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研究生: 王乃弘
論文名稱: 山藥、薏仁對停經婦女性激素、血脂與抗氧化性的影響
The influences of Dioscorea and adlay on sex hormone, blood lipids and antioxidant status in postmenopausal women.
指導教授: 吳文惠
學位類別: 碩士
Master
系所名稱: 人類發展與家庭學系
Department of Human Development and Family Studies
論文出版年: 2004
畢業學年度: 92
語文別: 中文
論文頁數: 128
中文關鍵詞: 薏仁山藥性激素抗氧化性血脂
英文關鍵詞: adlay, dioscorea(yam), sex hormone, antioxidant, blood lipids
論文種類: 學術論文
相關次數: 點閱:298下載:29
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  • 由於美國最近有關傳統雌激素補充劑的大型前瞻性實驗研究結果,不但更進一步確認會增加乳癌的發生率,還推翻過去所認為傳統雌激素補充劑的預防心血管疾病效果。植物性雌激素是否能預防與治療停經症狀、心血管疾病、骨質疏鬆與老人失智等疾病,取代傳統雌激素,更受矚目。本研究目的在發掘含有植物性雌激素的本土產物。
    研究食材選用傳說有雌激素功能的山藥(台南學甲)、薏仁(彰化二林的台中1號薏仁雪花片) ,探討兩者併用對停經婦女性激素代、血脂與抗氧化性之影響。招募師大附近29位健康、飲食規律、半年內無使用女性荷爾蒙的停經婦女,受試者隨機分組,進行交叉、單盲實驗,以米粉當安慰劑。實驗開始前兩週為run-in period後,15人每天食用山藥粉50克+薏仁粉50克持續5週後,休息3週為清除期,改食用50克米粉5週,另14人次序相反。實驗期間指導受試者減少主食類攝取量,且持續規律的正常生活飲食。在每期食用前後收集血液與尿液樣本,比較血糖、血脂(血漿及各種脂蛋白中的三酸甘油酯、膽固醇含量)、抗氧化(LDL氧化遲滯期和 TBARS產生量)與性激素(血清Estrone、Estradiol、SHBG、DHEAS、FSH )的變化。有23人持續參加至實驗結束。
    研究結果發現攝取山藥+薏仁複方或米粉後,體脂肪均顯著高於攝取前,但山藥+薏仁期的增高量顯著高於米粉期。攝取山藥+薏仁後血糖顯著低於攝取前,其改變量與米粉期的改變量有顯著差異(p=0.014)血漿總膽固醇有降低的趨勢(p=0.073),而HDL2-C雖有顯著下降(p=0.042),但LDL-C/HDL-C比值沒有顯著改變,故認為山藥+薏仁複方對血脂並沒有造成不良影響。抗氧化性方面,山藥+薏仁複方顯著降低LDL氧化的TBARS產生量。而在性激素方面,兩期攝取前後均無顯著改變,但攝取山藥+薏仁後FSH上升量與米粉期的改變量有顯著差異(p=0.039),原因與意義不明。綜合以上結果可知,停經婦女攝取山藥+薏仁複方可能有助於下降血糖與LDL氧化產物。

    Recent evidence from Women’s Health Initiative (WHI) clinical trails show increased risks of breast cancer, coronary heart disease, stroke and pulmonary embolism in women receiving traditional hormone (combined estrogen/progestin) replacement therapy. Interest in the use of phytoestrogen in place of traditional HRT has increased tremendously. This study is designed to investigate the influences of yam plus adley on sex hormone, blood lipids and antioxidant status in postmenopausal women.
    A randomized, single-blind, placebo-controlled, cross-over,trial was conducted on twenty-nine apparently healthy postmenopausal women without HRT recruited from the area of National Taiwan Normal University. After 2-wk run-in period, 15 subjects took 50 g of yam powder plus 50 g of adley powder per day and the others took rice powder as a placebo for 5 weeks and then the order was switched vice versa to continue for another 5 weeks with 3-week washout period. Subjects maintained their usual diet and physical activity throughout the intervention and took their powder from the laboratory every week. Blood and first morning urine samples were collected in the beginning and the end of each period for the measurements of blood sugar, blood lipids, antioxidant capacity (the susceptibility of LDL to oxidation, TBARS level) and sex hormones (serum Estrone, Estradiol, SHBG, DHEAS, FSH). Twenty-three subjects completed the study.
    The results showed that body fat increased significantly after both supplements and the increase was significantly greater in yam plus adley than in placebo. the levels of blood sugar, plasma cholesterol and plasma HDL2-Cdecreased (p=0.014, p=0.073, p=0.042, respectively) after yam plus adley .Since the decrease in HDL2-C did not resulted in an increase in LDL-C/HDL-C, it appears not to have deleterious effect. TBARS production of oxidized LDL decreased significantly after yam plus adley supplementation. There was no significant difference in sex hormones except in FSH where the decrease after yam + adley was significant as compared with that after placebo. The results show that the ingestion of yam and adley might be beneficial in decreasing plasma glucose and LDL oxidation.

