乳癌病患治療前後的飲食改變及營養補充品效用之探討

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標題:	乳癌病患治療前後的飲食改變及營養補充品效用之探討 Dietary Changes of Breast Cancer Patients Before and After Treatment and The Use of Nutritional Supplements [背景] 乳癌的發生率從2003年起超過子宮頸癌，成為台灣女性癌症第一位。而適當的營養除了可提昇乳癌病人存活率，並預防慢性疾病及肥胖的發生，也能促進病人的健康及良好的生活品質。但國內較少有此議題的研究探討，本研究是以某教學醫院乳癌病患為對象，比較其治療前後飲食的改變，以提供健康飲食教育的參考。國內研究也發現癌症病患使用的營養補充品五花八門，已成為全世界和台灣的潮流與趨勢。其安全性與有效性值得探討，本研究希望藉由乳癌病患各種營養補充品的效用，作為各界未來的參考依據。[方法] 研究設計採用問卷訪談的方式，研究對象為門診或病房篩選符合標準的99位女性乳癌患者，年齡介於30至75歲之間，包含已經完成所有的治療療程，或目前正在接受治療，身心狀態穩定者。問卷收集後以SPSS 12.0 for Windows 版套裝軟體進行統計分析，敘述性統計在類別變數的部份，以次數和百分比方式分析，連續變數則以平均數及標準差的方式分析。推論性統計則以McNemar交叉表和魏克生符號檢定。比較乳癌病患一般飲食攝取頻率在確診前與後之差異，以卡方檢定、變異數分析(ANOVA)與事後檢定進行各治療組別的分析比較。p value<0.05顯示有統計上的意義。[結果] 乳癌確診年齡以46到60歲居多，病理分期以第一期和第二期佔大部分(81%)，治療療程分賀爾蒙治療組、門診追蹤組和化學、放射及標靶治療組，其中以賀爾蒙治療組佔多數(54.5%)。有67.7%患者使用營養補充品，其中以使用維他命與礦物質類最常見(71.6%)，其次為特殊營養品(56.7%)。營養品使用後，64.7～92.6%病患覺得身體狀況有改善，其中以使用胺基酸類營養品感到身體狀況有改善的比例最高(92.6%)，以化學、放射及標靶治療的患者使用營養補充品的比例最高(100%)。分析營養補充品使用的訊息來源，則以親友為最主要(50.7%)，其次為家人(34.3%)、醫院營養師(31.3%)。比較病患確診前與確診後的飲食習慣，發現在高油、含糖飲料、高醣、喝酒、醃漬、加工食品、燒烤和沾醬料食物方面，皆達到非常顯著差異(p<0.001)，黃豆製品和蔬菜方面達到顯著差異(p<0.05)，而水果方面則沒有達到顯著差異(p=0.124)。探討飲食習慣改變的原因，則以擔心影響病程為主。[結論] 無論原本飲食型態如何，患者都能夠配合調整她的飲食習慣，同時因為擔心病程，對於補充品需求皆會增加。因此，各種補充品對乳癌之有效性及作用機轉以及能提供病患正確營養的資訊來源，都是可以幫助病患正面接受醫療及降低恐懼之重要角色。 [Background] The incidence of breast cancer has exceeded the cervical cancer and has become the most common cancer in female in Taiwan since 2003. Appropriate nutrition in breast cancer surviving patients can improve the survival rate and prevent the occurrence of chronic diseases and obesity, it also can promote the health and good quality of life. There are few studies on this topic till now. Breast cancer patients in a teaching hospital were enrolled in this study. We compared the dietary changes of breast cancer patients before and after treatment and hoped to provide a reference for dietary education. The nutritional supplements used by cancer patients varied and has become a trend in Taiwan and the world. Its safety and effectiveness are worth exploring. This study hopes to discuss the effectiveness of various nutritional supplements use for breast cancer patients and to provide a reference for various experts. [Methods] The study design was a questionnaire interview. 99 female breast cancer patients who met the criteria, aged between 30 and 75 years old, were enrolled in this study from outpatient department or ward. All the patients had completed the treatment courses, or were currently undergoing treatment and were physically and mentally stable. After the questionnaires were collected, statistical analysis was performed using the SPSS 12.0 for Windows software package. Descriptive statistics for categorical variables were analyzed by means of frequency and percentage, and continuous variables by means of mean and standard deviation. Inferential statistics were analyzed by means of McNemar method and Wilcoxon sign rank test to compare the difference of general dietary intake in breast cancer patients before and after confirmed diagnosis. Chi-square test, analysis of variance(ANOVA) and a posteriori test were analyzed to compare the differences of treatment groups. P value <0.05 shows statistical significance. [Results] The age of diagnosis of breast cancer was mostly 46 to 60 years, and the pathological stage was mainly the first and second stage, accounting for 81%. The treatment groups were divided into hormone therapy, outpatient department follow-up and chemotherapy, radiation and target therapies. The hormone treatment patients accounted for the majority (54.5%). 67.7% of patients used nutritional supplements, of which vitamins and minerals were the most common (71.6%), followed by special dietary therapies (56.7%). After uses of nutritional supplements, 64.7 to 92.6% of patients felt that their physical condition had improved, and amino acids products had the highest improvement rate on their physical condition, reaching 92.6%. Among the treatment groups, the chemical, radiation, and target therapies group had the highest percentage of nutritional supplements use, reaching 100%. The sources of information on the use of nutritional supplements are largely from relatives and friends (50.7%), followed by family members and hospital nutritionists (34.3% & 31.3%, respectively). Comparing the dietary habits of patients before and after confirmed diagnosis, we found that there were markedly significant differences in high oil, sugary drinks, high carbodydrates, alcohol drinks, pickled, processed, grilled and sauced foods (p<0.001). There were significant differences from soybean products and vegetables (p<0.05), but no significant difference from fruits (p= 0.124). The main reason for changes of dietary habits was to worry about affecting the course of the treatment. [Conclusion] Regardless of the previous dietary habits, all patients can adjust her dietary patterns after confirmed diagnosis. Because of concerns about the course of the disease, the demand for nutritional supplements will increase. Therefore, the effectiveness and mechanism of various nutritional supplements on breast cancer, as well as source of correct nutritional information, have an important roles that can help patients receiving medical treatment positively and reduce fear.
作者:	周秀蓁
貢獻者:	保健營養系盧彥哲蕭慧美
關鍵字:	營養補充品飲食乳癌 nutritional supplement diet breast cancer
日期:	2020
上傳時間:	2022-10-21 10:30:17 (UTC+8)
關聯:	電子全文公開日期：2025-07-30 學年度：108， 116頁
顯示於類別:	[保健營養系(所) ] 博碩士論文

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