【摘要】 王琦院士提出，体质的三个关键科学问题为体质可分、体病相关、体质可调。基于体质可分，痰湿质临床模型较丰富，动物模型较少；基于体病相关，痰湿质与心脑血管疾病、糖尿病、脂肪肝等疾病的发病相关；基于体质可调，痰湿质的调理中药以二陈汤为主，针灸多选脾俞、阴陵泉、足三里、丰隆等穴位，作用机制可能与PI3K-Akt信号通路、糖酵解/糖原异生等有关。目前，研究还存在以下问题：(1)有的研究没有说明体质的疾病情况，有的研究甚至没有痰湿质重要的基线资料，如腰围、体重等，这样会影响后期的系统评价等研究质量；(2)部分研究混淆了痰湿质和痰湿证，甚至混淆了痰湿质积分和痰湿证候积分；(3)目前只有较少的临床研究有伦理和临床注册，不同研究样本量差距较大，在观察性研究中，混杂因素较多，多为相关性分析；部分试验研究缺乏系统设计，非随机的对照研究较多，干预后缺乏随访。今后，还应渐进式深入研究痰湿体质，在临床中辨体与辨病相结合，在研究方法中定性与定量相融合；合理计算或适当增加样本量，同时构建痰湿体质动态生物数据库，多领域交叉融合分析，开展前瞻性队列研究；运用多维组学，构建深度学习的多维动态模型，观察痰湿质的指标和靶标与相关疾病严重程度的关系；综合比较中药或适宜技术各方面优势，为痰湿质的防病调体提供更广阔的思路。更多还原

【Abstract】 Academician Wang Qi proposes that the three key scientific issues of constitution are separable constitution, disease-related constitution, and adjustable constitution.Based on separable constitution, there are more clinical models of phlegm dampness and fewer animal models.Based on disease-related constitution, phlegm-dampness constitution is related to cardiovascular and cerebrovascular diseases, diabetes, fatty liver and other diseases.Based on adjustable constitution, the formula for regulating phlegm and dampness is mainly Two Matured Substances Decoction; while acupuncture and moxibustion mostly select Pishu(BL 20),Yinlingquan(SP 9),Zusanli(ST 36),Fenglong(ST 40),etc.The mechanism of action may be related to PI3K-Akt signaling pathway, glycolysis/gluconeogenesis, etc.At present, there are still the following problems in the research:(1) Some research has not explained the disease situation of the constitution, and some even do not have important baseline data of phlegm-dampness, such as waist circumference, weight, BMI,etc.,which will affect the quality of the later systematic evaluation and other studies.(2) Some research has confused phlegm-dampness constitution and phlegm-dampness syndrome, and even confused phlegm-dampness constitution score and phlegm-dampness syndrome score.(3) At present, only a few clinical research has ethical and clinical registration, and the sample size of different ones is large.In terms of observational research, there are many confounding factors, most of which are correlation analysis; some experimental research lacs systematic design, there are many non-randomized controlled ones, and there is a lack of follow-up after intervention.In the future, it is necessary to gradually further study phlegm-dampness constitution, combine the identification of constitution and disease in clinical practice, and integrate qualitative and quantitative research methods; reasonably calculate or increase the sample size, and construct a dynamic biological database of phlegm-dampness constitution, conduct multi-domain cross-fusion analysis, and carry out prospective cohort study; use multi-omics to construct a multi-dimensional dynamic model of deep learning, and observe the relationship between the indexes and targets of phlegm-dampness constitution and the severity of related diseases; comprehensively compare the advantages of Chinese medicine or appropriate technology, and provide a broader idea for the prevention and regulation of phlegm-dampness constitution.更多还原