Regulating Effects of HQ Yi Jin Jing on the Cardiac Functions of Old and Middle-aged People

With their advancement of age, the circulation systems of old and middle-aged people will have a series of anatomic, histological, and physiological changes. Physiologically, these changes mainly include reduced cardiac compliance, reduced cardiac contractility, and changes in the cardiac output. These changes play an important role in the generation and development of cardiovascular disease of old and middle-aged people [1]. Therefore the active investigations into the methods and approaches for slowing down the tissue aging and enhancing the cardiac functions of old and middle-aged population have become important topics in the present medical community and health preservation industry. Main indexes that reflect the cardiac functions—left-heart diastolic function and volume ejection per heart beat-are used to investigate the improving effect of Health Qigong•Yi Jin Jing on the cardiac functions of old and middle-aged people and to provide scientific basis for the promotion and popularization of Health Qigong.

1. Objects and methodology

1.1 Objects

Old students from University for the Aged People of Jiangxi Province and Activity Center for Retired Cadres of the Provincial Party Committee of Jiangxi are selected in this research as the experimental objects. These objects are aged between 50 and 70 and do not have any history of systematic physical exercises or severe diseases.The experimental group contained 39 objects (8 males and 31 females, aged 61.18.34±6.66 on an average) who kept practicing the exercise and complete the tests respectively taken before the experiment, after 3 months of the experiment, and after 6 months of the experiment. 21 objects of the experimental group took an immediate efficacy test after 3 months of the experiment. The control group contained 31 objects (12 males and 19 females, 59.87±6.74 years of age on an average) that normally completed the tests performed before the experiment and after 6 months of the experiment. x2-test (x2=2.8，P＞0.05) and t-test (t=0.81，P＞0.05) were respectively used on the genders and ages of both groups. No significant difference was found in the comparison of general data between both groups.

1.2. Method

Objects of the experimental group practiced Health Qigong for 1h every morning for at east 5 days a week. Instructors were assigned to coach and instruct these objects. Official versions released by Health Qigong Administration Center of General Administration of Sports of China were used as the basis for the routines, requirements, and teaching guidance of Health Qigong•Yi Jin Jing[2]. The control group did not participate in Health Qigong exercise or any other systematic fitness activity.

Cardiac functions of both the experimental group and the control group were tested respectively before the exercise and after 6 months of the exercise. 3 months after the start of practice, the test objects of the experimental group took a test of immediately efficacy-in other words the test object first took a cardiac function test, practiced Health Qigong•Yi Jin Jing twice for about 30 min to the accompanying music, and then had the cardiac function test again.

The test indexes were LV blood pumping function and ventricle diastolic & systolic function. US ATL-HDI3000 Color Doppler ultrasonic diagnosis device was used. The patient was put in the left lateral position. A cardiac scanning probe was used with a working frequency of 2.5~4.0MHz. The probe was placed between the 3rd and 4th ribs on the left edge of the breastbones of the patient to display the standard section of the LV long-axis plane. M-modecursor was placed perpendicular to the interventricular septum and posterior left ventricular wall. After scanning, the systolic diameter and diastolic diameter of the LV were measured. The per-beat volume ejection (SV), the peak value of the early-stage diastolic flow rate of mitral orifice (VE), and the late-stage diastolic flow rate (VA) were mainly recorded and the ratio VE/VA was derived.

Statistical analysis: SPSS10.0 statistical software was used to analyze the data. T-test was used for comparison of mean values.According to the principles of statistics, before-and-after test results of both the experimental group and the control group were respectively put to intra-group and inter-group and intra-group difference tests.Before-and-after test results of both the experimental group and the control group were put to inter-group difference tests.

2. Results

2.1 Vertical comparison study

(1) Changes in cardiac functions of the experimental group after 6 months of experiment

Table 1 shows that after 6 months of Qigong exercise, the SV of the experimental group was significantly raised. The increases in VE and VE/VA indicated that Qigong exercise could improve the compliance of cardiac muscles and the diastolic and systolic functions of the ventricles. Therefore we believe that Qigong exercise can improve the cardiac functions of the exercisers.

