| ObjectiveThis study for clinical syndrome of TCM of 216 myasthenia gravis cases is under the guidance of the theory of five viscera correlation originated by Prof. Deng Tietao, using epidemiology, nonlinear principal component analysis, structural equation modeling method to discuss the relationship between five viscera.MethodsThe data collecting was acuired from survey of 216 myasthenia gravis cases by 973 Project—Inheritance and innovation Research of the theory of five viscera correlation. The database is established and managed by EpiData software. The Epidata database is conversed by StatTrans software to SPSS and SAS database, then to delete excess variable and merge similar variable. Descriptive statistical analysis by SPSS16.0:216 MG cases'basic information and clinical syndrome of five viscera. Nonlinear principal component analysis by SAS9.1:to generate five principal components representing composite index of clinical syndrome of five viscera, and then complete structural equation modeling analysis to study the relationship between the five viscera.ResultsThe total syndromes of five viscera is 100, including spleen 32, liver 14, lung 18, kidney 16, heart 20. General data analysis showed that patients aged from 21 to 40 year-old is most (40.3%), patients aged from 41 to 60 year-old is second(34.7%). Gender distribution is fair. The number of patients displayed moderate body type (ⅡB-type) is most, except muscle atrophy (Ⅴ-type), the other four types (ocular, mild generalized, severe aggressive type, severe delayed-type) distributed more evenly. The more combined diseases are lung infection, myasthenia gravis crisis, hypertension, heart disease and thymoma after operation. Symptoms frequency analysis showed that he main clinical manifestations of five visera are spleen deficiency,eye diseases,respiratory disorders,language abnormalities,sputum, cough,lung-qi deficiency,kidney-qi deficiency,mental disorder lack of blood supply. Structural equation modeling analysis showed that the direct path coefficient which has statistical significant are heart to lung, spleen to kidney,0.3451 and 0.3176, respectively, they are all positive effects. The larger indirect path coefficients involving three visera are spleen-kidney-liver spleen-kidney-heart,kidney-heart-lung,liver-spleen-kidney,-0.0145,-0.01178,-0.0128,-0.0109 respectively. The indirect path coefficients involving four or five visera are small. In addition, the relationship symbols of lung-kidney,liver-lung,liver-spleen heart-kidney are same with the Five Elements theory.ConclusionIn this study, using the method of nonlinear principal component analysis combined structural equation modeling analysis to analyze comprehensively the clinical symptoms of myasthenia gravis and quantitative relationship between the five visera. The five viscera correlation of myasthenia gravis showed that the most closely of visera are heart-lung,spleen-kidney,spleen-kidney-liver,spleen-kidney-heart,kidney-heart-lung,liver-spleen-kidney, the result conform to the theories of myasthenia gravis of TCM pathogenesis—spleen and stomach deficiency, five visera correlation which originated by Prof. Deng Tietao. The reasons that the path coefficient involving four or five visera is small may be due to its own characteristics of this disease and related to the incomplete data collection. In addition, from the symbol of path coefficients, the relationships of metal generates water,metal restricts wood,wood restricts earth,water restricts fire are proved to be the same with the Five Elements theory, and other relationships could not be verified. That shows the limitations of the Five Elements Theory, and also shows the connectivity and integrity of five visera correlation.In this study, the clinical data after statistical analysis showed that five visera are closed to each other, abnormal physiological function of one will affect the others. Therefore, discussing the interrelationship between the five visera of myasthenia gravis will be helpful for MG diagnosis and treatment. |
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