Liver-associated patterns as anger syndromes in traditional Chinese medicine: A preliminary literature review with theoretical framework based on the World Health Organization standards of terminologies and pattern diagnosis standards

Abstract

IntroductionAccording to traditional Chinese medicine (TCM), anger is closely related to the liver. This review was conducted to understand the liver-associated patterns that manifest as anger syndromes in TCM. MethodsData regarding preclinical and clinical studies extracted from the China National Knowledge Infrastructure were reviewed to investigate whether it is justifiable and possible to define liver-associated patterns as anger syndrome. TCM patterns from two standard data sources—the World Health Organization standardization of terminologies in TCM and the pattern diagnosis standards of TCM—were analyzed for liver-associated patterns with the anger symptom. The direction, duration, and severity of anger symptoms of the extracted patterns were classified according to the TCM theory concepts such as yin and yang and excess and deficient by two independent authors. ResultsAmong 18 liver-associated patterns involving anger symptoms from the two data sources, 12 were associated with outward-focused anger (tendency to express anger verbally and/or behaviorally), four with inward-focused anger (tendency to suppress anger), and two with both outward-focused and inward-focused anger (a problem of anger control). All studies retrieved from the database were examined for the relationship between the liver and anger, with few or no studies examining the relationship between the other four viscera and anger. ConclusionsThis review suggests that using liver-associated patterns in TCM may be a useful strategy for understanding and managing anger syndromes. However, because this study presents only a theoretical framework and preliminary review, further studies linking liver-associated patterns with various anger states are warranted.