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研究生:吳嘉玲
研究生(外文):WU, JIA-LING
論文名稱:呼吸與阻力訓練對第二型糖尿病足傷口癒合、血糖控制與生活品質之成效
論文名稱(外文):Effects of Breathing and Resistance Yraining on Wound Healing, Blood Sugar Control and Quality of Life for Type 2 Diabetic Foot
指導教授:葉美玲葉美玲引用關係
指導教授(外文):YEH, MEI-LING
口試委員:彭成康鍾美玲
口試委員(外文):PERNG, CHERNG-KANGCHUNG, MEI-LING
口試日期:2020-07-22
學位類別:碩士
校院名稱:國立臺北護理健康大學
系所名稱:護理研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2020
畢業學年度:108
語文別:中文
論文頁數:71
中文關鍵詞:糖尿病足阻力訓練呼吸傷口癒合血糖控制生活品質
外文關鍵詞:diabetic footresistance exercisebreathing methodwound healingblood sugar controlquality of life
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目的:第二型糖尿病足潰瘍會因傷口感染、發炎而反覆住院換藥及手術,影響生 活品質,傷口治療期望癒合,但血糖控制不佳也會影響傷口癒合,運動對血糖控制成效已有許多文獻支持,但在下肢有傷口情形下運動選擇變少,本研究旨在探討運用呼吸與腿部阻力運動對於第二型糖尿病合併下肢傷口病人在傷口癒合、血糖控制與生活品質的成效。
方法:本研究實驗性研究設計,在北部某醫學中心招募45位第二型糖尿病合併下肢潰瘍患者,並將其隨機平均分為運動組(n=24)和對照組(n=21)。對照組接受傷口照護;運動組提供傷口照護及每週3次,每次20分鐘腹式呼吸加上腿部阻力訓練,共計12週之介入措施;對照組則維持常規傷口照護。以糖化血色素、空腹血糖、傷口測量及台灣版世界衛生組織生活品質問卷(WHOQOL-BREF)於介入前、介入後四週、介入後八週、介入後十二週後分別測量。資料收集後使用SPSS 22.0統計軟體,以獨立樣本t檢定(independent t-test)、卡方檢定(Chi-squrae test)及概化估計方程式(Generalized estimating equation, GEE),以研究呼吸合併阻力訓練對糖尿病足病人傷口癒合、血糖控制及生活品質的成效。
結果:兩組在基本屬性及前測皆無顯著性差異(p>0.05),運動組在運動介入第8週開始,傷口癒合隨時間有顯著差異(β=-3.539, p<0.001) ;糖化血色素(β=-0.988,p =0.001)及空腹血糖(β=-36.034,p=0.031 )在12週皆較對照組有顯著性差異;在生活品質心理範疇(p=0.05)及環境範疇(p=0.002)兩組達到顯著差異。
結論: 呼吸合併阻力訓練對第二型糖尿病合併下肢潰瘍病人血糖控制、傷口癒合和生活質量的患者有益。此研究結果可作為糖尿病合併下肢傷口病人選擇運動種類之參考。
Objective: Type 2 diabetic foot ulcers can cause repeated hospitalizations and dressing changes due to wound infection and inflammation, which affects the quality of life. Wound treatment expects to heal, but poor blood sugar control can also affect wound healing. There are many literatures on the effect of exercise on blood sugar control Support, However, there are fewer exercise options in the case of lower extremities. This study aims to explore the effects of breathing and leg resistance exercises on wound healing, blood sugar control and quality of life g in patients with type 2 diabetic foot ulcers
Methods: For this experiment a randomized controlled trial was used. A total of 45 patients with type 2 diabetic foot ulcers were recruited from one medical center of Northern Taiwan, and randomly and equally assigned into the exercise (n=24) and control groups(n=21). The control group received usual care for diabetic foot from clinicians. The exercise group received usual care with an addition of leg resistance combined with breathing exercise training. Each session had a duration of 20 minutes, and proceeded 3 times a week for 12 weeks. Outcomes for the intervention effects were the fasting of blood glucose, hemoglobin A1c (HbA1c), wound healing, and The World Health Organization Quality of Life – BREF (WHOQOL-BREF) Taiwan Version. These were repeatedly measured before the intervention as the baseline, 4th week, 8th week, and 12th week session during the intervention period. The data were collected and analyzed by IBM SPSS 22.0 software, including the percentage, chi-square test, generalized estimation equation..
