摘要
目的 探讨偏颇质对健康相关生命质量(HRQOL)的影响及睡眠质量在偏颇质与HRQOL关系间的作用机制.方法 选用2015年3月—2016年12月在北京市和河北省石家庄市健康体检人群中收集的数据.采用中医体质量表(CCMQ)得分评估偏颇质倾向性,CCMQ是包含平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质9个亚量表的标准化测评工具,其中平和质外的8种体质为偏颇体质;简明健康状况调查问卷(SF-36)得分评估HRQOL;匹兹堡睡眠质量指数量表(PSQI)得分评估睡眠质量.运用Pearson相关分析探究8种偏颇质、睡眠质量、HRQOL之间的相关性,进一步构建结构方程模型探讨8种偏颇质对HRQOL的影响及睡眠质量的中介效应.结果 数据库中共有样本2170例,剔除不符合要求的样本188例后纳入1982例作为研究对象.调查对象SF-36得分为(79.73±12.89)分,PSQI得分为(4.29±2.66)分,8种偏颇质CCMQ得分分别为气虚质(27.46±14.84)分、阳虚质(25.12±19.17)分、阴虚质(23.55±14.99)分、痰湿质(21.57±15.20)分、湿热质(23.67±15.49)分、血瘀质(21.68±14.49)分、气郁质(22.00±16.14)分、特禀质(16.13±14.19)分.Pearson相关分析显示,8种偏颇质得分与SF-36得分均呈负相关(r=-0.562～-0.327,P<0.01),与PSQI得分均呈正相关(r=0.272～0.431,P<0.01),PSQI得分与SF-36得分呈负相关(r=-0.471,P<0.01).结构方程模型结果显示,8种偏颇质对HRQOL均有负向影响,且睡眠质量在8种偏颇质与HRQOL关系的中介作用均具有统计学意义.8种偏颇质对HRQOL的总效应分别为气虚质-0.776、阳虚质-0.528、阴虚质-0.603、痰湿质-0.684、湿热质-0.596、血瘀质-0.678、气郁质-0.751、特禀质-0.452,气虚质和气郁质总效应绝对值高于其他偏颇质;睡眠质量中介效应分别为气虚质-0.242、阳虚质-0.272、阴虚质-0.291、痰湿质-0.261、湿热质-0.265、血瘀质-0.395、气郁质-0.203、特禀质-0.287,其中,睡眠质量在血瘀质与HRQOL关系的中介效应绝对值高于其他偏颇质.结论 8种偏颇质对HRQOL均有负向影响,睡眠质量在8种偏颇质与HRQOL关系中起不同程度的中介作用.
Abstract
Objective To explore the effects of biased constitutions on health-related quality of life (HRQOL) and mechanisms of the role of sleep quality in the relationship between biased constitutions and HRQOL.Methods Data collected from the propulation of Beijing and Shijiazhuang,Hebei province for health check-up from March 2015 to December 2016. The biased constitutions were evaluated using the Constitution in Chinese Medicine Questionnaire (CCMQ) score;CCMQ consists of gentleness type (A type),qi-deficiency type (B type),yang-deficiency type (C type),yin-deficiency type (D type),phlegm-wetness type (E type),wet-heat type (F type),blood-stasis type (G type),qi-depression type (H type),and special diathesis type (I type),the eight constitutions except A type are classified as biased constitution (BC),Sleep quality (SQ) was evaluated using the Pittsburgh Sleep Quality Index (PSQI). HRQOL was evaluated using the 36-item Short Form Health Survey (SF-36). Pearson's correlation analysis was used to explore the correlation among the eight BCs,SQ,and HRQOL,and the structural equation model was further constructed to explore the effects of the eight BCs on HRQOL and the mediating effect of SQ.Results A total of 2,170 samples were included in the database. Finally,1,982 samples were included as study subjects after excluding 188 unqualified samples. The SF-36 and PSQI scores of the samples were 79.73±12.89 and 4.29±2.66,respectively,and the scores for the eight BCs were 27.46±14.84,25.12±19.17,23.55±14.99,21.57±15.20,23.67±15.49,21.68±14.49,22.00±16.14,and 16.13±14.19 for B,C,D,E,F,G,H,and I types,respectively. The result of Pearson's correlation analysis showed that all biased constitution scores were negatively correlated with the SF-36 score (r=-0.562 to-0.327,P<0.01),and were positively correlated with the PSQI score (r=0.272 to 0.431,P<0.01),and PSQI score was negatively correlated with the SF-36 score (r=-0.471,P<0.01). The result of the structural equation model showed that all biased constitutions had a negative effect on HRQOL and that the mediating role of SQ in the relationship between eight BCs and HRQOL was all statistically significant. The total effects of the eight BCs on HRQOL were-0.776,-0.528,-0.603,-0.684,-0.596,-0.678,-0.751,and-0.452 for the B,C,D,E,F,G,H,and I types,respectively. Moreover,the absolute effects of the B and H types were significantly higher than in other BCs;the mediation effect of SQ was-0.242,-0.272,-0.291,-0.261,-0.265,-0.395,-0.203,and-0.287 for the B,C,D,E,F,G,H,and I types,respectively,the absolute value of the mediation effect between G type and HRQOL was significantly higher than that of other BCs. Conclusion The eight BCs had negative effects on HRQOL,and SQ played a mediator role in the relationship between the eight BCs and HRQOL.
基金项目
北京市自然科学基金面上项目(7222282)
北京中医药大学基本科研业务费揭榜挂帅项目(2022-JYB-JBZR-036)
国家科技期刊平台
NSTL
万方数据