臺灣博碩士論文加值系統

根據世界衛生組織之報告，目前全世界罹患缺鐵性貧血推估有2.1億。四物主要由當歸、川芎、熟地及白芍四種藥材所組成之中國傳統藥方，具有調節經期、補血及活血的功效。女性每個月經週期中血液流失鐵質，且飲食中鐵質攝取不足，使得身體中鐵質容易缺乏。本研究針對鐵質缺乏之未停經婦女於連續三次月經週期結束後，探討補充6天含鐵四物飲是否能改善月經週期鐵質流失之情形。篩選60位20-50歲未停經婦女受試者，依其血中儲鐵蛋白(ferritin)之生化值分為兩組，儲鐵蛋白小於20 ng/mL為L組，大於等於20 ng/mL為N組。實驗開始時受試者當月月經來潮(第一個月)之第16天與下次月經(第二個月)結束後隔天進行抽血作為基準值。並於第二個月抽血結束後給予連續6天含鐵四物飲(一天一瓶，含5 mg 亞鐵/每瓶120 mL)，第三與四個月月經結束後給予連續6天含鐵四物飲，於第二、三及四個月月經來潮之第16天抽血，此三次抽血作為飲用含鐵四物飲實驗值。結果顯示未給予含鐵四物飲L組之血清鐵、儲鐵蛋白及鐵調節素(hepcidin)濃度相較於N組濃度稍低，給予含鐵四物飲後，L組顯著增加血液中儲鐵蛋白、血清鐵與鐵調節素之濃度。L組給予含鐵四物飲顯著降低於未給予含鐵四物飲血液中interleukin-6(IL-6)之濃度。給予含鐵四物飲對於鐵質缺乏之未停經婦女可改善鐵質狀態，並降低發炎指標。

Iron deficiency anemia is the most common type of anemia, affecting approximately 2.1 billion people around the world. Si-Wu is a traditional Chinese herbal medicine that has been widely used for regulating menstruation by promoting blood circulation and supplying iron. Si-Wu is comprised of four herbs, Angelica sinensis, Chuanxiong, Rehmannia glutinosa ,and Paeonia lactiflora. Pre-menopausal women are particularly susceptible to iron deficiency anemia due to blood loss during menstruation, especially when the diet is low in iron intake. This study investigated the effectiveness of iron-containing Si Wu drink in alleviating iron deficiency in pre-menopausal women. Sixty pre-menopausal women (20-50 years of age) were divided into two groups based on their blood ferritin levels; those with blood ferritin less than 20 ng/mL were designated as L (iron-deficient) group, and those with blood ferritin greater than 20ng/mL were designated as N (normal iron) group. The blood was drawn on the sixteenth day of their first menstruation (first month) and on the day after their next menstruation cycle (second month) to serve as the basal level of blood iron level. After the second blood collection and after each subsequent menstruation (second-fourth months), subjects were given one bottle of iron-containing (5 mg ferrous/bottle) Si-Wu drink a day for six days. Blood was drawn on the sixteenth day of the second, third, and fourth menstruations to serve as the experimental level of blood iron with iron-containing Si-Wu drink supplement. Prior to administration of Si Wu drinks, the L group showed lower blood ferritin, serum iron, and hepcidin than the N group. After consumption of iron-containing Si-Wu drinks, subjects in the L group had significantly increased blood ferritin, serum iron, and hepcidin, and significantly reduced pro-inflammatory factor interleukin-6 (IL-6). However, the N group showed no significant changes. Therefore, supplementation with iron-containing Si-Wu drink alleviates iron deficiency and suppresses inflammation in iron-deficient pre-menopausal women.

中文摘要…………………………………………………………………I
Abstract………………………………………………………………….II
致謝…………………………………………………………………….IV
目錄 ……………………………………………………………………VI
表目錄…………………………………………………………………..X
圖目錄 …………………………………………………………………XI
第一章 緒論……………………………………………….…………..1
第二章 文獻回顧…………………………………………………...…4
第一節 鐵之相關介紹…………………………………………….4
一、 鐵的生化與生理功能 4
二、 體內鐵質代謝與生物利用率 6
三、 鐵質建議量 10
四、 鐵質攝取過量 10
五、 鐵質補充劑與造成危害 10
第二節 缺鐵性貧血之簡介……………………………………...12
一、 缺鐵性貧血之流行病學數據 12
二、 鐵質缺乏之因素 12
三、 缺鐵性貧血之診斷標準 22
四、 缺鐵性貧血之進程 26
五、 缺鐵性貧血之族群與症狀 28
六、 缺鐵性貧血之受試者給予鐵劑 29
第三節 四物之成分……………………………………………...31
一、 當歸 (Angelica sinensis) 31
二、 川芎 (Chuanxiong) 32
三、 熟地 (Rehmannia glutinosa) 32
四、 白芍 (Paeonia lactiflora) 33
五、 四物對於貧血之影響 33
第三章 研究目的…………………………………………………….35
第四章 實驗材料與方法…………………………….………………36
第一節 受試者招募……………………………………………..36
第二節 實驗設計………………………………………………..38
第三節 分析方法及項目………………………………………..39
一、 飲食管理與基本紀錄 39
二、 含鐵四物飲之產品組成 39
三、 血液樣本 40
四、 血液分析 41
五、 統計分析 49
第五章 結果………………………………………………………….50
一、 受試者之基本資料 50
二、 飲食攝取量 52
三、 運動時間 54
四、 血液分析生化值 56
第六章 討論………………………………………………………….72
第一節 鐵質缺乏之診斷………………………………………...72
一、 血液生化指標 72
第二節 易造成鐵質缺乏之原因………………………………...74
一、 飲食 74
二、 運動 77
第三節 含鐵四物飲改善鐵質缺乏……………………………...78
一、 鐵質狀態 78
二、 紅血球狀態 79
三、 鐵質吸收相關因子 80
第四節 研究限制………………………………………………...82
第七章 結論………………………………………………………….83
第八章 參考文獻…………………………………………………….84
第九章 附件………………………………………………………….93

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