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研究生:洪尚志
研究生(外文):Shang-chih Hung
論文名稱:十週社區型負重式健走運動介入對太魯閣族第2型糖尿病患健康之影響
論文名稱(外文):Ten weeks community-based weight-bearing walking program intervention for the health effects of Truku people with type 2 diabetes
指導教授:謝婉華謝婉華引用關係
指導教授(外文):Wan-hua Hsieh
學位類別:碩士
校院名稱:慈濟大學
系所名稱:原住民健康研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
畢業學年度:95
語文別:中文
論文頁數:72
中文關鍵詞:原住民血脂肪血糖糖尿病身體組成血壓運動介入負重式健走社區型
外文關鍵詞:indigeneserum lipidsblood glucoseblood pressurediabetesbody compositionexercise interventionweight-bearing walkingcommunity-based
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本研究目的為探討十週社區型負重式健走運動訓練對太魯閣族原住民第2型糖尿病患者健康狀況之影響。以自願參加之11位秀林鄉太魯閣族第2型糖尿病患者為研究對象(6位男性,5位女性),平均年齡54.7 ± 13.5歲,利用漸進式中強度(最大心跳率50∼65%)之負重式健走運動介入,進行為期十週、每週5次、每次50分鐘的運動訓練計畫,並分別於運動介入前、後測量參與個案之身體組成、心跳、血壓、血糖及血脂肪等各項健康指標。所得資料以描述性統計、配對t檢定、皮爾森積差相關等統計方法進行分析。研究結果顯示:十週的社區型負重式健走運動介入前、後測顯著改善的健康指標包括:(1)身體組成指標(體重75.4 ± 15.2 kg vs. 72.2 ± 14.2 kg, p<0.001、身體質量指數29.6 ± 4.5 kg/m2 vs. 28.4 ± 4.3 kg/m2, p<0.001、體脂肪38.5 ± 10.0 % vs. 34.8 ± 8.1 %, p=0.019、腰圍99.4 ± 9.0 cm vs. 97.4 ± 8.0 cm, p=0.001);(2)安靜時血壓(收縮壓137.5 ± 14.5 mm Hg vs. 122.2 ± 9.0 mm Hg, p=0.001、舒張壓85.6 ± 17.6 mm Hg vs. 75.5 ± 8.7 mm Hg, p=0.039);(3)血糖(空腹血糖181.1 ± 46.1 mg/dl vs. 141.1 ± 19.3 mg/dl, p<0.001、糖化血色素7.6 ± 0.9 % vs. 6.9 ± 0.7 %, p<0.001);(4)血脂肪(總膽固醇206 ± 21.4 mg/dl vs. 176.3 ± 25.3 mg/dl, p<0.001、三酸甘油脂218 ± 99.5 mg/dl vs. 161.8 ± 91.2 mg/dl, p<0.001、低密度脂蛋白膽固醇122.0 ± 22.6 mg/dl ± 100.5 ± 26.3mg/dl, p=0.039)。另外,在運動訓練期間,個案收縮壓(r= - 0.46, p<0.001)、舒張壓(r= - 0.31, p<0.001)及空腹血糖(r= - 0.32, p<0.001)均與介入時間呈現負相關。本研究結論為:單純的負重式健走運動訓練,可以有效改善太魯閣族第2型糖尿病患者的身體組成、血壓、血糖和血脂肪的控制。
The purpose of this study was to investigate the effects of community based weight-bearing walking intervention on the health effects of Truku people with type 2 diabetes mellitus. Eleven voluntary Truku people with type 2 diabetes in Shou-Lin County were recruited as the subjects (6 male, 5 female, average aged 54.7 ± 13.5 yrs). Progressive moderate intensity (50∼65 % maximal heart rate) of walking with weight bearing, 5 times per week and 30∼50minutes per session, intervened for ten weeks. Health indicators such as body composition, heart rate, blood pressure, fasting blood glucose, and lipid profile were compared before and after intervention. Descriptive Statistics, paired t test, and Pearson product moment correlation were used to analyze the data. Results indicated:(1) body composition (weight 75.4 ± 15.2 kg vs. 72.2 ± 14.2 kg, p<0.001; body mass index 29.6 ± 4.5 kg/m2 vs. 28.4 ± 4.3 kg/m2, p<0.001; body fat 38.5 ± 10.0 % vs. 34.8 ± 8.1 %, p=0.019; waist 99.4 ± 9.0 cm vs. 97.4 ± 8.0 cm, p=0.001), (2) blood pressure (systolic blood pressure 137.5 ± 14.5 mm Hg vs. 122.2 ± 9.0 mm Hg, p=0.001; diastolic blood pressure 85.6 ± 17.6 mm Hg vs. 75.5 ± 8.7 mm Hg, p=0.039), (3) blood glucose (fasting blood glucose 181.1 ± 46.1 mg/dl vs. 141.1 ± 19.3 mg/dl, p<0.001; glycosylated hemoglobin 7.6 ± 0.9 % and. 6.9 ± 0.7 %, p<0.001), and (4) serum lipids (total cholesterol 206 ± 21.4 mg/dl and 176.3 ± 25.3 mg/dl, p<0.001; triglyceride 218 ± 99.5 mg/dl and 161.8 ± 91.2 mg/dl, p<0.001; low density lipoprotein cholesterol 122.0 ± 22.6 mg/dl and 100.5 ± 26.3 mg/dl, p=0.039) were significantly improved after intervention. The systolic blood pressure (r= - 0.46, p<0.001), diastolic blood pressure (r= - 0.31, p<0.001) and fasting blood sugar (r= - 0.32, p<0.001) were shown significant negative correlation with the intervention time. Evidence drawn from this study confirmed that community based weight-bearing walking intervention was able to improve body composition, blood pressure, serum lipids and blood glucose control in Truku people with type 2 diabetes.