Results: There was no significant between-group difference in all outcomes at baseline (p >0.05) . The exercise group started at the 8th week of exercise intervention, there was a significant difference in wound healing over time (β=-3.539, p< 0.001).The results revealed the significant differences of between-groups in Fasting blood glucose (β=-36.034, p=0.031) and HbA1c (β=-0.988,p =0.001). There were significant between-group differences at Week 12 in quality of life psychological domain(p=0.05) and environment ( p=0.002).

Conclusions:This study provided evidence that the leg resistance combined with breathing exercise training was beneficial for patients with type 2 diabetic foot ulcers on blood sugar control, wound healing and quality of life in the long-term period. The findings of this study can provide the informations as a reference to choose the types of exercise for patients with type 2 diabetic foot ulcers
中文摘要………………………………………………………………………..…...…i
英文摘要………………………………………………………………………...…….ii
目次……………………………………………………………………………...……iii
表次……………………………………………………………………………….…..iv
圖次……………………………………………………………………………………v
第一章 緒論
第一節 研究動機及重要性……………………………………………….…1
第二節 研究目的………………………………………………………….…2
第三節 研究質疑…………………………………………………………….2
第四節 研究假設…………………………………………………………….3
第二章 文獻探討
第一節 糖尿病足病理機轉及治療…………………………….....................4
第二節 呼吸與阻力訓練對糖尿病足病人血糖控制及相關研究….............7
第三節 糖尿病與運動及生活品質……………………………….………..10
第三章 研究架構
第一節 研究架構................................................................................................14
第二節 名詞界定……………..……………………………………………..…14
第四章 研究方法
第一節 研究設計……………………………………………………..…….16
第二節 研究地點與研究對象……………...................................................17
第三節 研究工具...........................................................................................18
第四節 研究對象權益維護與倫理量…………………………………..…..…23
第五節 研究步驟………………......……………………………………….….23
第六節 資料處理與分析………………………………………………………24
第五章 研究結果
第一節 研究對象基本資料之屬性……………………………………………26
第二節 呼吸及阻力訓練對糖尿病足病人在傷口癒合之成效………………31
第三節 呼吸及阻力訓練對糖尿病足病人在血糖控制之成效……………....36
第四節 呼吸及阻力訓練對糖尿病足病人在生活品質之成效……………....41
第六章 討論
第一節 研究對象基本資料之分析………………………….………………..45
第二節 呼吸及阻力訓練後,運動組及對照组在傷口癒合之成效….…..…46
第三節 呼吸及阻力訓練後,運動組及對照组在血糖控制之成效….……..46
第四節 呼吸及阻力訓練後,運動組及對照组在生活品質上之成效………47
第七章 結論
第一節 結論………………………………………………………………....…48
第二節 護理上應用……………………………………………………………48
第三節 研究限制與建議………………………………………………………49
參考文獻
中文部分………………………………………………………………...……...50
外文部分………………………………………………..……………………....51
目錄
附錄一 台灣版世界衛生組織生活品質量表使用同意書…………….…...58
附錄二 台北榮民總醫院人體試驗通過公文………………………..……..59

一.中文部分
高祥傑. (2013). 阻力訓練對第二型糖尿病血液生理之影響.中原體育學報(2), 35-5341.doi: 10.6646/CYPEJ.2013.2.35.
姚開屏 (2002). 台灣版世界衛生組織生活品質問卷之發展與應用. 台灣醫學, 6(2), 193-200.doi: 10.6320/FJM.2002.6(2).09.
張景泓, & 陳碩菲. (2017). 有氧運動對於糖尿病病患血脂肪及糖化血色素的影響.中華民國糖尿病衛教學會會訊, 13(4), 9-15.doi: 10.6583/TADE.201712_13(4).0003.
陳欣湄, & 顏啟華. (2014). 糖尿病足部潰瘍的治療方法.家庭醫學與基層醫療, 29(11), 296-302. doi: 10.6965/FMPMC.
劉利, 劉曉玲, 劉德線, &吳靜. (2017). 糖尿病患者運動自我管理現狀調查與分析. 現代醫藥衛生, 33(8), 1263-1265.
黃秋玲, 黃佳進, 張耿維, & 戴研光. (2018). 彈力帶低阻力訓練對第二型糖尿病病患功能性體適能, 血糖及血脂之影響. 醫學與健康期刊, 7(1), 29-39. doi:10.29585/YYWYLL.
