中医体质与血脂、尿酸、体重指数等的相关性研究

郑美鸿; 张斌; 李东彩; 梁绮君; 董承煊; 潘智斌; 关锦图; 徐光镇; 刘继洪

doi:10.16766/j.cnki.issn.1674-4152.003175

中医体质与血脂、尿酸、体重指数等的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.003175

广州中医药大学附属佛山中医院治未病中心，广东佛山 528000

基金项目:

广东省中医药局科研项目 20223038

详细信息

通讯作者:
刘继洪，E-mail：544279373@qq.com

中图分类号: R241 R589.2
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- 被引次数: 0
出版历程
- 收稿日期: 2023-03-15
- 网络出版日期: 2023-10-19

Study on the correlation between TCM constitution and blood lipid, uric acid and body mass index

Department of Preventive Treatment of Disease, FoShan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine, Foshan, Guangdong 528000, China

摘要

摘要: 目的探讨中医体质与血脂、体重指数、尿酸、脂肪含量的相关性，分析影响血脂异常发生的危险因素。方法选取2019年1月—2020年12月在佛山市中医院体检的1 061例人群进行横断面回顾性研究，运用SPSS 24.0统计学软件分析不同体质者的血脂、尿酸、体重指数和脂肪含量的相关性以及血脂异常和超重/肥胖发生率，采用二元logistic回归分析方法分析血脂异常发生的危险因素。结果 1 061例体检人群中，平和质300例(28.28%)，偏颇体质761例(71.73%)，其中，偏颇体质中痰湿质202例(19.04%)，阳虚质172例(16.21%)，气虚质136例(12.82%)；男性痰湿质占比高于女性，女性气郁质、阴虚质和血瘀质占比高于男性(均P＜0.05)；偏颇质者TC、LDL-C、BMI高于平和质者(均P＜0.05)；与平和质相比较，痰湿质者TG、LDL-C、BMI偏高，HDL-C偏低，湿热质者LDL-C、BMI、脂肪含量偏高，气郁质者BMI偏低(均P＜0.05)；痰湿质和湿热质者超重/肥胖发生率高于平和质者(均P＜0.05)；男性患血脂异常的风险是女性的2.521倍，尿酸偏高者患血脂异常的风险是尿酸正常者的1.808倍，脂肪含量、BMI水平与血脂异常呈正相关关系(均P＜0.05)。结论性别为男性，高UA、高BMI和脂肪含量偏高是影响血脂异常发生的危险因素，纠正偏颇体质和控制体重有助于减少血脂异常和超重/肥胖的发生。
- 中医体质 /
- 体重指数 /
- 血脂异常 /
- 超重/肥胖
Abstract: Objective To explore the correlation between traditional Chinese medicine (TCM) constitution and blood lipid, body mass index, uric acid and fat content, and analyze the risk factors affecting the occurrence of dyslipidemia. Methods A cross-sectional retrospective study was conducted on 1 061 patients who underwent physical examination in Foshan Hospital of Traditional Chinese Medicine from January 2019 to December 2020. SPSS 24.0 statistical software was used to analyze the correlation between blood lipid, uric acid, body mass index and fat content of people with different physical conditions, as well as the incidence of dyslipidemia and overweight/obesity. Binary logistic regression analysis was used to analyze the risk factors of dyslipidemia. Results Among the 1 061 cases of physical examination, 300 cases (28.28%) of peaceful constitution, 761 cases (71.73%) of biased constitution, of which 202 cases (19.04%) of phlegm-wet, 172 cases (16.21%) of Yang deficiency, 136 cases (12.82%) of qi deficiency; The proportion of phlegm-wet in male was higher than that in female, and the proportion of Qi-stagnation, Yin deficiency and blood stasis in female was higher than that in male (all P < 0.05).The TC, LDL-C and BMI of the biased constitution were higher than those of the peaceful constitution (all P < 0.05). TG, LDL-C and BMI were higher and HDL-C was lower in phlegm-wet patients, LDL-C, BMI and fat contents were higher in damp-heat patients, and BMI was lower in Qi-stagnation patients (all P < 0.05). The incidence of overweight/obesity was higher in phlegm-wet and damp-heat constitution than in peaceful constitution (all P < 0.05). The risk of dyslipidemia in males was 2.521 times higher than that in females, and the risk of dyslipidemia in those with high uric acid was 1.808 times higher than that of those with normal uric acid. Fat content and BMI were positively correlated with dyslipidemia (all P < 0.05). Conclusion Sex for male, high uric acid, high BMI and high fat content are risk factors for dyslipidemia. Correcting biased constitution and controlling weight can help reduce the occurrence of dyslipidemia and overweight/obesity.
- Constitution of TCM /
- Body mass index /
- Dyslipidemia /
- Overweight/obesity

