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研究生:吳紹枝
研究生(外文):Chao-Chih Wu
論文名稱:飲食補充多元不飽和脂肪酸對經痛婦女經痛程度及紅血球細胞膜中脂肪酸之影響
論文名稱(外文):Effect of Polyunsaturated Fatty Acid Supplementation on Levels of Pain and RBC Membrane Fatty Acid Composition in Dysmenorrhea Women
指導教授:黃永勝黃永勝引用關係
指導教授(外文):Yung-Sheng Huang
學位類別:碩士
校院名稱:元培科學技術學院
系所名稱:生物技術研究所
學門:生命科學學門
學類:生物科技學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:87
中文關鍵詞:前列腺素花生四烯酸琉璃苣油魚油非固醇類抗發炎藥物
外文關鍵詞:prostaglandinsarachidonic acidborage oilfish oilNSAIDs
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經痛是婦科門診很常見的主訴症狀之ㄧ,常伴有頭痛、噁心、便秘或腹瀉、頻尿及嘔吐等症狀。約10%的經期婦女因經痛導致每月有1-3天無法上課或上班。經痛治療藥物如前列腺素合成酶抑制劑,或稱非固醇類抗發炎藥物NSAIDs,長期使用會造成腎功能損傷及腸胃道出血等顯著不良影響。多元不飽和脂肪酸及其代謝物具有與NSAIDs類似藥理作用,已證實可減少發炎性前驅物的產生,相對增加抗發炎性物質,進而減輕發炎反應,減緩疼痛症狀。本研究目的是針對飲食中補充多元不飽和脂肪酸婦女,探討其經痛程度及紅血球細胞膜中脂肪酸的變化。研究方法採隨機及雙盲試驗方式,排除生殖系統疾病受試者,分正常對照組及經痛實驗組,各組再細分為食用葵花籽油、琉璃苣油、濃縮魚油、琉璃苣油/魚油併用四組,給予食用三個月油品,監測經痛程度及紅血球中脂肪酸的變化。實驗結果顯示食用葵花籽油、琉璃苣油、濃縮魚油三組經痛程度明顯減輕,而琉璃苣油/魚油併用組效果並不顯著。從紅血球細胞膜脂肪酸的變化顯示經痛組對於轉化亞麻油酸到廿碳三烯酸(是抗發炎性PGE1的前驅物)的代謝速度可能較對照組為慢。因此適當的營養補充品(例如多元不飽和脂肪酸)對人體並無副作用,但是經由多元不飽和脂肪酸之補充可抑制花生四烯酸之合成減少促發炎性物質PGE2之產生,用於改善經痛症狀應是值得推薦的替代療法之ㄧ。
Menstrual pain or dysmenorrhea is one of the main complaints in woman clinics. The pain is often accompanied with other symptoms such as headache, nausea, constipation or diarrhea, urinary frequency, and vomiting. About 10% of those patients have indicated that the menstrual pain has left them incapacitated for work or school for 1 to 3 days. Dysmenorrhea is typically treated with medicine such as inhibitors of the prostaglandin synthase, or the non-steroidal anti-inflammatory drugs(NSAIDs). It has been shown that chronic use of these drugs in treating inflammatory disorders is associated with significant adverse effects such as impaired kidney function and gastrointestinal bleeding. Evidence has demonstrated that dietary supplementation of polyunsaturated fatty acids(PUFAs)and their metabolites lowers the level of pro-inflammatory markers while raises that of anti-inflammatory markers. As the degree of inflammation is decreased, the symptoms of dysmenorrhea are alleviated. The purpose of the present study was to explore the effect of PUFA supplementation on the level of pain and RBC membrane fatty acid composition in dysmenorrhea women. Both normal controls and dysmenorrhea subjects(excluding those with reproductive problems)were randomly divided into 4 groups receiving supplementation of sunflower seed oil, borage oil, fish oil concentrate and a combination of borage and fish oil for three months. The changes in dysmenorrhea-associated symptoms and RBC membrane fatty acid compositions were determined. The results show that levels of pain were significantly decreased in subjects supplemented with sunflower seed, borage oil and fish oil, but not in those supplemented with a combination of borage and fish oils. Results from RBC membrane fatty acid analysis have also indicated that the metabolic rate in converting linoleic acid, via gamma-linolenic acid, to dihommo-gamma-linolenic acid(a precursor of anti-inflammatory prostaglandin E1)was slower in dysmenorrhea subjects than in the controls. Since dietary supplementation of PUFAs is known to suppress the formation of arachidonic acid(a precursor of pro-inflammatory PGE2), and there are no known side-effects associated with supplementation of these nutrients, management of dysmenorrhea through nutrition modulation should be an applausive alternative to drug treatments.
目 錄
頁次
誌謝 Ⅰ
中文摘要 Ⅲ
英文摘要 Ⅳ
目錄 Ⅵ
圖目錄 Ⅷ
表目錄 Ⅹ
縮寫表 ⅩⅠ