盧佳怡, 張美智, &林光洋. (2010). 以糖化血色素診斷糖尿病.北市醫學雜誌, 7(2), 109-118.doi: 10.6200/TCMJ.2010.7.2.01.
賴義隆、賴亮全(2013).呼吸生理學.新北市:金名。
鄭文昌, 張木信, 塗宜育, & 張克士. (2019). 糖尿病足潰瘍治療回溯研究. 臨床
醫學月刊, 83(1), 43-48.doi:1 0.6666/ ClinMed.201901_83(1).0009.衛生福利統計專區(2018).國民營養健康狀況變遷調查成果報告2013-2016年. Retrieved May 6, 2020 from https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=3999&pid=11145

二.外文部分
American College of Sports Medicine (2018). ACSM's guidelines for exercise testing and prescription: Wolters Kluwer.
American Diabetes Association. (2014). Standards of medical care in diabetes--2014. Diabetes care, 37, S14.doi: 10.2337/diacare.27.2007.S15.
Armstrong, D. G., Boulton, A. J., & Bus, S. A. (2017). Diabetic foot ulcers and their recurrence. New England Journal of Medicine, 376(24), 2367-2375.doi: 10.1056/NEJMra1615439.
Arshad, M., Arshad, S., Arshad, S., & Abbas, H. (2020). The Quality of Life in Patients with Diabetic Foot Ulcers. J Diab Metab, 11, e101. doi.org/10.1080/09638280010005585.
Bandyk, D. F. (2018). The diabetic foot: Pathophysiology, evaluation, and treatment. Paper presented at the Seminars in vascular surgery31(2), 100-10543-48. doi.org/10.1053/ j.semvascsurg. 2019.02.001.
Boulton, A. J. (2019). The diabetic foot. Medicine, 47(2), 100-105.
doi.org/10.1016/j.mpmed.2018.11.001.
Boulton, A. J., Armstrong, D. G., Kirsner, R. S., Attinger, C. E., Lavery, L. A., Lipsky, B. A., . . . Steinberg, J. S. (2018). Diagnosis and management of diabetic foot complications. DOI:
10.2337/db20182-1.
Colberg, S. R., Parson, H. K., Nunnold, T., Holton, D. R., Swain, D. P., &Vinik, A. I. (2005). Change in cutaneous perfusion following 10 weeks of aerobic training in Type 2 diabetes. Journal of Diabetes and its Complications, 19(5), 276-283. doi.org/10.1016/ j.jdiacomp.2005.02.006.
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., . . . Tate, D. F. (2016). Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079. doi.org/10.2337/dc16-1728.
D’hooge, R., Hellinckx, T., Van Laethem, C., Stegen, S., De Schepper, J., Van Aken, S., . . . Calders, P. (2011). Influence of combined aerobic and resistance training on metabolic control, cardiovascular fitness and quality of life in adolescents with type 1 diabetes: a randomized controlled trial. Clinical Rehabilitation, 25(4), 349-359. doi.org/10.1177/0269215510386254.
Elert, G., Forsberg, C., &Wahren, L. (2002). Temperature of a healthy human (body temperature).Scandinavian Journal of Caring Sciences, 16(2), 122-128.
Eraydin, Ş., & Avşar, G. (2018). The Effect of Foot Exercises on Wound Healing in Type 2 Diabetic Patients With a Foot Ulcer. Journal of Wound, Ostomy and Continence Nursing, 45(2), 123-130. doi.org/10.1097/ WON.0000000000000405.
Eskandary, S., & Rahimi, E. (2017). Effects of eight weeks aerobic training,resistance training and concurrent training on the metabolic syndrome and HbA1c in men with type 2 diabetes. Journal of Physical Activity and Hormones, 1(2), 51-64.
Everett, E., & Mathioudakis, N. (2018). Update on management of diabetic foot ulcers. Annals of the New York Academy of Sciences, 1411(1), 153. Doi:10.1111/nyas.13569.
Flahr, D. (2010). The effect of nonweight-bearing exercise and protocol adherence on diabetic foot ulcer healing: a pilot study. Ostomy Wound Manage, 56(10), 40-50.
