The Study On The Theory Of Five Viscera Correlation Of Motor Neuron Disease Base On Structural Equation Model

ObjectiveThis study for clinical syndrome of TCM of 258 Motor neuron disease(MND) 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 258 MND 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 SPSS16.0:258 MND 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 64, including spleen 21, liver 6, lung 8, kidney 16, heart 13. General data analysis showed that patients aged from 41 to 50 year-old is most(27.9%), patients aged from 51 to 60 year-old is second(25.6%). Gender distribution is fair. Amyotrophic lateral sclerosis patients is most(72.5). Symptoms frequency analysis showed that the main clinical manifestations of five visera are myasthenia of limbs,muscular atrophy,lacking in strength,muscular tremble,tired and no desire to speak. Structural equation modeling analysis showed that the direct path coefficient which has statistical significant are heart to kidney, spleen to lung,0.8539 and 0.7403, respectively, they are all positive effects. The larger indirect path coefficients involving three visera are lung-kidney-heart,spleen-lung-kidney,kidney-heart-lung,spleen-kidney-heart, heart-lung-kidney,liver-spleen-lung, kidney-heart-spleen, liver-spleen-kidn ey, heart-spleen-lung,-0.4210,-0.3650,-0.2941,-0.2493,-0.1698,0.0403, 0.0175,0.0159,0.0152 respectively. The indirect path coefficients involving four or five visera are small. In addition, the relationship symbols of liver-kidney,liver-heart,heart-spleen,spleen-lung 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 MND and quantitative relationship between the five visera. The five viscera correlation of MND showed that the most closely of visera are heart-kidney,spleen-lung,lung-kidney-heart,spleen-lung-kidney,kidney-heart-lung,spleen-kidney-heart,heart-lung-kidney,liver-spleen-lung,kidney-heart-spleen,liver-spleen-kidney,heart-spleen-lung. 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 water generates wood,wood generates fire,fire generates earth,earth generates gold 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 MND will be helpful for MND diagnosis and treatment.