【目的】研究上海地区超重/肥胖患者的中医体质特征及其与人体成分分析的相关性。【方法】对2020年8月至2022年12月 至上海市第十人民医院内分泌科针灸埋线专病门诊就诊的有完整中医体质和人体成分检测的患者数据进行分析，根据体质 量指数（body mass index，BMI）情况将患者分为正常体质量组（BMI＜24 kg/m2）、超重组（24 kg/m2 ≤ BMI＜28 kg/m2）和肥胖症 组（BMI ≥ 28 kg/m2），分析3组患者的中医体质分布特征，并采用多元回归分析探讨中医体质与人体成分的关系。【结果】 （1）共纳入315例患者，其中正常体质量43例，超重85例，肥胖症187例。（2）正常体质量人群体质分布比例从高到低依次为 脾虚＞肝郁＞湿热＞阳虚＞阴虚，超重人群体质分布比例从高到低依次为脾虚＞肝郁＞湿热＞阳虚＞阴虚，肥胖症人群体 质分布比例从高到低依次为脾虚＞阳虚＞湿热＞肝郁＞阴虚，超重/肥胖症组体质分布比例从高到低依次为脾虚＞湿热＞阳 虚＞肝郁＞阴虚。正常体质量人群与超重/肥胖症人群的中医体质分布情况比较，差异无统计学意义（P＞0.05）；正常体质量 和超重/肥胖症患者均以单一体质较多，兼夹体质少见，组间比较，差异无统计学意义（P＞0.05）。（3）多元回归分析结果显 示：所有患者基础代谢均与阳虚质呈正相关，与湿热质呈负相关，差异均有统计学意义（P＜0.01），即阳虚质分数上升1分， 基础代谢增加0.54 kcal；湿热质分数下降1分，基础代谢减少1.005 kcal。【结论】在上海地区，肥胖可能是体质改变的主要阶 段；肥胖症患者体质除脾虚外，阳虚、湿热、肝郁的占比也较高。在中医体质与人体成分关系方面，基础代谢与阳虚质呈 正相关，与湿热质呈负相关，故阳虚质和湿热质患者要注意自身基础代谢水平对疾病发展的影响。

Objective To study the traditional Chinese medicine（TCM）constitution characteristics of overweight/ obese patients in Shanghai region and to investigate the correlation of TCM constitution with body composition. Methods Relevant data were collected from the patients with complete information of TCM constitution and human body composition analysis who visited the specialized outpatient clinic of acup- moxibustion catgut embedding therapy in the Department of Endocrinology，Shanghai Tenth People’s Hospital from August 2020 to December 2022. The patients were divided into a normal body mass group（BMI＜24 kg/m2），an overweight group（24 kg/m2 ≤ BMI＜28 kg/m2）and obesity group（BMI ≥ 28 kg/m2），and then the distribution of TCM constitution types in the three groups of patients were analyzed. After that，the correlation between TCM constitution and body composition were explored with multiple regression analysis. Results（1）A total of 315 patients were included， of which 43 patients had normal body mass， 85 patients were overweight and 187 patients were obese.（2）The TCM constitution types in descending order of the composition ratio in the normal body mass group and in the overweight group were spleen deficiency constitution，liver stagnation constitution，damp-heat constitution，yang deficiency constitution， and yin deficiency constitution， in the obese group were spleen deficiency constitution， yang deficiency constitution，damp-heat constitution，liver stagnation constitution，and yin deficiency constitution， and in the overweight/obese group were spleen deficiency constitution，damp-heat constitution，yang deficiency constitution，liver stagnation constitution，and yin deficiency constitution. No statistically significant differences of the distribution of TCM constitution types were shown between normal body bass population and overweight/obese population（P＞0.05）. In both normal body mass population and overweight/obese population， the single body constitution type was common， and biased constitution was rare， and there was no statistically significant difference when comparing between the two groups（P＞0.05）.（3）The results of multiple regression analysis showed that the basal metabolism of all patients was positively correlated with yang deficiency constitution and was negatively correlated with damp-heat constitution，and the differences were statistically significant（P＜0.01）. It is indicated that if the score of yang deficiency constitution rose by one point，the basal metabolism would increase by 0.54 kcal， and if the score of damp-heat constitution decreased by one point， the basal metabolism would decrease by 1.005 kcal. Conclusion In Shanghai region，obesity may be the main indication of the variation of the body constitution. In addition to spleen deficiency constitution， the proportions of yang deficiency constitution， damp-heat constitution and liver stagnation constitution are also higher in obese patients. In terms of the correlation between TCM constitution and body composition， basal metabolism is positively correlated with yang deficiency constitution and is negatively correlated with damp- heat constitution. Therefore， for the patients with yang deficiency constitution and damp-heat constitution，the influence of the basal metabolism level on the development of the disease should be taken into account.

R589.3

上海市卫生健康委员会中医药科研项目（编号：2022QN070）