健康促進計劃對非酒精性脂肪肝者之影響

Effects of a health promotion program on NAFLD

李祥瑞(Shiang-Juei Lee)

指導教授 ： 劉珍芳

臺北醫學大學/公共衛生暨營養學院/保健營養學研究所/碩士(2008年)

摘要

本研究於臺安醫院招募18歲以上、50歲以下，體重過重且總膽固醇(total cholesterol, TC) 或三酸甘油酯(triglyceride, TG) 超過標準數值的非酒精性脂肪肝 (nonalcoholic fatty liver disease, NAFLD) 患者，共計31位。主要的目的是希望藉由健康促進的方式，讓非酒精性脂肪肝患者能減輕體重、降低異常肝功能指數及減輕脂肪肝嚴重程度。其中有16位參與12週的健康促進減重計劃 (稱為實驗組)，在飲食方面給予每公斤標準體重25大卡，其中脂肪占25~30%、蛋白質占16~17%、醣類占55%，再加上至少共18小時的飛輪運動，運動強度設定為50~85% 保留心跳率；另15位則僅給予定期健康檢查的追蹤 (視為對照組)。
結果顯示，在12週之後，實驗組的體重平均減去5.23±10.78公斤(下降幅度為6.28%)、BMI、腰圍、臀圍、腰臀比、TC、天門冬胺酸轉胺酶 (AST)、丙胺酸轉胺酶 (ALT)、麩胺醯轉移酶 (γ-GT) 也均較對照組顯著下降。而且心肺適能及柔軟度方面也較對照組有顯著進步。實驗組在活動後，體位測量方面雖然均下降，但前後未達顯著的差異；而在TC, ALT, AST, γ-GT及脂肪肝的嚴重程度方面，則均有顯著的改善。再者在體適能方面，心肺適能及柔軟度也有明顯的進步 (p<0.05)。
本實驗證實，藉由均衡減重飲食、飛輪運動處方，能幫助NAFLD且合併肥胖患者，可有效地減輕體重、減少腰圍及改善異常生化指標如，ALT, AST, γ-GT及TC。亦能有效地改善其柔軟度及心肺適能。

關鍵字

非酒精性脂肪肝 ； 飛輪運動 ； 體重 ； 肝功能指標

並列摘要

This research was conducted In the Taiwan Adventist Hospital. We recruited 31 non-alcoholic fatty liver disease patients (NAFLD) whose ages are between 18 and 50 years old. These patients had body mass index larger or equal to 25 and had higher total cholesterol (TC) or triglyceride (TG) than standard. The objective was to help NAFLD patient reduce their weight, abnormal liver function index and the level of severity for fatty liver, by taking the health promotion program. Among all participates, 16 patients joined a 12-week health promotion program (called experimental group). This group took balanced diet (25 kcal/IBW, 25~30% fat, 16~17% protein and 55% carbohydrate) combined with 18 hours spinning exercise. The exercise intensity was set on 50~85% heart rate reserve. The other 15 patients, as the control group, were only provided health check and track status periodically.
After 12 weeks, the weight of experimental group were reduced to an average of 5.23±10.78kg (declined 6.28%) and the BMI, waist circumference, hip circumference, waist-hip ratio, TC, ALT, AST and γ-GT were obviously lower than the control group. In the meantime, cardiovascular endurance and flexibility were also better than the control group. However, there was no significant decrease for the anthropometric during the period. Nevertheless, the levels of TC, ALT, AST, γ-GT and the severity of fatty liver were substantially improved. In physical fitness, the cardiovascular endurance and flexibility also showed good improvement (p<0.05). This research has proved that we can help NAFLD with obese patients reduce their weight, abdominal circumference and improve unusual liver functions ALT, AST, γ-GT and TC effectively by a balanced diet and spinning exercise. Furthermore, it also has improved their cardiovascular endurance and flexibility as well.

並列關鍵字

NAFLD ； spinning exercise ； weight ； liver function index

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