Table 1. Comparison of Cardiac functions of the Experimental Group after 6 Months of experiment (n=39， )

Test itemBefore experimentAfter 6 months of experimentt

SV(ml)55.72±15.7867.15±13.67 5.606**

VE(cm/s)66.50±18.2475.05±17.66 3.104**

VA(cm/s)83.02±13.8983.76±15.210.297

VE/VA-16.53±25.96-10.25±23.32 2.132*

Notes: *means P<0.05; ** means P＜0.01; same as below.

(2) Test of immediate efficacy of the exercise on cardiac functions

From the data shown in Table 2 we can see that after a practice, the ventricular diastolic late-stage wave (A-wave) was reduced but there were no significant changes in SV or VE/VA. This indicates that one Qigong practice did not provide any significant immediate efficacy. The effect of Health Qigong on cardiac functions is the result of long-term exercise.

Table 2. Comparison between Test Results of Immediate Efficacy of the Exercise on Cardiac functions of the Experimental Group after 6 Months of experiment (n=21， )

Test itemBefore practiceAfter practicet

SV(ml)55.76±16.0158.38±23.30.534

VE(cm/s)71.05±14.5362.6±13.552.798*

VA(cm/s)89.62±13.4580.58±13.762.785*

VE/VA-19.05±17.06-18.45±19.500.196

(3) Changes in cardiac functions of the control group after 6 months of experiment

From Table 3 we can see that no differential changes took place with the cardiac functions of the control group after 6 months of the experiment.

Table 3. Comparison of Cardiac functions of the Control Group after 6 Months of experiment (n=31， )

Test itemBefore experimentAfter 6 months of experimentt

SV(ml)57.94±16.0158.51±16.990.175

VE(cm/s)65.95±19.9566.30±19.750.100

VA(cm/s)84.36±15.1282.68±14.100.559

VE/VA-18.41±23.98-16.38±24.680.384

2.2 Horizontal comparison study

(1) An analysis of cardiac function tests of the experimental group and control before experiment

No significant differences were found between the cardiac function indexes of the experimental group and the control group before the experiment, indicating that both groups had good comparability.

(2) Comparison of cardiac function tests of the experimental group and control after 6 months of experiment

After 6 months of the exercise, the SV of the experimental group was significantly higher than that of the control group (P<0.05). As to VE/VA which reflects the diastolic and systolic functions of the left ventricle, the value of the experimental group was higher than the control group but the difference was not statistically significant.

3. Discussion

The LV diastolic function is an important index that reflects the cardiac functions. The clinical evaluation of the LV diastolic function is mainly dependent on Doppler ultrasound cardiogram. Changes in the LV diastolic function are mainly measured by the mitral orifice blood flow parameters. When the diastolic function is normal, VE should be greater than VA. Generally speaking, the blood pumping function of the left heart is mainly affected by 5 basic factors: preload, afterload, myocardial contractile force, heart rate, and wall motion coordination [3]. Ventricular diastole includes isovolumetric relaxation period (IRP), early-stage rapid filling period, slow filling period, and LV systole. When the compliance of cardiac muscles (adaptability of ventricular walls to the preload and afterload) falls, the speed of E-wave will fall and the speed of A-wave will rise and VE/VA will fall. This study shows that Health Qigong•Yi Jin Jing can promote the blood circulation of the human body, increase the myocardial contractile force, improve the cardiac afterload, and raise the SV. Due to the improved cardiac evacuation, the preload can be improved, the compliance of cardiac muscles and the diastolic function are enhanced, and E-peak and VE/VA were raised. From this we can see that perseverance on Qigong exercise can improve the cardiac functions.

