International Journal of Molecular Medical Science, 2024, Vol.14, No.6, 380-392 http://medscipublisher.com/index.php/ijmms 383 The predisposition of different constitution types to diabetes can be explained by the underlying pathophysiological mechanisms in TCM. For example, a yin-deficient constitution is characterized by a lack of cooling and moistening functions in the body, leading to symptoms such as dry mouth, thirst, and weight loss, which are common in diabetes. Similarly, a phlegm-dampness constitution is associated with an accumulation of dampness and phlegm in the body, which can obstruct the normal flow of qi and fluids, contributing to insulin resistance and metabolic dysfunction (Li et al., 2019; Bai et al., 2021). 3.3 Relationship between constitution identification and the classification-based treatment of diabetes The identification of an individual's constitution is crucial for the classification-based treatment of diabetes in TCM. By understanding a patient's constitution, TCM practitioners can tailor treatment strategies to address the specific imbalances and deficiencies that contribute to their condition. This personalized approach is a hallmark of TCM and aligns with the principles of precision medicine (Li et al., 2019; Chen and Yu, 2024). For instance, a patient with a yin-deficient constitution may benefit from treatments that nourish yin and clear heat, such as herbal formulas containing Rehmannia glutinosa and Ophiopogon japonicus. On the other hand, a patient with a phlegm-dampness constitution may require treatments that transform phlegm and drain dampness, such as formulas containing Poria cocos and Citrus reticulata (Li et al., 2019; Bai et al., 2021). The effectiveness of constitution-based treatment strategies has been demonstrated in various studies. For example, a randomized controlled trial examining the use of a TCM-based mobile health app for individuals with prediabetes found that the app, which provided constitution-specific dietary and exercise advice, significantly improved hemoglobin A1c (HbA1c) levels, body mass index (BMI), and quality of life compared to usual care (Figure 2)(Chung et al., 2022). Another study on the application of TCM constitution theory in health maintenance and disease prevention highlighted the potential of constitution-based interventions to improve clinical outcomes and enhance overall health (Li et al., 2019). Figure 2 Changes in primary outcomes (Adopted from Chung et al., 2022) Image caption: (A) Fasting plasma glucose. (B) HbA1c. (C) Yang deficiency body constitution. (D) Ying deficiency body constitution. (E) Phlegm stasis body constitution. (F) Body energy. (G) Physical component score. (H) Mental component score. Within-group across-time comparisons were made from a paired t test with T1 as the reference. Between-group comparisons were based on one-way ANOVA with the Scheffe posthoc test, with the results presented below graphs. mHealth: mobile health; T1: baseline; T2: end of the intervention; T3: 1 month after the intervention; TCM: traditional Chinese medicine. *P<.05, #P<.001 (Adopted from Chung et al., 2022)
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