臺灣博碩士論文加值系統

論文摘要
論文名稱：規律運動訓練對代謝症候群個案身體組成、心肺適能與血
液生化值成效之探討
研究所名稱：臺北醫學大學護理學研究所
研究生姓名：謝長華
畢業時間：九十四學年度第二學期
指導教授：蔡仁貞 臺北醫學大學護理研究所教授
代謝症候群是心血管疾病許多危險因素聚集的現象，近年來許多學者研究發現肥胖及久坐工作生活型態、飲食、基因遺傳、環境因素等可能是導致此症候群的原因。而本研究的目的在探討規律運動訓練對代謝症候群個案身體組成、心肺適能與血液生化值之成效。
本研究採類實驗設計法，以台北市某醫學中心18-65歲代謝症候群個案為對象，本計畫先進行運動組之計畫，再招募對照組，共有22位完成此研究，其中運動組與對照組各11人。運動組個案進行每週3次，每次30分鐘，共為期12週的跑步機運動訓練，對照組則保持原有的生活型態。研究計畫前後以個案基本資料表、血液分析、運動測試等進行資料收集。研究資料分別以百分比、平均值、標準差、曼－惠特尼考驗（Mann-Whitney U test）、魏氏帶符號等級考驗（Wilcoxon signed ranks test）等統計方法進行分析。研究結果發現：（一）不同人口學特性個案在代謝症候群危險因子，在不同學歷、抽菸有無與喝酒之個案在代謝症候群危險因子並無顯著的差異。而男性腰臀圍比、VO2 max、靜態舒張壓、三酸甘油酯皆高於女性；有工作者VO2 max高於無工作者；經濟況狀較優者，其VO2max愈高、血液中的總膽固醇、低密度脂蛋白膽固醇含量也較高；具心血管家族史之個案其空腹血糖值高於無心血管家族史者。（二）兩組個案在研究計畫前後，靜態收縮壓之變化達顯著差異（p = .04），而運動組個案在代謝症候群危險因子中，腰圍（p = .003）、腰臀圍比（p = .02）、VO2 max（p = .01）、靜態收縮壓（p = .04）、靜態舒張壓（p = .02）、三酸甘油酯（p = .03），在12週的運動訓練後有顯著改善的趨勢。（三）在代謝症候群診斷指標方面，運動組個案於研究計畫前有11位符合代謝症候群≧3項指標，在研究計畫後有4位（36.4%）不再屬於代謝症候群。
本研究結果顯示，中高強度的規律運動訓練對改善代謝症候群之危險因子仍扮演重要角色，護理人員可指導代謝症候群個案每週3次，每次30分鐘，為期12週以上中高強度之運動計畫。

關鍵字：代謝症候群、規律運動訓練、身體組成、心肺適能、胰島
素阻抗

Abstract
Title of Thesis: The Effects of Regular Exercise Training
Author：Chang-Hua Hsieh
Thesis directed by：Jen-Chen Tsai, Professor
Many scholars’ researches have found in recent years, the metabolic syndrome is mainly caused by cardiovascular risks factor such as sedentary life style, dietary factors, genetic factors, and environment factors etc.
The purpose of this study was set to evaluate effects of regular exercise training on body composition, cardiorespiration fitness, and blood biochemical index in subjects with metabolic syndrome.
A quasi-experimental design was used to guide the study. Subjects in this study were metabolic syndrome with age from 18-65. They were chosen from a medical center hospital in Taipei, Taiwan. Subjects were assigned into an exercise or a control group. Complete data are available for 22 subjects in total, with 11 from exercise group and 11 from control group. The exercise group participated in a 12-weeks treadmill exercise program, three times each week, 30 minutes each time. The control group remained their living pattern. Data collected was mainly focusing on subjects’ personal data chart, blood biochemistry analysis, and exercise test. Data was analysed using percentage, mean, standard deviation, Fisher’s exact test, Mann-Whitney U test, and Wilcoxon signed ranks test.
Results: (1)There is no significant difference in metabolic syndrome research results on subjects’ educational background, and smoking or drinking habits. However, male subjects’ waist to hip ratio, VO2 max , and resting diastolic blood pressure are higher than those observed in female subjects. For those subjects who have a regular job, their VO2 max are significantly higher than those who are unemployed . Subjects with better economic status also have higher VO2 max , total cholesterol, and LDL-C levels than . Subjects with family history of cardiovascular disease have fasting plasma sugar that is higher than those who have no family history. (2)After 12 weeks, two groups had significant in their resting systolic blood pressure ( p = .04). However, exercisers have improvement in their waist circumference (p = .003), waist to hip ratio (p = .02), VO2 max (p = .01), resting systolic blood pressure (p = .04), resting diastolic blood pressure (p = .02), and triglycerides (p = .03). (3)After 12 weeks, 4 exercisers (36.4%) no longer had metabolic syndrome.
This study has revealed that 12-week moderate to vigorous intensity regular exercise training may help subjectsts minimizing their cardiovascular risk factors of metabolic syndrome.

