臺灣博碩士論文加值系統

現代醫學對食物與過敏的關聯性研究常僅見於特定易導致過敏的食物，對於傳統醫學所謂的食物屬性與呼吸道過敏之相關研究並不多見。本研究針對兒童進行飲食問卷調查，以瞭解呼吸道過敏兒與正常兒在食物攝取上之差異，是否與呼吸道過敏症狀間有所關聯。研究採橫斷式調查研究法，以新竹市某國小一至六年級學生為對象，採集束抽樣法於每年級隨機抽取2班並以中選班級之全班學生為抽樣對象，以結構式問卷分別在8月-9月及11月-12月對學童家長進行同意書及學童性別、年齡、學童身體活動量、過敏史、父母過敏史及食物攝取等資料的收集。兩次調查共抽取12班約720名學童，實際回收問共369份；本研究以其中填寫完整的問卷資料198份進行統計分析。
　　分析時將學童依其呼吸道過敏狀況分為對照組、過敏性鼻炎或氣喘組、過敏性鼻炎合併氣喘組進行各項比較。在年齡、性別、身高、體重、BMI、受試者活動量及運動量的分佈上三組無顯著的差異。有過敏性鼻炎的家族史比例，呼吸道過敏兒顯著高於對照組。過敏性鼻炎或氣喘病例組與兩者皆有組在平性蔬菜類的攝取比例高於對照組；而平性水果類的攝取比例則是兩者皆有組高於其它兩組；涼性水果及寒性蔬菜的攝取比例則在對照組高於其他兩組；寒性水果攝取比例則是過敏性鼻炎或氣喘組高於其他兩組。另以各屬性食物攝取總量比例比較則結果顯示，在寒性食物攝取比例上對照組高於其他兩組，且具顯著差異。另將食物分類後進行因素分析，共得到8個飲型態食，結果顯示過敏性鼻炎或氣喘病例組與兩者皆有組在第三類飲食(涼寒性茶飲類、溫平性淺綠葉菜類、溫平性水果類)型態上的因素分數具顯著差異。
本研究顯示對照組父母患有氣喘、過敏性鼻炎、皮膚過敏疾患的比例低於其他兩組。在平性蔬菜及水果的攝取比例上，患有呼吸道過敏兒比對照組來得高；而在寒性蔬菜的攝取比例上則是呼吸道過敏兒低於對照組。綜合各類食物比較顯示呼吸道過敏兒在寒性食物類攝取比例較對照組為低。呼吸道過敏兒童與非呼吸道過敏的對照組在傳統食物屬性分類中特定類別的食物選擇上似乎有所差異。

Modern research on the relation of dietary intake to allergy usually focuses on certain food containing allergens. There are few studies exploring if there is any relationship between food characteristics, based on traditional Chinese medical belief, and diseases of respiratory allergy. The current study was conducted to examine if there is any difference in food selection between children with and without respiratory allergic diseases, and whether there is relationship between food selection and symptoms of respiratory allergy. The cross-sectional study was conducted in an elementary school in Hsinchu City. A cluster random sampling scheme was employed to obtain a sample of two classes from each of the six grades, which resulted in a total sample of 720 students. The survey was conducted in half of the sampled students in August to September and in another half in November to December, resplectively, to control for the seasonal effect. Informed consent form and a structural questionnaire were provided to the parents or guardians of the children to obtain information on the childrens’ characteristics, level of physical activity, allergic history of the child and his/her parents, and dietary intake of the child. Overall there were 396 of the sampled students returning the questionnaire and the informed consent form. In the current analysis, a total of 198 students with complete questionnaire data was included.
The students were first grouped into the controls, with asthma or allergic rhinitis, or with both asthma and allergic rhinitis. There were no significant differences in the mean age, sex distribution, height, weight, BMI, and the level of physical activity among the three groups. The proportion of children with family history of allergies was significantly higher in those with respiratory allergic problems than in the controls. Compared to the controls, children with respiratory allergic diseases had significantly higher intake in the category of neutral vegetable, and the intake of the category of neutral fruit was significantly higher in those with both asthma and allergic rhinitis, whereas the intake of the categories of cool fruit and cold vegetable was significantly higher in the controls, and the children with either asthma or allergic rhinitis had significantly higher intake of cold fruit. In terms of the proportion of each category, the controls were significantly higher in the intake of cold food.
