TCM Comprehensive Intervention On Women Of Childbearing Age To Optimize Physical Evaluation

BackgroundTraditional Chinese medicine has a long eugenic history, it believes that baby is strong or not depends on parents’ essence and blood to a large extent. It is the best time to gave birth to the child when parents are in the moderate state, is conducive to the growth and development of children, shall will be improving baby’s resistance to disease.However, the frequently-used eugenic interventions are mainly based on modern medicine, traditional Chinese medicine theory did not play a proper role in the field of eugenics. In recent years, with the development and the evolving of traditional Chinese medicine theory, the constitution in traditional Chinese medicine (TCM) theory gradually formed and become an important part of the system of traditional Chinese medicine. And that, the Constitution in Chinese Medicine Questionnaire (CCMQ) quantizes TCM diagnosis and treatment, not only to find a breakthrough point of the modern development of the basic theory of TCM, but also to provide the technical support for application in the field of eugenics of TCM.AimsTo discuss effect on the improvement of the biased constitution under TCM comprehensive intervention.This research not only enriching the content of the constitution Chinese medicine intervention study, and providing powerful basis for the application of TCM constitution in the field of eugenics.MethodsThe study choose the PingGu district of Beijing as the test site, by the method of epidemiological field test.1Randomization.In order to ensure the intervention area and control area are comparable in the following factors, such as economy, culture, transportation and so on. First, partitioning the PingGu administrative area into two regions, and then divided it into intervention and control group randomly.2Constitution Assessment and Baseline Survey. Firstly, using the Constitution in Chinese Medicine Questionnaire (CCMQ) to choose biased constitution women of childbearing age. Secondly, depending the research object selection criteria to bring93cases into intervention group and105cases into control group. Thirdly, collecting the basic information of the research object.3Intervention and Assessment. Project team carry out regular eugenics intervention for Control group, on this basis, add Chinese medical comprehensive measures for intervention group at the same time firstly. After3months of follow-up, estimating compliance and outcomes of the objects, adopting9.1.3version of statistical software to make descriptive analysis and statistical test. Measurement data should be in the form of mean±std, using the paired samples T-test, two groups of independent sample T-test, Wilcoxon signed-rank test and Wilcoxon rank sum test method to make statistical analysis. Adopting chi-square test to compare intervention efficient between the two groups, in order to evaluate the effect of comprehensive intervention in the optimization of constitution of traditional Chinese medicine.Results and DiscussionThe study included198cases subjects, after3months intervention, loss rate reach to13.64%(27cases).Finally, collecting intervention data of198cases, and making statistical analysis. The results are as follows:1BaselineThe object of study of composition of age, occupation, education and income levels between the two groups had no significant difference:Average age is25.84years, private enterprise and individual enterprise account for the very great proportion, total44.45%;Followed by institutions, civil servants and state-owned enterprises, accounting for33.84%.The majority is in middle culture level, technical secondary school degree or above accounted for92.42%.The intervention group and control group show no significant differences in the composition of constitutional type, Yangxu constitution accounting for34.34%, is the highest proportion, followed by Yinxu constitution is14.65%, Qiyu constitution is13.64%, Qixu type is13.13%; Tanshi constitution and type are equally, account to7.58%equally; Xueyu constitution (5.56%) and Tebing constitution(3.54%) are the least. Besides, the score of Pinghe constitution between two groups has no statistical difference before intervention. 2Intervention Effect Evaluation(1) Using paired samples T-test method to compare after the intervention with before by groups self-matching respectively:the Pinghe constitution score of intervention group increased from59.07±13.79to64.18±16.04, with statistical significance; the control group increased from60.25±13.22to60.53±12.81, no statistical significance.(2) Defining Δd=score mean of Pinghe constitution before the intervention-score mean of Pinghe constitution after the intervention. Using Two-sample T-test to compare the difference of Δd between the two groups. If using normality test to confirm Δd does not meet the normal distribution, so Wilcoxon rank sum test is only use. The Δd of intervention group reached to5.1, which4.83points higher than the control group (Δd=0.28),and there are statistically significant.