臺灣博碩士論文加值系統

糖尿病是導致末期腎臟疾病的重要因素, 以限制蛋白質飲食來控制腎臟病
變速率, 在臨床膳食治療上早已被普遍接受與應用。然而, 病人對飲食控
制的執行度時常不盡理想, 評估其可能原因為營養知識不足、飲食技巧生
疏等。有鑑於此, 本研究即針對台中榮總新陳代謝科門診中, 41位非胰島
素依賴型糖尿病腎病變患者, 進行營養教育研究, 其中20名自願參與營養
教育者為實驗組, 其餘21名為對照組。研究進行前後, 實驗組及對照組均
進行營養知識、飲食行為的問卷測試並分析血液與尿液生化值, 研究期間
實驗組接受了兩個月共五次的營養課程教育, 以及二至三個月的追蹤控
制 , 而對照組則僅給予飲食衛教單張。研究結果顯示: 1.營養教育前後
對照組之營養知識總分無任何改變, 而實驗組則有明顯進步, 且高於對照
組(P<0.001)。 2.在食物攝取頻率方面, 實驗組在營養教育後, 對於乾豆
類、種子核果類、黃豆製品等植物性蛋白食物及高飽和脂肪肉類食物之選
擇頻率, 顯著少於對照 組(P<0.01;P<0.01;P<0.05; P<0.05)。 3.營養素
攝取量在教育前、後之比較對照組皆無變化, 而實驗組之總蛋白質( 包括
動物性及植物性蛋白質 )、醣類攝取量有顯著減少, 經組間比對照現, 總
蛋白質攝取量實驗組顯著少於對照組(P<0.01)。 4.體位狀況的變化, 實
驗組之身體質量指數教育後較教育前有顯著減少情形(P<0.05), 對照組則
是無明顯變化, 組間比較有顯著差異(P<0.05)。 5.尿液白蛋白之流失
率, 營養教育前後明顯改變, 而實驗組則有減少,且對明顯低於對照組(
P<0.001)。 6.患者在使用降血糖藥物劑量方面, 實驗組在教育後有顯著
減少(P<0.05) ,對照組則是顯著增加(P<0.05), 組間比較有顯著差異(
P<0.001)。由以上資料可知, 營養教育對非胰島素依賴型糖尿病腎病變患
者之營養知識、選擇食物行為、蛋白質攝取量、體位狀況、尿蛋白流失及
血糖控制方面皆有較好的影響。

The purpose of this research was to assess the effect of nutri-
tion education intervention on nutrition knowledge, dietary
behavior and the cilnical condition of individuals with non-
insulin dependent diabetic nephropathy. Forty-one subjects with
non-insulin dependent diabetic nephro- pathy in the Taichung
Veterans' Hospital were studied: 20 volunteers were in the case
group, and the other 21 subjects were in the con- trol group.
Blood and urine samples were collected for measurement, while
nutrition knowledge questionnaire, dietary and clinical data
were collected by interviews. The subjects in the case group
re- ceived 5 classes of nutrition education within 2 months and
followed up for 2-3 months . The control group had no
nutritional lessons, but received leaflets. The results of this
study were as follows: 1.The case group scored significantly
higher points than the control group for a test of
nutritionknowledge after education (P<0.001). 2.The case group
was significantly lower than thecontrol group for the frequency
of intake of plant protein food such as beans, seeds and nuts
soy bean products and high fat meats (P<0.01;p<0.01; P<0.05;
P<0.05). 3.Regarding nutrients intake, no change was observed
for the control group. The case group had decreased intake of
total protein (both animal protein and plant protein) and
carbohydrate. Compared with the control group, protein intake
had significantly decreased in case group(P<0.01). 4.After the
nutrition education, the variation of body mass index ( B.M.I.)
for the control group showed no change were observed, but the
case group had significantly lower B.M.I. than the control
group(P<0.05). 5.Urinary albumin excretion rate for the control
group showed no change. The case group had much less urinary
albumin. It was also lower than the controlgroup after the
education (P<0.001).