Chin J Integr Med •1•

C
Available online at link.springer.com/journal/11655
hinese Journal of Integrative Medicine Journal homepage: www.cjim.cn/zxyjhen/zxyjhen/ch/index.aspx
E-mail: cjim_en@cjim.cn

Original Article
Correlation between Chinese Medicine Constitution and
Skin Types: A Study on 187 Japanese Women
Seika Kanezawa1,3, ZHU Yan-bo2, and WANG Qi3

ABSTRACT Objective
Objective:: Chinese medicine (CM) is widely applied in cosmetics and dermatology. The theory
of CM believes that skin characterizations reflect the internal status of balance which can be represented
by body constitution, but relevant studies are few. This study aims to analyze the relationship between body
constitution of CM and skin condition. Methods: Participants were recruited from a private health and beauty
clinic in Tokyo, Japan from June 2013 to January 2015. Each participant was assessed using Constitution in
Chinese Medicine Questionnaire (CCMQ) for body constitution and the Baumann Skin Type Questionnaire for
skin type. Spearman's rank correlation and stepwise multiple linear regression were used to investigate the effect
of body constitutions on skin types. Results: A total of 187 Japanese females were recruited in this study. Higher
dampness-heat and phlegm-dampness scores were associated with oilier skin while higher qi-depression and
blood-stasis were associated with drier skin. Higher score in Inherited Special and yin-deficiency constitutions
tended to have more sensitive skin, and higher score in blood-stasis was associated with more pigmented
skin and wrinkles. Conclusions: Our findings supported the "Constitution-Skin Correlated theory" in CM.
Understanding of the association between skin conditions and the body constitutions might be helpful to explore
more individualized treatment options for skin care and dermatological diseases through modifications of the
unique body constitutions using CM modalities.
KEYWORDS Chinese medicine, constitution in Chinese medicine, Baumann Skin Type, constitution-skin
correlated theory

Constitution is body type that Chinese medicine
(CM) employs to classify individual differences in
terms of physique structure, physiological function,
and psychological status.(1,2) It is influenced by various
genetic and acquired factors, which determine
the individual's adaptability to environment and
susceptibility to disease. The concept of constitution
has been widely used in CM clinical practices for
disease management and health promotion. Different
constitution classification systems were developed
to help CM practitioners make decision in clinical
diagnosis and treatment. In 2009, China Association
of Traditional Chinese Medicine standardized
classification of constitution and developed a validated
questionnaire to measure the 9 constitutions,(3) which
is now most widely used in mainland China.
The interest of CM as a complementary and
alternative medicine has been growing across the
world. The utilization of different CM modalities,
particularly Chinese herbal medicine, has become
increasingly popular for treating dermatological
diseases and managing skin conditions.(4-7) CM believes
that skin condition is an external manifestation of
internal balance, and adjustment of the internal status
will alter skin conditions. For healthy population,
individuals with different body constitutions may
have different skin features in terms of skin texture
and appearance.(8,9) For patients with skin problems,
individuals with different constitutions tend to acquire
different types of skin diseases and even if they suffer
from the same skin disorders, different treatment
formulas may be required. (4,10,11) It is therefore
important to understand individual's body constitution
©The Chinese Journal of Integrated Traditional and Western
Medicine Press and Springer-Verlag GmbH Germany, part of
Springer Nature 2019
1. BHY Corporation Limited, Shibuya-ku, Tokyo (151-0063),
Japan; 2. School of Management, Beijing University of Chinese
Medicine, Beijing (100029), China; 3. Center for Studies in
Constitution Research of Traditional Chinese Medicine, School
of Basic Medicine, Beijing University of Chinese Medicine,
Beijing (100029), China
Correspondence to: Prof. WANG Qi, Tel: 86-10-6428-6867,
Fax: 86-10-6428-6312, E-mail: wangqi710@126.com
DOI: https://doi.org/10.1007/s11655-019-2709-3
•2•
when taking the CM approach to improve skin
beauty and well-being. However, as far as we know,
previous studies on the effect of body constitution
on skin conditions mainly focused on a single type of
constitution and neglected the fact that many people
might have mixed types of constitutions and different
constitutions might interact with each other. Previously,
Wang, et al(12) summarized the characteristics of the
skin for all the 9 body constitutions based on clinical
experience and scientific research. In this study, we
aim to investigate the effect of body constitution on
skin types using validated measurement instruments.
