| Objective:MRI was used to measure the thickness of ligamentum flavum in patients with low back pain of liver kidney deficiency type and non liver kidney deficiency type,and the expression of collagen type I,II and III in ligamentum flavum was compared,Objective to investigate the correlation between the expression of collagen type I,II,III in ligamentum flavum and the thickness of ligamentum flavum in patients with low back pain of liver kidney deficiency type and non liver kidney deficiency type.Method:from January 2020 to December 2020,patients who underwent open posterior lumbar surgery in Ruikang Hospital Affiliated to Guangxi University of traditional Chinese medicine were collected,The general clinical data,signs,TCM syndrome types,involved segments were recorded,and the thickness of ligamentum flavum was measured by MRI.With reference to the standard for diagnosis and treatment of TCM diseases and syndromes formulated by the State Administration of traditional Chinese medicine,30 cases of low back pain due to deficiency of liver and kidney were selected as experimental group,30 cases of low back pain of non liver kidney deficiency type were selected as the control group.Two groups of ligamentum flavum were collected as experimental specimens,After collection,the blood clots were washed with normal saline and put into sterile test tubes,Then it was quickly put into the liquid nitrogen tank and transferred to the refrigerator at-80 ℃ for standby,Collagen type I,II and III in ligamentum flavum were determined by Western blot,The thickness of ligamentum flavum was measured by PACS software on MRI.To evaluate the relationship between the three kinds of collagen and the thickness of ligamentum flavum.The data were analyzed by spss22.0.Result:The thickness of ligamentum flavum was measured by MRI:In the experimental group,L3/4(4.78±0.12)mm、L4/5(4.79±0.15)、L5/S1(4.79±0.18),respectively;In the control group,L3/4(2.63±0.12)、L4/5(3.31±0.13)、L5/S1(2.36±0.15).The experimental group and the control group were tested for homogeneity of variance,Analysis of variance,L3/4、L4/5、L5/S1 were performed with two independent samples t test for homogeneity of variance;L3/4、L4/5、L5/S1 was significant difference in the thickness of ligamentum flavum between the experimental group and the control group,The difference was statistically significant(the results are as follows).L3/4(t=20.454,P=0.000<0.001);L4/5(t=25.510,P=0.000<0.001);L5/S1(t=32.234,P=0.000<0.001).Western blot was used to detect the content of collagen type Ⅰ,Ⅱ and Ⅲ in liver kidney deficiency group and non liver kidney deficiency group,The experimental group and the control group were corrected by internal reference antibody,and the image bands were obtained,Image J software is used to measure the gray value of the image strip,The results were as follows:In the experimental group,ColⅠ(0.80±0.02)、ColⅡ(0.87±0.04)、ColⅢ(0.57±0.07)were significantly higher than those in the control group;In the control group,ColⅠ(0.58±0.05)、ColⅡ(0.78±0.07)、ColⅢ(0.59±0.05)were significantly higher than those in the control group.The experimental group and the control group were tested for homogeneity of variance,Analysis of variance,Col Ⅰ and col Ⅱwere tested by two independent sample adjusted t test(t ’test);ColⅢ was performed with two independent samples t test.There were significant differences in gray value between the experimental group and the control group,The difference was statistically significant,There was no significant difference in gray value between the experimental group and the control group,There was no statistical significance.ColⅠ(t=20.788,P=0.00<0.001);ColⅡ(t=6.830,P=0.000<0.001);Col Ⅲ(t=-1.156,P=0.252>0.05)The thickness of ligamentum flavum measured by MRI and the content of collagen type I,II and III in the same sample were compared,Pearson correlation test was used to analyze the correlation between them,The results were as follows:There was a significant positive correlation between Col I and the thickness of ligamentum flavum(r=0.974,P=0.000<0.001),The confidence interval of ρ was(0.943,0.989);There was a significant positive correlation between col Ⅱ and the thickness of ligamentum flavum(r=0.873,P=0.000<0.001),The confidence interval of ρ was(0.698,0.976);There was no significant correlation between colⅢ and the thickness of ligamentum flavum(r=-0.264,P=0.159>0.05),The confidence interval of ρ was(-0.535,0.031).The results showed that the thickness of ligamentum flavum increased with the increase of col Ⅰ and col Ⅱ.Conclusion:1.The increase of ligamentum flavum thickness measured by MRI may be one of the important reasons for the corresponding clinical symptoms.2.The content of collagen type I and II in ligamentum flavum of patients with low back pain due to deficiency of liver and kidney is higher,It may be that liver dominates tendons and kidney dominates bone,The deficiency of liver and kidney leads to the loss of muscle and bone and the degeneration of ligament,Under the same stress condition,The body compensatively increases the content of collagen fibers,To increase its tensile and compressive stress.3.There was a positive correlation between the thickness of ligamentum flavum and collagen type Ⅰ and Ⅱ in patients with low back pain of liver kidney deficiency type,The results showed that the thickness of ligamentum flavum increased with the increase of collagen fibers.Especially,the proliferation of col Ⅰ and colⅡ may be one of the main reasons for the hypertrophy of ligamentum flavum. |
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