| Objectives1.Study one:TCM constitution has developed rapidly and has accumulated a large number of literatures.Through the metrological analysis of the literatures on TCM constitution research in the past decade,the hotspots and frontiers in the field of TCM constitution research are sorted out to provide a direction for promoting the development of San-Yin San-Yang constitution theory.2.Study two:Physical fitness classification scale is the most important scientific measurement tool in physical fitness theory.Professor Zhao Jinxi’s team has developed the "San-Yin San-Yang constitution Initial Scale".In this study,we re-evaluated its validity and provided validity test support for the application of this scale.3.Study three:Professor Zhao Jinxi’s proposed the diagnosis and treatment model of"distinguish constitution-distinguish disease-distinguish symptoms of diseases" and accumulated a wealth of experience in the diagnosis and treatment of diabetes.This study summarized Professor Zhao Jinxi’s experience in the treatment of type 2 diabetes with Yang-Ming constitution and summarized and inherited the academic thoughts of experts.Methods1.Study one:CiteSpace software was applied to mine the TCM constitution related literatures published in core journals from 2010 to 2019,and the author cooperation map,institutional cooperation map,keyword co-occurrence map,keyword timeline view,and keyword cited sudden detection map were drawn.2.Study two:We collected the patients with type 2 diabetes and diabetic kidney disease,from June 2019 to December 2019,who were diagnosed and treated by Professor Zhao Jinxi in the ward and outpatient department of Dongzhimen Hospital,affiliated to Beijing university of Chinese Medicine.We used the "San-Yin San-Yang Physical Constitution Initial Scale"to collect the physical information,and then constructed the first-order oblique confirmatory factor analysis model according to Zhao Jinxi’s "San-Yin San-Yang Physical Constitution Theory",and next test the model’s convergent validity and discriminative validity by using AMOS software.3.Study three:In this study,we selected the medical records of patients with Yang-Ming constitution determined by "San-Yin San-Yang constitution Initial Scale",used frequency distribution to describe the distribution of patients in diabetic stage and compared with patients in diabetic kidney disease stage,and used Bayesian theory to explore the estimated probability of TCM syndrome based on Yang-Ming constitution;The frequency information of drug use was counted,NetDraw software was used to visualize the drug social network,Ucinet software was used for core edge analysis,and the degree centrality,betweenness centrality,and closeness centrality of each drug were calculated;logistic regression method was used to gradually screen the symptoms,tongue,and pulse factors affecting drug use.Results1.Study one:There were 12 authors with more than 10 published literatures.Professor Wang Qi from Beijing University of Chinese Medicine had the highest published literatures.The institutions of physical research mainly focused on the School of Basic Medical Sciences,Dong-Fang Hospital and School of Management of Beijing University of Chinese Medicine.The clustering results of keywords were:correlation,diabetes,research,physical fitness,risk factors,physical classification,impaired glucose tolerance,sub-health,type 2 diabetes,peaceful quality and hypertension.According to the timeline view of the clustering results,diabetes,research,and constitution are the three keywords that have emerged at high frequency continuously in the last decade and related studies have consistently continued until 2019.The keywords cited in the sudden detection map suggest that the keywords that continue to 2019 are health management,traditional Chinese medicine,yang deficiency constitution,and correlation analysis.2.Study two:A total of 252 valid scale data were collected including Tai-Yang constitution(n=4),Yang-Ming constitution(n=46),Shao-Yang constitution(n=102),Tai-Yin constitution(n=5),Shao-Yin constitution(n=6),and Jue-Yin constitution(n=89);convergent validity results:"Can you usually tolerate the cold environment?","Did you always feel energetic?","Did you commonly feel sad?","How is your stool?","Are you sleeping well?","Did you easily get angry to others?" were the best measurable items."Can you usually tolerate the cold environment?","Did you always feel energetic?","Do you have a good appetite?","Did you commonly feel sad?","Are you sensitive or emotionally fragile?","How often do you have stools?","How is your stool?","Are you sleeping well?","Did you easily get angry to others?","Are you irritable?",and "Can you control your angry emotions?",these questions have good item reliability.The combined reliability and average variance extraction of the six types of constitution were Tai-Yang constitution(0.163/0.082),Yang-Ming constitution(0.344/0.167),Shao-Yang constitution(0.404/0.206),Tai-Yin constitution(0.235/0.154),Shao-Yin constitution(0.072/0.077),and Jue-Yin constitution(0.324/0.270);discriminative validity results:the arithmetic square root of the average variance extraction was greater than the correlation coefficient between Tai-Yin and Jue-Yin constitution and other constitutions.While the arithmetic square root of the average variance extraction of the other four types of constitution was not all greater than the correlation coefficient between them;Model fitting index and degree of thrift:RMSEA 0.079<0.08,X2/df 2.557<3.3.Study three:A total of 46 patients with Yang-Ming constitution were included in this study,and a total of 39 prescriptions in the diabetic period and 77 prescr:iptions in the diabetic kidney disease period were collected for core prescription analysis and use.TCM symptoms distribution results:Among the patients with Yang-Ming constitution in this study,the top four most frequent ones were blood stasis syndrome,yin deficiency syndrome,intestinal heat syndrome,and stagnant heat syndrome.Bayesian estimation:Patients diagnosed with heat toxin syndrome and liquid cessation syndrome speculated that the probability of Yang-Ming constitution was greatly improved compared with the general population,while patients diagnosed with liver-yang syndrome and qi stagnation syndrome speculated that the probability of Yang-Ming constitution was decreased compared with the general population;A total of 15 drug combinations were collected for the use of borderline drugs;the results of symptoms factors affecting herb use by multivariate logistic regression:the causal relationships including insomnia and amnesia-Gegen,limb weakness-Huangqi,dreaminess and sleep badly-Banxia,insomnia and amnesia-Chenpi,dreaminess and sleep badly-Chenpi,Loose stools-Chenpi,nocturnal increase in localized tingling-Huanglian,yellow and red urine with astringent pain-Huanglian,Pulse string-Huanglian.Conclusions1.Through the bibliometric study of TCM constitution research in the past decade,it is found that TCM constitution research mainly focuses on constitution classification and physical disease-related fields,of which constitution and diabetes-related research is the most abundant,and the possible development direction of San-Yin San-Yang constitution theory in the future is the field of treating diseases.2.Through the examination of convergence validity and difference validity of the structural equation model of the "San-Yin San-Yang Physical Constitution Initial Scale",it is found that the convergence validity of this model is general,and the difference validity between some latent variables reaches a significant level,so this scale can be selected and applied according to the study object and research purpose in clinical practice,but it still has room for further optimization and improvement.3.Based on the results of data analysis of type 2 diabetic patients with Yang-Ming constitution in this study,Professor Zhao Jinxi,on the basis of physical differentiation,emphasized grasping the core of "heat injuring qi and yin" of diabetes,attaching importance to the diagnosis and treatment ideas combining disease differentiation and syndrome differentiation,and drugs use with the effects of clearing away heat,supplementing qi,and activating blood circulation to treat diabetes,and his experience needs to be further explored. |
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