Grennan, D. (2019). Diabetic foot ulcers. Jama, 321(1), 114-114.doi: doi:10.1001/jama.2018.18323
Hegde, S. V., Adhikari, P., Subbalakshmi, N., Nandini, M., Rao, G. M., & D'Souza, V. (2012). Diaphragmatic breathing exercise as a therapeutic intervention for control of oxidative stress in type 2 diabetes mellitus. Complementary therapies in clinical practice, 18(3), 151-153.doi: 10.1016/j.ctcp.2012.04.002.
Hsieh, P.-L., Tseng, C.-H., Tseng, Y. J., & Yang, W.-S. (2018). Resistance training improves muscle function and cardiometabolic risks but not quality of life in older people with type 2 diabetes mellitus: A randomized controlled trial. Journal of Geriatric Physical Therapy, 41(2), 65-76.doi: 10.1519/JPT.0000000000000107.
Hopper, S. I., Murray, S. L., Ferrara, L. R., & Singleton, J. K. (2019). Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review. JBI Evidence Synthesis, 17(9), 1855-1876. doi: 10.11124/JBISRIR-2017-003848.
Jamshidpour, B., Bahrpeyma, F., & Khatami, M.-R. (2019). The effect of aerobic and resistance exercise training on the health related quality of life, physical function, and muscle strength among hemodialysis patients with Type 2 diabetes. Journal of Bodywork and Movement Therapies.doi: 10.1016/j.jbmt.2019.10.003.
Kalra, S., & Jacob, J. (2019). Activity day rules in diabetes. JPMA. The Journal of the Pakistan Medical Association, 69(12), 1919-1921.
Kekäläinen, T., Kokko, K., Sipilä, S., & Walker, S. (2018). Effects of a 9-month resistance training intervention on quality of life, sense of coherence, and depressive symptoms in older adults: randomized controlled trial. Quality of life research, 27(2), 455-465.doi: 10.1007/s11136-017-1733-z.
Khan, A. I., Vasquez, Y., Gray, J., Wians, F. H. J., & Kroll, M. H. (2006).The variability of results between point-of-care testing glucose meters and the central laboratory analyzer. Archives of Pathology & Laboratory Medicine, 130(10), 1527-1532.
Khanum, A., Khan, S., Kausar, S., Mukhtar, F., & Kausar, S. (2019). Effects of Diaphragmatic Breathing Exercises on Blood Sugar Levels in Working Class Females with Type-2 Diabetes Mellitus. International Journal of Medical Research & Health Sciences, 8(1), 34-42.
Koenig, R. J., Peterson, C. M., Jones, R. L., Saudek, C., Lehrman, M., &Cerami, A. (1976).Correlation of glucose regulation and hemoglobin AIc in diabetes mellitus.New England Journal of Medicine, 295(8), 417-420.doi: 10.2337/diabetes.26.5.507.
Lavery, L. A., Davis, K. E., Berriman, S. J., Braun, L., Nichols, A., Kim, P. J., . . . Attinger, C. (2016). WHS guidelines update: diabetic foot ulcer treatment guidelines. Wound Repair and Regeneration, 24(1), 112-126.doi: 10.1111/wrr.12391.
Liao, F., An, R., Pu, F., Burns, S., Shen, S., & Jan, Y.-K. (2019). Effect of exercise on risk factors of diabetic foot ulcers: a systematic review and meta-analysis. American journal of physical medicine & rehabilitation, 98(2), 103-116.doi:10.1097/ PH.0000000000001002.
Misra, A., Alappan, N. K., Vikram, N. K., Goel, K., Gupta, N., Mittal, K., . . . Luthra,K. (2008). Effect of supervised progressive resistance-exercise training protocol on insulin sensitivity, glycemia, lipids, and body composition in Asian Indians with type 2 diabetes. Diabetes Care, 31(7), 1282-1287.
Myers, V. H., McVay, M. A., Brashear, M. M., Johannsen, N. M., Swift, D. L., Kramer, K., . . . Church, T. S. (2013). Exercise Training and Quality of Life in Individuals With Type 2 Diabetes A randomized controlled trial. Diabetes care, 36(7), 1884-1890.doi: 10.2337/dc12-1153.
Nicolucci, A., Balducci, S., Cardelli, P., Cavallo, S., Fallucca, S., Bazuro, A., . . . Pugliese, G. (2012). Relationship of exercise volume to improvements of quality of life with supervised exercise training in patients with type 2 diabetes in a randomised controlled trial: the Italian Diabetes and Exercise Study (IDES). Diabetologia, 55(3), 579-588.doi: 10.1007/s00125-011-2425-9.
