to 42.86% among different age groups but difference is statistically insignificant(P>.05).In terms of weight,among BMI18.50-22.99 group there are 20% balanced BC,among BMI23-27.49 group there are 42.86% balanced BC and among BMI?27.5 group,there are 24.34% balanced BC,difference is statistically insignificant(P>.05).5.Patients who were within the first 1-5 years of the onset of gout,37% have balanced BC,20.37% have qi-deficiency,and 11.11% are damp-heat whereas in patients with more than 10 years of gout,the proportion of balanced BC decreases(20.00%),while the proportion of qi-deficiency(22.50%),yang-deficiency(20.00%)and stagnant-qi(20.00%)increase.The difference in the number of balanced and unbalanced cases between the various age groups is statistically significant(P<.05).6.Hypertension(60 cases),dyslipidemia(49 cases)and diabetes(17cases)are the most common GA comorbidities,the difference in the number of balanced and unbalanced cases between the comorbidities is statistically insignificant(P>.05).Among patients with hypertension and dyslipidemia,qi-deficiency,yin-deficiency and damp-heat are the top 3 unbalanced BC,proportions varies between 10.20%-16.33%.While in patients with diabetes,there is more qi-deficiency(35.29%)and phlegm-dampness(17.65%).The difference between the individual BC is statistically significant(P<.05).7.Lifestyle:in patients who drink alcohol,unbalanced BC stands at 76.91% as compared to 50% in non-drinker,difference is statistically significant(P<.05);In those who exercise regularly,proportion of balanced BC is higher at 39.47% than those who did not exercise(29.33%),however difference is statistically insignificant(P>.05);Patients who have high purine diets present with more yin-deficiency BC(19.35%)and damp-heat BC(12.9%)and fewer qi-deficiency BC(16.13%)as compare to those who had an average diet,at 8.45%,9.76% and 23.17% respectively,difference is statistically insignificant(P>.05).Conclusion:1.GA occurs more frequently in man,age above 50 years old and has an unhealthy weight.2.Patients with gouty arthritis exhibits higher proportion of unbalanced BC.The most common individual BC is the balanced constitution and the most common unbalanced BC is qi-deficiency,yin-deficiency,and damp-heat.3.Qi-deficiency and blood-stasis are the most common secondary BC tendencies and patients with unbalance BC are more prone to display secondary BC tendency.4.Sex affects the overall balanced BC proportion in GA patient but does not affect the individual distribution of unbalanced BC whereas age and weight have no influence on their BC.5.As gouty arthritis progresses to later stage,the proportion of balanced BC decreases.6.TCMBC distribution is the same among patients with hypertension and dyslipidemia,namely qi-deficiency,yin-deficiency and damp-heat.Whereas in patients with diabetes,qi-deficiency and phlegm-dampness prevails.7.Drinking or not exercising regularly is linked to higher proportion of unbalanced BC while in patients with high purine diet,there are more yin-deficiency and damn-heat BC and fewer qi-deficiency BC. |
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