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表 1 1 061名体检人员不同体质类型的分布情况

Table 1. Distribution of different types of TCM constitution of 1 061 physical examination personnel

体质类型	频数	构成比(%)
平和质	300	28.28
痰湿质	202	19.04
阳虚质	172	16.21
气虚质	136	12.82
湿热质	100	9.43
气郁质	66	6.22
阴虚质	41	3.86
血瘀质	32	3.02
特禀质	12	1.13

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表 2 1 061名体检人员不同性别的体质分布情况[例(%)]

Table 2. Distribution of TCM constitution types of 1 061 physical examination personnel in different genders

性别	例数	平和质	痰湿质	阳虚质	气虚质	湿热质	气郁质	阴虚质	血瘀质	特禀质
男性	612	175(28.6)	133(21.7)	103(16.8)	86(14.1)	61(10.0)	26(4.2)	10(1.6)	8(1.3)	10(1.6)
女性	449	125(27.8)	69(15.4)	69(15.4)	50(11.1)	39(8.7)	40(8.9)	31(6.9)	24(5.3)	2(0.4)
χ²值		0.041	4.671	0.295	1.530	0.413	8.460	17.795	13.516	3.205
P值		0.840	0.031	0.587	0.216	0.520	0.005	＜0.001	＜0.001	0.084

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表 3 不同形体肥胖程度体检人员的中医体质分布情况[例(%)]

Table 3. Distribution of TCM constitution types in physical examination personnel with different body obesity degree[cases (%)]

组别	例数	平和质	痰湿质	阳虚质	气虚质	湿热质	气郁质	阴虚质	血瘀质	特禀质
正常/偏瘦	638	190(29.8)	101(15.8)	106(16.6)	79(12.4)	51(8.0)	51(8.0)	32(5.0)	23(3.6)	5(0.8)
超重/肥胖	423	110(26.0)	101(23.9)	66(15.6)	57(13.5)	49(11.6)	15(3.5)	9(2.1)	9(2.1)	7(1.7)
χ²值		1.006	7.176	0.138	0.210	3.159	7.683	5.317	1.792	1.685
P值		0.316	0.007	0.710	0.647	0.076	0.006	0.021	0.181	0.194

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表 4 不同体质体检人员的血脂和尿酸的比较(x±s)

Table 4. Comparison of blood lipid and uric acid in physical examination personnel of different TCM constitution types(x±s)

体质类型	例数	TCH (mmol/L)	TG (mmol/L)	LDL-C (mmol/L)	HDL-C (mmol/L)	UA (μmol/L)
平和质	300	4.79±0.89	1.40±1.30	2.76±0.80	1.30±0.32	369.63±95.97
痰湿质	202	4.93±0.96	1.64±1.29^a	2.94±0.78^a	1.24±0.27^a	384.90±105.43
阳虚质	172	4.94±0.93	1.53±1.16	2.87±0.76	1.29±0.28	365.06±104.43
气虚质	136	5.02±1.03	1.52±1.20	2.87±0.85	1.32±0.38	368.15±108.85
湿热质	100	4.89±0.94	1.40±0.90	2.95±0.81^a	1.28±0.26	390.36±94.48
气郁质	66	4.79±0.92	1.18±0.75	2.71±0.74	1.37±0.36	357.53±96.96
阴虚质	41	4.91±0.79	1.07±0.55	2.84±0.64	1.39±0.39	320.09±92.10^a
血瘀质	32	4.65±0.79	1.12±0.66	2.53±0.65	1.49±0.31^a	302.71±76.99^a
F值		1.525	2.479	2.394	3.601	4.683
P值		0.144	0.012	0.015	＜0.001	＜0.001
注：与平和质比较，^aP＜0.05。

