不同肥胖表型者中医体质特点分析研究  

Traditional Chinese Medicine Constitution Features of Different Obesity Phenotypes

作　　者：孟令杰 朱燕波[1] 徐佳 贾丽燕 吕晓颖 谢宜沙[1] 郑昆 张会[1] 刘涵 MENG Lingjie;ZHU Yanbo;XU jia;JIA Liyan;LYU Xiaoying;XIE Yisha;ZHENG Kun;ZHANG Hui;LIU Han(School of Management,Beijing University of Chinese Medicine,Beijing 100029,China;Third Affiliated Hospital,Beijing University of Chinese Medicine,Beijing 100029,China;School of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]北京中医药大学管理学院,北京市100029 [2]北京中医药大学第三附属医院,北京市100029 [3]北京中医药大学中医学院,北京市100029 [4]中国中医科学院中医临床基础医学研究所,北京市100070

出　　处：《中国全科医学》2020年第2期221-226,共6页Chinese General Practice

基　　金：科技部基础性工作专项(2013FY114400-5);国家自然科学基金青年科学基金资助项目(81703950);中国中医科学院新思路新方法研究专项(Z0438)

摘　　要：背景有研究表明肥胖者和代谢紊乱者的中医体质类型存在一定的相似性,但是不同肥胖者发生代谢紊乱的风险不完全相同,是否中医体质为其内在原因?目前尚不可知。目的探究不同肥胖表型者中医体质特点。方法从2012年6月2014年1月北京同仁医院、安徽中医药大学第一附属医院以及广东省中医院珠海医院治未病中心健康体检人群1814例数据库中,排除年龄<18岁者、分析变量存在缺失值及体质量过轻和超重者,纳入1267例体质量正常和肥胖样本进行分析。根据代谢正常/异常及体质量正常/肥胖组合形成4种代谢肥胖表型,即代谢正常体质量正常表型(MHNW)、代谢异常体质量正常表型(MUNW)、代谢正常肥胖表型(MHO)、代谢异常肥胖表型(MUO)。采用中医体质量表评价中医体质,采用最小二乘回归法(控制社会人口学因素及行为习惯因素)计算不同肥胖表型者9种中医体质(平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质)得分。结果1267例调查对象中,MHNW 584例(46.1%),MUNW 207例(16.3%),MHO 174例(13.7%),MUO 302例(23.9%)。不同肥胖表型者平和质、阳虚质、痰湿质得分比较,差异均有统计学意义(P<0.05);其中MUO者平和质得分高于MHNW和MUNW者,阳虚质得分低于MHNW和MUNW者;MHO和MUO者痰湿质得分高于MHNW和MUNW者(P<0.05)。男性不同肥胖表型者平和质、阳虚质、痰湿质得分比较,差异均有统计学意义(P<0.05);其中MUO者平和质得分高于MHNW和MUNW者,阳虚质得分低于MHNW和MUNW者;MUNW、MHO和MUO者痰湿质得分高于MHNW者(P<0.05)。女性不同肥胖表型者阳虚质、痰湿质得分比较,差异均有统计学意义(P<0.05);其中MUO者阳虚质得分低于MHNW者,MHO者痰湿质得分高于MHNW和MUNW者,MUO者痰湿质得分高于MUNW者(P<0.05)。结论代谢状况相近的情况下,肥胖者痰湿质、平和质倾向更高,阳虚质倾向更低;体质量相近Background Studies have shown that there are certain similarities in the types of TCM constitutions between obese people and those with metabolic disorders,but the risk of metabolically unhealthy in different obese people is not exactly the same.However,it is still unknown whether this difference is essentially related to TCM constitution.Objective To explore the TCM constitution features of different obesity phenotypes.Methods During June 2012 to January 2014,from the database of 1 814 physical examinees recruited from Preventive Treatment Center,Beijing Tongren Hospital,the First Affiliated Hospital of Anhui University of Chinese Medicine,and Zhuhai Branch,Guangdong Provincial Hospital of Traditional Chinese Medicine,1 267 normal-weight and obese cases were included after excluding those who were less than 18 years old,underweight,overweight,and had missing data.According to metabolic and obese phenotypes,they were divided into four groups:metabolically healthy normal weight(MHNW),metabolically unhealthy normal weight(MUNW),metabolically healthy obesity(MHO),and metabolically unhealthy obesity(MUO).The TCM Constitution Questionnaire was used to investigate the TCM constitution.Partial least squares regression was used to calculate the scores of 9 types of TCM constitution for different obesity phenotypes after controlling sociodemographic and behavioral factors,including constitution of gentleness,Qi-deficiency,Yang-deficiency,Yin-deficiency,phlegm-dampness,damp-heat,blood stasis,Qi depression,and allergic.Results The number of cases in groups of MHNW,MUNW,MHO,and MUO was 584(46.1%),207(16.3%),174(13.7%),and 302(23.9%),respectively.The mean scores of constitution of gentleness,Yang-deficiency and phlegm-dampness differed significantly by obesity phenotype(P<0.05).To be specific,MUO group showed higher mean score of gentleness constitution,and lower mean score of Yang-deficiency constitution compared with MHNW and MUNW groups(P<0.05).MHO and MUO groups showed higher mean score of phlegm-dampness constitution com

关 键 词：肥胖表型 代谢正常肥胖表型 代谢异常肥胖表型 中医体质量表 痰湿体质 

分 类 号：R589.2[医药卫生—内分泌]