Key words: Metabolic Syndrome, Regular Exercise Training, Body Composition, Cardiorespiratory Fitness, Insulin Resistance.

目錄
致 謝------------------------------------------------------------------- Ⅰ
論文摘要------------------------------------------------------------------- Ⅲ
英文摘要------------------------------------------------------------------- Ⅴ
目 錄------------------------------------------------------------------- Ⅶ
圖表目次------------------------------------------------------------------- XI

第一章 緒論------------------------------------------------------------- 1
第一節 研究動機與重要性---------------------------------- 1
第二節 研究目的---------------------------------------------- 4
第三節 研究假設---------------------------------------------- 4
第四節 名詞界定---------------------------------------------- 5
第二章 文獻查證------------------------------------------------------- 8
第一節 代謝症候群之定義及診斷標準------------------- 8
第二節 代謝症候群流行病學研究------------------------- 10
第三節 代謝症候群病理機轉------------------------------- 13
第四節 代謝症候群與心血管疾病危險因子的相關性- 17
第五節 運動訓練對代謝症候群個案之成效------------- 32
運動訓練對身體組成之影響--------------------- 32
目錄
運動訓練對心肺適能之影響--------------------- 35
運動訓練對血壓之影響--------------------------- 37
運動訓練對血液生化值、胰島素阻抗之影響- 40
第六節 運動處方---------------------------------------------- 45
第七節 研究架構---------------------------------------------- 50
第三章 研究方法------------------------------------------------------- 52
第一節 研究設計---------------------------------------------- 52
第二節 研究對象及場所------------------------------------- 54
第三節 研究工具---------------------------------------------- 56
第四節 運動測試---------------------------------------------- 59
第五節 運動訓練計畫---------------------------------------- 61
第六節 資料收集過程---------------------------------------- 63
第七節 資料統計與分析------------------------------------- 65
第四章 研究結果------------------------------------------------------- 67
第一節 人口學特性------------------------------------------- 67
第二節 人口學特性與代謝症候群危險因子------------- 76
第三節 運動訓練對代謝症候群個案改善之成效------- 83



第五章 討論------------------------------------------------------------- 89
第一節 人口學特性與代謝症候群危險因子------------- 89
第二節 運動訓練對身體組成改善之成效---------------- 94
第三節 運動訓練對心肺適能改善之成效---------------- 102
第四節 運動訓練對血壓改善之成效---------------------- 104
第五節 運動訓練對血液生化值、胰島素阻抗之成效- 107
第六節 運動訓練對代謝症候群診斷指標改善之成效- 116
第六章 結論與建議---------------------------------------------------- 117
第一節 結論---------------------------------------------------- 117
第二節 研究限制---------------------------------------------- 119
第三節 應用與建議------------------------------------------- 120
參考資料------------------------------------------------------------------- 122
中文部份------------------------------------------------------------- 122
英文部分------------------------------------------------------------ 125
附錄------------------------------------------------------------------------- 136
附錄一 研究計畫同意書--------------------------------------- 136
附錄二 個案基本資料表--------------------------------------- 137
附錄三 Modified Bruce Protocol------------------------------- 139

附錄四 運動訓練記錄表------------------------------------------ 140
附錄五 Borg’s自覺費力程度量表------------------------------ 141
附錄六 謝症候群三日飲食記錄--------------------------------- 142































圖表目次
圖一 研究架構-------------------------------------------------------- 51
圖二 資料收集過程-------------------------------------------------- 64
表一 統計分析方法-------------------------------------------------- 66
表二 代謝症候群個案人口學特性之檢定----------------------- 72
表三 代謝症候群相關危險因子連續變項之描述統計-------- 73
表四 代謝症候群危險因子連續變項分佈情形----------------- 74
表五 運動組與對照組代謝症候群相關危險因子連續變項之檢定----------------------------------------------------------

75
表六 人口學特性與代謝症候群危險因子連續變項之差異- 77
表七 運動組於研究計畫前後代謝症候群危險因子連續變項之變化--------------------------------------------------------

85
表八 對照組於研究計畫前後代謝症候群危險因子連續變
項之變化--------------------------------------------------------

86
表九 比較兩組於研究計畫前後代謝症候群危險因子變化
之差異-----------------------------------------------------------

87
表十 運動組與對照組代謝症候群診斷指標分佈情形-------- 88

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