The Analysis of Constitutions of Traditional Chinese Medicine in Relation to Cerebral Infarction in a Chinese Sample.

OBJECTIVE: To investigate the relationships between the constitutions of Traditional Chinese Medicine (TCM) and patients with cerebral infarction (CI) in a Chinese sample. METHODS: A total of 3748 participants with complete data were available for data analysis. All study subjects underwent complete clinical baseline characteristics' evaluation, including a physical examination and response to a structured, nurse-assisted, self-administrated questionnaire. A population of 2010 neutral participants were used as the control group. Multiple variable regression (MLR) were employed to estimate the relationship between constitutions of TCM and the outcome. DESIGN: A cross-sectional study was conducted to evaluate the association of body constitution of TCM and CI. SETTINGS/LOCATION: Communications and healthcare centers in Shanghai. SUBJECTS: A total of 3748 participants with complete data were available for data analysis. OUTCOME MEASURES: All study subjects underwent complete clinical baseline characteristics' evaluation, including a physical examination and response to a structured, nurse-assisted, self-administrated questionnaire. A population of 2010 neutral participants were used as the control group. MLR were employed to estimate the relationship between constitutions of TCM and the outcome. RESULT: The prevalence of CI was 2.84% and 4.66% in neutral participants and yang-deficient participants (p = 0.012), respectively. Univariate analysis demonstrated a positive correlation between yang deficiency and CI. After adjustment for relevant potential confounding factors, the MLR detected significant associations between yang deficiency and CI (odds ratio = 1.44, p = 0.093). CONCLUSION: A yang-deficient constitution was significantly and independently associated with CI. A higher prevalence of CI was found in yang-deficient participants as compared with neutral participants.

The prevalence rate of deviations in body constitutions and related factors in follow-up stage breast cancer patients-A nationwide study.

OBJECTIVES: The aim of this study was to apply a rigorous traditional Chinese medicine (TCM) body constitution questionnaire (BCQ) to survey the prevalence rate of deviations in body constitution and to explore the health-related lifestyle behavior factors of deviations in body constitution. DESIGN: A cross-sectional study was administered through postal mail. Subjects were recruited from a national organization for breast cancer patients (Taiwan Breast Cancer Alliance). SETTING/MAIN OUTCOME MEASURES: Data were obtained from 311 breast cancer patients by questionnaires including a demographic record sheet, lifestyle behavior scales and the BCQ (Yang-Xu, Yin-Xu, and Stasis). Differences concerning the presence of body constitutions were analyzed by Chi-square tests and analyses of variance, and potential predictive factors were analyzed using multivariate logistic regression. RESULTS: In total, 55.3% of the subjects had a Yang-Xu constitution, 61.0% had a Yin-Xu constitution, and 47.6% had a Stasis constitution. A total of 42.8% of the patients displayed a combination of the three types of body constitutions. Feeling stressed, physical exercise, and favoring fried food were predictors of the combined Yang-Xu, Yin-Xu and Stasis constitutions (p<0.05). Staying up late was significantly associated with Yin-Xu (p=0.017), and favoring salty food was significantly associated with Stasis (p=0.019). CONCLUSIONS: A high prevalence of deviations in body constitutions was observed in the follow-up stage of breast cancer patients. Increasing the adherence to healthy lifestyle behaviors might strengthen and balance body constitution, which could improve supportive care in breast cancer survivors.

Statistical validation of Traditional Chinese Medicine syndrome postulates in the context of patients with cardiovascular disease.

OBJECTIVE: Traditional Chinese Medicine (TCM) has many postulates that explain the occurrence and co-occurrence of symptoms using syndrome factors such as yang deficiency and yin deficiency. A fundamental question is whether the syndrome factors have verifiable scientific content or are purely subjective notions. This analysis investigated the issue in the context of patients with cardiovascular disease (CVD). DESIGN: In the past, researchers have tried to show that TCM syndrome factors correspond to real entities by means of laboratory tests, with little success. An alternative approach, called latent tree analysis, has recently been proposed. The idea is to discover latent variables behind symptom variables by analyzing symptom data and comparing them with TCM syndrome factors. If there is a good match, then statistical evidence supports the validity of the relevant TCM postulates. This study used latent tree analysis. SETTING: TCM symptom data of 3021 patients with CVD were collected from the cardiology departments of four hospitals in Shanghai, China, between January 2008 and June 2010. RESULTS: Latent tree analysis of the data yielded a model with 34 latent variables. Many of them correspond to TCM syndrome factors. CONCLUSIONS: The results provide statistical evidence for the validity of TCM postulates in the context of patients with CVD; in other words, they show that TCM postulates are applicable to such patients. This finding is important because it is a precondition for the TCM treatment of those patients.

