Zhongguo quanke yixue (Feb 2024)
Analysis of Traditional Chinese Medicine Constitutions Attributable to the Burden of Wasting Thirst Disorder among the Middle-aged and Older adults in Guangzhou Based on ICD-11
Abstract
Background The 72nd World Health Assembly reviewed and adopted the International Classification of Diseases Eleventh Revision (ICD-11) , which for the first time included traditional medicine originating from traditional Chinese medicine (TCM) in its chapter coding, of which the code for wasting thirst disorder is SD71 (TM1) . At present, wasting thirst disorder is a high clinical prevalence disease, with middle-aged and older adults being the high incidence population, and TCM constitutions bias are risk factors for wasting thirst disorder. There was no research on the burden of TCM diseases and risk factors. Objective Based on the ICD-11 chapter on traditional medicine and the national standards of TCM, the burden of wasting thirst disorder among middle-aged and elderly in Guangzhou was calculated and attributed to the TCM constitutions. The role of TCM constitutions monitoring in health management was evaluated, providing reference for the prevention and treatment of wasting thirst disorder by TCM and the application of constitutions theory. Methods A cross-sectional survey was conducted in 2020 to investigate the prevalence of wasting thirst disorder and the distribution of TCM constitutions among middle-aged and elderly in Guangzhou. The comprehensive theory of Global Burden of Disease (GBD) , calculate the years of life lost (YLL) , years lived with disability (YLD) , and disability adjusted life year (DALY) of wasting thirst disorder in the middle-aged and elderly population in Guangzhou were used to evaluate the disease burden of wasting thirst disorder. Relative risk (RR) was used to assess the risk of different TCM constitutions for wasting thirst disorder in middle-aged and elderly people. Results A total of 1 576 middle aged and older adults in central Guangzhou were surveyed, 55 were lost, 1 521 valid questionnaires were recovered, and the effective response rate was 96.51%. Among them, 782 were male, aged 62 (56, 69) years; 739 were female, aged 62 (55, 70) years. The prevalence of wasting thirst disorder among middle-aged and elderly people in Guangzhou was 13.08%, with a standardized prevalence of 12.64%. The most distributed constitution among middle-aged and elderly people in Guangzhou were phlegm-dampness constitution, qi-deficiency constitution, and damp-heat constitution; among them, the most distributed constitutions in patients with wasting thirst disorder were phlegm-dampness constitution, yin-deficiency constitution, and qi-deficiency constitution. The DALY rate of wasting thirst disorder burden was 86.46‰, with a YLL rate of 4.86‰ and a YLD rate of 81.60‰. The proportion of single constitution and composite constitution was 48.98% and 51.02%, respectively. Yin-deficiency constitution was the risk constitution of wasting thirst disorder (RR=1.73, P<0.01) , which led to a disease burden of 33 092 DALY, with a DALY rate of 10.98, accouting for 12.70% of the disease burden in the middle-aged and elderly population with wasting thirst disorder. In terms of different age groups, phlegm-dampness constitution (RR=1.62, P<0.05) and yin-deficiency constitution (RR=1.80, P<0.05) were risk constitutions in the age group of 60-69 years, in which phlegm-dampness constitution resulted in a wasting thirst disorder burden of 18 530 DALY, with a DALY rate of 18.75‰, accounting for 21.63% burden of wasting thirst disorder in this age group; yin-deficiency constitution led to wasting thirst disorder burden of 10 520 DALY, with a DALY rate of 10.65‰, accounting for 12.28% of burden of wasting thirst disorder in this age group; the disease burden caused by the combination of phlegm-dampness constitution and yin-deficiency constitution was 26 780 DALY, with a DALY rate of 27.10 ‰, accounting for 31.26% of the burden of wasting thirst disorder in this age group. For different genders, male phlegm-dampness constitution (RR=2.29, P<0.01) and female yin-deficiency constitution (RR=2.27, P<0.01) were risk constitutions for wasting thirst disorder. The disease burden caused by phlegm-dampness constitution in middle-aged and elderly males was 45 017 DALY, resulting in a DALY rate of 30.96‰, accounting for 36.82% of the burden of wasting thirst disorder in middle-aged and elderly males. The burden of wasting thirst disorder caused by female yin-deficiency constitution was 28 753 DALY, resulting in a DALY rate of 18.43‰, accounting for 20.79% of the burden of wasting thirst disorder among middle-aged and elderly females. Conclusion The prevalence of wasting thirst disorder among middle-aged and older adults aged≥50 in Guangzhou is relatively high, with heavy disease burden. Yin-deficiency and phlegm-dampness constitutions are risk constitutions for wasting thirst disorder in middle-aged and elderly people. TCM constitutions monitoring and management can effectively reduce the burden of wasting thirst disorder .
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