屏南原住民社區之飲食習慣與口腔癌前病變相關性之探討

The Association between Diet and Oral Precancer Lesions in Indigenous Communities of the Southern Pingtung

陳秋琴(Chiu-Chin Chen)

指導教授 ： 楊奕馨

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2010年)

https://doi.org/10.6832/KMU.2010.00057

摘要

中文摘要
研究背景：
口腔黏膜病變與嚼食檳榔、喝酒、抽菸等之相關性，過去已有相當多的研究，除此之外，國外文獻也報導各類營養素與口腔上皮癌的發病率有關。國內飲食習慣與口腔黏膜病變的相關性研究較少，因此引發本研究動機。
研究目的：
主旨在探討原住民社區之飲食習慣與口腔癌前病變之相關性。
研究方法：
本研究以行政院衛生署屏東縣94年度山地離島地區整合式篩檢之30歲以上居民，篩檢地區為屏東縣4個山地鄉(來義、泰武、春日、獅子)，每位民眾接受牙醫師口腔檢查及問卷訪談，共取得有效樣本為1477人，統計分析方法包含卡方檢定及對數廻歸分析，並以JMP 版統計軟體進行。
研究結果：
在口腔黏膜病變方面，口腔癌前病變患者(oral precancer lesions)有313人佔21.19%，口腔良性病灶患者(oral benign lesions)有130人佔8.80%。每星期吃水果次數愈少、喝牛奶次數越少、喝茶次數越少或是有嚼食檳榔、抽菸、喝酒習慣者，口腔癌前病變的得病比例顯著愈高，但在廻歸分析加入調整因子性別、年齡、檳榔、菸、酒習慣及教育、工作地點 、每月收支後，各項飲食頻率之廻歸係數皆不顯著。
結論：
本研究發現屏南地區原住民社區，每週飲食頻率中增加水果、牛奶、茶類使用頻率與降低口腔癌前病變有相關性，但經廻歸調整後並不顯著；顯示飲食頻率，並非對口腔癌前病變之顯著相關因素。過去文獻顯示檳榔是造成疾病之主要原因，可透過健康促進的概念，讓社區民眾了解，要讓口腔黏膜病變發生率降低，必須先從戒治嚼食檳榔、抽菸與喝酒開始。

關鍵字

口腔黏膜病變 ； 生活型態 ； 飲食習慣

並列摘要

Abstract
Background:
Oral mucosal lesions and betel quid chewing, drinking, smoking, and their associations have been intensively studied in the past; in addition, despite many reports of various nutrients related to the incidence of oral carcinoma from abroad. Limited studies have been investigated the relationship of dietary habits
and oral mucosal lesions in Taiwan.
Study objective:
To examine the eating habits of indigenous communities and the association with precancer lesions.
Methods:
In this study, the Department of Health, Executive Yuan, Pingtung County’s 94 Integrated Mountain Islands region residents aged over 30 were screened, with screening areas in Pingtung County of four mountain areas (Lai-yi, Tai-wu, Chuen-zi, Shih-zih);each gave public acceptance of dental oral examination and questionnaire interview, for a total effective sample of 1477 people. Statistical methods included Chi-square test and logistic regression analysis, and JMP statistical software was used.
Results:
In terms of oral mucosal lesions, there were 21.19% (313) patients with oral precancer lesions and 8.80% (130) patients with oral benign lesions.In those subjects consuming less fruit, milk or tea, or consuming more betel quid, alcohol and smoking had significantly higher proportions of oral precancers lesions.
However in linear regression analysis with adjustment of gender, age, betel quid chewing, smoking habit and drinking habit, education, place of work, monthly
payments, various food consumption frequency, none of the regression coefficients was significant.
Conclusion:
The study found that people in Indigenous Communities of the Southern Pingtung area who had increased consumption frequency every week of fruit, milk, tea had related lower frequency of oral precancer lesions, but after adjustment by linear regression, this was not significant; this shows that diet frequency does not have an influence on the significant related factors of oral precancer lesions. Previous studies have demonstrated betel quid is the main cause of disease, therefore, through health promotion concepts, community residents could be led to understand the incidence of oral mucosal lesions can be minimized through a physical therapy program impacting betel quid chewing, smoking and drinking.

並列關鍵字

oral mucosal lesions ； lifestyle ； eating habits

參考文獻

參考資料

1.吳幸娟、章雅惠、張新儀、潘文涵. (2004). 台灣地區成年人維

生素A、B1、B2、C、E及菸鹼酸的食物來源：1993~1996國民營養

健康狀況變遷調查結果. 中華民國營養學會雜誌, 26(4), 213-

229.