中医体质辨识对社区居民慢性病防控的意义

 目的 分析中医体质与慢性病之间的关系，探讨中医体质辨识指导社区慢性病管理的可行性。方法 居民体质辨识采用黄炎东方(北京)健康科技有限公司设计的KY3H中医体质识别软件，使用二手数据挖掘的方法，对长宁区居民电子健康档案和中医体质辨识数据库的信息进行对接、整合、清理、分析。结果 完成居民中医体质辨识与健康档案对接11 321人，其中32.38%的居民为平和质。偏颇体质中，以阳虚质和气虚质最为常见，分别占25.66%和21.05%。女性偏颇体质居民比例显著高于男性，尤其在阴虚、阳虚、气虚、气郁和血瘀上。随着年龄增长，不同性别间偏颇体质的差异逐步减小(P<0.001)。糖尿病、高血压病患者中偏颇体质比例均显著高于无慢性病的人群，OR(95%CI)分别为1.873 (1.494～2.348)和2.907(2.578～3.278)。结论 女性、年龄较大者、慢性病患者偏颇体质比例较高。运用中医诊疗技术对不同偏颇体质的人群进行调整，对社区人群的慢性病防治工作有积极的意义。

Significance of traditional Chinese medicine constitution identification for chronic diseases control in community population

Objective To  analyze the relationship of traditional Chinese medicine constitution with chronic diseases, and to discuss the feasibility of chronic diseases management using integrated traditional Chinese medicine (TCM) constitution identification system. Methods Constitution identification was carried out using the system developed by HuangYan Oriental (Beijing) Technology Co.Ltd.Second hand data mining was conducted by connecting, clearing and analyzing both constitution identification database and electronic health record (EHR) of community residents in Changning District, Shanghai. Results The information of 11 321 residents was connected in TCM constitution identification system and EHR, in which 32.28% were gentleness type. Qi-deficiency and Yang-deficiency were the most common types among pathologic constitutions which accounted for 25.66% and 21.05%, respectively. Females had a higher proportion in pathologic constitutions especially in Yin-deficiency, Yang-deficiency, Qi-deficiency, Qi-depression and Blood-stasis. With the age increase, the pathologic constitution differences between males and females decreased (trend chi-square P<0.001). People with diabetes or hypertension had a much higher proportion of pathologic constitutions than healthy people in Logistic regression the OR (95% CI) were 1.873 (1.494-2.348) and 2.907 (2.578-3.278) compared with people without above diseases. Conclusions Females, the elders and chronic disease patients have a higher proportion of pathologic constitutions. Appropriate TCM techniques applied in adjusting pathologic constitutions for community people is meaningful in chronic disease management and prevention.