    目 錄 頁碼 中文摘要 Ⅰ 英文摘要 Ⅱ 目錄 Ⅲ 表目錄 Ⅵ 圖目錄 Ⅶ 第一章 緒論 ……………………………………………………… 1 第一節 研究背景與動機 ……………………………………… 1 第二節 研究問題與假設 ……………………………………… 3 第三節 名詞縮寫 ……………………………………………… 4 第二章 文獻探討 ………………………………………………… 5 第一節 山藥 …………………………………………………… 5 一、山藥的簡介 …………………………………………… 5 二、山藥的生理作用 ……………………………………… 15 第二節 薏仁 …………………………………………………… 24 一、糙薏仁的簡介 ………………………………………… 24 二、薏仁的生理作用 ……………………………………… 29 第三節 停經婦女的定義與生理變化 ………………………… 31 一、停經婦女的定義 ……………………………………… 31 二、停經婦女的生理變化 ………………………………… 32 三、體內雌激素(estrogen)的合成與代謝 ………………… 33 第四節 植物性雌激素優於傳統荷爾蒙補充法的原因 ……… 39 第三章 研究設計與實施 ………………………………………… 42 第一節 研究對象 ……………………………………………… 42 第二節 研究設計 ……………………………………………… 43 第三節 實驗材料與器材 ……………………………………… 47 第四節 分析項目與方法 ……………………………………… 54 第五節 實驗品質控制 ………………………………………… 63 第六節 統計分析 ……………………………………………… 64 第七節 實驗限制 ……………………………………………… 65 第四章 結果 ……………………………………………………… 67 (一)受試者基本資料 …………………………………………… 67 (二)受試者體重與身體組成的變化情形 ……………………… 69 (三)受試者的飲食攝取情形 …………………………………… 68 (四)血液中血糖濃度的變化情形 ……………………………… 69 (五)血清中性激素濃度的變化情形 …………………………… 69 (六)血漿與各種脂蛋白中膽固醇的變化情形 ………………… 69 (七)血漿與極低密度脂蛋白中三酸甘油酯的變化情形 ……… 70 (八)conjugated diene形成之lag time的變化情形 …………… 70 (九)TBARS產生的變化情形 ………………………………… 70 (十)尿鈣 ………………………………………………………… 71 (十一)血清中glycerol的變化情形 …………………………… 71 第五章 討論 ……………………………………………………… 85 (一)受試者基本資料 …………………………………………… 85 (二)受試者體重與身體組成 …………………………………… 85 (三)受試者的飲食攝取情形 …………………………………… 86 (四)血液中血糖之濃度 ………………………………………… 87 (五)血清性激素濃度的變化 …………………………………… 90 (六)血漿中血脂的變化 ………………………………………… 91 (七)抗氧化性的改變 …………………………………………… 93 第六章 結論 ……………………………………………………… 97 參考文獻 ………………………………………………………… 98 附錄一 邀請停經婦女參加計劃 ……………………………… 119 附錄二 計劃進行說明會 ……………………………………… 120 附錄三 問卷調查 ……………………………………………… 122 附錄四 參加計劃同意書 ……………………………………… 126 附錄五 收集血液與尿液注意事項 …………………………… 127 附錄六 受試期間注意事項 …………………………………… 128 表 目 錄 頁碼 表2-1. 不同山藥品種(Dioscorea alata)的營養組成 …………… 8 表2-2. 薏苡籽實不同部位之一般成分 ………………………… 26 表2-3 不同產地糙薏仁的一般成分 …………………………… 27 表2-4. 薏苡中特殊植物活性成分的生理機能性 ……………… 28 表3-1. 山藥成分分析 …………………………………………… 49 表3-2. 米粉成分 ………………………………………………… 51 表4-1. 受試者基本資料 ………………………………………… 72 表4-2-1.受試者實驗期間體重、身體質量指數與體脂肪率的變化 73 表4-2-2. 受試者實驗期間身體組成的變化……………………… 74 表4-3. 受試者實驗前(baseline)與實驗期間 ( yam + adlay and placebo period)總熱量、碳水化合物、蛋白質與脂肪的攝取情形 ……………………………………………… 75 表4-4. 受試者實驗期間血液中血糖的濃度 …………………… 76 表4-5. 受試者實驗期間血清中賀爾蒙濃度 …………………… 77 表4-6. 受試者實驗期間血漿中各種脂蛋白膽固醇的濃度 …… 78 表4-7. 受試者實驗期間血漿與極低密度脂蛋白中三酸甘油酯的濃度 ……………………………………………………… 79 表4-8. 受試者食用前後LDL以銅離子催化氧化反應時conjugated dienes 形成之lag time 與TBARS 產生量之變化情形 …………………………………………… 80 表4-9. 受試者實驗期間尿液中肌酸酐與尿鈣的濃度 ………… 81 表4-10. 受試者實驗期間血清中glycerol濃度 ………………… 82 表5-1. 各研究中薏仁對性激素和血脂影響之文獻整理 ……… 95 表5-2. 山藥粉、薏仁粉與米粉之脂肪酸組成 ………………… 96 圖 目 錄 頁碼 圖2-1. Diosgenin 的化學結構 …………………………………… 10 圖2-2. 薯蓣皂配基的生合成途徑 ……………………………… 12 圖2-3. 以化學方法降解薯蓣皂配基生產娠烯醇酮 …………… 13 圖2-4. 娠烯醇酮中間體在固醇醫藥品合成上之中心角色 14 圖2-5. 雌激素的生合成 ………………………………………… 37 圖2-6. 雌激素在人體內的代謝途徑 …………………………… 38 圖2-7. 內生性雌激素與植物性雌激素化學結構 ……………… 41 圖3-1. Cross-over研究設計 ……………………………………… 45 圖3-2. 研究設計流程圖 ………………………………………… 46 圖3-3. 山藥(Dioscorea alata spp.)塊莖與葉片 ………………… 48 圖3-4. 冷凍乾燥山藥粉 ………………………………………… 48 圖3-5. 台中1號薏苡果實、脫殼後的糙薏仁和精白薏仁 …… 50 圖3-6. 糙薏仁雪花片 …………………………………………… 50 圖4-1. 每位受試者在食用安慰劑前後的LDL以銅離子催化氧化反應時,conjugated diene 形成之lag time變化 …… 83 圖4-2. 每位受試者在食用山藥+薏仁前後的LDL以銅離子催化氧化反應時,conjugated diene 形成之lag time變化 … 84

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