[Clinical features of neuromyelitis optica and the distribution of Chinese medical syndrome types: a case report of 63 cases].

OBJECTIVE: To explore the clinical features of neuromyelitis optica (NMO) patients, and to study the distribution of Chinese medical syndrome types and the pathogenesis of NMO. METHODS: The clinical features, figures of tongue and pulse, Chinese medical syndromes were comprehensively analyzed in 63 NMO patients using statistical methods for clinical data. RESULTS: The age ratio of male to female in 63 NMO patients was 1: 6.88. Their average age of first onset was 31.67 +/- 12.44 years old, and 28. 57% of patients had obvious inducing factor. Urgent onset with relieved recurrence were often seen, with the average recurrence times of 4.60. Most patients complained about sensation disorders, vision disorders, and movement disorders as their first attack and visit. The Chinese medical syndrome types included Gan-Shen yin deficiency syndrome and phlegm-heat collateral stagnation syndrome, mainly involved Gan and Shen. Gan-Shen yin deficiency, sputum, blood stasis, and heat were most often seen syndrome elements. CONCLUSIONS: Gan-Shen yin deficiency was dominated in the deficiency in origin of NMO. Phlegm, blood stasis, mingled heat were main dominant evils. Of them, the pathogenesis of Gan-Shen yin deficiency and phlegm-heat collateral stagnation had universality and representativeness, which could be verified from patients' tongue picture and pulse picture.

[Correlation analysis of 102 hypertension patients and northwest dryness syndrome in xinjiang region].

OBJECTIVE: To analyze the correlation between 102 hypertension patients and northwest dryness syndrome (NDS). METHODS: In the treatment group recruited were 102 hypertension patients from hospitals with the level above the county level in Hotan, Turpan, Hami, Yili, and Urumqi from August to December 2009. Another 173 sub-healthy subjects were recruited as the control group. The incidence rate and the NDS integral were compared between the two groups. The correlation analysis and canonical correlation analysis were performed between Chinese medical integral in the treatment group and main and complicated syndromes integrals of NDS. RESULTS: The incidence rate of NDS was 31.37% (32/102) in the treatment group and 16.76% (29/102) in the control group, showing statistical difference (chi2 = 7.934, P<0.01). The total integral of NDS was higher in the treatment group than in the control group (P<0.05). Of them, the integrals of Fei-orifice obstruction induced dry syndrome (FOOIDS), Xin-Shen yin deficiency syndrome (XSYDS), and Pi-Wei damp accumulation syndrome (PWDAS) were higher in the treatment group than in the control group (P<0.05), with the most obvious shown in XSYDS. Various syndromes of hypertension were strongly correlated with main and complicated syndromes of NDS (P<0.01). Of them, the strongest correlation was shown between yin-yang deficiency syndrome (YYDS) and NDS (r=0.864, P<0.01), followed by yin deficiency and yang hyperactivity syndrome (r=0.765, P<0.01). The standard canonical correlation coefficient was the highest in YYD (r=0.5599) and the independent variable was the highest in PWDAS (r=0.4191). CONCLUSIONS: DNS was the contaminant state for most hypertension patients in Xinjiang region, with XSYDS as the most outstanding manifestation. DNS could aggravate the Chinese medical integrals of hypertension. YYDS was closest correlated with DNS. PWDAS showed most significant effects on the syndrome integral of hypertension. YYDS and PWDAS were decisive factors between hypertension and DNS.

[Study on the regional features of Chinese medicine etiology and pathogenesis of AIDS].