O'Brien, J., Finlayson, K., Kerr, G., & Edwards, H. (2016). Evaluating the effectiveness of a self‐management exercise intervention on wound healing, functional ability and health‐related quality of life outcomes in adults with venous leg ulcers: a randomised controlled trial. International wound journal.doi: 10.1111/iwj.12571.
Ogrin, R., Woodward, M., Sussman, G., & Khalil, Z. (2011). Oxygen tension assessment: an overlooked tool for prediction of delayed healing in a clinical setting. International wound journal, 8(5), 437-445.doi: 10.1111/j.1742-481X.2011.00784.x.
Otterman, N.,VanSchie, C., Van Der Schaaf, M., Van Bon, A., Busch‐Westbroek, T., &Nollet, F. (2011). An exercise programme for patients with diabetic complications: a study on feasibility and preliminary effectiveness. Diabetic medicine, 28(2), 212-217.doi: 10.1111/j.1464-5491.2010.03128.x.
Rejeski, W. J., & Mihalko, S. L. (2001). Physical activity and quality of life on older
adults.Journal of Gerontology, 56, 23-35.
Rodriguez, P. G., Felix, F. N., Woodley, D. T., & Shim, E. K. (2008). The role of oxygen in wound healing: a review of the literature. Dermatologic surgery,34(9), 1159-1169.
Russo, M. A., Santarelli, D. M., & O’Rourke, D. (2017). Thephysiological effects of
slow breathing in the healthy human. Breathe, 13(4), 298-309.
Doi:10.1183/20734735.009817.
Russell, R. D., Hu, D., Greenaway, T., Blackwood, S. J., Dwyer, R. M., Sharman, J.E., . . . Otahal, P. (2017). Skeletal muscle microvascular-linked improvements in glycemic control from resistance training in individuals with type 2 diabetes. Diabetes Care, 40(9), 1256-1263.doi:
10.2337/dc16-2750.
Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., . . . Ogurtsova, K. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice, 157, 107843.doi.org/10.1016/j.diabres.2019.107843.
Singh, S., Young, A., & McNaught, C.-E. (2017). The physiology of wound healing. Surgery (Oxford), 35(9), 473-477.
doi.org/10.1016/j.mpsur.2017.06.004.
Sukala, W. R., Page, R., Lonsdale, C., Lys, I., Rowlands, D., Krebs, J., . . . Cheema, B. S. (2013). Exercise improves quality of life in indigenous Polynesian peoples with type 2 diabetes and visceral obesity. Journal of Physical Activity and Health, 10(5), 699-707.doi: 10.1123/jpah.10.5.699.
Tapehsari, B. S., Alizadeh, M., Khamseh, M. E., Seifouri, S., & Nojomi, M. (2020). Physical activity and quality of life in people with type 2 diabetes mellitus: A randomized controlled trial. International Journal of Preventive Medicine, 11.doi: 10.4103/ ijpvm.IJPVM_202_18.
Tricco, A. C., Antony, J., Vafaei, A., Khan, P. A., Harrington, A., Cogo, E., . . . Straus, S. E. (2015). Seeking effective interventions to treat complex wounds: an overview of systematic reviews. BMC medicine, 13(1), 89.doi: 10.1186/s12916-015-0288-5.
Van Netten, J. J., Bus, S. A., Apelqvist, J., Lipsky, B. A., Hinchliffe, R. J., Game, F., . . . Peters, E. J. (2020). Definitions and criteria for diabetic foot disease. Diabetes/metabolism research and reviews, 36, e3268.doi: 10.1002/dmrr.3268.
Wagner Jr, F. W. (1981). The dysvascular foot: a system for diagnosis and treatment. Foot & ankle, 2(2), 64-122.doi:10.1177/107110078100200202.
World Health Organization(2016).Global report on diabetes . Retrieved May 6, 2020 from https://www.who.int/diabetes/global-report/zh/.
World Health Organization (1997). Measuring quality of life. Geneva: The World Health Organization, 1-13.
Zhang, P., Lu, J., Jing, Y., Tang, S., Zhu, D., & Bi, Y. (2017). Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis. Annals of Medicine, 49(2), 106-116. doi:10.1080/07853890.2016.1231932
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