第一章 緒論 1
1.1. 經痛的分類 1
1.2. 形成原發性經痛的原因 2
1.3. PGE2、PGF2α的的代謝與經痛 3
1.4. 經痛的臨床治療 5
1.5. 多元不飽和脂肪酸在人體內的代謝及GLA、EPA/DHA的作用 6
1.6. 研究動機 8
第二章 研究材料與方法 10
2.1. 實驗儀器及藥品 10
2.2. 實驗用油品 11
2.3. 經痛病人的選擇及分組 17
2.4. 經期經痛疼痛問卷調查 17
2.5. 試驗設計 18
2.6. 進行方法 20
2.7. 血液的採集及分離 20
2.8. 紅血球細胞膜中總脂質的萃取 21
2.9. 薄層層析法 22
2.10. 氣相層析法 23
2.11. 評估及統計方法 24
第三章 研究結果 26
3.1. 對照組及經痛組基本資料比較 26
3.2. 對照組及經痛組分組基本資料比較 27
3.3. 經痛組食用油品後疼痛問卷分析比較 30
3.4. 食用葵花籽油、琉璃苣油、濃縮魚油及琉璃苣油/魚油併用前後紅血球細胞膜中脂肪酸成分之變化 40
第四章 討論與結論 56
4.1. 經痛問卷結果分析 56
4.2. 食用油品後紅血球細胞膜中脂肪酸變化分析 56
4.2.1 葵花籽油組 56
4.2.2 琉璃苣油組 59
4.2.3 濃縮魚油組 61
4.2.4 琉璃苣油/魚組併用組 63
4.3. 結論 64

參考文獻 66
附錄一 葵花籽油健康來源證明 75
附錄二 葵花籽油成分分析證明 76
附錄三 琉璃苣油健康來源證明 77
附錄四 琉璃苣油成分分析證明 78
附錄五 濃縮魚油健康來源證明 79
附錄六 濃縮魚油健康成分分析證明 80
附錄七 受試者問卷表 81
附錄八 食油後受試者問卷表 82
附錄九 大千綜合醫院受試者同意書 83
附錄十 元培科技大學人體試驗申請表 84
附錄十一 元培科技大學人體試驗審查證明 85
附錄十二 元培科技大學受試者同意書 86
附錄十三 受試者採血時間說明書 87

