A Meta-analysis of Traditional Chinese Medicine constitution distribution in people with functional constipation

doi:10.19852/j.cnki.jtcm.2026.02.001

Abstract

Abstract:

OBJECTIVE: To investigate the distribution of Traditional Chinese Medicine (TCM) constitution among individuals with functional constipation, which would provide insights for developing constitution-targeted prevention and treatment strategies.

METHODS: A systematic search was conducted across eight databases (China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal for Chinese Technical Periodicals, SinoMed, PubMed, Web of Science, Embase, and the Cochrane Library) to identify relevant observational studies assessing Traditional Chinese Medicine (TCM) constitution types among people with functional constipation. The protocol for this review has been registered on International Prospective Register of Systematic Reviews (registration number: CRD42022345996).

RESULTS: A total of sixteen cross-sectional studies involving 2976 participants were included in this review. Among functional constipation patients, the proportions of Yin-deficiency, Yang-deficiency, and Qi-deficiency constitution were 27.0% [95% confidence interval (CI) 19.9% to 36.7%], 25.2% (95% CI 17.5% to 35.0%) and 23.7% (95% CI 15.8% to 34.0%), respectively. Besides, females accounted for a higher percentage of the population with functional constipation in the included studies, and most patients were aged 45 years or older. These findings may reflect the demographic characteristics of the general functional constipation population, where older adults and women are more commonly affected. The impact of gender and age on TCM constitution distribution merits further exploration.

CONCLUSION: Our finding revealed that Yin-deficiency, Yang-deficiency, and Qi-deficiency are the predominant TCM constitution types in people with functional constipation. This study suggests that clinicians should focus on patients with these TCM constitution types in the prevention and management of functional constipation. Larger sample sizes and more rigorous methodological designs are needed in future studies. Furthermore, future researches should also focus on developing individualized prevention and treatment strategies based on different TCM constitution types.

Key words: physical constitution theory, cross-sectional studies, correlation, systematic review, Meta-analysis

WANG Xuehui, SUN Yuxin, Birling Yoann, LI Xun, ZHAO Ruotong, ZHENG Youyou, SONG Zhenmei, ZHANG Yanli, DU Hongbo, WANG Jianyun, LI Yinqing, LIU Zhaolan, LIU Jianping. A Meta-analysis of Traditional Chinese Medicine constitution distribution in people with functional constipation[J]. Journal of Traditional Chinese Medicine, 2026, 46(2): 261-273.

Figures/Tables 8

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Study ID	Study area	Study setting	Duration	Sample size	Age (years)	Gender ratio (M/F)	Number of constitutions assessed	AHRQ score
Fu SH 2021³⁹	Liaoning province	Hospital	2018.10-2019.12	106	20-72	39/67	7 types^a	4
Zhang JY et al 2021³⁵	Shanghai	Hospital & University	2016.6-2018.1	180/181	40.00±14.44	T: 40/140 C: 71/110	9 types	4
Ding XJ et al 2020⁵	Yantai	University	2016.10-2017.10	40	NR	NR	9 types	4
Wang CJ et al 2024³⁴	Qiannan Buyi and Miao Autonomous Prefecture	Hospital	2021.8-2023.1	210	20-81	82/128	9 types	4
Cheng XY et al 2018⁴	Hubei province	Hospital	2014.1-2017.1	242	47.7±12.4	89/153	8 types^b	4
Luo WZ 2017²	Jiangsu province	Hospital	2016.5-2017.3	184	20-85	78/106	9 types	3
Li M et al 2017³⁶	Nanjing	Hospital	2013.4-2016.1	211	15-80	81/130	9 types	3
Zhang Q et al 2017³⁸	Jiangsu province	Hospital	2016.1-2017.3	218	50.15±16.31	92/126	9 types	3
Zhao CY 2017⁴³	Guangdong province	Hospital	2016.3-2017.3	129	16-83	47/82	9 types	3
Guo R 2015⁴⁰	Harbin	Community	2014.3-2014.6	300	≥60	NR	9 types	4
Chen X 2015⁴¹	Fuzhou	Hospital	2013.10-2015.2	142/142	52.83±7.72	T: 40/102 C: 40/102	9 types	4
Chen FM 2015⁴⁴	Unclear	Hospital	2014.3-2015.2	220	45-75	NR	5 types^c	2
Song YN 2015⁷	Guangzhou	Hospital	2013.9-2015.1	52/24	18-80	NR	9 types	3
Shi GD 2014⁴²	Shandong province	Hospital	2012.12-2013.12	300	60-89	101/199	8 types^b	4
Yang M 2014³⁷	Fujian province	University	2012.5-2013.4	200	Unclear	66/134	9 types	3
Jia YT 2012¹⁶	Chengdu & Hebei province & Nanjing	Hospital	2010.6-2012.1	242	18-80	96/146	9 types	7

