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Original Article | Open Access

Associations between qi stagnation constitution, suboptimal health status, and lifestyle factors in southern China: A population-based cross-sectional study

Haiyun Zhanga,b,1Jieyu Chenc,d,e,1Jieling Chenc,fYangzhi LiucJiahui YucJi Wanga,bYumei Zhoua,bLongmei Yua,bHiu Yee KwangXiaoshan Zhaoa,c,d,e( )
Wangqi Academy of Beijing University of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 102488, China
School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou 510515, China
Guangdong Basic Research Center of Excellence for Integrated Traditional and Western Medicine for Qingzhi Diseases, Guangzhou 510515, China
Integrated Traditional Chinese and Western Medicine Hospital, Southern Medical University, Guangzhou 510315, China
School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, 999077, China

1 These authors have contributed equally to this work.

Peer review under responsibility of Beijing University of Chinese Medicine.

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Abstract

Objective

To study the relationship between qi stagnation constitution and suboptimal health status (SHS) or lifestyle.

Methods

From 2012 to 2013, we conducted a cross-sectional survey of 24159 Chinese individuals aged 12–80 years. The qi stagnation constitution was assessed using the Constitution in Chinese Medicine Questionnaire. Health status was evaluated through medical records and the Subhealth Measurement Scale V1.0 (SHMS V1.0). Health-promoting lifestyles were measured using the Health-Promoting Lifestyle Profile Ⅱ (HPLP-Ⅱ).

Results

Of the 24159 participants, 16.1% and 15.2% were classified as “always” and “sometimes” having the qi stagnation constitution, respectively. Those classified as “rarely” having the qi stagnation constitution scored higher on both the HPLP-Ⅱ and SHMS V1.0. The participants classified as “always” having the qi stagnation constitution showed a significant association with SHS or disease compared to other imbalanced constitutions. Those in the “always” category were approximately 21 times more likely to be classified as having SHS (odds ratio [OR]: 21.17, 95% confidence interval [CI]: 15.74–28.45), whereas those in the “sometimes” category were approximately six times more likely (OR: 5.89, 95% CI: 5.04–6.90). Accordingly, the qi stagnation constitution score was significantly associated with the diagnosis of SHS, with an area under the curve of 0.77 (P < .001). A score of 18.75 yielded the highest Youden Index (0.407), with a sensitivity of 60.5% and a specificity of 80.3%. Significant associations were observed between health-promoting lifestyles and qi stagnation constitution severity in an ordinal regression analysis (P < .001). Protective factors included stress management (OR: 1.59), self-actualization (OR: 1.57), and exercise (OR: 1.36). In contrast, poorer interpersonal relationships (OR: 0.79), greater health responsibilities (OR: 0.86), and poorer nutrition (OR: 0.91) were associated with increased severity.

Conclusion

Modulating the qi stagnation constitution through lifestyle interventions may help prevent the progression of SHS to disease, which aligns with core preventive principles in traditional Chinese medicine.

References

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Journal of Traditional Chinese Medical Sciences
Pages 521-530

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Cite this article:
Zhang H, Chen J, Chen J, et al. Associations between qi stagnation constitution, suboptimal health status, and lifestyle factors in southern China: A population-based cross-sectional study. Journal of Traditional Chinese Medical Sciences, 2025, 12(4): 521-530. https://doi.org/10.1016/j.jtcms.2025.09.002

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Received: 16 February 2025
Revised: 07 September 2025
Accepted: 09 September 2025
Published: 13 September 2025
© 2025 Beijing University of Chinese Medicine.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).