OBJECTIVE: To analyze the differences in the Chinese medicine (CM) etiology and pathogenesis of AIDS. METHODS: A cross-sectional investigation study of AIDS patients and non-infected people was carried out in Henan, Guangdong and Xinjiang provinces respectively by questionnaire of clinical epidemiology and analyzed with frequencies of symptoms and signs combined with syndrome factors. The distribution differences of syndrome factors in the 3 provinces were compared. RESULTS: Totally 321 cases were investigated in the 3 provinces. As for the syndrome factors of AIDS, qi deficiency, blood deficiency, yin deficiency, yang deficiency, dampness evil, phlegm, qi stagnation, essence deficiency, and so on were dominated in the 3 provinces, but with their own features. For example, the scores of dampness evil were higher in Guangdong Province. Yin deficiency was dominated in Xinjiang Province. The scores of Henan Province were generally higher. As for the location of syndrome factors, Shen, Fei, Pi, and Gan were dominated in the 3 provinces. The score of Pi was the highest in Guangdong Province, while the score of Shen was the highest in Henan and Xinjiang provinces. CONCLUSIONS: AIDS has regional features in the nature and the syndrome factors of location in different provinces. It is necessary to take into consideration the regional factors when analyzing the pathogenesis of AIDS.

Construction of a traditional Chinese medicine syndrome-specific outcome measure: the Kidney Deficiency Syndrome Questionnaire (KDSQ).

BACKGROUND: Development of Traditional Chinese Medicine (TCM) syndrome-specific outcome measures is needed for the evaluation of TCM syndrome-specific therapies. We constructed a Kidney Deficiency Syndrome Questionnaire (KDSQ) for the evaluation of the common TCM syndromes Kidney-Yin Deficiency Syndrome (KDS-Yin) and Kidney-Yang Deficiency Syndrome (KDS-Yang) in middle-aged women with menopausal symptoms. METHODS: KDS-Yin and KDS-Yang were traditionally defined by expert opinion were validated by exploratory factor analysis (EFA) and structural equation modeling (SEM). Content validity was tested by EFA on a sample of 236 women from a seminar and SEM on another sample of 321 women from a postal survey. Other psychometric properties were tested on 292 women from the seminar at baseline and two systematically selected sub-samples: 54 who reported no changes in discomforts 11-12 days after the baseline and 31 who reported changes in discomforts 67-74 days after the baseline. All participants completed the KDSQ, the Greene Climacteric Scale and the standard 12-item Short Form Health Survey. RESULTS: The EFA and SEM established the measurement models of KDS-Yin and KDS-Yang supporting content validity of the KDSQ. Internal consistency was good (Cronbach's Alpha >0.70). Construct validity was supported by theoretically-derived levels of correlation with the established external measures. Test-retest reliability was strong (ICC(agreement): KDS-Yin, 0.94; KDS-Yang, 0.93). The KDSQ was responsive to changes over time as tested by effect size and longitudinal validity. CONCLUSIONS: The KDSQ was a valid and reliable measure for KDS-Yin and KDS-Yang in Hong Kong Chinese middle-aged women with menopausal symptoms.

[Clinical epidemiologic investigation on Chinese medicine syndrome laws in patients with chronic heart failure].

OBJECTIVE: To study the distribution laws of Chinese medicine syndromes in patients with chronic heart failure (CHF) by clinical epidemiologic investigation. METHODS: 512 CHF patients were studied, including 168 items of symptoms and 48 items of tongue and pulse pictures. A database of Chinese medicine syndromes was established, and 9 disease nature elements and 5 disease location elements were extracted. Frequency analysis was performed on all symptoms, tongue and pulse pictures. The variables with frequency constituent ratio less than 10.0% were deleted. Then the features of clinical epidemiology, syndrome patterns, syndrome elements, main symptoms, as well as tongue and pulse pictures were analyzed. RESULTS: (1) The disease nature elements of CHF covered qi deficiency, yin deficiency, and yang deficiency (categorized as the essential deficiency), as well as blood stasis, turbid phlegm, and the retained fluid (categorized to the superficiality excess). Among them, frequencies of qi deficiency and blood stasis (both more than 85.0%) were the highest. The disease location elements of CHF were ordered in frequency as Xin (97.9%), Pi (88.1%), followed by Shen (43.0%), Fei (30. 1%), and Gan (7.0%). (2) In the distribution of syndrome patterns in CHF patients, qi deficiency phlegm-stasis syndrome was the most (59.2%), followed by qi-yin deficiency with phlegm-stasis intermingle syndrome (20.3%), Xin-yang decline with phlegm-stasis obstruction syndrome (7.0%), and yang-deficiency with water overflowing syndrome (5.5%). (3) Patients with heart function grade II, III, and IV mainly manifested as qi-deficiency with phlegm-stasis syndrome. Besides, qi-yin deficiency with phlegm-stasis intermingle syndrome could be often seen in those with grade III. And Xin-yang decline with phlegm-stasis obstruction syndrome and yang-deficiency with water overflowing syndrome could often be seen in those with grade IV. CONCLUSIONS: The pathogenesis of CHF is essential deficiency and superficiality excess. The essentiality consists of qi deficiency, yin deficiency, and yang deficiency, and the superficiality consists of blood stasis, turbid phlegm, and retained fluid. The disease was located at the five zang-organs, mainly dominated at Xin and Pi, and associated with Fei, Shen, and Gan. Qi deficiency phlegm-stasis syndrome was dominated in Chinese medicine syndrome patterns. Along with the aggravation of CHF, Chinese medicine syndrome pattern shows certain development laws.

