How to prevent and treat “muscle deficiency”?

Author: Yuan Li, Beijing Longfu Hospital

Reviewer: Wang Rui, Chief Physician, Beijing Longfu Hospital

At present, my country is accelerating into an aging society. According to relevant data, the number of elderly people over 60 years old has exceeded 200 million, accounting for about 14.9% of the total population. In the next 20 years, the number of elderly people will increase by about 10 million per year on average. By around 2050, the elderly population in my country will reach 1/3 of the national population. As one of the diseases of the elderly, sarcopenia has a high incidence rate and seriously affects the physical health and quality of life of the elderly. Let's learn about the relevant knowledge of sarcopenia.

1. What is sarcopenia?

Sarcopenia is a comprehensive degenerative disease characterized by a decrease in skeletal muscle mass, strength and function with age. It is also known as "sarcopenia", "muscle loss" and "muscle attenuation syndrome". The main clinical manifestations are decreased muscle strength, fatigue, weight loss, decreased muscle mass, decreased hand grip strength, slow walking, etc.

Sarcopenia is very harmful to the elderly. For example, it can lead to a decline in the quality of daily life of the elderly in the community and at home, insulin resistance, osteoporosis, increased risk of falls, and significantly prolong hospital stay for hospitalized patients, increasing the risk of death.

Therefore, the elderly should be screened and prevented early to prevent further deterioration of physical function.

2. How to prevent sarcopenia?

The best prevention is improved nutrition and active physical activity.

First , the protein intake should be increased in the diet. Studies have recommended that the protein intake of the elderly in China should be maintained at 1.0-1.5 g/(kg·d), and that high-quality proteins rich in branched-chain amino acids such as leucine, such as whey protein and other animal proteins, should be appropriately increased.

Secondly , insist on moderate exercise. Ensure 30 minutes of moderate-intensity aerobic exercise every day, such as walking, jogging, cycling, Tai Chi, aerobics, etc. Resistance training 2 to 3 times a week can also significantly reduce muscle loss, such as lifting dumbbells and pull-ups.

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Finally , elderly people who have the conditions can go to professional institutions regularly for elderly health management and insist on participating in comprehensive and continuous chronic disease management.

3. How to treat sarcopenia?

Sarcopenia is a complex multifactorial disease. The purpose of clinical treatment is to slow down or reverse the decline of muscle mass and function, reduce related complications, and improve the quality of life. The current treatment methods for sarcopenia involve rehabilitation therapy, drug therapy, nutritional support, etc.

1. Rehabilitation

(1) Aerobic exercise

Regardless of age, aerobic exercise can increase the number of mitochondria and enzyme activity, promote muscle protein synthesis and improve muscle quality. It can also reduce body fat (including intramuscular fat), thereby improving muscle function.

(2) Resistance training

Resistance training is a type of exercise that resists resistance. Its main purpose is to train the body's muscles. Traditional resistance training includes push-ups, dumbbells, barbells, seated leg raises, static wall squats, and elastic band pulls. Resistance training can delay aging, reduce fat content, reduce injuries and pain, improve the body's carbohydrate metabolism, increase bone density, and reduce osteoporosis.

Studies have shown that both aerobic exercise and resistance training can effectively slow down the decline of muscle mass and muscle strength, and resistance training is better than aerobic exercise in reducing the progression of sarcopenia.

2. Traditional Chinese Medicine Treatment

(1) Traditional Chinese medicine treatment

In traditional Chinese medicine, sarcopenia can be classified as a "paralysis disease", which is mainly related to the dysfunction of the liver, spleen, stomach, kidney and lung. Traditional Chinese medicine believes that the occurrence of sarcopenia is mostly due to spleen and stomach deficiency, liver and kidney deficiency, and blood stasis. The treatment focuses on tonifying deficiency and removing blood stasis, and enhancing muscle strength and endurance. Clinically, syndrome differentiation and prescription selection can be carried out according to the patient's symptoms, tongue and pulse, etc.

For those with insufficient spleen and stomach, the main manifestations are gradually worsening weakness of limbs, fatigue, muscle atrophy, shortness of breath and laziness to speak, reduced food intake, unformed stool, pale or sallow complexion, dullness and other symptoms. Bu Zhong Yi Qi Tang can be used with modifications.

For patients with liver and kidney deficiency, the main symptoms are weakness of the limbs, especially in the lower limbs, soreness of the waist and knees, inability to stand for a long time or even inability to walk, obvious muscle atrophy, or accompanied by dizziness, tinnitus, dry tongue and throat, etc., Huqian Pills with modifications can be used.

For those with blood stasis, the main symptoms are weakness of the limbs, thin muscles, numbness of the hands and feet, and exposed blue veins in the limbs, which may be accompanied by dull pain and discomfort when moving the muscles or joints. Buyang Huanwu Decoction with modifications can be used.

It should be noted that the above medicines should be prescribed by a professional physician and taken under the guidance of a physician.

Diet therapy

In addition to taking Chinese medicine decoctions, you can also use diet therapy. Chinese diet therapy is a method of preventing and treating diseases and promoting recovery based on the theoretical basis of Chinese medicine, using the nature, taste, meridians, and efficacy of food, and following the principles of dietary conditioning. The elderly, especially patients with sarcopenia, can eat more foods such as yam, coix seed, lotus seed, tangerine peel, jujube, mulberry, lily, etc. Recommended diet recipes: angelica stewed chicken, astragalus and jujube porridge, peach kernel porridge, hawthorn porridge, etc.

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(3) Massage therapy

Massage therapy mainly uses holding, kneading, patting, pressing, and kneading techniques to dredge the meridians and promote the flow of qi and blood.

Commonly used acupoints: Shousanli, Yanglao, Fuliu, Jianjing, Hegu, Waiguan, Zusanli, Weizhong, Chengshan, etc.

You can massage each acupoint for about 3 minutes every day, and then use different techniques to act on the acupoints, meridians or limbs. The operator's technique should be moderate and not too strong, and the degree should be based on the comfort of the elderly.

(4) Traditional physical exercise

It mainly involves active limb movement, combined with breathing exercises or self-massage to achieve the purpose of strengthening the body, prolonging life, and curing diseases. You can choose traditional sports training such as Wu Qin Xi, Ba Duan Jin, Tai Chi, etc. every day. Exercise should be moderate and should not cause excessive fatigue of skeletal muscles.

3. Nutritional support

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Nutritional intervention is one of the important means to prevent and treat sarcopenia. It is recommended that patients with sarcopenia increase their protein intake and eat more foods with high protein content such as beef, milk, eggs, and lean meat. In addition, whey protein should be selected as the main protein, which is better than casein and soy protein, and protein hydrolysate can play a better role. In addition to protein intake, various vitamins should also be taken, such as vitamin D, vitamin C, vitamin E, etc.

In addition to the above treatment methods, strengthening nursing care is also very important to avoid complications . In daily care, the following should be noted: ① The bedding should be soft, changed frequently, and the patient should be turned over frequently; ② Pay attention to dietary hygiene to avoid gastrointestinal diseases; ③ Keep warm to avoid colds; ④ Pay attention to emotional changes and keep a happy mood every day.

Finally, patients with sarcopenia should also pay attention to psychological counseling and entertainment to relieve negative emotions such as pessimism, depression, and impatience. Appropriate participation in entertainment activities, such as calligraphy practice, painting, and listening to music, can not only regulate emotions, but also allow the body to move.