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表 5 不同体质体检人员BMI、脂肪含量、体脂百分比、内脏脂肪等级的比较(x±s)

Table 5. Comparison of BMI, fat content, body fat percentage and visceral fat grade in physical examination personnel of different TCM constitution types(x±s)

体质类型	例数	BMI	脂肪含量(kg)	体脂百分比(%)	内脏脂肪等级
平和质	300	22.80±3.57	15.81±6.33	24.94±7.78	6.32±3.17
痰湿质	202	23.83±3.64^a	16.77±6.56	25.50±7.17	6.68±3.40
阳虚质	172	23.33±4.08	16.58±7.40	25.52±8.07	6.65±3.64
气虚质	136	23.19±3.85	16.17±6.92	25.04±7.43	6.34±3.64
湿热质	100	24.20±3.87^a	17.88±7.35^a	26.46±7.52	7.32±3.83
气郁质	66	21.78±3.09^a	15.03±5.60	25.88±7.48	6.05±3.09
阴虚质	41	22.04±2.59	15.68±5.83	27.49±7.72	6.59±3.54
血瘀质	32	22.80±2.86	16.52±5.76	28.28±7.81	6.88±3.39
F值		4.892	2.281	1.467	1.790
P值		＜0.001	0.020	0.165	0.075
注：与平和质比较，^aP＜0.05。

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表 6 平和质和偏颇质体检人员之间的血脂、尿酸及BMI的比较(x±s)

Table 6. Comparison of blood lipid, uric acid and BMI in physical examination personnel between peaceful constitution and biased constitution(x±s)

组别	例数	TC(mmol/L)	TG(mmol/L)	HDL-C(mmol/L)	LDL-C(mmol/L)	UA(μmol/L)	BMI
平和质	300	4.79±0.89	1.41±1.30	1.30±0.32	2.76±0.80	368.35±98.43	22.80±3.57
偏颇质	761	4.91±0.95	1.47±1.11	1.50±5.62	2.88±0.78	372.40±139.05	23.37±3.77
t值		-2.086	-0.820	-1.006	-2.058	-0.532	-2.289
P值		0.037	0.413	0.315	0.040	0.595	0.022

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表 7 不同体质体检人员的血脂异常、超重/肥胖发生率比较[例(%)]

Table 7. Comparison of the incidence of dyslipidemia and overweight/obesity in physical examination personnel of different TCM constitution types[cases (%)]

体质类型	例数	血脂异常	χ²值^a	P值^a	超重/肥胖	χ²值^a	P值^a
平和质	300	183(61.00)			110(36.67)
痰湿质	202	128(63.37)	0.287	0.592	101(50.00)	8.808	0.003
阳虚质	172	108(62.79)	0.148	0.700	66(38.37)	0.136	0.712
气虚质	136	83(61.03)	< 0.001	0.995	55(40.44)	0.567	0.452
湿热质	100	65(65.00)	0.509	0.475	49(49.00)	4.764	0.029
气郁质	66	36(54.55)	0.938	0.333	15(22.73)	4.674	0.031
阴虚质	41	25(60.98)	< 0.001	0.998	9(21.95)	3.438	0.064
血瘀质	32	14(43.75)	3.566	0.059	9(28.13)	0.917	0.338
注：^a为与平和质比较。

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表 8 体检人员血脂异常发生风险的二元logistic回归分析