A result of 8 intake patterns were obtained by factor analysis, and it appeared that the scores of the 3rd factor, which was consisted of cold
beverage, neutral fruit, and neutral light green vegetable, significantly differed among the groups.
In conclusion, the results of this current study showed that dietary intake in food groups by traditional Chinese medical belief appeared to be different such that children with respiratory allergic diseases seemed to consume less cold foods than the controls.

目錄
誌謝 I
中文摘要 II
Abstract IV
縮寫對照表 VI
表目錄 3
第一章、前言 5
第二章、文獻探討 7
第一節、疾病盛行率 7
第二節、疾病定義及症狀 8
第三節、危險因子及症狀 10
第四節、呼吸道過敏性疾病與現代飲食 12
第五節、呼吸道過敏的處置方式 13
第六節、傳統醫學與呼吸道過敏性疾病 14
第七節、傳統醫學食物與過敏性疾病 15
第三章、研究目的 18
第四章、研究對象與方法 19
第一節、研究設計及研究對象 19
第二節、研究方式 20
第三節、統計分析 22
第五章、結果 24
第六章、討論 47
第七章、研究限制與結論 52
參考文獻 54
附錄1、中山醫學大學附設醫院人體試驗委員會臨床試驗許可書 57
附錄2、中山醫學大學暨附設醫院臨床研究受訪者問卷說明及同意書 58
附錄3、兒童呼吸道過敏評估表及飲食問卷 61

Calixto, M. C., Lintomen, L., Schenka, A., Saad, M. J., Zanesco, A., & Antunes, E. (2010). Obesity enhances eosinophilic inflammation in a murine model of allergic asthma. British Journal of Pharmacology, 159(3), 617-625.
Chatzi, L., Torrent, M., Romieu, I., Garcia-Esteban, R., Ferrer, C., Vioque, J., et al. (2007). Diet, wheeze, and atopy in school children in Menorca, Spain. Pediatr Allergy Immunol, 18(6), 480-485.
Cynthia, M. V., Stephanie, J. L., London, J. L., Daniels, J. L., & Kaufman, J. S. (2009). Association of Obesity with IgE and Allergy Symptoms in Children and Adolescent:Results from NHANES 2005-2006. J.Allergy Ciln Immunol., 123(5), 1163-1169.
de Vries, A., & Howie, S. E. (2009). Diet and asthma — Can you change what you or your children are by changing what you eat? Pharmacology & Therapeutics, 122, 78-82.
Devereuxa, G. (2010). Allergic disease Nutrition as a potential determinant of asthma. Proceedings of the Nutrition Society 69, 1-10.
Ginde, A. A., Jonathan, M. M., & Camargo, J. (2009). Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med, 169(4), 384-390.
Hatch, G. E. (1995). Asthma, inhaled oxidants, and dietary antioxidants. American Journal of Clinical Nutrition, 61, 625s-630s.
Jesenak, M., Rennerova, Z., Babusikova, E., Havlicekova, Z., Jakusova, L., Villa, M. P., et al. (2008). Food allergens and respiratory symptoms. J Physiol Pharmacol, 59 Suppl 6, 311-320.
Pakhale, S., Doucette, S., Vandemheen, K., Boulet, L. P., McIvor, R. A., Fitzgerald, J. M., et al. (2010). A comparison of obese and nonobese people with asthma: exploring an asthma-obesity interaction. Chest, 137(6), 1316-1323.
Visness, C. M., London, S. J., Daniels, J. L., Kaufman, J. S., Yeatts, K. B., Siega-Riz, A. M., et al. (2010). Association of Childhood Obesity With Atopic and Nonatopic Asthma: Results From the National Health and Nutrition Examination Survey 1999-2006. J Asthma.
Wen-Hsiang, H., Yung-Zen, L., & Fu-Yuan, H. (2000). Effect of ice water ingestion on asthmatic children after exercise challenge. Acta Paediatr Taiwan, 41(4), 184-188.
