含黃豆分離蛋白及乳清蛋白之管灌配方對營養不良住民營養狀況之改善

The improvement on the nutritional status of residents with malnutrition by the tube feeding formula containing soybean protein isolate and whey protein

陳怡萍(Yi-Ping Chen)

指導教授 ： 王進崑

中山醫學大學/健康管理學院/營養學系碩士班/碩士(2016年)

摘要

在長期照護機構中的住民大多有營養不良現象，適當的腸道配方提供良好營養支持來源，有助於獲得良好的營養狀況，進而降低感染發生率及死亡率。本研究主要探討管灌餵食含黃豆分離蛋白及乳清蛋白之配方對營養不良住民營養狀況之改善。
本研究共納入使用管灌餵食的營養不良受試者共30位，其中男性14名，女性16名，平均年齡為78歲，研究介入期為12週。在營養配方介入前、後（第0週、第12週）評估體位、血液生化值、營養狀況、臨床症狀及攝食情形。結果顯示，給予受試者完全營養配方後，受試者的實際熱量攝取、碳水化合物及蛋白質的攝取量有極顯著增加（p＜0.01）。而受試者之身體質量指數（BMI）、皮下脂肪厚度（TSF）、中臂圍（MAC）及中臂肌圍（MAMC）有極顯著增加（p＜0.01），且體重有顯著提高（p＜0.05）。此外，血清白蛋白、前白蛋白、鎂及三酸甘油酯有極顯著增加（p＜0.01），膽固醇、鈣、磷、鈉、鉀、鐵及尿酸則沒有顯著影響。綜合上述結果，給予含黃豆分離蛋白及乳清蛋白之管灌配方12週後，可顯著改善體位及營養狀況。

關鍵字

黃豆分離蛋白 ； 乳清蛋白 ； 白蛋白 ； 前白蛋白 ； 營養不良

並列摘要

People in the long-term care organization generally have malnutrition problem. Appropriate formula of enteral nutrition provides good sources of nutritional support to improve the nutritional status of residents and reduce the incidence of infection and mortality. The main objective of this study was to understand the effect of tube feeding formula containing soybean protein isolate and whey protein on the improvement of nutritional status of subjects with malnutrition. 30 subjects (14 males and 16 females, average age was 78 years old) of tube feeding with malnutrition were enrolled in this study. The experimental period was 12 weeks. Biochemical analyses, anthropometric factors, physiological symptoms and dietary condition were measured before and after 12 weeks of intervention. Results showed that the daily energy intake and the intake of carbohydrate, protein were significantly increased after using the formula (p<0.01). There were very significant difference in anthropometric measurements, including BMI, TSF, MAC and MAMC (p<0.01) and significant difference was found in body weight (p<0.05). Serum albumin, prealbumin, magnesium and triglyceride were very significantly increased (p<0.01). Serum cholesterol, calcium, phosphorus, sodium, potassium, iron and uric acid showed no difference. In conclusion, the intervention of this tube feeding formula could greatly improve the anthropometric data and nutritional status of the subjects.

並列關鍵字

soybean protein isolate ； whey protein ； blood albumin ； blood prealbumin ； malnutrition

參考文獻

賴冠菁、黃詩瑩(2012)慢性腎臟疾病腎利飲食原則。國泰醫療財團法人國泰綜合醫院國泰醫訊(77)。

吳蔓君 (2015) 肌少症簡介。家庭醫學與基層醫療30(4)：103-107。

陳弘哲、許慧雅、周明岳、杜明勳 (2014) 老人營養評估與篩檢。台灣家庭醫學會家庭醫業29(3)：64-74。

衛生福利部中央健康保險署(2005)如何選擇正確的科別就醫—不明原因體重減輕。

Alpers, D.H.and Klein, S.(2003). Approach to the patient requiring nutritional supplementation. In Yamada T, ed. Textbook of Gastroenterology, 4th edn. Baltimore: Lippincott Williams & Wilkins.