臺灣博碩士論文加值系統

本研究目的在探討太極拳運動訓練對輕度高血壓患者之血壓、心跳速率、血脂肪濃度及焦慮之成效改善情形及其影響之相關因素。
本研究採類實驗設計法，先以立意選樣法於台北市某衛生所選取血壓介於130-159/85-99mmHg，且符合收樣條件者，再以隨機方式將其分為運動組及對照組，共有40位個案完成此研究，其中運動組及對照組各20人。運動組參與為期12週的太極拳運動訓練;對照組則保持其原本的生活型態，運動訓練前後經運動訓練、結構式問卷(包括人口學特性調查表、特質性及狀態性焦慮量表)及血脂肪濃度進行資料收集。資料分別以百分比、平均值、標準差、Spearman correction、Paired t檢定、Mann-Whiteny U test及t test 等統計方法進行分析。
經由本研究之運動訓練後結果發現:（一）本研究個案的年齡明顯與其高密度脂蛋白膽固醇濃度及特質性焦慮程度有相關（rs＝0.54，rs＝0.45，p＜0.01）。其教育程度則與高密度脂蛋白膽固醇濃度（rs＝-0.35，p＜0.05）、特質性焦慮及狀態性焦慮呈現顯著負相關（rs＝-0.62; -0.47，p＜0.01）。經濟狀況明顯分別與高密度脂蛋白膽固醇濃度（rs＝-0.40，p＜0.05）、特質性及狀態性焦慮負相關（rs＝-0.68; -0.54，p＜0.01），高血壓病史大於或等於1年者明顯與低密度脂蛋白膽固醇濃度正相關（rs＝0.40，p＜0.05），食物口味較偏向鹽醃製品及罐頭類個案具有較高的總膽固醇濃度呈正相關（rs＝0.39，p＜0.05），沒有運動習慣者有較高的收縮壓（rs＝0.32，p＜0.05）。體重與三酸甘油脂濃度有顯著正相關（rs＝0.32，p＜0.05），但其明顯與高密度脂蛋白膽固醇濃度及狀態性焦慮呈負相關（rs＝-0.55; -0.32，p＜0.01; 0.05）。（二）運動組在研究計劃前後，其血壓、血脂肪濃度、特質性及狀態性焦慮都有明顯下降（p＜0.01）。研究期間，兩組個案在血壓、總膽固醇、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇濃度、特質性及狀態性焦慮之變化亦具有顯著差異（p＜0.01）（三）參與太極拳訓練之個案平均運動訓練強度可達個案預期最大心跳速率之64%，運動強度對於降低特質性及狀態性焦慮改善成效上，都呈現明顯的正相關（rs＝0.68; 0.53，p＜0.01; 0.05）。
關鍵詞：高血壓、血脂肪濃度、特質性及狀態性焦慮、太極拳運動訓

This study explores the effects of Tai Chi Chuan exercise training on the blood pressure, lipid profile and anxiety in patients with mild hypertension and determines the relationship between the personal characteristic and blood pressure, lipid profile and anxiety of developing mild hypertension disease. Forty patients with systolic blood pressure 130-159mmHg or diastolic blood pressure 85-99mmHg at a Taipei municipal health institution were selected from among a larger pool of patients for inclusion in this study.
Criteria for selection are based on quasi-experimental design with purposive sampling. The patients were divided into two groups, the non-training control group and the training experimental group, 20 patients each. Questionnaire, including the personal characteristic measurement, and the anxiety level evaluation, was completed for each subject. We evaluated the experimental group before and after 12 weeks of regular Tai Chi Chuan exercise training at three times each week and 30 minutes each time whereas evaluated the control group, that continues their usual lifestyles during the study period, at the absence of 12-week Tai Chi Chuan exercise training. Blood pressure data was collected before and after the exercise training. Lipid profile concentration was measured by means of laboratory methodology for each subject. In addition, questionnaire was repeated at the end of this study. Pre- and post-training data within group and among the groups were analyzed by means of paired t-test, student t-test, and Mann-Whiteny’ U test.
Research results were shown as follows: patient’s age showed positive correlation with high-density lipoprotein cholesterol ( HDL-C) level ( rs=0.54, p<0.01). Patient’s education levels were negative correlated with resting heart rate (R-HR) ( rs=-0.36, p<0.05) , HDL-C level (rs=-0.35, p<0.05), trait anxiety (rs=-0.62, p<0.01), and state anxiety ( rs=-0.47, p<0.01). Economic background showed negative correlation with HDL-C level (rs=-0.40, p<0.05), trait anxiety( rs=-0.68, p< 0.01), and state anxiety ( rs=-0.54, p< 0.01). Non regular exercise habit showed positive correlation with systolic blood pressure ( rs=0.32, p<0.05). Body weight showed negative correlation with HDL-C level (rs=-0.55, p< 0.01), and state anxiety (rs=-0.32, p<0.05), and positive correlation with triglyceride (TG) level (rs=0.32, p< 0.05). Significant increases in the measured total cholesterol were noted in subjects with high salty or preservative canned food intake (rs=0.39, p<0.05). In addition, systolic pressure showed increased in the subjects with poor, even no, intensity of the exercise performed (rs=0.39, p<0.05).
Results of the study showed significant decreases (p<0.001) in measured blood pressure, T-C level, LDL-C level concentration and increases in measured HDL-C (p<0.05), and improvements in anxiety level (p<0.001) in the exercise-trained group when pre- and post-training values were compared. Regular Tai Chi Chuan exercise training results in reduced (p<0.01) blood pressure and blood lipid concentration and improved anxiety levels in the exercise-trained group compared to the non-training control group. Tai Chi Chuan exercise leads to a training intensity of 64% of maximal heart rate (HRmax) on average, which is enough to improve the anxiety levels. The relationship between the exercise training intensity and the anxiety levels is shown to be a positive correlation (rs=0.68; 0.53, p<0.01; 0.05).
Key words: Tai Chi Chuan, exercise training, hypertension, lipid profile, anxiety

