| Abstract: | 研究背景、動機
便秘是一種常見的腸胃道疾病，社區民眾因便秘之苦，常到藥局購買緩瀉劑、浣腸或腸道保健品等，然而有些保健品為求療效添加番瀉苷、氧化鎂等，是否能長期使用也是隱憂。另外使用富含膳食纖維的營養補充品則是較安全有效的改善方法，而菇類食材富含較易消化的膳食纖維，有些菇類更屬於藥食兩用資源中同時含有豐富多醣體，並且有益於腸道內的益生質環境，有保健腸道的功能。因此期望透過菇菌類保健食品的食用介入，達到腸道健康的改善。
研究方法
本研究於社區民眾中招募有功能性便秘症狀的成人，年齡滿20歲以上，不分男女30人，參與者符合羅馬Ⅲ型功能性便秘標準的要求，實驗期為期10週，使用菇類萃取保健食品做飲食介入，隨機將患者區分A試驗組(含銀耳、杏鮑菇、金滑菇、綠藻萃取)，B試驗組(只含銀耳萃取)二組，食用前後每周填寫:健康資訊表(體重、BMI、體脂率、血壓等)，便秘問卷調查表，依「布里斯托爾糞便量表」評估糞便類型，便秘嚴重度評估表，及便秘患者生活質量表。於研究完成後收集並分析問卷評量表結果。
研究結果
收案數共30人，分為A試驗組15人，B試驗組15人，第4周到第8周菇類萃取飲食介入後，布里斯托爾糞便量表（BSFS）評估糞便類型稠度，發現A試驗組的飲食介入後的第4-8周與第1-3周比較，有顯著改善(p=0.04)，第9-10周停止介入後，並沒有因停用介入而糞便稠度變硬情形(p=0.59)；而B試驗組介入後第4-8周，也有顯著改善(p＜0.001)，第9-10周停止介入後B試驗組的糞便硬度也沒有與第4-8周有顯著差異(p=0.12)，比較兩組之糞便硬度沒有顯著差異。將便秘嚴重度評估表(CSI)細分成排便障礙、慢性傳輸和解便疼痛及其總分加總等四個項目，相較第1~3周前測與飲食介入後第4~8周之試驗期便排便障礙情況，發現A試驗組在排便障礙、傳輸和疼痛及嚴重度方面都有非常顯著改善；而停用後第9~10周便秘嚴重的四項都沒有顯著差異(p＞0.05)。而B試驗組飲食介入後4~8周便秘嚴重有非常顯著的改善(p＜0.001)；第9~10周B試驗組的介入停止後，沒有顯著差異p＞0.05。在便秘患者生活質量表(PAC-QOL) 也分成生理、擔憂、社會心理、滿意度和其加總，而A試驗組在飲食介入後4~8周PAC-QOL這五項，都有顯著改善(p＜0.001)；停用後第9~10周，總生活質量卻有極顯著差異(p=0.02)。而B試驗組飲食介入後4~8周也都有非常顯著的改善(p＜0.001)；第9~10周B試驗組介入停止後(p=0.51)，沒有顯著差異。A試驗組與B試驗組均可使便秘嚴重程度降低，同時也使生活質量提高，但統計上兩組之間無顯著性差異。本論文研究結果認為含菇類萃取物的保健品可望成為改善功能性便秘替代療法。
Background
Constipation is a common gastrointestinal disorder. Because of constipation, community residents often go to the pharmacy purchase laxatives, bowel diarrhea, or health care products. For showing curative effects, some health products add sennoside, magnesium oxide, etc. It should be concerned that can they be used in the long-term treatment. In addition, using nutritional supplements rich in dietary fiber is a safer and effective way to improve the problem of constipation. Mushroom ingredients are rich in dietary fiber. Some mushrooms, is the source that can be used as food in the dual-purpose resources of medicine and food. The mushrooms are also rich in polysaccharides, which are beneficial to the probiotic environment in the intestinal tract and have the function of protecting the intestinal tract. Therefore, it is expected that the improvement of intestinal health can be achieved through the edible intervention of mushroom health food.
Research methods
This study was recruited 30 adults which is regardless of gender with functional constipation symptoms from the community. These patients need be in line with more than 20 years of age with a diagnosis of functional constipation according to Rome III diagnostic criteria. The experimental period is 10 weeks, the patients use mushroom extract health food for dietary intervention and they were randomly assigned into two groups which is expermintal group A (contains Tremella fuciformis, Flammulina velutipes, Pleurotus eryngii, Chlorella extract) and experimental group B(Tremella fuciformis extract only). The patient needed to provide personal fill the Health Information (weight, BMI, body fat rate, blood pressure etc.) and finished Constipation questionnaire. According to “Bristol Stool Scale”, to assess the type of stool, constipation severity instrument, and the quality of life for patient’s assessment with constipation every week before and after having the mushroom health food. The questionnaire assessment form is collected and analyze after the study is completed.
Results
A total of 30 adults were randomly assigned into experimental group A and experimental group B. During the 4th to 8th weeks, using the Bristol Stool Scale (BSFS) to assesses the consistency of stool. It was found that compared the assessing result of 1st to 3rd weeks with assessing result of the 4th to 8th weeks, the group A was significantly improved after the intervention (p=0.04). When the intervention was stopped, the stool consistency was not hardened immediately (p=0.59). The group B also had a very significant improvement (p<0.001). Compared the result of 4th to 8th weeks with result of 9th to 10th weeks, there was no significant difference (p=0.12) in the stool hardness of group B. There was no significant difference between the two groups.
The Constipation Severity Assessment Form (CSI) also subdivides into four items such as defecation disorders, chronic transmission and pain relief, and total scores. Compared the result of 1st to 3rd weeks with result of 4th to 8th weeks, it was found that the fecal and defecation disorders in group A has significant improvements in defecation disorders, transmission, pain and severity. When stopping the mushroom diet behavior, there was no significant difference (p>0.05) in the four items of severe constipation.
In group B, severe constipation was significantly (p<0.001) improved in 4th to 8th weeks. When group B stopped the mushroom diet in 9th to 10th weeks, there was the no significant difference (p>0.05).
In the constipation patient quality of life table (PAC-QOL), it is divided into physiology, worry, social psychology, satisfaction and the total score. In group A, the five items of PAC-QOL were significantly (p <0.001) improved when diet intervention was in 4th to 8th weeks. When diet was stopped in the 9th to 10th week, there was a significant difference (p=0.02) in the total quality of life. Group B also had a very significant improvement (p<0.001) in 4th to 8th weeks. When diet was stopped in the 9th to 10th week, there was no significant difference(p=0.51) in group B.
Both group A and B reduced the severity of constipation caused by constipation and improved the quality of life, however, there was no statistic significantly difference between the two groups. Therefore, the diet of mushroom health care products can be an alternative issue or management for improving functional constipation. |
