The 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.

The 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.

Three case–control and 26 cross-sectional studies involving 30435 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.

Phlegm-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.

A growing number of randomized controlled trials (RCTs) have explored the significance of adjusting constitution for preventive treatment of disease in traditional Chinese medicine (TCM). In this study, we sought to comprehensively analyze the characteristics of these RCTs.

All RCTs related to constitutional adjustment and preventive treatment of disease were included in the study. Literature was screened searching seven databases, including Pubmed, Web of Science, Embase, SinoMed, CNKI, Chongqing VIP, and Wangfang Database, from inception to December 2018. Data pertaining to bibliometrics, participants, and interventions were extracted and analyzed.

Two hundred and forty papers were published between 2007 and 2018, involving 240 RCTs with 55977 total participants. Sample size in these RCTs ranged from 30 to 7800. Among them, 59 RCTs addressed disease prevention prior to onset involving 11 healthy states of participants, mainly for general health or sub-health population (40.68%) using health care and non-drug therapy. In control the development of existing disease (n = 174), 59 diseases were involved. Based on the number of RCTs and sample sizes, diseases including type 2 diabetes mellitus, primary hypertension, nonalcoholic fatty liver disease, and hyperlipoproteinemia accounted for 51.15% of the total patients studied. Drug therapy as an intervention was frequently used. In preventing recurrence after recovery (n = 7), over 4 kinds of health status in participants were involved. Drug therapy combined with health care was mostly used. Most RCTs reported positive outcomes, with only one reporting negative findings (1/240).

The number of RCTs of constitutional adjustment on preventive treatment of disease has gradually increased since 2012. Participants and intervention measures from the above-mentioned types of RCTs exhibit their own characteristics. Future systematic reviews or meta-analyses on constitutional adjustment for preventive treatment of disease are warranted.

To evaluate the correlation between the body constitution types of Tibetan medicine and traditional Chinese medicine (TCM).

The cluster sampling method was employed to recruit participants from a university in the Tibet Autonomous Region. Tibetan medicine and TCM questionnaires were respectively used to assess the participants' constitution information. Descriptive statistics were applied to analyze the baseline and constitution characteristics of the participants. Two-factor correlation analysis and the paired chi-square test were applied to analyze the correlation between Tibetan and TCM constitution types.

Data from 466 Tibetan students were analyzed. The mean scores of the rlung, mkhris pa, and bad kan constitution types in Tibetan medicine were 43.2 (11.1), 42.1 (10.1), and 45.0 (8.0), respectively; participants with the three-factor convergence body constitution type accounted for 13.7% of the whole population. Among the TCM constitution types, qi stagnation was the most common (21.5%), followed by the balance type (16.5%); the other constitutions detected were qi deficiency, yin deficiency, and yang deficiency. The rate of consistency for the identification of the three-factor convergence constitution in Tibetan medicine and the balance constitution in TCM was 89.1%, with a Kappa coefficient of 0.57 (P > .05). The rlung constitution in Tibetan medicine was associated with the yin deficiency, yang deficiency, and blood stasis constitutions in TCM. The mkhris pa constitution in Tibetan medicine was associated with the damp heat and yin deficiency constitutions in TCM. The bad kan constitution in Tibetan medicine was associated with the phlegm dampness, qi deficiency, and yin deficiency constitutions in TCM.

There is a correlation between the body constitution types of Tibetan medicine and TCM. The reliability and validity of the Questionnaire for Tibetan Medicine Constitution requires improvement, and more studies with larger sample sizes and more varied populations are warranted to verify the correlation between Tibetan medicine and TCM constitutions.

To measure vascular endothelial function (VED) in obese/overweight people grouped according to the constitutional theory of traditional Chinese medicine (TCM). We wished to predict the risk of VED and cardiovascular diseases in obese/overweight populations.

This was a cross-sectional study. Eighty-six obese/overweight volunteers from Beijing Chao-Yang Hospital were enrolled and divided into four groups based on body-constitution type: phlegm dampness (PD); phlegm dampness with blood stasis (PDBS); qi-deficiency (QD); balance (BA). Height, weight, waist circumference and hip circumference were measured, and percent body fat and reactive hyperemia index (RHI) calculated. Levels of vascular endothelial growth factor (VEGF), von Willebrand factor (vWF) and plasma endothelial-1 (ET-1) were detected by immunohistochemistry.

The RHI and vWF levels in the PDBS group were significantly lower than those in the BA group and QD group (P < .05), but there was no significant difference compared with the PD group (P > .05). These two indicators displayed no significant differences among BA, QD, and PD groups (P > .05). There was no significant difference among the four groups in level of ET-1 or VEGF (P > .05).

Of the four indicators selected, the RHI and vWF displayed significant differences between the PDBS group and BA group, and between the PDBS group and QD group. Hence, in an obese/overweight population with different constitutional types, compared with BA and QD groups, a relatively higher risk of suffering from VED was detected in the PDBS group. Meanwhile, this study provides the experimental basis for confirming the feasibility of constitutional classification in obese/overweight population.

To explore the possible correlation between traditional Chinese medicine (TCM) constitution and facial features in color images and to improve the accuracy of automated constitution classification.

Color images were taken of 5150 individuals of different professions. Automated face detection and key point positioning were performed on the collected images, which were then transformed into a standard size. The relationship between facial features and TCM constitution based on the red, green, blue (RGB) pixel and the local binary pattern (LBP) texture features was explored.

The overall accuracy rate and robustness of TCM constitution classification based on RGB features were low. Classification results of the phlegm-dampness, damp-heat, blood stasis, and balance constitutions achieved high accuracy rates. Classification accuracy rate using the LBP texture feature was higher than that of the RGB feature, with the best accuracy observed for the balance constitution.

Application of computer image acquisition and processing of facial features may serve as an adjunct to the TCM diagnostic method of inspection.

We studied the consistency between two classification systems for categorizing patients: traditional Chinese medicine (TCM) constitution-based methods, versus genetic clustering. Genetic classification in constitutional identification was also evaluated.

A TCM physician evaluated the constitution of each patient, according to four examinations (inspection, auscultation-olfaction, interrogation, and palpation). Those who met the criteria for Yang-deficient, Yin-deficient, and balanced constitutions were enrolled in the study. Peripheral blood samples were obtained from the participants, and peripheral blood mononuclear cells were separated from the samples within 2 hours. Total RNA extraction from the white blood cells was performed; and an Affymetrix HG-U133 Plus2.0 array was used to determine the peripheral blood gene expression profiles. The samples were classified using a support vector machine genetic classifier, and the “leave-one-out” method was used for validation.

The global gene expression profiles of 32 samples were grouped into three categories, and the samples in each of the gene categories corresponded with the three constitution categories. The three constitution types were distinguished using the genetic classifier with 165 genes. The accuracy of the prediction classification was greater than 95% using mathematical method.

Participants with Yin-deficient, Yang-deficient, and balanced constitutions have varying physical characteristics and gene expression patterns. Additionally, the results from TCM constitution classification matched those obtained by genetic classification. Finally, our preliminary gene classifier distinguishes among Yin-deficient, Yang-deficient, and balanced constitutions, and provides a methodological basis for identifying the different constitutions.