It is believed in traditional Chinese medicine that the normal pulsation of the heart is mainly dependent on the propelling and warming effects of the Yang Qi of the heart. It is only when the heart is filled with sufficient Yang Qi that the normal cardiac efficiency, heart rate, and cardiac rhythm can be maintained and the blood can be normally circulated to all parts of the body [4]. Research has shown that even if they do not have a history of cardiac diseases, patients afflicted by deficiency of Qi will still tend to have attenuated myocardial contractile force and decreased cardiac output [5]. Through Daoyin of the body, Health Qigong•Yi Jin Jing unblocks and promotes the circulation of blood and Qi in the channels. Through the pulling and stretching movements of the meridian musculatures and channels, it regulates the visceral functions and enhances the functions of the main blood vessels of the heart. By coordinating spirit and mind with form and Qi, it excites the Qi of the entire body, nourishes the primordial Qi, and thus improves the cardiac functions and preserves health.

For example: For example, in the first routine of “Wei Tuo Presenting the Pestle”, both palms are closed in front of the chest and the roots of the palms are put at the same height of the Tanzhong Acupoint, which is the the Mu-front acupoint of the pericardium channel. When both hands are closed at this position, the mind and spirit will be united, Qi will be calmed, and spirit will be colleted to regulate the cardiac functions. Acupuncture and moxibustion experiments of traditional Chinese medicine have proved that Tanzhong Acupoint has specific regulating effects on cardiac functions [6]. In the fifth routine “Pulling back Tails of Nine Bulls”, the twisting movement of the waist drives the shoulder blades to stimulate Jiaji, Feiyu, and Xinyu Acupoints on the back. Clinical experiments have shown that: Stimulations to Xinyu and Tanzhong Acupoints can significantly increase the vibration amplitude of the LV wall and the stroke volume and enhance the myocardial contractile force [7]. In the sixth routine “Showing Claws and Wings”, the Daoyin effect of the arm-stretching, palm-pushing, arm-bending, palm-withdrawing, arm-spreading, and shoulder-extending movements can repeatedly open and close Yunmen and Zhongfu Acupoints to purge the pulmonary Qi. It is believed in traditional Chinese medicine that: The lungs master Qi of the entire body. The purging of lungs will facilitate the blood and Qi circulation over the body. And both the heart and lungs are located in the chest and all vessels converge in the lungs. The lungs can promote the circulation of cardiac blood. The normal cardiorespiratory functions are the fundamental guarantee of the normal blood and Qi circulation of the human body [8].

To sum up, after 6 months of Health Qigong•Yi Jin Jing exercise, the SV and ventricular diastolic function were improved but to a less significant extent than other indexes. And no difference was found in the test of immediate efficacy of the exercise on cardiac functions.

References

[1]Cheng Bei，Zeng Erkang. Geriatrics[M]. Science Press, Beijing, 2004:60.

[2] Health Qigong Administration Center of General Administration of Sports of China. Health Qigong•Yi Jin Jing [M]. Beijing: People’s Sports Publishing House, 2003.

[3] Huang Chengxiao. Ultrasonic medical imageology [M].People’s health Publishing House, Beijing, 1996:69-70.

[4] Li Dexin. Basic Theories of Chinese Medicine [M]. People’s health Publishing House, Beijing, 2001,8:67.

[5] Han Bin, et. al. A study of the dialectric relationships between changes in the sphygmobologram, cardiac functions, and hemorrheological parameters and Qi deficiency and Yang deficiency [J]. Chinese Journal of Traditional Medical Science and Technolog, 2002,3(7):133.

[6] Health Qigong Administration Center of General Administration of Sports of China. Health Qigong•Yi Jin Jing [M]. Beijing: People’s Sports Publishing House, 2003:30

[7] Yang Jiasan. Yu Acupoints in Acupuncture [M]. Shanghai Scientific and Technical Publishers, Shanghai,1986.12: 239. 239.

[8] Yang Fuguo. Viscera state and clinical practice in traditional Chinese medicine [M]. Chinese Medicine Classic Books Publishing House, Beijing, 2001.2 :36.