title: Liver Governs Tendon: A Theory from Traditional Chinese Medicine-Evidence from a Population-Based Matched Cohort Study in Taiwan for the Association of Chronic Liver Disease and Common Diseases in the Chiropractic Office.
abstract: In traditional Chinese medicine (TCM) theory, the liver governs the tendons. This retrospective cohort study investigated the relationship between chronic liver disease and common orthopedic conditions by utilizing the National Health Insurance Research Database of Taiwan. The populations included within this study were chronic liver disease patients (International Classification of Diseases/ICD-9 code: 571) and a comparison group composed of patients with nonchronic liver disease. The medical event that was evaluated was internal derangement of joints (ICD-9 codes: 717-718). In comparison with the control group, patients with chronic liver disease were 1.29 times more likely to develop internal derangement of joints when major trauma had also occurred. We did not find the association of viral hepatitis with internal derangement of joints. Patients with chronic liver disease as well as anemia were 3.01 times more likely to develop joint derangements. Our study shows that patients with anemia in addition to chronic liver disease are more prone to develop joint derangements. This is the first documented research study that endorses "the liver governs the tendons which gives the body the ability to move" theory of TCM. The incidence rate of internal derangement of knee joints was higher in patients with chronic liver disease.
authors.affiliation: Department of Dermatology, Taichung Veterans General Hospital, Taichung 407, Taiwan.
authors.forename: Chia-Man
authors.identifier: 0000-0002-4526-7265
authors.initials: CM
authors.lastname: Ma
authors.affiliation: Division of Chinese Medicine, China Medical University-An Nan Hospital, Tainan 709, Taiwan; Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan.
authors.forename: Lih-Hwa
authors.initials: LH
authors.lastname: Lin
authors.affiliation: Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; Departments of Medical Research, Obstetrics and Gynecology, and Urology, Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan; Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan.
authors.forename: Yung-Hsiang
authors.identifier: 0000-0002-8756-5113
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; Departments of Medical Research, Obstetrics and Gynecology, and Urology, Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan.
authors.forename: Huey-Yi
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; Departments of Medical Research, Obstetrics and Gynecology, and Urology, Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan.
authors.forename: Jen-Huai
authors.initials: JH
authors.lastname: Chiang
authors.affiliation: Graduate Institute of Chinese Medicine, School of Chinese Medicine, Graduate Institute of Integrated Medicine, Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung 404, Taiwan; Departments of Medical Research, Obstetrics and Gynecology, and Urology, Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan.
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chen