Study ID	Study area	Study setting	Duration	Sample size	Age (years)	Gender ratio (M/F)	Number of constitutions assessed	AHRQ score
Fu SH 2021³⁹	Liaoning province	Hospital	2018.10-2019.12	106	20-72	39/67	7 types^a	4
Zhang JY et al 2021³⁵	Shanghai	Hospital & University	2016.6-2018.1	180/181	40.00±14.44	T: 40/140 C: 71/110	9 types	4
Ding XJ et al 2020⁵	Yantai	University	2016.10-2017.10	40	NR	NR	9 types	4
Wang CJ et al 2024³⁴	Qiannan Buyi and Miao Autonomous Prefecture	Hospital	2021.8-2023.1	210	20-81	82/128	9 types	4
Cheng XY et al 2018⁴	Hubei province	Hospital	2014.1-2017.1	242	47.7±12.4	89/153	8 types^b	4
Luo WZ 2017²	Jiangsu province	Hospital	2016.5-2017.3	184	20-85	78/106	9 types	3
Li M et al 2017³⁶	Nanjing	Hospital	2013.4-2016.1	211	15-80	81/130	9 types	3
Zhang Q et al 2017³⁸	Jiangsu province	Hospital	2016.1-2017.3	218	50.15±16.31	92/126	9 types	3
Zhao CY 2017⁴³	Guangdong province	Hospital	2016.3-2017.3	129	16-83	47/82	9 types	3
Guo R 2015⁴⁰	Harbin	Community	2014.3-2014.6	300	≥60	NR	9 types	4
Chen X 2015⁴¹	Fuzhou	Hospital	2013.10-2015.2	142/142	52.83±7.72	T: 40/102 C: 40/102	9 types	4
Chen FM 2015⁴⁴	Unclear	Hospital	2014.3-2015.2	220	45-75	NR	5 types^c	2
Song YN 2015⁷	Guangzhou	Hospital	2013.9-2015.1	52/24	18-80	NR	9 types	3
Shi GD 2014⁴²	Shandong province	Hospital	2012.12-2013.12	300	60-89	101/199	8 types^b	4
Yang M 2014³⁷	Fujian province	University	2012.5-2013.4	200	Unclear	66/134	9 types	3
Jia YT 2012¹⁶	Chengdu & Hebei province & Nanjing	Hospital	2010.6-2012.1	242	18-80	96/146	9 types	7

Constitution type	Number of included studies	Sample size (events/total)	The proportion of the total sample (%)	95% CI (%)	I ² (%)	P value
DHC	16	583/2976	18.2	(12.7, 26.2)	96	<0.01
QSC	16	463/2976	13.9	(9.7, 20.0)	96	<0.01
PDC	15	367/2756	10.2	(5.7, 18.1)	98	<0.01
BSC	15	330/3082	7.5	(0.4, 14.0)	97	<0.01
BC	15	279/2756	9.4	(5.7, 13.8)	93	<0.01
ISC	12	148/2108	5.3	(1.1, 12.4)	97	<0.01

Constitution type	Number of included studies	Sample size (events/total)	The proportion of the total sample (%)	95% CI (%)	I ² (%)	P value
DHC	16	583/2976	18.2	(12.7, 26.2)	96	<0.01
QSC	16	463/2976	13.9	(9.7, 20.0)	96	<0.01
PDC	15	367/2756	10.2	(5.7, 18.1)	98	<0.01
BSC	15	330/3082	7.5	(0.4, 14.0)	97	<0.01
BC	15	279/2756	9.4	(5.7, 13.8)	93	<0.01
ISC	12	148/2108	5.3	(1.1, 12.4)	97	<0.01

Constitution type	Location	Proportion of the total population (%)	95% CI (%)
DHC	E	20.0	(11.3, 35.2)	14
	S	19.9	(6.6, 60.4)
	N	9.2	(6.7, 12.7)
	W	14.3	(9.9, 19.8)
QSC	E	17.2	(9.7, 30.4)	14
	S	12.7	(4.8, 33.5)
	N	9.9	(7.4, 13.3)
	W	14.8	(10.3, 20.3)
PDC	E	12.4	(5.3, 29.1)	14
	S	12.4	(2.3, 66.3)
	N	7.2	(5.1, 10.2)
	W	10.0	(6.3, 14.9)
BSC	E	11.2	(4.8, 26.1)	13
	S	8.1	(1.5, 42.1)
	N	8.3	(5.5, 12.1)
	W	2.4	(0.8, 5.5)
BC	E	11.3	(5.7, 18.5)	14
	S	13.0	(9.9, 16.5)
	N	1.5	(0.2, 3.8)
	W	3.8	(1.1, 6.8)
ISC	E	6.7	(0.8, 17.6)	11
	S	12.7	(0, 55.2)
	N	0.0	(0, 1.2)
	W	3.8	(1.7, 7.4)

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