目 錄
頁 數
致 謝‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥Ⅰ
中文摘要‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥Ⅱ
英文摘要‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥Ⅳ
目 錄‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥Ⅶ
表 目 錄‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥Ⅸ
圖 目 錄‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥Ⅸ
第一章 緒 論
第一節 研究動機‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥3
第二節 研究目的 ‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥ 6
第三節 研究假設‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥…‥‥‥6
第四節 名詞界定‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥7
第二章 文獻查證
第一節 血壓的形成與高血壓的定義‥‥‥‥‥‥‥‥‥‥‥ 9
第二節 高血壓之危險因子‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥11
第三節 高血壓的控制措施‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥17
第四節 運動對人體生理的反應‥‥‥‥‥‥‥‥‥‥‥‥‥19
第五節 運動對人體心理的影響‥‥‥‥‥‥‥‥‥‥‥‥‥25
第六節 太極拳運動訓練‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥26
第七節 研究架構‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥30
第三章 研究方法
第一節 研究設計‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥32
第二節 收案地點‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥34
第三節 研究對象‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥34
第四節 太極拳運動訓練計畫‥‥‥‥‥‥‥‥‥‥‥‥‥‥35
第五節 研究工具與信效度之測試‥‥‥‥‥‥‥‥‥‥‥‥37
第六節 研究步驟‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥40
第七節 資料的統計與分析‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥42
第四章 研究結果
第一節 高血壓患者描述性統計‥‥‥‥‥‥‥‥‥‥‥‥43
第二節 高血壓患者人口學特性與其血壓、心跳速率、血脂肪濃渡及焦慮程度之相關性‥‥‥‥‥‥‥‥‥‥‥53
第三節 運動訓練對高血壓患者血壓、心跳速率、血脂肪濃渡及焦慮改善之成效‥‥‥‥‥‥‥‥‥‥‥‥‥‥55
第四節 運動強度與血壓、心跳速率、血脂肪濃渡及焦慮改善成效之相關性‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥59
第五章 討論
第一節 高血壓患者人口學特性與血壓、心跳速率、血脂肪濃渡及焦慮成度之相關性‥‥‥‥‥‥‥‥‥‥‥‥‥61
第二節 太極拳運動訓練對血壓及心跳速率之成效‥‥‥‥65
第三節 太極拳運動訓練對血脂肪濃渡之成效‥‥‥‥‥‥67
第四節 太極拳運動訓練對焦慮之成效‥‥‥‥‥‥‥‥‥70
第五節 運動強度與血壓、心跳速率、血脂肪濃渡及焦慮改善成效之相關性‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥72
第六章 結論及建議
第一節 結論‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥75
第二節 研究限制‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥77
第三節 應用與建議‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥78
參考資料
中文部分‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥80
英文部分‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥83
附 錄
附錄一 參與研究計劃同意書‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥95
附錄二 人口學特性及生活狀況問卷調查表‥‥‥‥‥‥‥‥‥97
附錄三 特質性焦慮量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥99
附錄四 狀態性焦慮量表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥100
附錄五 運動訓練記錄表‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥101
圖表目次
圖一 研究架構圖‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥31
圖二 資料收集流程圖‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥41
表一 美國監測、評估及治療高血壓國家聯合委員會針對18歲以上成年人血壓的定義‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥10
表二 有氧運動訓練與血壓相關的研究‥‥‥‥‥‥‥‥‥‥20
表三 運動訓練對血脂肪濃度的影響相關研究‥‥‥‥‥‥‥24
表四 太極拳運動訓練對人體生理反應‥‥‥‥‥‥‥‥‥‥28
表五 研究設計‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥33
表六 高血壓患者人口學特性‥‥‥‥‥‥‥‥‥‥‥‥‥‥45
表七 高血壓患者人口學特性之檢定‥‥‥‥‥‥‥‥‥‥‥47
表八 高血壓患者疾病相關屬性之類別變項‥‥‥‥‥‥‥‥49
表九 高血壓患者疾病相關類別變項之檢定‥‥‥‥‥‥‥‥50
表十 高血壓患者相關屬性之連續變項‥‥‥‥‥‥‥‥‥‥51
表十一 高血壓患者疾病相關之連續變項檢定‥‥‥‥‥‥‥‥52
表十二 人口學特性與血壓、心跳速率、血脂肪濃度及焦慮得分之相關性‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥54
表十三 運動組血壓、心跳速率、血脂肪濃度、特質性及狀態性焦慮之變化‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥56
表十四 對照組血壓、心跳速率、血脂肪濃度、特質性及狀態性焦慮之變化‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥57
表十五 兩組患者血壓、心跳速率、血脂肪濃度、特質性及狀態性焦慮變化之差異‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥58
表十六 運動強度與血壓、心跳速率、血脂肪濃度及焦慮改善成效之相關性‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥‥60

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