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Evidence-Based Complementary and Alternative Medicine
Volume 2016, Article ID 7210705, 8 pages
Research Article

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

1Department of Dermatology, Taichung Veterans General Hospital, Taichung 407, Taiwan
2Division of Chinese Medicine, China Medical University-An Nan Hospital, Tainan 709, Taiwan
3Graduate 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
4Departments of Medical Research, Obstetrics and Gynecology, and Urology, Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
5Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan

Received 13 January 2016; Revised 26 April 2016; Accepted 2 June 2016

Academic Editor: Yuewen Gong

Copyright © 2016 Chia-Man Ma et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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.