國人檳榔、菸、酒使用與氣喘、心血管疾病、消化性潰瘍之相關性探討

研究背景: 嚼食檳榔在台灣是非常普遍的一種嗜好，依行政院衛生署九十年度科技研究發展計畫「台灣地區檳榔嚼食率、吸菸率及對檳榔健康危害意識調查」結果(18歲以上)嚼食檳榔盛行率為11.2%，目前仍在嚼食者為8.5%(楊奕馨，2001)，由此推估約有120萬的民眾有嚼食檳榔的習慣。嚼食檳榔除了與口腔白斑、口腔黏膜下纖維化症以及口腔癌有密切的關聯之外，還可能引發其他多種系統疾病，近年來也漸漸受到關注，然而這方面的研究於文獻上卻仍嫌不足，嚼食檳榔與全身個組織器官相互關係與影響未明確證實。研究目的： 1.瞭解氣喘、心臟病、消化性潰瘍的現況2.瞭解社會人口(性別、年齡層)與氣喘、心血管疾病、消化性潰瘍、呼吸道疾病、心血管疾病、腸胃系統疾病彼此的相關性3.探討檳榔、菸、酒使用與氣喘、心臟病、消化性潰瘍疾病、呼吸道疾病、心血管疾病、腸胃系統疾病之相關性。材料方法:依據行政院衛生署九十年度科技研究發展計畫:台灣地區檳榔嚼食率、吸菸率及對檳榔健康危害意識調查之結果11723人為樣本數，以卡檢定及對數廻歸進行統計分析。結果:本研究發現，年齡層與疾病的分佈以18-34歲年齡層疾病盛行率最低，50歲以上呈增加的趨勢，65歲以上者疾病盛行率的增長為18-34歲的2.3倍至31.9倍。樣本疾病資料不論性別、年齡分類上所佔之比率排序均呈現共同性及一致性，且有統計上顯著意義。研究中發現檳榔使用與消化性潰瘍、呼吸道疾病、腸胃系統疾病在統計上有明顯相關，檳榔嚼食年數與心臟病、心血管疾病有顯著關聯，且與檳榔嚼食年數成正比，心臟病、心血管疾病檳榔嚼食30年以上者分別為嚼食0-9年的14.2倍、2.6倍，檳榔嚼食顆數則以10-29顆佔多數。吸菸與消化性潰瘍、呼吸道疾病、腸胃系統疾病在統計分析上呈正相關有明顯差異，至於吸菸包數以1-2包者為多數，吸菸年數與疾病的關係於排序上呈共同性與一致性。喝酒習慣與本研究所列之各項疾病在統計上呈顯著意義，喝酒30年以上更增加其危險性。檳榔與酒同時使用者在消化性潰瘍、呼吸道疾病、腸胃道疾病有顯著的統計差異，菸與酒同時使用者在心臟病、心血管疾病為最高比率，單項檳榔使用最高比率為心血管疾病，氣喘疾病比率最低。檳榔、菸、酒的使用於氣喘、心臟病、消化性潰瘍、呼吸道疾病、心血管疾病、腸胃道疾病各疾病均呈現其相關性影響因素。

關鍵字

消化性潰瘍；嚼食檳榔；氣喘；心血管疾病

並列摘要

Research Background: Chewing betel quid is a very popular habit in Taiwan. According to the Ministry of Health’s 2001 Science Technology Research and Development Plan Survey of Betel Quid Chewing Rate, Smoking Rate and Betel Quid Health Risk Awareness for Taiwan, results indicate 11.2% of the population aged 18 and above chew betel quid. Currently, 8.5% (Yang 2001) still chew betel quid. Based on these figures an estimated 1.2 million Taiwanese have a betel quid chewing habit. Chewing betel quid is not only closely linked to leukoplakia, oral submucous fibrosis, and oral cancer, but may also cause other multisystematic diseases. This has received more and more attention in recent years. However, due to a lack of research and literature in this area the influence of chewing betel quid on human tissues and organs has yet to be clearly proven. Research Objectives: 1. To understand the current situation of asthma, heart disease, and peptic ulcer. 2. To understand the ways age and gender relate to asthma, cardiovascular disease, peptic ulcer, respiratory disease, and gastrointestinal disease. 3. To research and discuss the relationship of betel quid, cigarette, and alcohol consumption to asthma, heart disease, peptic ulcer, respiratory disease, cardiovascular disease, and gastrointestinal disease. Methods and Materials: In the aforementioned Ministry of Health Survey there were 11723 samples. The statistics were analyzed by Chi-square rest, One-way ANOVA and Logistic regression. Results: We found in the research that the distribution of age and disease is the lowest for those 18-34 years old. The distribution shows an increasing trend for samples aged 50 and above. However, the incidence of disease among those samples aged 65 and above was between 2.3 and 31.9 times that of samples from the 18-34 age group. The data clearly indicated similarities and consistency across all age groups and genders. The research also showed betel quid chewing was clearly related to peptic ulcer, respiratory disease, and gastrointestinal disease from a statistical perspective. The period of time betel quid was consumed was also clearly related to incidence of heart disease and cardiovascular disease. Those samples who chewed betel quid for 30 years or longer were 14.2 times more likely to contract heart disease than those who chewed 0-9 years. In contrast, those who chewed betel quid for 30 years or longer were 2.6 times more likely to contract cardiovascular disease. The focal group was those samples who chewed between 10 and 29 betel quid. The relationship of smoking to peptic ulcer, respiratory disease, and gastrointestinal disease showed clear statistical differences. For those who smoked 1-2 packs per day, the period of time over which tobacco was consumed and the incidence of disease also showed consist correlation. Drinking is also statistic meaningful to all disease mentioned above. Drinking longer than 30 years put the health of the subjects studied at a high risk to subjects with both drinking and smoking habits were the most susceptible to heart disease and cardiovascular disease. Samples using betel quid only were the most susceptible to contract cardiovascular disease but the least to contrast asthma.