Wood, L. G., Garg, M. L., Powell, H., & Gibson, P. G. (2008). Lycopene-rich treatments modify noneosinophilic airway inflammation in asthma: proof of concept. Alternative Medicine Review 42(1), 94-102.
王鳳英. (2002). 中醫食療與養生.
台北市衛生局. (2010). 台北市國小一年級學童氣喘之最新盛行率及分析結果發表. from http://www.health.gov.tw/Default.aspx?cx=010452195314214636335%3Auwwukbpzbjg&cref=http%3A%2F%2Fwww.health.gov.tw%2Fannotations.xml&cof=FORID%3A9&tabid=597&ie=UTF-8&q=%E6%B0%A3%E5%96%98%E7%9B%9B%E8%A1%8C%E7%8E%87&siteurl=www.health.gov.tw%2Finputform.html#1103
台灣兒童過敏氣喘及免疫學會. (2009). 氣喘病童是否可以吃冰. from http://www.air.org.tw/air/medical03.aspx
江伯倫. (2001). 過敏疾病要不要作減敏治療. 健康世界, 220, 81-82.
江伯倫. (2002). 過敏性疾病的致病機轉. 科學發展, 353, 14-19.
江伯倫, 和 徐世達. (2001). 過敏氣喘兒. 健康世界, 14-117.
呂克桓, 江伯倫, 和 黃璟隆. (2007). 過敏性鼻炎及其對氣喘的影響簡易指導手冊.
沈慶法. (2009). 膳食療養學中醫實症的食物療法. 合記圖書出版社, 3-347.
谷口克, 和 宮坂昌之. (2006). 標準免疫學.
周聰成. (2001). 中藥藥性總義.
林欣儒, 和 蔡忠昌. (2006). 運動介入對兒童青少年肥胖與氣喘之影響. 彰化師大體育學報, 6, 37-49.
邱幼樵, 和 許清祥. (2002). 過敏原特異性減敏治療的最新進展. 台灣兒童過敏氣喘及免疫學會通訊, 2, 15-17.
胡俊銘, 和 呂克桓. (2005). 從流行病學觀點來看兒童肥胖與氣喘的關係. 台灣兒童過敏氣喘及免疫學會, 6, 15-17.
徐伯平. (2010). 浅谈肿瘤患者的忌口. from http://www.sysucc.org.cn/cn/department/gdk/newsview.asp?id=67
張立德, 林佑蓉, 和 唐進勝. (2006). 台北縣八鄉鎮國小學童氣喘盛行率之調查. 輔仁醫學期刊, 4, 61-72.
梁美玲. (2005). 飲食行為偏好與鼻過敏嚴重度之研究.
陳珮瑩. (2007). COPD病患及正常人維生素C維生素E血漿濃度及攝取量比較:與飲食型態的相關性.
郭壽雄. (2006). 氣喘的臨床診斷.
郭麗娃, 和 黃健. (2009). 諸侯病原論飲食致病說對中醫病因學的貢獻. 北京中醫藥, 28(8), 599-601.
黃川原, 和 吳建民. (1999). 飲食與呼吸道過敏. 秀傳醫學雜誌, 1, 73-83.
黃群峰. (2006). 台灣東部地區學童過敏性疾病盛行率調查及過敏原研究-以花蓮玉里鎮全鎮國小學童為研究對象.
楊崑德. (2001). 環境生態和遺傳與兒童氣喘. 台兒醫誌, 42, 27-28.
葉麗澤. (2009). 過敏性鼻炎的中醫藥診治研究進展. 中醫內科醫學雜誌, 4, 57-67.
蔡佩芬. (2002). 國小學童蟯蟲感染及飲食習慣與氣喘相關性之探討.
蔡肇基. (2003). 告別氣喘與過敏. 時報文化, 14-157.
賴香如. (2001). 氣喘學生與非氣喘學生身體活動及運動社會心理狀況之比較研究.
諾曼.埃德曼. (1999). 氣喘及過敏家庭小百科.
謝禮雲. (2009). COPD患者及正常人維生素A和各種類胡蘿蔔素攝取量及血漿濃度的比較：與飲食型態的關連.