[Epidemiologic study on basic TCM syndrome in the subhealth population in the Zhengzhou area].

OBJECTIVE: To study the distribution characteristics of clinical manifestation and TCM basic syndromes in the subhealth population. METHODS: The investigation list for basic syndrome of subhealth used in the study was formulated through retrieving a large amount of literatures, referring to principles of epidemiology, computer science, mathematics and international metrics, and according to the standard denoting figure of GR/T 1.1-2000 and ZY/T001.1-94. The data obtained were analyzed by the statistical methods like multiple factor analysis and cluster analysis to explore the distribution of main symptoms and syndromes in the subhealth condition. RESULTS: The analysis of data from 2,133 lists showed that in the Zhengzhou area, the main clinical symptoms presented in the subhealth population were aversion to cold, fatigue, spontaneous perspiration, poor memory, bad-temper, short breath, palpitation, etc.; with the syndrome key elements of deficiency, dampness, phlegm, stagnancy, stasis, qi-stagnation, and body fluid loss; the dysfunction of zang-fu organs was mainly observed in Xin, Pi, Shen, Gan, Dan, Wei, Fei, etc.; and the most commonly encountered basic syndromes were Xin-Pi deficiency, Xin-Shen deficiency, Gan-qi stagnation, Pi insufficiency with dampness stagnation, phlegm-qi cementation, Shen-yin deficiency, Shen-yang deficiency, qi insufficiency, Gan-stagnancy transforming to fire, damp-heat accumulation, etc. CONCLUSION: The clinical manifestation of the subhealth population in the Zhengzhou area is characterized by a syndrome composed of a certain main symptom with some other accompanied symptoms, the distribution of the basic syndrome is mainly dominated by the deficiency syndrome.

[A multi-centeric epidemiological survey on TCM syndrome in 1016 patients with IgA nephropathy and analysis of its relevant factors].

OBJECTIVE: To investigate the distribution pattern of TCM syndrome in patients with IgA nephropathy and its relationship with the main clinical prognostic indexes to provide a basis for the standardization of integrative medicine in diagnosis and treatment of IgA nephropathy. METHODS: Multi-centeric epidemiological field survey was adopted to collect the materials of 1016 IgA nephropathic patients, including demography, TCM syndrome and laboratory findings, for exploring the distribution pattern of TCM syndrome of IgA nephropathy patients. RESULTS: Probability of over 10% could be found in the TCM syndromes as yin deficiency, qi deficiency, yang deficiency, damp-heat and blood stasis syndrome, the highest (41.5%) was found in qi-yin deficiency syndrome and the lowest (8.1%) in yang deficiency of Pi and Shen. Along with the increasing of age, the percentage of patients with Pi-Fei qi asthenia syndrome descended while those with Pi-Shen yang asthenia ascended. In the accompanying syndromes, damp-heat syndrome and blood stasis syndrome, with the proportion of 32.6% and 28.9% respectively, were the most frequently encountered. The levels of 24 h urinary protein, serum creatinine and urea nitrogen in patients with Pi-Fei qi asthenia syndrome, qi-yin deficiency syndrome and Gan-Shen yin asthenia syndrome were significantly lower than those in patients with Pi-Shen yang asthenia syndrome, respectively (P < 0.05), while the blood pressure in patients with Pi-Fei qi asthenia syndrome, and qi-yin deficiency syndrome were significantly lower than that in patients with Gan-Shen yin asthenia syndrome and Pi-Shen yang asthenia syndrome (P<0.01). CONCLUSION: Qi-asthenia and yin deficiency is the principal clinical manifestation of IgA nephropathy. TCM syndrome types are closely related with the prognostic indexes as urine protein, hypertension, renal lesion, etc.

[A preliminary epidemiological study and discussion on traditional Chinese medicine pathogenesis of chronic fatigue syndrome in Hong Kong].

