摘要： 背景 偏頗質(zhì)、運(yùn)動(dòng)和健康相關(guān)生命質(zhì)量（HRQOL）三者之間兩兩關(guān)系的研究較多，但關(guān)于三者之間關(guān)系的研究較少。 目的 探討運(yùn)動(dòng)在8種偏頗質(zhì)與HRQOL間的作用機(jī)制。 方法 采用方便抽樣法選取2015年7—11月、2016年5—9月于北京市紅十字血液中心獻(xiàn)血小屋和采血車上的無償獻(xiàn)血者和陪同的非獻(xiàn)血者為研究對(duì)象進(jìn)行問卷調(diào)查。運(yùn)動(dòng)水平由自我報(bào)告獲得；偏頗質(zhì)采用中醫(yī)體質(zhì)量表（CCMQ）得分評(píng)價(jià)；HRQOL采用簡(jiǎn)明健康狀況調(diào)查問卷（SF-36）得分評(píng)價(jià)，得分越高代表生命質(zhì)量越好。采用Pearson相關(guān)分析探究HRQOL、運(yùn)動(dòng)水平和8種偏頗質(zhì)之間的相關(guān)性，進(jìn)一步采用多元線性回歸模型探討運(yùn)動(dòng)在偏頗質(zhì)與HRQOL之間的中介作用。 結(jié)果 本研究共發(fā)放問卷1 828份，回收1 771份，剔除不合格問卷（填寫不完整、存在邏輯錯(cuò)誤）29份，有效問卷1 742份，有效回收率為95.30%。1 742例受試者SF-36得分為（84.42±12.05）分，CCMQ中8種偏頗質(zhì)亞量表得分分別為：氣虛質(zhì)（23.20±14.61）分，陽虛質(zhì)（20.03±18.12）分，陰虛質(zhì)（20.87±15.20）分，痰濕質(zhì)（19.78±14.65）分，濕熱質(zhì)（21.70±16.57）分，血瘀質(zhì)（17.68±14.08）分，氣郁質(zhì)（19.63±15.63）分，特稟質(zhì)（15.30±13.62）分。Pearson相關(guān)分析結(jié)果顯示，8種偏頗質(zhì)得分與HRQOL（SF-36得分）均呈負(fù)相關(guān)（r為-0.413~-0.612，P<0.01）；除特稟質(zhì)外，其余7種偏頗質(zhì)得分與運(yùn)動(dòng)水平呈負(fù)相關(guān)（r為-0.072~-0.176，P<0.01）；運(yùn)動(dòng)水平與HRQOL（SF-36得分）呈正相關(guān)（r=0.145，P<0.01）。中介效應(yīng)檢驗(yàn)結(jié)果顯示，運(yùn)動(dòng)在除特稟質(zhì)外的其余7種偏頗質(zhì)與HRQOL間的中介作用具有統(tǒng)計(jì)學(xué)意義（P<0.05），中介作用效果量從大到小依次是痰濕質(zhì)（2.13%）、陽虛質(zhì)（2.05%）、濕熱質(zhì)（1.88%）、陰虛質(zhì)（1.55%）、血瘀質(zhì)（1.48%）、氣郁質(zhì)（1.37%）、氣虛質(zhì)（1.16%）。 結(jié)論 中醫(yī)體質(zhì)的8種偏頗質(zhì)（痰濕質(zhì)、陽虛質(zhì)、濕熱質(zhì)、陰虛質(zhì)、血瘀質(zhì)、氣郁質(zhì)、氣虛質(zhì)、特稟質(zhì)）與HRQOL呈負(fù)相關(guān)，運(yùn)動(dòng)在除特稟質(zhì)外的7種偏頗質(zhì)與HRQOL中起不同程度的部分中介作用，但中介作用效果量均較小。

關(guān)鍵詞: 中醫(yī)體質(zhì), 偏頗質(zhì), 健康相關(guān)生命質(zhì)量, 運(yùn)動(dòng), 中介作用

Abstract:

Background

The pairwise correlation among biased constitution, exercise and health-related quality of life (HRQOL) has been extensively studied, while the relationship among the three has been rarely explored.

Objective

To explore the mediating effect of exercise on the relationship of 8 kinds of biased constitution with HRQOL.

Methods

By use of convenience sampling, unpaid blood donors and their companions were selected as participants from blood donation cabins and blood collecting vehicles of Beijing Red Cross Blood Center from July to November 2015 and May to September 2016 . The exercise level was obtained by the self-report method. The biased constitution was assessed using the Constitution in Chinese Medicine Questionaire (CCMQ) . The HRQOL was evaluated by the Chinese version of the 36-Item Short Form Health Survey (SF-36) , and a higher score indicates a higher quality of life. Pearson correlation analysis was used to explore the correlation among HRQOL (score of SF-36) , exercise level and 8 kinds of biased constitution. Multiple linear regression model was applied to explore the mediating effect of exercise on the relationship between HRQOL and biased constitution.

Results

A total of 1 828 cases attended the survey, 1 771 of them returned questionnaires, and after excluding 29 who inappropriately (incompletely or illogically) answered questionnaires, the remaining 1 742 cases (95.30%) were included for analysis. The mean SF-36 score of 1 742 subjects was (84.42±12.05) points. And the mean scores of the 8 biased constitution subscales of CCMQ for them were: qi-deficiency: (23.20±14.61) points, yang-deficiency: (20.03±18.12) points, yin-deficiency: (20.87±15.20) points, phlegm-dampness: (19.78±14.65) points, dampness-heat: (21.70±16.57) points, blood-stasis: (17.68±14.08) points, qi-depression: (19.63±15.63) points, specific-diathesis: (15.30±13.62) points. The score of each of the 8 kinds of biased constitution was negatively correlated with HRQOL (r: -0.413 - -0.612, P<0.01) . Except for specific-diathesis type, biased constitution scores were negatively correlated with exercise level (r: -0.072 - -0.176, P<0.01) . Exercise level was positively correlated with HRQOL (r=0.145, P<0.01) . Mediation analysis revealed that, exercise played a significant mediating effect on the relationship between HRQOL and biased constitution except the specific-diathesis type (P<0.05) . And the size of mediating effect in a descending order was 2.13% between HRQOL and phlegm-dampness, 2.05% between HRQOL and yang-deficiency, 1.88% between HRQOL and dampness-heat, 1.55% between HRQOL and yin-deficiency, 1.48% between HRQOL and blood-stasis, 1.37% between HRQOL and qi-depression, 1.16% between HRQOL and qi-deficiency.

Conclusion

Eight kinds of biased constitution (phlegm-dampness, yang-deficiency, dampness-heat, yin-deficiency, blood-stasis, qi-depression, qi-deficiency, and specific-diathesis) negatively affected the HRQOL. Although exercise partially played a role in mediating the relationship of HRQOL with the other 7 types of biased constitution except specific-diathesis, the effect size was generally little.

Key words: Traditional Chinese medicine constitution, Biased constitution, Health-related quality of life, Sports, Mediating effect

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