Longitudinal studies on the characteristics of TCM constitutions and related factors of adult Chinese women in Hong Kong
Authors: He Yanhua , Sun Youzhi , Chan Jessie Suet Mui , You Jeishu , Jia Lei , Wang Qi , Ganesan Kumar , Chen Jianping 
Published: August 2021

Abstract
Background

Traditional Chinese Medicine Constitution (TCMC, Named Tizhi in Chinese) is essential to reflect an individual’s body-mind and health. Understanding TCMCs and their influencing factors would be beneficial for improving the individual’s health and disease prevention. Earlier our studies have found the characteristics of TCMCs and related influencing factors at a single time point, however, longitudinal data on the development of characteristics of TCMC constitutions over time is limited. Hence, this follow-up study was attempted to investigate the changes in characteristics of TCMCs and explore the factors influencing the development of individual TCMC types at baseline and follow-up.
Materials and methods

We conducted a follow-up cross-sectional survey of Chinese women in Hong Kong to compare with the characteristics of TCMCs as well as influencing factors related to each TCMC type at baseline with a 4-year interval by using the questionnaires with slight modifications. Statistical methods were employed as similar to that of the initial study including students’ T-test, Chi-square test one way ANOVA, multiple stepwise logistic regression analysis, and association rules mining method.
Results

A response rate of 59.0% was achieved in the follow-up study. Of 81.5% among 249 participants were diagnosed with unbalanced TCMCs. Qi-deficiency constitution (QDF, 51.8%), Yang-deficiency (PD, 45.4%), and Phlegm-wetness (PW, 38.6%) were still the top three unbalanced TCMCs types and the Yin-deficiency (ND), Blood stasis (BS) and Qi-depressed (QDP) constitutions were significantly increasing. The percentage of owning 1 to 2 unbalanced TCMC types by individual decreased from 30.9% at baseline to 26.9% at follow-up, whereas having 3–6 unbalanced TCMC types had increased from 47.4% at baseline to 58.2% at follow-up. Results of the association mining rules showed the top three paired-unbalanced TCMC types were in QDP paired with QDF (93.75%), PW paired with QDF (85.42%), and PD paired with QDF (81.65%) respectively. Stepwise logistic analysis indicated that poorer health condition (OR, 1.37–2.56), suffering negative effect on body-mind health (OR, 2.70–4.06), negative emotion (OR = 2.57) was significantly positively correlated with certain unbalanced TCMCs. Aging (OR, 0.91–0.93), regular exercise (OR = 0.71) usage of TCM habit (OR = 0.12), and women who experienced menopause (OR, 0.37–0.39) showed inverse correlations with certain unbalanced constitutions.
Conclusion

Owned unbalanced and more complex TCMC types were the main characteristics of TCMCs in most adult Chinese women in Hong Kong with a 4 -year interval during follow-up. QDF, PD, and PW constitutions were still the top three frequent unbalanced TCMC types at baseline and follow-up, but ND, BS, and QDP constitutions significantly increased during the menopausal stage. Poor health status, unhappy emotions, and/or suffering negative effects on body-mind health and suffering in the menopause stage may be the diverse factors for the development of unbalanced TCMC types, however, regular exercise and habit of regular usage of TCM might be potential protectors for maintaining in the normal constitution.