[Clinical study on improving the strength and activity of lumbar spine with Qiang Jin exercises].

OBJECTIVE: To observe the effect of Qiang Jin exercises on the muscle strength and activity of lumbar spine in patients with lumbar disc herniation. METHODS: From March 2016 to September 2017, at the Department of Orthopaedics, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, a total of 110 subjects were enrolled, and 98 eligible subjects were screened. The subjects were randomized by stratified randomization and divided into experimental group and control group, 49 cases in each group, 25 males and 24 females in the experimental group, 25 males and 24 females in the control group. The experimental group exercised with Qiang Jin exercises, one time each morning and evening, each time10 sets were made;the control group used classic rehabilitation training, training twice a week, and three months was a course of treatment. After 12 weeks of training, the muscle strength and activity of the lumbar spine were evaluated and compared with the muscle strength and activity of the lumbar spine before training. RESULTS: The experimental group and the control group had different muscle strength and activity of the lumbar spine before and after treatment (P<0.05). There was no significant difference between two groups after treatment(P>0.05). CONCLUSION: Qiang Jin exercises can effectively improve the muscle strength and activity of the lumbar spine and improve the daily living ability of patients.

[A comparative study on the surface electromyography of lumbosacral multifidus muscle in patients with lumbar disc herniation].

OBJECTIVE: To compare the degeneration of lumbosacral multifidus muscle in patients with lumbar disc herniation. METHODS: Thirty-five healthy volunteers and 35 patients with unilateral L4,5 lumbar disc herniation from December 2015 to September 2017 were recruited. There were 20 males and 15 females in each group, aged from 25 to 55 years old. In healthy volunteers group, the mean age was (35.66±8.73) years old and the BMI was (21.85±1.94) kg /m2. In patients with lumbar disc herniation, the mean age was (36.09±7.70) years old, the BMI was (21.50±1.78) kg /m2, the VAS score was 4.40±0.88, the course of disease was (11.20±7.14) months. Surface electromyography analysis was performed on the multifidus muscle of the two groups. The average myoelectric amplitude of the multifidus muscle in the two groups were compared. RESULTS: The average myoelectric amplitude of the multifidus muscle of healthy volunteers was (48.84±7.77) µV on the left and (49.13±7.86) µV on the right. There was no significant difference between the two sides (P>0.05). The average myoelectric amplitude of multifidus muscle in patients with lumbar disc herniation was(48.82±8.14) µV on the healthy side and (42.81±7.00) µV on the affected side, and the difference was statistically significant between two sides(P<0.05). There was no significant difference in the average myoelectric amplitude of multifidus muscle between the healthy side of lumbar disc herniation and on the left of healthy volunteers, or between the healthy side of lumbar disc herniation and on the right of healthy volunteers (P>0.05). There was significant difference in the average myoelectric amplitude of multifidus muscle between the affected side of lumbar disc herniation and on the left of healthy volunteers, and also between the affected side of lumbar disc herniation and on the right of healthy volunteers(P<0.05). CONCLUSION: Patients with chronic lumbar disc herniation have an imbalance in myoelectric activity, and the muscle strength of the multifidus muscle on the affected side is significantly reduced.

[Imaging study of lumbosacral multifidus muscle fat changes in patients with lumbar disc herniation].

OBJECTIVE: To compare the degeneration of lumbosacral multifidus muscle in patients with lumbar disc herniation. METHODS: Magnetic Resonance Spectroscopy was performed on the multifidus muscle of 35 healthy volunteers and 35 patients with unilateral L4,5 lumbar disc herniation. There were 20 males and 15 females in each group, aged from 25 to 55 years old. In healthy volunteers, the mean age was (35.66±8.73) years old and the BMI was (21.85±1.94) kg/m2; in the patients, the mean age was (36.09±7.70) years old, the BMI was (21.50±1.78) kg/m2, the VAS score was (4.40±0.88) points, the course of disease was (11.2±7.14) months. The proportion of fat in the L4,5 lumbosacral multifidus muscle and the proportion of fat-suppressed cross-sectional area were observed by MRI, the differences of the observation indexes of the two groups were compared through data analysis. RESULTS: In healthy volunteers, the proportion of fat on the left side of the multifidus muscle was (0.169± 0.035)%, the proportion of fat removal cross-sectional area on the left side of the multifidus muscle was (0.699±0.070)%, the proportion of fat on the right side of the multifidus muscle was (0.168±0.031)%, and the proportion of fat removal cross-sectional area on the right side of the multifidus muscle was (0.712±0.056)%, there was no significant difference between the two sides (P>0.05). In patients, the proportion of fat on the healthy side of multifidus muscles was (0.173±0.021)%, the proportion of fat removal cross-sectional area on the healthy side of multifidus muscles was (0.695±0.054)%, the proportion of fat on the affected side of the multifidus muscle was (0.228±0.027)%, and the proportion of fat removal cross-sectional area on the affected side of the multifidus muscle was (0.629±0.048)%, the differences of the above indexes on both sides were statistically significant (P<0.05). There was a statistically significant difference in the proportion of multifidus muscle fat and the ratio of fat-suppressed cross-sectional area between the affected side and volunteers (P<0.05). There was no significant difference in fat ratio and fat-suppressed cross sectional area ratio between the left and right sides of healthy volunteers and healthy side of patients (P>0.05). CONCLUSION: There is degeneration of lumbosacral multifidus muscle on the affected side of patients with unilateral L4,5 intervertebral disc herniation, featuring multifidus muscular atrophy and fat infiltration.

Mechanism of YLTZ on glycolipid metabolism based on UPLC/TOF/MS metabolomics.

Type 2 diabetes mellitus (T2DM) is a metabolic disease characterized by dysfunction of glycolipid metabolism. YLTZ is used to treat hyperlipidemia, yet its hypolipidemic and hypoglycemic mechanism on T2DM are unknown. Thus, UPLC/TOF/MS was applied in this study to identify the potential bio-markers, and deduce the possible metabolic pathways. According to bio-indexes, the increased blood lipid levels, including TC, TG, LDL and FA, and the decreased HDL, the elevated glucose, reduced insulin level and impaired OGTT were observed in diabetic rat model. While YLTZ can decrease the lipid levels and glucose content, as well as increased insulin standards and improve OGTT. After data from UPLC/TOF/MS processed, 17 metabolites were obtained, including phospholipids (LPCs, PCs and PGP (18:1)), beta-oxidation production (HAA, VAG and CNE) and precursors (THA), bile acid (CA, CDCA and IDCA), hydrolysate of TG (MG (22:4)), glycometabolism (G6P), cholesterol-driven synthetics (ADO) and production of arachidonate acid (THETA). As a result, YLTZ was able to reduce LPCs, PCs, PGP (18:1), HAA, VAG, CNE, CA, ADO and THETA, as well as enhance MG (22:4) and G6P. After analyzing results, several metabolic pathways were deduced, which containing, cholesterol synthesis and elimination, FA beta-oxidation, TG hydrolysis, phospholipids synthesis, glycolysis, gluconeogenesis and inflammation. Consequently, YLTZ performed to prohibit the FA beta-oxidation, synthesis of cholesterol and phospholipids, gluconeogenesis and inflammation level, as well as promote TG hydrolysis, glycolysis and blood circulation. Hence, applying metabonomics in TCM research can uncover its pharmacological edges, elucidating comprehensively that YLTZ has capacity of hypolipidemic, hypoglycemic and promoting blood circulation, matching the effect of removing blood stasis, eliminating phlegm and dampness.