圖 目 錄
頁次
圖1-1 從細胞膜釋出花生四烯酸之代謝途徑與其產物 4
圖1-2 Omega-6及omega-3多元不飽和脂肪酸的代謝 7
圖2-1 葵花籽油脂肪酸氣相層析分析圖形 14
圖2-2 琉璃苣油脂肪酸氣相層析分析圖形 15
圖2-3 濃縮魚油脂肪酸氣相層析分析圖形 16
圖2-4 脂肪酸標準品氣相層析分析圖形 25
圖3-1 食用葵花籽油前及食用三個月後,經痛症狀變化比較圖 30
圖3-2 食用葵花籽油經痛組七位受試者,M0至M3個別經痛疼痛十分量表趨勢圖
及平均趨勢線 31
圖3-3 食用琉璃苣油前及食用三個月後,經痛症狀變化比較圖 32
圖3-4 食用琉璃苣油經痛組七位受試者,M0至M3個別經痛疼痛十分量表趨勢圖
及平均趨勢線 33
圖3-5 食用濃縮魚油前及食用三個月後,經痛症狀變化圖 34
圖3-6 食用濃縮魚油經痛組九位受試者,M0至M3個別經痛疼痛十分量表趨勢圖
及平均趨勢線 35
圖3-7 琉璃苣油及魚油併用前及食用三個月後,經痛症狀變化比較圖 36
圖3-8 合併食用琉璃苣油/魚油經痛組七位受試者,M0至M3個別經痛疼痛十分量
表趨勢圖及平均趨勢線 37
圖3-9 經痛組四組,食用油品前後M0至M3經痛平均十分量表趨勢圖 39
圖3-10 對照組及經痛組食用油品前(M0)經期及經後,紅血球細胞膜中多元不飽
和脂肪酸所佔比例比較圖 42
圖3-11 食用油品前,對照組及經痛組ARA/LA、ARA/(EPA+DHA)比值比較 43
圖3-12 食用葵花籽油之對照組及經痛組,M0至M3紅血球細胞膜中多元不飽和
脂肪酸變化 44
圖3-13 食用琉璃苣油之對照組及經痛組,M0至M3紅血球細胞膜中多元不飽和
脂肪酸變化 46
圖3-14 食用濃縮魚油之對照組及經痛組,M0至M3紅血球細胞膜中多元不飽和
脂肪酸變化 48
圖3-15 琉璃苣油/魚油併用之對照組及經痛組,M0至M3紅血球細胞膜中多元
不飽和脂肪酸變化 50
圖3-16 對照組及經痛組各組ARA/LA比值 53
圖3-17 對照組及經痛組各組DGLA/ARA比值 53
圖3-18 對照組及經痛組各組ARA/(EPA+DHA)比值 54
圖4-1 各組M0至M3 之ARA/LA比值比較 58
圖4-2 各組M0至M3 之DGLA/ARA 比值比較 60
圖4-3 各組M0至M3 之ARA/(EPA+DHA)比值比較 62

表 目 錄
頁次
表2-1 葵花籽油、琉璃苣油及濃縮魚油脂肪酸主要成分分析 13
表2-2 各組食用葵花籽油、琉璃苣油、濃縮魚油顆數及多元不飽和脂肪酸劑量表 19
表3-1 對照組及經痛組基本資料 26
表3-2 對照組及經痛組分組基本資料 29
表3-3 對照組及經痛組M0之經期及經後脂肪酸主要成分 41
表3-4 葵花籽油對照組及經痛組M0至M3經期脂肪酸主要成分 45
表3-5 琉璃苣油對照組及經痛組M0至M3經期脂肪酸主要成分 47
表3-6 濃縮魚油對照組及經痛組M0至M3經期脂肪酸主要成分 49
表3-7 琉璃苣油/魚油併用之對照組及經痛組M0至M3經期脂肪酸主要成分 51
表3-8 葵花籽油、琉璃苣油、濃縮魚油、琉璃苣油/魚油併用四組之對照組及
經痛組M0至M3經期紅血球細胞膜中ARA/LA、DGLA/ARA、
ARA/(EPA+DHA)比值 55

縮寫表(Abbreviation)
1. ALA:Alpha-linolenic acid
2. ARA:Arachidonic acid
3. BMI:Body mass index
4. COX-2:cycloxygenase-2
5. DGLA:Dihomo-gamma-linolenic acid
6. DHA:Docosahexaenoic acid
7. EPA:Eicosapentaenoic acid
8. GLA:Gamma Linolenic acid
9. GLC:gas-lipid chromatography
10. LA:Linoleic acid
11. LOX:lipoxygenase
12. LTB4:leukotrienes B4
13. NSAIDs:non-steroidal anti-inflammatory drugs
14. OA:Oleic acid
15. PA:Palmitic acid
16. PGE2:prostaglandin E2
17. PGHS:prostaglandin H synthase
18. PGSI:prostaglandin synthase inhibitor
19. PL:phospholipids
20. PLA2:phospholipid A2
21. PUFA:Polyunsaturated fatty acid
22. RBC:Red blood cell
23. TLC:Thin layer chromatography
24. TXA2:thromboxanes A2
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