METHODS
Study Population and Data Collection
From June 2013 and January 2015, all female
clients aged above 18 years who visited the first
author's private health & beauty clinic in Tokyo,
Japan, were invited and asked if they would like to
participate in the study. Exclusion criteria included
previous history of plastic surgery, regular laser
facial treatment, severe skin damage, or alcohol
consumption on the date of recruitment. Eligible
participants with written informed consent were asked
to complete the Japanese version of Constitution in
Chinese Medicine Questionnaire (CCMQ)(13,14) and the
Baumann Skin Type Questionnaire.(15) Demographic
information including age, weight, height, and marital
status were also collected.
Body Constitution
The CCMQ was originally developed by Wang, et
(2,16)
al with good reliability and validity in the population
of mainland and Hong Kong SAR of China,(17-19) while
the Japanese version was also validated during the
development process of the questionnaire. (13,14,20)
The questionnaire consists of 9 modules that evalute
each of the 9 basic body constitutions respectively
(the Balanced, qi-deficiency, yang-deficiency, yin-
deficiency, phlegm-dampness, dampness-heat,
blood-stasis, qi-depression, and the Inherited Special
constitutions). A total of 60 items are included (some
items may be allocated to more than one constitution
modules and each module comprises 6–8 items), each
with 5 responses on a Likert scale scoring from 1 to 5.
For each constitution module, a final score is calculated
based on the formula: constitution score = [(the raw
sum score–the number of questions in that module)/
(4×the number of questions in that module)]×100,
with higher score indicating higher tendency to have
Chin J Integr Med
the given constitution. Subjects with a score in the
Balanced module >60 and scores in all the other
8 (unbalanced) modules <30 will be considered as
Balanced constitution, while subjects with a score >40
in any of the unbalanced modules will be diagnosed as
having the corresponding unbalanced constitution(s).
A more detailed analysis guide is elaborated in the
Standards of Classification and Determination of
Constitution of Chinese Medicine issued by China
Association of Traditional Chinese Medicine in 2009.(3)
Skin Types
The Baumann skin-type indicator (BSTI) is
a widely used approach to characterize the skin
based on 4 dichotomous parameters: dry or oily,
sensitive or resistant, pigmented or non-pigmented,
and wrinkled or tight, derived from the answers to
the 64-item Baumann Skin Type Questionnaire.(15,21)
The questionnaire comprises 4 sections evaluating
the 4 parameters individually, with each section of
11–21 items. Each item is scored 1, 2, 3, 4, and 5,
depending on the response. If subjects cannot make
a judgment on the item, they can select the option
of "neutral", which is scored 2.5 points. A numeric
score for each parameter is created by summing
the scores within that section, with higher scores
indicating oilier, more sensitive, more pigmented, or
more wrinkled skin. Standard cut-off scores could be
used to categorize the skin into dry or oily, sensitive
or resistant, pigmented or non-pigmented, wrinkled or
tight skin types.(15) The questionnaire was translated
into Japanese following the procedures recommended
for cross-cultural adaptation of patient-reported
outcomes, (22) including forward translation, back
translation, expert panel discussion, pilot study for
reliability test in 20 subjects, and finalization.
Data Analysis
All statistical analyses were carried out in SPSS
17.0 and the significance level was set at 0.05 until
otherwise stated. Descriptive statistics were used to
describe the participants' baseline characteristics,
body constitutions and skin types. Spearman's rank
correlation was used to assess the association
between each CCMQ constitutional score and each
BSTI parameter score. To further examine the effect
of body constitutions on skin characteristics, stepwise
multiple linear regression analysis was performed,
taking the score of each BSTI parameter as the
outcome variable, respectively. The criterion for
Chin J Integr Med •3•

inclusion of variables in the regression model was Table 1. Body Constitution Score and Skin Types of
P <0.15 and the criterion for exclusion from the model Chinese Medicine in 187 Participants
was P >0.10. # of participants
Range of Constitution categorized with a
Constitution types
scores score (x–±s ) particular constitution
RESULTS [Case (%)]
A total of 187 participants completed both Balanced 19–91 60.55±14.73 11 (5.9)
questionnaires and included for analyses in this Qi-deficiency 6–78 33.99±14.30 94 (50.3)
study. All participants were female, with a mean Yang-deficiency 0–93 38.12±18.50 109 (58.3)
age of 35.31 years old (range: 20–60, SD: 7.90). Yin-deficiency 3–75 43.42±15.42 47 (25.1)
According to the classification of BSTI, 72 (38.5%) Phelgm-dampness 3–75 32.37±14.50 73 (39.0)
of them had oily skin, 115 (61.5%) sensitive skin, 6 Damp-heat 4–83 32.48±15.65 58 (31.0)
(3.2%) pigmented skin, and 102 (54.6%) wrinkled
Blood-stasis 4–75 35.46±14.79 59 (31.6)
skin. For CCMQ body constitutions, the most
Qi-depression 0–75 33.59±15.93 53 (28.3)
common constitution was yang-deficiency (109,
Inherited Special 0–82 30.57±16.92 50 (26.7)
58.3%), followed by qi-deficiency (94, 50.3%) and
# of participants
phelgm-dampness (73, 39.0%). Only 11 (5.9%) Range of BSTI score categorized with a
BSTI skin types
participants were classified as Balanced constitution. scores (x–±s ) particular
constitution (Case)
Totally 119 (63.6%) participants had more than one
D/O 12.0–40.0 25.6±4.61 115/72
unbalanced constitutions (Table 1).
