tag:blogger.com,1999:blog-57429006886911362292024-03-05T17:04:08.335+08:00胃食道逆流●食道炎資料彙集Unknownnoreply@blogger.comBlogger27125tag:blogger.com,1999:blog-5742900688691136229.post-85664314387701012112012-09-14T17:34:00.004+08:002020-08-22T13:19:02.703+08:00到診所掛號就診的前置準備工作<div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div><ol><li><span style="font-size: large;">本診所根據的治病原理及方法,與傳統西醫或中醫截然不同。</span></li>
<span style="font-size: large;"> </span>
<li><span style="font-size: large;">請先進入診所網頁</span><a href="http://www.ckwang.com.tw/"><span style="color: #351c75; font-size: large;">http://www.ckwang.com.tw</span></a><span style="font-size: large;">診所網頁首頁可點入,閱聽完下列影音專輯,瞭解並認同「腸腦漏自癒療法」後,再打電話預約掛號求診。</span></li>
<span style="font-size: large;"> </span>
<li><span style="font-size: large;">由於您已完成前置作業,醫師不必再向您講解基本原理,可省節您寶貴的時間。醫師才能有更充分時間深入瞭解您的病情,再做看診分析。</span></li>
<span style="font-size: large;"> </span>
<li><span style="font-size: large;">請先行記錄下您心中的疑點,到時可當面請教醫師。</span></li>
<span style="font-size: large;"> </span>
<li><span style="font-size: large;">稍後,我們將會製作「精神疾病」、「心律不整」、「自體免疫」、「耳鳴腦鳴與暈眩」的自然療法影音專輯,把深奧艱澀的醫療資訊簡約化、公開透明化,希望患者與醫師之間能更趨零距離。</span></li>
</ol><br />
<h3> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN-Aj1Di4OIjahoDhJnUjnIHUSm1EtmOTJwOasIUmmLmXB3f0JY4ZNQczv_46U6ODaLVe5P3vs7hTjz8ylDvExF2MHqh55qZQ2wAMq7wo8ADvuvV8BfVr22T7BrPZI2PG5W1uHksFYmj2P/s1600/icon-video.gif" target="_blank" /><a href="http://youtu.be/qGyDt8OlG2s"><span style="color: red;">YouTube:過敏斷根細胞療法原理及成果</span></a></h3><br />
<h3> <span style="color: red;">中道自然醫學腸腦漏自癒療法影音專輯</span></h3><h4 class="separator" style="clear: both; text-align: left;" target="_blank"><span style="color: #6aa84f;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN-Aj1Di4OIjahoDhJnUjnIHUSm1EtmOTJwOasIUmmLmXB3f0JY4ZNQczv_46U6ODaLVe5P3vs7hTjz8ylDvExF2MHqh55qZQ2wAMq7wo8ADvuvV8BfVr22T7BrPZI2PG5W1uHksFYmj2P/s1600/icon-video.gif" target="_blank" /></span><a href="http://www.youtube.com/watch?v=T1yeic4bDOE&feature=youtu.be"><span style="color: #6aa84f;">YouTube:第一集 疾病的源頭-腸漏症與腦漏症</span></a></h4><h4><span style="color: #6aa84f;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN-Aj1Di4OIjahoDhJnUjnIHUSm1EtmOTJwOasIUmmLmXB3f0JY4ZNQczv_46U6ODaLVe5P3vs7hTjz8ylDvExF2MHqh55qZQ2wAMq7wo8ADvuvV8BfVr22T7BrPZI2PG5W1uHksFYmj2P/s1600/icon-video.gif" target="_blank" /></span><a href="http://www.youtube.com/watch?v=R-dXvV6AEeQ&feature=g-upl"><span style="color: #6aa84f;">YouTube:第二集 腸腦漏自癒療法五大要點</span></a></h4><h4><span style="color: #6aa84f;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN-Aj1Di4OIjahoDhJnUjnIHUSm1EtmOTJwOasIUmmLmXB3f0JY4ZNQczv_46U6ODaLVe5P3vs7hTjz8ylDvExF2MHqh55qZQ2wAMq7wo8ADvuvV8BfVr22T7BrPZI2PG5W1uHksFYmj2P/s1600/icon-video.gif" /></span><a