Table 8. Binary logistic regression analysis of the risk of dyslipidemia in physical examination personnel

变量	B	SE	Wald χ²	P值	OR值	95% CI
男性	0.924	0.240	14.860	＜0.001	2.521	1.575~4.033
BMI	0.105	0.048	4.737	0.030	1.110	1.010~1.220
尿酸偏高	0.592	0.159	13.852	＜0.001	1.808	1.323~2.469
脂肪含量	0.131	0.058	5.143	0.023	1.140	1.018~1.277

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参考文献(23)

[1]	吴涛涛, 王琦, 李岩, 等. 基于体病相关探讨临床预测模型的构建[J]. 中医杂志, 2022, 63(16): 1507-1510, 1531. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202216002.htm WU T T, WANG Q, LI Y, et al. Construction of clinical prediction models based on the theory of constitution disease correlation[J]. Journal of Traditional Chinese Medicine, 2022, 63(16): 1507-1510, 1531. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202216002.htm
[2]	李雅纯, 孟成鑫, 刘一璇, 等. 中医体质学的发展与研究现状[J]. 现代养生, 2022, 22(8): 568-571. https://www.cnki.com.cn/Article/CJFDTOTAL-YSXD202208002.htm LI Y C, MENG C X, LIU Y X, et al. Development and research status of traditional Chinese medicine constitution[J]. Health Protection and Promotion, 2022, 22(8): 568-571. https://www.cnki.com.cn/Article/CJFDTOTAL-YSXD202208002.htm
[3]	卜军, 陈章炜, 崔晓通, 等. 中国成人代谢异常与心血管疾病防治[J]. 上海医学, 2020, 43(3): 129-164. doi: 10.19842/j.cnki.issn.0253-9934.2020.03.001 PU J, CHEN Z W, CUI X T, et al. Current status of metabolic abnormality and prevention and treatment of cardiovascular diseases in Chinese adults[J]. Shanghai Med. J, 2020, 43(3): 129-164. doi: 10.19842/j.cnki.issn.0253-9934.2020.03.001
[4]	商广芸, 高燕飞, 曹洪波, 等. 急性心肌梗死的危险因素分析[J]. 实用临床医药杂志, 2020, 24(12): 48-50. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL202012015.htm SHANG G Y, GAO Y F, CAO H B, et al. Analysis in risk factors of acute myocardial infarction[J]. Journal of Clinical Medicine in Practice, 2020, 24(12): 48-50. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL202012015.htm
[5]	刘磊, 冯浩, 杨兴东, 等. 急性脑梗死发病危险因素分析[J]. 山东医药, 2020, 60(12): 85-87. doi: 10.3969/j.issn.1002-266X.2020.12.023 LIU L, FENG H, YANG X D, et al. Analysis of risk factors of acute cerebral infarction[J]. Shandong Medical Journal, 2020, 60(12): 85-87. doi: 10.3969/j.issn.1002-266X.2020.12.023
[6]	谢翔. 动脉粥样硬化患者甘油三酯升高的管理中国专家共识[J]. 中华全科医学, 2019, 17(5): 709-713. http://www.zhqkyx.net/article/id/14aba754-bd51-49cf-ae2e-a2393c8e6958 XIE X. Chinese expert Consensus on the management of elevated triglycerides in atherosclerotic patients[J]. Chinese Journal of General Practice, 2019, 17(5): 709-713. http://www.zhqkyx.net/article/id/14aba754-bd51-49cf-ae2e-a2393c8e6958
[7]	童双, 吴克瑾, 沈红艺. 血脂异常与中医体质相关性研究进展[J]. 世界科学技术—中医药现代化, 2020, 22(7): 2454-2459. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX202007038.htm TONG S, WU K J, SHEN H Y. Research progress on the correlation between dyslipidemia and TCM constitution[J]. World Science and Technology-Modernization of TCM, 2020, 22(7): 2454-2459. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX202007038.htm
[8]	中华中医药学会. 中医体质分类与判定[M]. 北京: 中国中医药出版社, 2009: 20. China Association of Chinese Medicine. Classification and Determination of Constitution in TCM[M]. Beijing: China Press of Traditional Chinese Medicine, 2009: 20.