誌謝..........................................................................I
摘要.........................................................................II
Abstract....................................................................III
總目錄.......................................................................IV
表目錄......................................................................VII
第一章 緒論...............................................................VII
第一節 研究動機與重要性...................................................1
第二節 研究目的...........................................................3
第三節 名詞界定...........................................................4
第二章 文獻探討.............................................................6
第一節 糖尿病的介紹.......................................................6
第二節 血糖恆定的機轉.....................................................8
第三節 心肺適能對糖尿病的影響.............................................9
第四節 運動對糖尿病的治療效果............................................11
一、有氧運動對糖尿病的影響.............................................11
二、阻力式運動(Resistance exercise)對糖尿病的影響......................12
三、有氧運動加上阻力式運動訓練對糖尿病的影響...........................14
第五節 運動處方與運動計畫之設計..........................................16
第六節 結語..............................................................18
第三章 研究方法與步驟......................................................23
第一節 研究對象..........................................................23
第二節 研究時間與地點....................................................23
第三節 研究工具與方法....................................................24
一、結構式問卷.........................................................24
二、健康測量指標.......................................................24
三、糖尿病運動護照.....................................................25
四、運動介入課程.......................................................25
第四節 研究流程及步驟....................................................28
第五節 研究對象的保護措施................................................29
第六節 資料分析..........................................................29
第四章 研究結果............................................................30
第一節 基本資料分析......................................................30
第二節 運動介入前、後健康指標之差異......................................35
第三節 十週運動訓練血糖及血壓之改變趨勢..................................37
第五章 討論................................................................39
第一節 負重式健走運動對身體組成之成效....................................39
第二節 負重式健走運動對血壓之成效........................................40
第三節 負重式健走運動對血糖之成效........................................41
第四節 負重式健走運動對血脂肪之功效......................................42
一、總膽固醇...........................................................42
二、三酸甘油脂.........................................................43
三、高密度脂蛋白.......................................................44
四、低密度脂蛋白.......................................................44
第六章 結論與建議..........................................................45
第一節 結論..............................................................45
第二節 應用與建議........................................................45
第三節 研究限制及展望....................................................46
參考文獻.....................................................................48
附錄.........................................................................55
【附錄一】參與研究同意書...................................................55
【附錄二】運動安全調查表...................................................56
【附錄三】糖尿病運動護照...................................................57
【附錄四】問卷內容.........................................................61
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葛應欽、劉碧華、謝淑芬(1994)。台灣地區原住民的健康問題。高雄醫誌,10,337-351。
蔡世澤(2000)。臺灣糖尿病照護現況與省思。臨床醫學,45,316-320。
蔡世澤、蕭敦仁、江怡德、汪宜靜、黃莉棋(2004)。糖尿病新世代流行病。常春月刊,260,41-49。
蔡孟書(2002)。運動訓練對有自主神經病變之糖尿病患者心跳變異性及運動能力的效果。國立臺灣大學物理治療學研究所碩士論文,台北市。
論壇健康促進與疾病預防委員會。身體活動與第二型糖尿病。台北:國家衛生研究院,2001。
鄭綺(1999)。糖尿病患者最佳運動處方之探索。中華民國內分泌暨糖尿病學會會訊,48,33-34。
戴良全(2003)。運動與糖尿病。中華體育,17(3),61-69。
魏榮男、莊立民、林瑞雄、趙嘉玲、宋鴻樟(2002)。1996∼2000年臺灣地區糖尿病盛行率與住院率。臺灣公共衛生雜誌,21(3),173-180。
蘇雅玲(1997)。糖尿病與運動。護理雜誌,44(1),30-36。
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1. 魏榮男、莊立民、林瑞雄、趙嘉玲、宋鴻樟(2002)。1996∼2000年臺灣地區糖尿病盛行率與住院率。臺灣公共衛生雜誌,21(3),173-180。
2. 戴良全(2003)。運動與糖尿病。中華體育,17(3),61-69。
3. 鄭綺(1999)。糖尿病患者最佳運動處方之探索。中華民國內分泌暨糖尿病學會會訊,48,33-34。
4. 蔡世澤(2000)。臺灣糖尿病照護現況與省思。臨床醫學,45,316-320。
5. 葛應欽、劉碧華、謝淑芬(1994)。台灣地區原住民的健康問題。高雄醫誌,10,337-351。
6. 陳嫣芬、李玟玲(2001)。規律性的有氧運動對老年第二型糖尿病患者之影響。大專體育,53,153-159。
7. 郭清輝(1998)。糖尿病慢性併發症。臨床醫學,41(5):,336-348。
8. 周碧瑟、董道興、李佳琳、莊紹源、林敬恆、楊南屛等人(2002)。台灣地區糖尿病流行病學。台灣公共衛生雜誌,21(2),83-96。
9. 杜幸芳、馬素華(1997)。運動對非胰島素依賴型糖尿病患者之臨床運用。長庚護理,8(2),93-98。
10. 李蘭、陸玓玲、李隆安、黃美維、潘怜燕、鄧肖琳等人(1995)。台灣地區成人的健康行為探討:分佈情形、因素結構和相關因素。中華衛誌,14(4),358-367。
11. 李彩華、方進隆(1998)。十二週體能訓練對婦女健康體能與血脂肪之影響。體育學報,26,145-152。
12. 李哲全、傅振宗、吳篤安(2006)。糖尿病的診斷與治療。慈濟醫學,18(1) (增刊),1-9。
13. 蘇雅玲(1997)。糖尿病與運動。護理雜誌,44(1),30-36。