href="http://www.youtube.com/watch?v=iL4leH2NSzY&feature=youtu.be"><span style="color: #6aa84f;">YouTube:第三集 腸腦漏自癒療法的公正裁判</span></a></h4><h4><span style="color: #6aa84f;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN-Aj1Di4OIjahoDhJnUjnIHUSm1EtmOTJwOasIUmmLmXB3f0JY4ZNQczv_46U6ODaLVe5P3vs7hTjz8ylDvExF2MHqh55qZQ2wAMq7wo8ADvuvV8BfVr22T7BrPZI2PG5W1uHksFYmj2P/s1600/icon-video.gif" />YouTube:第四集 腸腦漏自癒療法處方精義</span></h4><h4><span style="color: #6aa84f;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN-Aj1Di4OIjahoDhJnUjnIHUSm1EtmOTJwOasIUmmLmXB3f0JY4ZNQczv_46U6ODaLVe5P3vs7hTjz8ylDvExF2MHqh55qZQ2wAMq7wo8ADvuvV8BfVr22T7BrPZI2PG5W1uHksFYmj2P/s1600/icon-video.gif" />YouTube:第五集 中道自然醫學簡介</span></h4><h3><br />
<img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiN-Aj1Di4OIjahoDhJnUjnIHUSm1EtmOTJwOasIUmmLmXB3f0JY4ZNQczv_46U6ODaLVe5P3vs7hTjz8ylDvExF2MHqh55qZQ2wAMq7wo8ADvuvV8BfVr22T7BrPZI2PG5W1uHksFYmj2P/s1600/icon-video.gif" /><span style="color: red;">YouTube:中道自然醫學腸腦漏自癒療法專輯(1~5全集)</span></h3><div><span style="color: red;"><br /></span></div><div><span><span style="color: red;"> </span><div align="center" class="MsoNormal" style="color: red; line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="color: red; text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="color: red; text-align: left; text-indent: 36pt;"><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></span></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-46259790420890443112012-08-10T13:05:00.005+08:002020-08-22T13:18:29.173+08:00YouTube:過敏斷根細胞療法原理及成果<div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div><div><br /></div><iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/qGyDt8OlG2s" width="560"></iframe><div><br /></div><div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div><div><br /></div></div></div></span></div><span style="font-size: large; text-align: left;"></span></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-41252664593807301292012-08-10T13:02:00.003+08:002020-08-22T13:18:08.604+08:00YouTube:過敏斷根細胞療法原理及成果<div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div><div><br /></div><iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/jSIcCd63TTk?rel=0" width="560"></iframe>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-4380853685762852472011-12-16T13:15:00.007+08:002020-08-22T13:17:57.902+08:00腸胃藥 Metoclopramide 引起的神經系統副作用<font face="verdana" size="3"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div>
<font color="">腸胃藥Metoclopramide引起的神經系統副作用</font><br />
<br />
甲. Primperan 的副作用<br />
