膳食性益生菌補充對於長期照護機構老年住民之排便情形的影響

Influence of Dietary Probiotic Supplementation on the Defecation Status in Elderly Living in a Long-term Care Institution

張詩莉(CHANG SHIH LI)

指導教授 ： 蒙美津 ； 張李淑女

亞洲大學/健康學院/長期照護研究所在職專班/碩士(2009年)

摘要

便秘是長期照護機構老年住民常見的健康問題；文獻報導顯示，長期照護機構住民的便祕盛行率約有50%~80%。臨床上對於便秘的處理包括藥物及非藥物治療，然而藥物治療不但會增加老人的生理負擔，也會產生藥物間的交互作用。此外，常用之灌腸侵入性處理方式，不僅會造成老人的不舒適感，亦會造成大腸穿孔等嚴重傷害，因此老人便秘宜考慮非藥物之治療方式。
益生菌的補充已被證實可維持良好的腸胃菌相，進而改善及預防便秘的狀況，其在應用上屬於一種非侵入性、非藥物之輔助便秘治療的方法，故本研究應用益生菌可促進正常的排便習慣的原理，以飲用市售優酪乳的介入方式來測試其對於長期照護機構老年住民便秘的改善效能。本研究的主要目的為：(1)了解中部某家小型養護機構住民便秘盛行率；(2)評估飲用市售優酪乳對長期照護機構住民排便情形的影響。
本研究以彰化某老人養護中心41位住民為研究對象，固定於每天下午飲用一瓶優酪乳(125m)，為期14天，然後比較優酪乳介入前、介入中及介入後之每日排便情形及相關影響因素(腸蠕動的次數及強度、排便的次數及性質、胃腸藥及緩瀉劑的使用量與灌腸情況)的變化情形。
研究結果顯示，優酪乳的飲用對於腸蠕動次數及強度的增加及糞便性質的改善有立即性之正面效應，亦有減少藥物使用量的效用，分析結果均具有統計上的顯著意義。優酪乳的飲用停止後，上述之效用並無法延續。因此，藉由優酪乳的持續飲用來補充益生菌，可改善長期照護機構老年住民的便秘情形，而且本研究結果提供了老人便秘非藥物治療輔助方法的實證依據。

關鍵字

益生菌 ； 便秘 ； 老人

並列摘要

Constipation is a common health problem for older adults residing in long-term care facilities. The prevalence of constipation in these residents was estimated to be 50%~80%. Treatments for constipation include pharmacological and nonpharmacological therapies. Pharmacological therapy, however, will increase physical burdens and induce the medication interactions. Use of enema may cause uncomfortableness and the trauma of colon perforation. Thus, non-pharmacological therapy may be better for older persons with constipation.
Supplementation with probiotics is considered to be an effective noninvasive and non-pharmacological therapy for constipation. Thus, the present study was undertaken to evaluate the efficacy of probiotics (Lactobacillus casei Shirota) for treating elderly with chronic constipation. The main purposes of this study were to assess the prevalence of constipation in elderly residents of a private long-term care center and to evaluate the impact of probiotic supplementation on the defecation status.
Forty-one elderly subjects were recruited from a long-term care center for senior citizens in Changhua. A bottle of yogurt drink (250 ml) was supplied to each of the subjects daily for a 14-day period. The constipation conditions and relevant factors of the subjects were compared before and after the yogurt drink intervention.
Results indicated that supplementation with yogurt drink for 14 days significantly increased the frequency and intensity of bowel movement, improved the consistency of feces and reduced the amount of medications. It is, therefore, concluded that dietary supplementation of probiotics in the form of yogurt drink might be an effective adjuvant treatment for elderly constipation.

並列關鍵字

Probiotics ； Constipation ； Elderly

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