S/R 19.0–58.5 32.5±7.19 115/72

A statistically significant correlation was found P/N 13.0–39.0 22.7±4.98 6/181

between each of the body constitution score and the
sensitive/resistant skin parameter score. Balanced
constitutional score was negatively correlated with the
sensitive/resistant parameter score (r =–0.256). For all
the 8 unbalanced constitutions, a positive correlation
was found with the sensitive/resistant parameter. For
dry/oily parameter, a positive correlation was found
with the dampness-heat (r =0.372) and the phlegm-
dampness (r =0.223) constitutions. For pigmented/
non-pigmented parameter, a negative correlation was
detected with balanced constitution; while a positive
correlation was found with the blood-stasis (r =0.284),
the phlegm-dampness (r =0.220), the dampness-heat
(r =0.199) and the qi-deficiency (r =0.168) constitutions.
For winkled/tight parameter, a positive correlation was
found with the blood-stasis (r =0.187), the qi-deficiency
( r =0.182) and the Inherited Special ( r =0.158)
constitutions (Table 2).
W/T 31.0–54.0 41.5±4.37 102/85
Notes: BSTI: Baumann Skin Type Indicator; CCMQ:
Constitution of Chinese Medicine Questionnaire; D/O: dry/oily
skin types; S/R: sensitive/resistant skin types; P/N: pigmented/
non-pigmented skin types; W/T: Wrinkled/ Tight skin types;
Participants could be diagnosed with more than one unbalanced
constitution.
In the stepwise multiple liner regression analysis,
5 constitutions remained in the final multivariable model
for dry/oily skin parameter, explaining 23.9% of the
variability in the dry/oily score (R2=23.9%). Higher score
in the dampness-heat (coefficient =0.16, P <0.001)
or phlegm-dampness (coefficient= 0.07, P =0.03)
constitutions was associated with more oily skin, while
higher scores in qi-depression (coefficient=–0.07,
P =0.02) and blood-stasis (coefficient=–0.06, P =0.02)
were more likely to have dry skin. For the sensitive/
resistant parameter, 3 constitutions remained in the
final model (R 2=24.3%), with higher score in yin-

Table 2. Spearman's Rank Correlation between CCMQ Body Constitutions and Each Parameter of the BSTI
CCMQ body constitutions
BSTI
parameters Balanced Qi-deficiency Yang-deficiency Yin-deficiency Phlegm- Dampness-heat Blood-stasis Qi-depression Inherited
dampness Special
D/O 0.012 0.040 –0.032 –0.008 0.223b 0.372b –0.087 0.002 0.003
b b b b b
S/R –0.256 0.370 0.330 0.355 0.378 0.317b 0.345b 0.347b 0.461b
P/N –0.157a 0.133 0.135 0.108 0.220b 0.199b 0.284b 0.168a 0.134
a a
W/T –0.139 0.182 0.045 0.006 0.129 0.135 0.187 0.130 0.158a
Notes: BSTI: Baumann Skin Type Indicator; CCMQ: Constitution of Chinese Medicine Questionnaire; SD: standard deviation; D/O:
dry/oily skin type; S/R: sensitive/resistant skin type; P/N: pigmented/non-pigmented skin type; W/T: wrinkled/tight skin type; aP <0.05，
b
P <0.01
•4• Chin J Integr Med

deficiency (coefficient= 0.08, P =0.03) and Inherited climate and life style may contribute to the differences
Special (coefficient =0.14, P <0.001) constitutions in body constitutions found between Japanese and
associated with more sensitive skin. Only blood-stasis Chinese, it should be noted that the two Chinese
score was found to be independently associated with studies recruited participants from general population
the pigmented/non-pigmented (R 2=7.6%) and the while this study recruited participants from a private
wrinkled/tight (R2=3.0%) skin parameters. Participants health & beauty clinic who might have sub-health
with higher score in blood-stasis were more likely concerns. This might help to explain why participants in
to have pigmented (coefficient=0.10, P <0.001) and this study tended to have less Balanced constitution.
wrinkled skin (coefficient=0.06, P =0.01, Table 3).
