关键词: 糖尿病, 2型；体质学说；兼夹体质；社区；老年人

Abstract:
Backgroud　The occurrence，development and prognosis of type 2 diabetes are related to pathological constitutions of Chinese medicine.But in this respect，the research is mainly focused on the general population in China，and most of them analysis of single pathological constitutions.Objective　To identify and analyze Traditional Chinese Medicine Constitutions （TCMCs） in elderly community members and their mixed constitutions，in order to determine the relationship between TCMCs （or mixed TCMCs） and the development of type 2 diabetes in elderly members of the community.Methods　From June 2016 to June 2017，1 600 elders living in a community in the Pearl River Delta who underwent routine physical examination in the community medical examination department were selected as the study subjects.The TCMCs were determined using classification and diagnosis basis of constitutions in Chinese medicine，and fasting plasma glucose （FPG） was determined from blood samples.A comparative analysis of the relationship between TCMCs and the development of type 2 diabetes was conducted，and factor analysis was used to assess the mixing and combination of single biased constitutions.Results　A total of 1 540 valid samples were screened from 1 600 samples with an effective rate of 96.25%.Sixty samples with incomplete physical examination data were excluded.The detection rate of diabetes among the 1 540 elderly subjects in the community was 21.49% （331/1 540）．With regard to TCMCs，there were 878 cases （57.01%） of normal constitution，while biased constitutions were observed in 197 cases （12.79%） of phlegm-dampness constitution，192 cases （12.47%） of Yang-deficiency constitution，182 cases （11.82%） of Qi-deficiency constitution，and 170 cases （11.04%） of Yin-deficiency constitution.Following factor analysis，three common factors were extracted from eight types of biased constitutions.Of these，phlegm-dampness，blood stasis，dampness-heat，Qi-stagnation，and special constitution constituted the stasis-dampness mix；Yang-deficiency constitution and Yin-deficiency constitution constituted the deficiency-mix；and Qi-deficiency constitution alone constituted a unique common factor.Phlegm-dampness，Yang deficiency，Yin deficiency，blood stasis，dampness-heat，Qi stagnation，and special constitution were related to the development of type 2 diabetes （P<0.05），with OR values ranked in order as follows：special constitution （OR=4.482），Qi-stagnation constitution （OR=3.129），dampness-heat constitution （OR=2.871），Yang-deficiency constitution （OR=2.201），blood stasis constitution （OR=1.936），Yin-deficiency constitution （OR=1.668），and phlegm-dampness constitution （OR=1.588）．Hydration and the combination of body composition and physical fitness were related to the occurrence of type 2 diabetes （P<0.05），in which the combined OR value of the dampness constitution was 1.360，and the OR value of the combined fitness was 1.729.Conclusion　In community elders，those with special constitution，Qi-stagnation constitution，dampness-heat constitution，Yang-deficiency constitution；mixed phlegm-dampness constitution，dampness-heat constitution，blood stasis constitution，Qi-stagnation constitution，special constitution；or mixed Yang-deficiency constitution and Yin-deficiency constitution，were more likely to develop type 2 diabetes.In community prevention and intervention programs，targeted health guidance should be provided for different constitutions in the elderly，and an integrated health care strategy of Chinese and Western medicine should be adopted to improve their health status.

Key words: Diabetes mellitus, type 2；Physical constitution theory；Mixed constitution；Community；Aged