OBJECTIVE: Our purpose is to conduct an epidemiological study of chronic fatigue syndrome (CFS) and its syndrome types and symptoms of traditional Chinese medicine (TCM) among adults (20-50 years old) in Hong Kong, and to discuss the TCM pathogenesis. DESIGN: Cross-sectional questionnaire survey. MEASURES: Demographic data, CDC (1994) CFS diagnostic criteria, Trudie Chalder fatigue scale, and China national standard for TCM syndrome types criteria. SUBJECTS: Twenty to fifty years old adults by convenient sampling. RESULTS: One thousand and thirteen subjects were successfully interviewed. Five hundred and eighty-five subjects (57.8%) had different levels of fatigue. Sixty-five subjects (6.4%) met CFS diagnostic criteria. In terms of TCM syndrome types, blood stasis due to qi deficiency had the highest prevalence (35.7%) among CFS. In the 54 symptoms investigated in total, the first eight symptoms in order of appearing rates were soreness of loins and weakness in knees, poor spirit, lassitude, pain, insomnia, forgetting, vessels blood stasis, vertigo and dazzle. The mostly appeared tongue figures were pale and corpulent or pale dim tongue proper, white and white greasy tongue coating, and the mostly appeared pulse figure was sunken-thin. CONCLUSION: The point prevalence of CFS among adults of 20 to 50 years old was found to be 6.4%. The most prevalent TCM syndrome type was blood stasis due to qi deficiency. The TCM pathogenesis of CFS was deficiency of origin, mainly deficiency of qi and kidney, with excess of superficiality.

[Epidemic survey on TCM syndrome typing and preliminary discussion on TCM etiology and pathogenesis of fatty liver].

OBJECTIVE: To investigate the common TCM syndrome types of fatty liver by way of epidemic questionnaire, their occurrence ratio, and the correlation between various syndrome types and objective indexes. METHODS: A total of national wide 503 subjects with fatty liver were enrolled, the TCM syndromes, body mass index (BMI), abdominal perimeter/hip circumference, liver function, blood lipids, B ultrasonic examination and CT in them were observed and recorded. RESULTS: In the 46 symptoms investigated in total, the first ten symptoms in order of appearing rate were lassitude, obese, oral dryness, vertigo, hypochondriac distending pain, soreness and pain in loin, spiritlessness, oral bitterness, aching and weakness in knee and abdominal distention. The mostly appeared tongue figures were pale and corpulent or pale dim tongue proper, white greasy or yellow greasy tongue coating, and the mostly appeared pulse figures were taut, taut-thin and taut slippery. Statistical cluster analysis showed that syndromes of fatty liver could be typed into 4 TCM types, the asthenia Pi-Shen with Gan-stagnation type, the asthenia Pi-Shen type, the asthenia Pi with phlegm-heat type and the unclassified type. Among them the asthenia Pi-Shen with Gan-stagnation type was the commonest one, which accounted to 62.32%. CONCLUSION: The mostly appeared syndrome type of fatty liver was asthenia Pi-Shen with Gan-stagnation type. The TCM pathogenesis of fatty liver was deficiency of origin, mainly deficiency of Shen, involving Pi, with excess superficiality, the turbid-phlegm and blood stasis.

[Effect of aging on the syndrome of essential debility and evil reality--an exploration on mechanism of senility by traditional Chinese medicine].

Effect of aging on essential debility and evil reality was explored by an epidemiological investigation of clinical syndrome with TCM in 878 cases of middle and old-aged patients, inquiring into their relation of senility with visceral weakness and stagnation of Qi, blood stasis, and phlegm turbid. The results indicated that (1) several viscera, feeble and damaged, were the basis of senility, and the feeble kidney was the stress; (2) the syndrome of stagnation of Qi, blood stasis and phlegm turbid speeded up process of senility. The mechanism of feeble phenomena appeared in the middle-old aged patients is that with the rise of age in the patients observed there was interaction between the feeble visceral function and the syndrome of stagnation of Qi, blood stasis and phlegm turbid, that is, there was interaction between essential debility and evil reality. Essential debility may lead to evil reality and the latter will worsen essential debility. Thus, on repeating themselves in alternate cycles, a systemic hypofunction will be formed up to exhaustion. Therefore, "to nourish essential debility first and to purge evil reality second" should be considered as an essential direction of preparing anti-aging drugs in TCM.