Association between Body Constitution and
Table 3. Stepwise Multiple Linear Regression Skin Types
Analysis of CCMQ Body Constitutions and
the Score of Each BSTI Parameter A few studies have demonstrated the relationship
between body constitution and dermatological
BSTI Multivariable Adjusted
Body constitutions P-value diseases. For example, people with dampness-heat
parameters coefficient R2
Dry/Oily Dampness-heat 0.16 <0.001 23.9% constitution were more likely to have acne. Among
Qi-depression –0.07 0.020 patients with psoriasis, the most commonly seen
Blood-stasis –0.06 0.019 were qi-deficiency, qi-depression, and sensitive
Phlegm-dampness 0.07 0.029 constitutions. (25) Several studies examined the
Yin-deficiency –0.05 0.050 association between the types of body constitutions
Sensitive/ Inherited Special 0.14 <0.001 24.3% and skin textures among healthy participants. Xu,
Resistant
Yin-deficiency 0.08 0.031 et al(9) found that people with qi-deficiency and qi-
Qi-deficiency 0.07 0.067
depression constitutions tended to have more
Pigmented/ Blood-stasis 0.10 <0.001 7.6% wrinkles. These studies either examined a single type
Non-pigmented
of body constitution or disease or used univariable
Wrinkled/Tight Blood-stasis 0.06 0.004 3.0%
analysis which did not control confounding factors.
Notes: BSTI: Baumann Skin Type Indicator; CCMQ: Constitution
of Chinese Medicine Questionnaire; In the multivariable model, all
variables were mutually adjusted, the inclusion criterion for variable In view of the fact that one can have mixed
selection into the multiple model was P <0.15 and the exclusion criterion
types of constitutions and that different constitutions
was P >0.10; A positive coefficient indicates that higher CCMQ modular
score was associated with higher BSTI parameter score, that is, more are inter-related in a dynamic way, we applied
oily, sensitive, pigmented or more wrinkled skin types. multivariable models to assess the independent
effect of each body constitution on skin types.
DISCUSSION Results showed that dampness-heat, qi-depression,
Distribution of Body Constitutions phlegm-dampness and blood-stasis scores were
We analyzed the relationship between CM body independently associated with the dry/oily parameter,
constitution as assessed by CCMQ and skin types as with more serious damp-heat and phlegm-dampness
assessed by BSTI among 187 female Japanese. The indicating oilier skin while more serious qi-depression
most common constitution was yang-deficiency (109, and blood-stasis for drier skin. Yin-deficiency was also
58.29%), followed by qi-deficiency (94, 50.27%) and associated with dry skin, with borderline significance
phelgm-dampness (73, 39.04%). Only 11 (5.88%) (P =0.05). We also found that higher score in Inherited
participants were classified as Balanced constitution. Special and yin-deficiency constitutions tended to
As far as we know, this is the first study reporting the have more sensitive skin, and higher score in blood-
distribution of CM constitutions among Japanese. The stasis was associated with more pigmented skin and
results were different from the findings of a nation- wrinkles.
wide survey in mainland China with 4,153 female
participants(23) and a cross-sectional survey in Hong Most of our results were in line with the
Kong SAR of China with 510 female participants.(24) descriptions as proposed by Wang, et al (12) in the
In these two studies, the most common constitution "Constitution-Skin Correlated Theory" in which
was Balanced constitution, followed by qi-deficiency, he summarized the skin characteristics of the 9
yang-deficiency, and blood-stasis, and the least constitutions based on clinical experience. Similar
common was Inherited Special constitution. Although to our findings, he also noted that people with
Chin J Integr Med
dampness-heat or phlegm-dampness constitution
tended to have oily skin while people with blood-
stasis, qi-depression and yin-deficiency tended to
have dry skin; and that people with blood-stasis
tended to have pigmented skin. However, we also
noted some differences between Wang's descriptions
and our findings, for example, while Wang suggested
that yin-deficiency was related with more wrinkles, it
failed to reach statistical significance in our analysis.
