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 Chia-Man Ma, 1 Lih-Hwa Lin, 2,3 Yung-Hsiang Chen, 3,4,5 Huey-Yi Chen, 3,4 Jen-Huai Chiang, 3,4 and Wen-Chi Chen 3,4 1 Department of Dermatology, Taichung Veterans General Hospital, Taichung 407, Taiwan 2 Division of Chinese Medicine, China Medical University-An Nan Hospital, Tainan 709, Taiwan 3 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 4 Departments of Medical Research, Obstetrics and Gynecology, and Urology, Management Ofce for Health Data, China Medical University Hospital, Taichung 404, Taiwan 5 Department of Psychology, College of Medical and Health Science, Asia University, Taichung 413, Taiwan Correspondence should be addressed to Wen-Chi Chen; wgchen@mail.cmu.edu.tw Received 13 January 2016; Revised 26 April 2016; Accepted 2 June 2016 Academic Editor: Yuewen Gong Copyright © 2016 Chia-Man Ma et al. Tis 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. Tis retrospective cohort study investigated the relationship between chronic liver disease and common orthopedic conditions by utilizing the National Health Insurance Research Database of Taiwan. Te populations included within this study were chronic liver disease patients (International Classifcation of Diseases/ICD-9 code: 571) and a comparison group composed of patients with nonchronic liver disease. Te 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 fnd 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. Tis is the frst documented research study that endorses “the liver governs the tendons which gives the body the ability to move” theory of TCM. Te incidence rate of internal derangement of knee joints was higher in patients with chronic liver disease. 1. Introduction Chronic liver disease is a common disease in Taiwan, and according to an ofcial report from the Taiwanese gov- ernment in 2011, hepatoma afected 25/100,000 men and 10/100,000 women [1–3]. Te incidence of hepatitis type B virus in Taiwan was 13.18%. In 2009, the incidence of hepatitis type B was 15.85% in men and 11.06% in women. Tere is a signifcant relationship between hepatitis and hepatomas in Taiwan. Te World Health Organization estimates that 240 million people, about 3.7% of the world’s population, are infected with chronic hepatitis B [4, 5], which means that chronic hepatitis B infection is also a major global health problem [6, 7]. Hepatitis C virus (HCV), the major cause of chronic liver disease and liver transplantation, has a global prevalence of 3%, with 170 million people infected worldwide [8]. However, the relationship between chronic liver disease and chiropractic disease is unknown and is not well documented. A basic concept of Traditional Chinese Medicine (TCM) states that there are fve important endoorgans that govern other organs or tissues, and these fve organs are the liver, Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2016, Article ID 7210705, 8 pages http://dx.doi.org/10.1155/2016/7210705