(3) Assuming Δd≥5is effective, the intervention group efficiency (45.12%) higher than the control group (29.21%), statistically significant. Thus, the TCM comprehensive intervention can effectively improve the biased constitution of reproductive population, which is better than conventional eugenics intervention methods.3The influence of intervention compliance to intervention effectAccording to the objects’compliance with TCM intervention, defining the behavior of insisting on4-7days a week according to the TCM intervention guide as Often, insist on less than four days a week’s behavior is defined as Not Often. The Often group follow the "dietary guidelines" for maintenance object accounted for47.57%,which Pinghe constitution mass average higher than Not Often group17.56;Often carried out in accordance with the "sports guidance" object accounted for29.27%, higher than Not Often group after the intervention and peaceful mass average is higher than9.34;Often carried out in accordance with the guide to the meridian health care aftercare object accounted for13.42%, higher than not often group after the intervention and peaceful mass average is higher than17.96, and is statistically significant. This shows dietary and exercise intervention is more likely to be accepted and insisted by the women of childbearing age, but poor adherence to meridian health intervention.Principal FindingsBased on the above research results, main findings are:1Before and after the intervention, the Pinghe constitution score of intervention group increased from59.07±13.79to64.18±16.04, was statistically significant; The Pinghe constitution score of Control group increased from60.25±13.22to60.53±12.81,there was no statistical significance.2After the intervention, the Pinghe constitution score of intervention group increased Δ d=5.11, the Pinghe constitution score of control group Δd=0.28, the intervention group than the control group changes value higher than4.83, with statistical significance.3The intervention effective rate of trial group was45.12%,the rate of control group was29.21%,there was statistical significance between the two groups.4Eugenics intervention methods of TCM at physical improvement is superior to the conventional eugenics intervention methods5The compliance of regimens of diet, exercise and meridian care are47.57%,29.27%and47.57%respectively, the way of diet and exercise aftercare is easier to be accepted and stick to it.6Even if intervention cycle of the study is shorter, compliance is not ideal, but constitutional improvement effect is obvious.Features1For the first time, Regard the score change of Pinghe constitution as biased constitution optimization evaluation indexes. Because this study is based on the theogy of TCM constitution, to explore eugenics intervention methods, its theoretical hypothesis is: when the parents’ physical state as "moderate state", its the best time to be pregnant. To individuals, different biased constitutions have relevance, when a biased constitution be improved, it may lead to score change of other constitution. With the increase of Pinghe constitution score, the biased constitution score will decrease accordingly. Therefore, this study regard score changes of Pinghe constitution as the physical intervention effect evaluation index, not only innovative, and more scientific.2Discussing the quantitative relationship between subjective improvement and score changes of constitutions. At present, research has not shown that how much score changes will produce biological significance to individuals. But this study has made preliminary exploration, carried out qualitative investigation when collecting outcome data. Trough setting up subjectivity questions in order to verify relationship between subjective feelings and the score changes of constitution. The results showed that, objects who feels "obvious improvement、a slight improvement" accounted to81.70%,whose average score change of Pinghe constitution increased5.70before and after intervention. Therefore, it is biological significant that average score of Pinghe constitution increase at least Δd score is5points. Advantages1Follow the principle of randomized controlled strictly. Research object is divided into intervention group and control group, by controlling influencing factor between the two groups which may affect the improvement on constitution, such as geographic environment, cultural degree, age, the type of constitution, in order to avoid the confounding bias influence on constitution improvement, ensure the scientific of the research.2Less lost to follow-up. The loss rate of intervention group is11.83%and is15.24%in the control group. For the sake of reducing the number of the lost in the study, the researchers adopted some measures. For example, followed-up research objects by telephone at regular intervals; Provided reliable and high constitution intervention material for free; Held TCM constitution lecture every half a month by TCM expert; Provide green channel when the children go to a doctor; Using face to face household survey, and issuing phone cards for free.