We found that higher score in Inherited Special and
yin-deficiency constitutions both tended to have more
sensitive skin while only Inherited Special constitution
was suggested to be associated with sensitive skin
in Wang's description. One of the reasons for the
observed difference between our findings and Wang's
descriptions might be that we used the numeric
score of each constitution for analysis, not "positive/
negative" dichotomous categories. It is possible that
some constitutions (for example, association between
yin-deficiency and wrinkles) which failed to reach
significance in our analysis might be significant if we
assign them to high-score (positive) and low-score
(negative) groups. The difference might also be due
to that we used multivariable models to control for
the inter-relationship among different constitutions.
This also explains the discrepancy between results
from Spearman correlation and stepwise multiple
linear regression analysis. In clinical practice,
some patients may present with mixed types of
constitution, and it may become difficult to tell which
external characterization is attributed to which body
constitution. In the multiple analysis, however, it is
possible to tell the "pure" association of constitution
with the skin types because the effect of other
constitutions are controlled for.
We also found that body constitutions explained
more variability in the dry/oily (R 2 =23.9%) and
sensitive/resistant (R2=24.3%) parameters than in the
pigmented/non-pigmented (R2=7.6%) and wrinkled/
tight (R2=3.0%) parameters of the skin. This means
that other unmeasured factors might explain a greater
proportion for pigmented/non-pigmented and wrinkled/
tight parameters. For example, Baumann suggested
that wrinkling and pigamentary changes are directly
associated with photo-ageing and are considered
its most salient cutaneous manifestations. (26) The
low R 2 for the two parameters might be explained
by the effect of photo-ageing which was not taken
into account in the model and which could not be
•5•
measured by the constitution questionnaire.
Limitations and Implications for Practice and
Research
The limitations of this study include that we did
not assess the physiological parameters of the skin.
And as this study was conducted in a beauty clinic and
all the participants were female, the generalizability of
the results might be limited.
Nevertheless, our findings provided suggestions
on the potential relationships between body
constitutions and skin characteristics, adding scientific
evidence to the "Integrative Constitution-Skin Theory".
Understanding of the association between skin
conditions and the body constitutions might help
us to explore more individualized treatment options
for skin care and dermatological diseases through
modifications of the unique body constitutions. Further
studies are required to understand the mechanism
of how body constitution predisposes skin conditions
and to evaluate whether modifications of body
constitutions can improve skin conditions.
Conclusions
Body constitutions in CM are associated with
the skin types, with different constitutions relating to
different skin types. For skin care and treatment of
dermatological diseases, body constitution might be
a promising target. Further studies are required to
investigate whether modifications of body constitutions
improve skin conditions.
Conflict of Interests
The authors declare that there is no conflict of interest
regarding the publication of this paper.
Author Contributions
Seika KZ and Wang Q conceived and designed the study.
Seika Kanezawa performed the study. Seika KZ and Zhu YB
analyzed the data. Seika KZ wrote the paper. All authors read and
approved the final manuscript.
REFERENCES
1. Wang J, Li Y, Ni C, Zhang H, Li L, Wang Q. Cognition
research and constitutional classification in Chinese
medicine. Am J Chin Med 2011;39:651-660.
2. Wang Q. The foundation of the classification and diagnosis
standards for the constitutions of traditional Chinese
medicine. China Standardization 2009;32:16-26.
•6•
3. China Association of Traditional Chinese Medicine. The
standards of classification and determination of constitution
of Chinese medicine. Beijing: China Press of Traditional
Chinese Medicine, 2009.
4. Chen HY, Lin YH, Hu S, Yang SH, Chen JL, Chen YC.
Identifying Chinese herbal medicine network for eczema:
implications from a nationwide prescription database. Evid
Based Complement Alternat Med 2015;2015:347164.
5. Baroni A, Ruocco E, Russo T, Piccolo V, Geng L, Zhou
H, et al. The use of traditional Chinese medicine in some
dermatologic diseases: Part Ⅱ–Autoimmune bullous
disorders and lichen planus. Skinmed 2015;13:195-203;
quiz 4.
6. Baroni A, Ruocco E, Russo T, Piccolo V, Geng L, Zhou
H, et al. The use of traditional Chinese medicine in some
dermatologic diseases: Part Ⅰ–Acne, psoriasis, and atopic
dermatitis. Skinmed 2015;13:32-38; quiz 9.
7. Chang LC, Huang N, Chou YJ, Lee CH, Kao FY, Huang
YT. Utilization patterns of Chinese medicine and Western
medicine under the National Health Insurance Program in
Taiwan, a population-based study from 1997 to 2003. BMC
Health Services Res 2008;8:170.