[9]	于欣, 李天星, 白帆, 等. 基于文献对全国七个地理区划中医体质类型构成情况的分析[J]. 中国医药科学, 2021, 11(14): 151-154, 158. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX202114048.htm YU X, LI T X, BAI F, et al. Literature-based analysis of traditional Chinese Medicine constitution types in seven geographic regions of China[J]. China Medical and Pharmacy, 2021, 11(14): 151-154, 158. https://www.cnki.com.cn/Article/CJFDTOTAL-GYKX202114048.htm
[10]	黄凯, 罗毅, 张美红, 等. 深圳市罗湖区17 084例老年人群中医体质类型分布特征分析[J]. 中医药管理杂志, 2022, 30(11): 65-67. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYG202211023.htm HUANG K, LUO Y, ZHANG M H, et al. Analysis of distribution characteristics of TCM constitution types in 17084 elderly population in Luohu District, Shenzhen[J]. Journal of Traditional Chinese Medicine Management, 2022, 30(11): 65-67. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYG202211023.htm
[11]	白明华, 王济, 郑燕飞, 等. 基于10 8015例样本数据的中国人群中医体质类型分布特征分析[J]. 北京中医药大学学报, 2020, 43(6): 498-507. https://www.cnki.com.cn/Article/CJFDTOTAL-JZYB202006010.htm BAI M H, WANG J, ZHENG Y F, et al. Analysis of distribution characteristics of TCM body constitution types in Chinese population based on data of 108 015 cases[J]. Journal of Beijing University of Traditional Chinese Medicine, 2020, 43(6): 498-507. https://www.cnki.com.cn/Article/CJFDTOTAL-JZYB202006010.htm
[12]	赵燕, 龙艳. 广州地区1 146例老年人群中医体质类型分析及其"治未病"健康管理初探[J]. 中医临床研究, 2021, 13(27): 17-19. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYLY202127007.htm ZHAO Y, LONG Y. Preliminary analysis on TCM physique types of 1146 elderly people in Guangzhou and health management of the preventive treatment of disease[J]. Clinical Journal of Chinese Medicine, 2021, 13(27): 17-19. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYLY202127007.htm
[13]	张冰婵, 陆琴. 高脂血症血脂水平和中医体质辨识分型的相关性研究[J]. 云南中医中药杂志, 2020, 41(6): 21-22. https://www.cnki.com.cn/Article/CJFDTOTAL-YZYY202006007.htm ZHANG B C, LU Q. The correlation between the level of blood lipid in hyperlipidemia and the classification of TCM constitution[J]. Yunnan Journal of Traditional Chinese Medicine and Materia Medica, 2020, 41(6): 21-22. https://www.cnki.com.cn/Article/CJFDTOTAL-YZYY202006007.htm
[14]	叶子怡, 陈恒, 李小燕, 等. 中医体质类型在健康体检人群中的分布及其体检结果分析[J]. 湖北中医药大学学报, 2018, 20(3): 32-36. https://www.cnki.com.cn/Article/CJFDTOTAL-HZXX201803008.htm YE Z Y, CHEN H, LI X Y, et al. Distribution of TCM constitution types in healthy population and analysis of physical examination results[J]. Journal of Hubei University of Traditional Chinese Medicine, 2018, 20(3): 32-36. https://www.cnki.com.cn/Article/CJFDTOTAL-HZXX201803008.htm
[15]	杨益. 低密度脂蛋白胆固醇升高与中医体质的临床相关性分析[J]. 黑龙江医药, 2022, 35(4): 896-898. https://www.cnki.com.cn/Article/CJFDTOTAL-HJYY202204055.htm YANG Y. Clinical correlation analysis of elevated LDL cholesterol and traditional Chinese medicine constitution[J]. Heilongjiang Medicine Journal, 2022, 35(4): 896-898. https://www.cnki.com.cn/Article/CJFDTOTAL-HJYY202204055.htm
