New Concept of Health with Perspective of Chinese Medicine

Health medicine has been the direction of the development of medicine. However, the definition of health defined by Western medicine and traditional medicine cannot completely cover the full meaning of health. Therefore, we propose the new concept of health: health is a state of physical and mental harmony of different individuals in the life process with the environment, and good self-adaptive and regulation ability to natural and social environment. The new concept of health enriches the connotation of health defined by Western medicine and improves the understanding of health in the past, which provide the conceptual basis for further study on health medicine     

Proteomic analysis of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention

ObjectiveTo investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers.MethodsSeventy-one subjects were enrolled in the study. We assessed blood glucose, blood lipids, body mass index (BMI), and phlegm-dampness pattern, which was confirmed by a traditional Chinese medicine clinician. Of the participants, we included healthy participants with normal weight (NW, n = 23), overweight/obese participants with normal metabolism (ONM, n = 19), overweight/obese participants with pre-diabetes (OPD, n = 12), and overweight/obese participants with marginally-elevated blood lipids (OML, n = 17). Among them, the ONM, OPD, and OML groups were diagnosed with phlegm-dampness pattern. The data-independent acquisition (DIA) method was first used to analyze the plasma protein expression of each group, and the relevant differential proteins of each group were screened. The co-expressed proteins were evaluated by Venn analysis. The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis (IPA) software. Parallel reaction monitoring (PRM) was used to verify the differential and common proteins in each group.ResultsAfter comparing ONM, OPD, and OML groups with NW group, we identified the differentially expressed proteins (DEPs). Next, we determined the DEPs among OPD, OML, and ONM groups. Using Venn analysis of the DEPs in each group, 24 co-expressed proteins were screened. Two co-expressed proteins were verified by PRM. IPA analysis showed that pathways including LXR/RXR activation, acute phase response signaling, and FXR/RXR activation were common to all three groups of phlegm-damp overweight/obesity participants. However, the activation or inhibition of these pathways was different among the three groups.ConclusionParticipants with overweight/obesity have similar proteomic characteristics, though each type shows specific proteomic characteristics. Two co-expressed proteins, VTN and ORM1, are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegm-dampness retention.     

中国古代四学与中医思维渊源探识

易学、道学、儒学、释学等"四学"是中国古代哲学的代表,对中医学的形成和发展具有不可忽视的基础作用,不仅以"水土"之功来涵养着中医思维方式,而且深刻影响着中医思维走向,阐述和分析"四学"对中医学思维的影响及中医学在此影响下的发展,明确中医学思维的哲学基础和动力。     

Case-control study on the associations between lifestyle-behavioral risk factors and phlegm-wetness constitution

OBJECTIVE： To explore the relationships between different lifestyle-behavioral factors and phlegm- wetness type of Traditional Chinese Medicine con- stitution, so as to provide health management strat- egies for phlegm-wetness constitution. METHODS： A case-control study was conducted with the cases selected from the database of Chi- nese constitution survey in 9 provinces or munici- palities of China. 1380 cases met the diagnostic cri-teria of phlegm-wetness type were taken as the case group, and 1380 cases were randomly select- ed from gentleness type as the control group. Us- ing Chi-square test to compare the differences of lifestyle-behavior composition in each group; sin- gle factor and multiple logistic regression analysis were used to compare the relationships of life- style-behavioral factors and phlegm-wetness type. RESULTS： There were statistically significant differ- ences between phlegm-wetness type group and gentleness type group in lifestyle behaviors （di- etary habits, tobacco and liquor consumptions, ex- ercise habits, sleeping habits）. The results of single factor logistic regression analysis demonstrated that the risk of phlegm-wetness constitution de- creased significantly in light diet （odds ratio, OR= 0.68）; The risk factors of phlegm-wetness type were fatty food intake （0R=2.36）, sleeping early and get- ting up late （0R=1.87）, tobacco smoking （0R=1.83）, barbecued food intake （0R=1.68）, alcohol drinking （0R=1.63）, salty food intake （0R=1.44）, sleeping er- ratically （OR=IA3）, less physical activities （OR= 1.42）, sweet food intake （0R=1.29）, sleeping and getting up late （0R=1.26）, and pungent food intake （0R=1.21）, respectively. Regardless of the interac- tion among lifestyle-behavioral factors, the results of the multiple logistic regression analysis revealed that the risk factors of phlegm-wetness type were sleeping early and getting up late （0R=1.94）, fatty food intake （0R=1.80）, tobacco smoking （0R=1.50）, sleeping erratic     