8. Qu JN, Wang J, Zhao Y, Xiong WG, Fang C, Dai J, et al. A
relevant research on facial skin conditions of Chinese urban
females and TCM constitutional types. Chin J Inform Tradit
Chin Med (Chin) 2014;21:22-25.
9. Xu YM, Wang X, Zhang N, Yang ZR, Jing LW, Li YW, et
al. Study on the relationship between traditional Chinese
medicine constitution and smoothness ,roughness and
texture. Chin J Aesthetic Med (Chin) 2012;21:751-753.
10. Dai J, Sun S, Peng J, Cao H, Zheng N, Fang J, et al.
Exploration of macro-micro biomarkers for dampness-heat
syndrome differentiation in different diseases. Evid Based
Complement Alternat Med 2013;2013:706762.
11. Choi IH, Kim S, Kim Y, Yun Y. The effect of TJ-15 plus
TJ-17 on atopic dermatitis: a pilot study based on the
principle of pattern identification. J Altern Complement Med
2012;18:576-582.
12. Wang J, Zhang HM, Li LR, Li YS, Zheng LY, Yu RX, et
al. Theory of skin relating to constitution put forward by
Professor Wang Qi and its application in dermatology. J
Beijing Univ Tradit Chin Med (Chin) 2013;36:476-479.
13. Zhu YB, Hideki O, Kazuo U, Xu FH, Wang Q. Development
and validation of the Japanese version of the Constitution
in Chinese Medicine Questionnaire (CCMQ). Kampo Med
(Jpn) 2008;59:783-792.
14. Zhu Y-b, Hideki O, Kazuo U, Xu F-h, Wang Q. Development
of Japanese version of the Constitution in Chinese Medicine
Chin J Integr Med
Questionnaire (CCMQ) and its performance evaluation.
Kampo Med (Jpn) 2006;57:271.
15. Baumann L. The skin type solution. New York: Bantam
Dell; 2005.
16. Wang Q, Zhu YB, Xue HS. Primary compiling of constitution
in Chinese medicine questionnaire. Chin J Clin Rehabilit
(Chin) 2006;10(3):12-14.
17. Wang Q, Zhu YB, Xue HS. Preliminary assessment
on performance of Constitution in Chinese Medicine
Questionnaire. Chin J Clin Rehabilit (Chin) 2006;10(3):15-17.
18. Zhu YB, Wang Q, Hideki O. Evaluation on reliability
and validity of the Constitution in Chinese Medicine
Questionnaire (CCMQ). Chin J Behav Med Sci (Chin)
2007;16:651-654.
19. Wong W, Lam CL, Wong VT, Yang ZM, Ziea ET, Kwan
AK. Validation of the constitution in Chinese medicine
questionnaire: does the traditional Chinese medicine
concept of body constitution exist? Evid Based Complement
Alternat Med 2013;2013:481491.
20. Zhu YB, Wang Q, Hideki O. Development process of
Constitution in Chinese Medicine Questionnaire. Jpn J
Public Health 2005;52:383.
21. Baumann L. Understanding and treating various skin
types: the Baumann skin type indicator. Dermatol Clin
2008;26:359-373, vi.
22. Wild D, Grove A, Martin M, Eremenco S, McElroy S,
Verjee-Lorenz A, et al. Principles of good practice for the
translation and cultural adaptation process for patient-
reported outcomes (PRO) measures: report of the ISPOR
Task Force for Translation and Cultural Adaptation. Value
in Health: J Int Society Pharmacoeconomics Outcomes
Res. 2005;8:94-104.
23. Wang Q, Zhu YB. Epidemiological investigation of
constitutional types of Chinese medicine in general
population: Base on 21,948 epidemiological investigation
data of nine provinces in China. China J Tradit Chin Med
Pharm. (Chin) 2009;24(1):7-12.
24. Huang ZJ, Li X, Liu B, Zang SW, Zhou YC. Epidemiological
investigation of constitutional types of Chinese medicine
in 1022 general population in Hong Kong. J Trop Med
2011;11:144-148.
25. Li B, Zhang CH, Liu HX. Traditional Chinese medicine
constitutions of 583 patients with 583 psoriasis. J Sichuan
Tradit Chin Med (Chin) 2010;28(10):62-64.
26. Baumann L. Skin ageing and its treatment. J Pathol
2007;211:241-251.
(Accepted March 23, 2017)
Edited by ZHANG Wen