[16]	韩燕, 杨月嫦, 周扬, 等. 超重/肥胖与中医体质相关性的横断面研究[J]. 上海中医药杂志, 2022, 56(10): 24-28. https://www.cnki.com.cn/Article/CJFDTOTAL-SHZZ202210005.htm HAN Y, YANG Y E, ZHOU Y, et al. A cross-sectional study of correlation between overweight/obesity and traditional Chinese medicine constitution[J]. Shanghai Journal of Traditional Chinese Medicine, 2022, 56(10): 24-28. https://www.cnki.com.cn/Article/CJFDTOTAL-SHZZ202210005.htm
[17]	肖定洪, 梁春耕, 徐辉, 等. 上海市老年人群代谢相关脂肪性肝病与体质相关性的横断面调查[J]. 中医杂志, 2022, 63(16): 1559-1565. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202216011.htm XIAO D H, LIANG C G, XU H, et al. Correlation between metabolic associated fatty liver disease and constitutional types of Chinese medicine in elderly in Shanghai: a cross-sectional study[J]. Journal of Traditional Chinese Medicine, 2022, 63(16): 1559-1565. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202216011.htm
[18]	杨燕, 梁雨晴, 曹蠡馨, 等. 基于"体病相关-体质可调"理论探析老年慢病防治策略[J]. 中华中医药杂志, 2022, 37(3): 1556-1559. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202203079.htm YANG Y, LIANG Y Q, CAO L X, et al. Based on the theory of physical disease related- adjustable constituon, the prevention and treatment strategies of chronic diseases in the elderly[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2022, 37(3): 1556-1559. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202203079.htm
[19]	邝秀英, 招敏虹, 许洪伟, 等. 广东地区代谢综合征患者中医体质类型及其相关因素研究[J]. 中医药导报, 2020, 26(10): 126-129. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZB202010032.htm KUANG X Y, ZHAO M H, XU H W, et al. Study on relevant factors of TCM constitution types in patients with metabolic syndrome in Guangdong area[J]. Guiding Journal of Traditional Chinese Medicine and Pharmacy, 2020, 26(10): 126-129. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZB202010032.htm
[20]	罗翠文, 徐福平, 梁咏竹, 等. 血脂异常与中医体质、体重指数、中心型肥胖的相关性研究[J]. 世界中医药, 2018, 13(7): 1786-1789. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZA201807055.htm LUO C W, XU F P, LIANG Y Z, et al. Study on relationship between dyslipidemia and TCM constitution, and body mass index and abdominal obesity[J]. World Chinese Medicine, 2018, 13(7): 1786-1789. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZA201807055.htm
[21]	尹艳, 王世燕, 孙志新, 等. 1 554例超重/肥胖人群的中医体质类型分析及临床防治思路探索[J]. 中医药信息, 2020, 37(2): 64-69. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXN202002018.htm YI Y, WANG S Y, SUN Z X, et al. Types analysis of TCM constitution of 1554 cases of overweight/obese people and exploration for clinical prevention and treatment[J]. Information on Traditional Chinese Medicine, 2020, 37(2): 64-69. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXN202002018.htm
[22]	YE H Q, CHEN Y X, XU G Z, et al. Standardized auricular therapy for patients with different constitutions and suboptimal health: a retrospective study[J]. Med Acupunct, 2019, 31(2): 98-102.
[23]	竺琼, 陈春凤. 体质辨识在社区高血压管理中的应用[J]. 中华全科医学, 2022, 20(5): 836-838, 871. doi: 10.16766/j.cnki.issn.1674-4152.002467 ZHU Q, CHEN C F. Application of constitution identification in community hypertension management[J]. Chinese Journal of General Practice, 2022, 20(5): 836-838, 871. doi: 10.16766/j.cnki.issn.1674-4152.002467