Association between metabolic syndrome and body constitution of traditional Chinese medicine: A systematic review and meta-analysis

BackgroundThe constitution theory of traditional Chinese medicine (TCM) states that body constitution and disease are associated; therefore, the identification of body constitution can provide reference for disease prevention and treatment. A series of clinical studies evaluating the association between TCM constitution and metabolic syndrome (MetS) have been conducted in recent years. The aim of this systematic review is to summarize and evaluate the clinical evidence of the relationship between constitution and MetS.MethodsThe PubMed, Embase, China National Knowledge Infrastructure (CNKI), Chongqing VIP, and Wanfang Data electronic databases were searched from April 2009 to July 2020. The search terms included “metabolic syndrome,” “constitution,” and “Chinese medicine.” Observational studies evaluating the relationship between body constitution of TCM and MetS were included. The primary outcome included the distribution of constitutional types in the MetS population, and odds ratio (OR) or relative risk (RR) between constitution and MetS. Effect size was expressed as proportion or OR with 95% confidence interval (CI). Methodological quality of included studies was evaluated by the Newcastle–Ottawa Scale (NOS) or the American Agency for Healthcare Research and Quality (AHRQ) criteria.ResultsThree case–control and 26 cross-sectional studies involving 30 435 cases were included. Phlegm-dampness, qi-deficiency, and damp-heat were the main constitution types in patients with MetS, accounting for 29% (22%–39%), 18% (13%–24%), and 12% (9%–17%) of the population, respectively; the risk of MetS in people with phlegm-dampness and qi-deficiency constitution was 1.74 [1.27, 2.38] and 1.29 [1.01, 1.65] times higher than that in those with other constitutions. There were sex- and age-related differences in the distribution of TCM constitution in patients with MetS.ConclusionPhlegm-dampness and qi-deficiency were associated with the occurrence of MetS. Well-designed cohort and case–control studies are needed to provide evidence for the use of TCM to prevent and treat MetS.     

Research on Constitution of Chinese Medicine and Implementation of Translational Medicine

Translational medicine is a new concept presented in recent decades, the core of which is to build a bridge between basic medical research and clinical application. From the beginning of constitution of Chinese medicine, clinical application has been given priority. Therefore, the idea of translational medicine is fully demonstrated in the research into the three key scientific problems of "classification of constitution of Chinese medicine", "relationship between constitution and disease" and "adjustment of constitution". Under its guidance, not only was the systematic theory of constitution of Chinese medicine established, but also the Constitution of Chinese Medicine Scale and the Standards of Classification and determination of Constitution of Chinese Medicine were developed, which translates methods of classifying the nine constitutional types into guidance for prevention of disease, management of health and clinical application. The research findings of constitution of Chinese medicine have been applied in clinical practice and public health, establishing the diagnosis and treatment model of constitution-disease-syndrome differentiation. The nationwide application of constitution differentiation has shown good effect. In the future, constitution of Chinese medicine should strengthen the evidence-based research and multi-disciplinary cooperation, and establish a research team on comprehensive constitution of Chinese medicine and translational medicine, to translate the findings into clinical practice and public health more accurately and quickly.     

痰湿体质系列研究与4P医学模式的实施

当今医学模式正在由疾病医学向健康医学转化,由此提出了强调个体化、预测性、预防性和参与性的4P医学模式。痰湿体质是中国人9种体质类型之一,也是研究最多的体质类型。对痰湿体质的基因组学和单核苷酸多态性研究体现了体质的个体差异性;痰湿体质与疾病的相关性研究表明痰湿体质者有患代谢综合征、高血压病、2型糖尿病等疾病的发病倾向,使用《中医体质量表》在人群中进行痰湿体质的判定,估计以上疾病发生的风险,体现了对疾病的预测性;通过干预痰湿体质,减少肥胖相关疾病的发生风险,体现了预防性。体质辨识应用于临床和公共卫生服务,在辨识过程中充分强调服务对象的参与性。因此,中医痰湿体质研究体现了4P医学模式的实践和运用,为其他学科在当今医学模式下的研究和发展提供了范式。     

Case-control study on the associations between lifestyle-behavioral risk factors and phlegm-wetness constitution

Objective

To explore the relationships between different lifestyle-behavioral factors and phlegm-wetness type of Traditional Chinese Medicine constitution, so as to provide health management strategies for phlegm-wetness constitution.

