臺灣博碩士論文加值系統

根據行政院衛生署於民國九十三年公告之國人十大死亡原因統計指出，糖尿病位居國人十大死亡原因第四位，死亡百分率為6.88%(行政院衛生署, 2004)。糖尿病為一種慢性病，需長時間飲食規劃及藥物控制，以延緩併發症的發生。而糖尿病的治療分別為飲食控制、運動及藥物治療，其中以飲食治療為最重要也是最基本的療法。Medical Nutrition Therapy(MNT)可使病患藉由良好飲食控制而改善病情，故對於糖尿病患者而言，如何透過良好的食物療法使血糖獲得良好控制，進而避免慢性併發症之發生，是糖尿病治療之重要課題。
自古以來薏仁在保健方面即佔有重要地位，其兼具藥食之用。本研究的目的在探討糙薏仁對第2型糖尿病人血糖及血脂肪之影響。給予16位第2型糖尿病人（Dehulled Adlay Diabetes Mellitus Group; DA-DM group）及5位新診斷未用藥之第2型糖尿病患者 ( Dehulled Adlay Diabetes Mellitus new onset group; DA-DM new onset group ) 每日100公克糙薏仁取代2份主食類，實驗進行12週。結果顯示DA-DM group空腹血糖分別在第4週、第8週及第12週減少50.8mg/dL、56.1mg/dL、56.6mg/dL(P<0.01)，而糖化血色素分別減少1.7%、2.6%及3.4%（P<0.01）。DA-DM new onset group方面，空腹血糖分別減少12.2mg/dL、12.0mg/dL及9.4mg/dL，糖化血色素減少1.0%、1.4%及1.4%，在第4週及第8週達顯著降低。此外，如果以Homeostasis model assessment（HOMA）推算食用糙薏仁對第2型糖尿病患β細胞功能(%)影響，結果發現DA-DM group β細胞功能在第8及12週明顯上升，分別上升54.8%(P<0.01)及30.3%(P<0.01)，而DA-DM new onset group則無顯著差異。血漿脂質部份，DA-DM group於第12週高密度脂蛋白膽固醇（HDL-C）明顯升高。綜合以上結果推測，以糙薏仁取代部份主食可改善第2型糖尿病人血糖及高密度脂蛋白膽固醇濃度。

In 2004, the record of Top Ten Death Risk from Department of Health was showed that Diabetes Mellitus is the 4th death risk and its death rate is 6.88% (Department of Health, 2004). Diabetes Mellitus is a chronic disease; needs a long time for diet therapy, physical activity and medication to delay the occurrence of side effect. Diet therapy is the most important and fundamental therapy. Dehulled adlay was used to be a key component in prevention medical and its function can be food and drug. Our aim was to investigate the effect of dehulled adlay on blood glucose and lipid concentration in diabetic patients.

We enrolled 16 type II DM patients (Dehulled adlay diabetes mellitus group, DA-DM group) and 5 new onset DM’s patients (Dehulled adlay diabetes mellitus new onset group, DA-DM new onset group). Subjects intake 100 gram dehulled adlay to replace 2 serving size cereals each day for three months. The results showed that the fasting blood glucose of DA-DM group significantly decreased about 50.8mg/dL, 56.1mg/dL and 56.6mg/dL at 4th, 8th and 12th week, respectively (p<0.01). Hemoglobin A1C also significantly decreased about 1.7%, 2.6% and 3.4% at 4th, 8th and 12th week, respectively (p<0.01). On DA-DM new onset group fasting blood glucose also decreased about 12.2mg/dL, 12.0mg/dL and 9.4mg/dL and A1c significantly decreased about 1.4% and 1.4% on 4th and 8th week, respectively. Moreover, we estimated the relationship between dehulled adlay and β cell function (%) of type II DM patients via homeostasis model assessment (HOMA), indicating that βcell function of DA-DM group significantly increased about 54.8% and 30.3% at 8th and 12th week, respectively (p<0.01), but there was no significant difference in DA-DM new onset group. The 12th week of High density lipid- cholesterol (HDL-C) on DA-DM group was significantly increased. In conclusion, dehulled adlay replaces partial cereal may regulate the serum glucose and HDL-C concentrations in type II DM patients.

目 錄
第一章　緒論 1
研究背景與目的 1
第二章　文獻整理 3
第一節 第2型糖尿病簡介 3
第二節 糙薏仁簡介 9
第三節 薏仁生理功能 11
第四節 膳食纖維對糖尿病的影響 15
第三章　材料與方法 18
第一節 研究設計 18
第二節 研究對象 18
第三節 研究材料與工具 19
第四節 研究步驟 28
第五節　 統計分析 31
第四章　結果 32
第一節 基本資料 32
第二節 熱量及營養素攝取 32
第三節 人體測量 33
第四節 血液生化檢驗 34
第五章 討論 39
第一節 重要發現與討論 39
第二節 研究限制 47
第三節 總結 48
參考文獻 50
附件 87
附件一、薏苡籽實不同部位之一般組成 87
附件二、薏苡籽實不同部位之膳食纖維含量 88
附件三、薏苡籽實不同部位之丙酮萃取物中脂肪酸組成和含量 89

表目錄
表1. 受試者之基本資料 71
表2. 糖尿病受試者之熱量及三大營養素每日平均攝取量 72
表3. 糖尿病新診斷受試者之熱量及三大營養素每日平均攝取量 72
表4. 糙薏仁糖尿病組受試者人體測量值之變化 73
表5. 糙薏仁糖尿病組血液生化值變化 74
表6. 糙薏仁糖尿病組血液生化值變化 75
表7. 糙薏仁糖尿病組受試者人體測量值之變化 76
表8. 糙薏仁糖尿病組血液生化值變化 77
表9. 糙薏仁糖尿病組受試者血液生化值之變化 78
表10. 糙薏仁糖尿病新診斷組受試者人體測量值之變化 79
表11. 糙薏仁糖尿病新診斷組受試者血液生化值之變化 80
表12. 糙薏仁糖尿病新診斷組受試者血液生化值之變化 81
表13. 糙薏仁糖尿病新診斷組受試者人體測量值之變化 82
表14. 糙薏仁糖尿病新診斷組組血液生化值變化 83
表15. 糙薏仁糖尿病新診斷組受試者血液生化值之變化 84


圖目錄
圖1. 比較糙薏仁糖尿病組及糙薏仁糖尿病新診斷組空腹血糖值變化 85
圖2. 比較糙薏仁糖尿病組及糙薏仁糖尿病新診斷組A1c值變化 86

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