Methods

A case-control study was conducted with the cases selected from the database of Chinese constitution survey in 9 provinces or municipalities of China. 1380 cases met the diagnostic criteria of phlegm-wetness type were taken as the case group, and 1380 cases were randomly selected from gentleness type as the control group. Using Chi-square test to compare the differences of lifestyle-behavior composition in each group; single factor and multiple logistic regression analysis were used to compare the relationships of lifestyle-behavioral factors and phlegm-wetness type.

Results

There were statistically significant differences between phlegm-wetness type group and gentleness type group in lifestyle behaviors (dietary habits, tobacco and liquor consumptions, exercise habits, sleeping habits). The results of single factor logistic regression analysis demonstrated that the risk of phlegm-wetness constitution decreased significantly in light diet (odds ratio, OR= 0.68); The risk factors of phlegm-wetness type were fatty food intake (OR=2.36), sleeping early and getting up late (OR=1.87), tobacco smoking (OR=1.83), barbecued food intake (OR=1.68), alcohol drinking (OR=1.63), salty food intake (OR=1.44), sleeping erratically (OR=1.43), less physical activities (OR= 1.42), sweet food intake (OR=1.29), sleeping and getting up late (OR=1.26), and pungent food intake (OR=1.21), respectively. Regardless of the interaction among lifestyle-behavioral factors, the results of the multiple logistic regression analysis revealed that the risk factors of phlegm-wetness type were sleeping early and getting up late (OR=1.94), fatty food intake (OR=1.80), tobacco smoking (OR=1.50), sleeping erratically (OR=1.50), barbecued food intake (OR=1.40), sleeping and getting up late (OR= 1.40), less physical activities (OR=1.31), sleeping late and getting up early (OR=1.27), and sweet food intake (OR=1.27), respectively, and the risk of phlegm-wetness type still decreased significantly in light food intake (OR=0.79).

Conclusion

Light diet can decrease the risk of being phlegm-wetness constitution, and bad lifestyle behaviors such as sleeping early and getting up late, sleeping erratically, fatty food, barbecued food or sweet food intake, tobacco and liquor consumptions, and less physical activities can increase the risks of becoming phlegm-wetness constitution.     

不同年龄人群中医体质特点对应分析

目的探讨不同年龄人群中医体质类型的分布特点,为体质过程论提供科学依据。方法采用2005年12月—2007年1月我国9省市（江苏、安徽、甘肃、青海、福建、北京、吉林、江西、河南）21 948例中医体质和健康状况调查数据作为研究样本;基于中医体质量表的数据,利用判别分析法对个体的体质类型进行诊断。使用对应分析方法,探索样本人群总体及其不同性别人群年龄与中医体质类型的相关性。结果阴虚质、湿热质、气郁质、特禀质等偏颇体质与15～24岁关联性较强;平和质与25～44岁关联性较强,此年龄段男性人群与痰湿质、湿热质,女性人群与血瘀质等实的偏颇体质关联性也较强;阳虚质、气虚质等虚的体质类型与45岁以后的年龄段关系较强,此年龄段与痰湿质、血瘀质等实的偏颇体质关联性也较强。结论不同年龄人群的中医体质类型分布特点不同,不同性别年龄人群体质类型也有所不同。     

从痰湿体质角度研究肥胖亚型

肥胖作为早期发现代谢疾病高危人群的重要标志,成为健康关注的热点。然而肥胖的研究存在诸多困惑,其衡量标准从体重到体重指数,再到体脂率、腰围,虽然在逐步接近代谢紊乱的实质,但是终归停留在形态学的层面上,不能对潜在的危险进行精确的描述,即有一部分人群虽然不肥胖,但是仍然符合代谢综合征的标准且为心脑血管疾病的高危人群,称为正常体重代谢性肥胖,也有一部分人群虽然肥胖,但是并没有代谢紊乱的现象,称为代谢正常肥胖,这两种现象统称为肥胖亚型。中医体质学认为,体质是在先天遗传和后天环境等共同作用下形成的相对稳定的固有特质,是疾病发生的背景及前景因素。研究结果显示,痰湿体质可能是代谢疾病发生的土壤。痰湿体质人形态多表现为肥胖,然而痰湿体质不等于肥胖,痰湿体质并不是简单的形态学概念,而是暗含了生理机制和发病倾向等内在本质,痰湿内蕴除可能表现为肥胖外,腹部松软、舌苔厚腻、面部出油、身体沉重等均可能出现,痰湿体质的诊断标准在进行代谢紊乱高危人群的识别中更为准确。结合肥胖亚型的概念,提出,痰湿体质可能是肥胖亚型现象存在的内在因素,或许可作为肥胖亚型研究的一个切入点,为早期发现和干预代谢疾病高危人群提供方法和手段。