a、胃腸藥Metoclo pramide的副作用<br />
b、口舌異動症-primperan的副作用<br />
c、變臉-錐體外症候群(EPS)<br />
d、長期服用primperan造成月經不來<br />
e、primperan的副作用<br />
<br />
乙. Takepron 的副作用<br />
a、Takepron的副作用<br />
b、Takepron(ppI)的副作用<br />
<br />
Metoclopramide(Primperan)會導致動作障礙-錐體外徑症候群(EPS)已經是一般常識了。美國FDA在2009年2月26日也因此發布了藥品安全資訊:長期或高劑量使用含Metoclopramide成分藥品可能會導致病患出現非自主性或重複性之肌肉運動障礙(tardive dyskinesia),甚至於病患停藥或不再使用該藥品時,症狀仍然存在。最常引起的部位是臉部(60%)和舌頭(45%),服用的時間平均是20 ± 15個月。Metoclopramide另一個常見的副作用是帕金森氏症候群,在動作障礙門診中,由Metoclopramide所導致的帕金森氏症候群約佔了所有藥物引起的帕金森氏症候群(Drug-induced parkinsonism, DIP)的30%。和原發性的帕金森氏症不同,DIP通常進行的速度比較快、而且兩側肢體同時發生。DIP對多巴胺樣藥物的反應不佳。容易發生DIP的風險因子包括年紀較大和女性。Metoclopramide另一個比較少被注意到的神經系統副作用是憂鬱症,雖然病例不多。除此之外,譫妄和急性精神病發作也有一些零星的病例。<br />
<br />
<font color="">Primperan的副作用 口舌異動症~藥物的副作用</font><br />
口舌異動症~藥物的副作用<br />
<br />
最近在診所連續碰到兩個類似的病例,都是本來就在大型醫院就診的患者,可能也有其他人有相同的問題卻沒有被相對忙碌的大醫院醫師注意到,所以拋磚一下,希望能提醒大家注意一些比較少見的藥物副作用。<br />
<br />
<font color="">案例 1</font><br />
70歲女性,最近一個多月來,嘴巴常常會做咀嚼的動作,舌頭也經常不由自主地動來動去,有時候甚至還會被牙齒咬到流血。沒有眨眼、斜頸或其他臉部和上下肢的異常運動。其他神經學檢查都正常。患者因為失眠在某醫學中心就診,每天睡前服用Xanax(抗焦慮藥)和Remeron(抗憂鬱藥)各半顆約兩年半。<br />
<br />
<font color="">案例 2</font><br />
64歲男性,六個月來舌頭常會不受控制地伸出來,也會在嘴裡面亂動。神經學檢查發現右下肢有略微僵硬及休息時不自主的抖動,但未曾服用任何多巴胺類藥物。患者因胃食道逆流,過去三年來服用Dogmatyl(50mg) (精神病狀態、消化性潰瘍)和Primperan,但只在覺得不舒服時才服用,平均每個星期只服用5次左右。<br />
<br />
<font color="">治療</font><br />
老太太由於服用抗憂鬱劑經年,不能任意停藥,所以請其回去原就診醫院調整藥物。至於胃病的先生,則先停掉原來的藥物,由於患者有輕微的巴金氏病症狀,於是開立Artane 2m g(抗巴金森氏藥)早晚1顆和Baclofen(肌肉鬆弛劑)早晚半顆,巴金森病的症狀有明顯進步,但是舌頭的症狀只有一點點好轉。如果沒有進一步改善,打算轉介去施打肉毒桿菌。<br />
<br />
<font color="">討論</font><br />
長期大量服用傳統抗精神藥物會導致遲發性異動症Tardive dyskinesia,在多年前就已經被注意到,在新一代非典型抗精神藥物出現以後就比較少見(但還是會有)。抗憂鬱劑包括SSRI和SIRI所引起的口舌異動症最近也有一些報告,至於增進腸胃蠕動和抑制胃酸的藥物所引起的,也並不是很罕見。這兩個案例特別的地方,在他們服用的藥物劑量都很低,症狀的發生可能與體質和服用藥物的時間較長有關。<br />
<br />
<font color="">變臉-錐體外症候群</font><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVF5oyvhtfYbbPnaGEwJbe9ihXIQcb2tIvnd8VAqjlSIk-cDCpTEX2GyPEB4lR2rrCxLKl_sDGhHYWZWQD6E6frvCEDPY8vPhO8Csy6z3vVMyYCXcPlbpSht4YpqgezvSyoT7YssYBVpco/s1600/1.jpg"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVF5oyvhtfYbbPnaGEwJbe9ihXIQcb2tIvnd8VAqjlSIk-cDCpTEX2GyPEB4lR2rrCxLKl_sDGhHYWZWQD6E6frvCEDPY8vPhO8Csy6z3vVMyYCXcPlbpSht4YpqgezvSyoT7YssYBVpco/s1600/1.jpg" width="400" /></a><br />
<br />
下午六時許..<br />
一位女高中生被父親帶來急診<br />
「醫生! 我女兒的臉突然扭曲歪嘴,眼睛直視不動」,父親焦急的說「是不是中風還是癲癇病!?」<br />
「你女兒最近有吃甚麼藥嗎」我心有所指的說<br />
「有ㄚ,我女兒這幾天因為腸胃不好,有吃腸胃科醫生開的藥」<br />
「好!那我知道了」,「待會兒給她打一針,很快就沒事了」<br />
經過二十分鐘後,這位女高中生果然恢復原本清純的臉龐<br />
「我知道那時候整個臉歪變僵硬,就是又無法控制,感覺很驚恐」女高中生回想說著<br />
以後看任何病都要告訴醫生「請不要開整腸藥,我會得EPS」對著女高中生及她父親說<br />
「就當作是”藥物過敏”,要讓醫生護士知道,病歷上要做記錄」 <br />
這是某一類腸胃藥所導致的副作用,平常人少見,在醫院有經驗的醫生一看就知道了<br />
三十分鐘後,這位為女高中生帶著笑容跟著父親往急診出口離開...<br />
<br />
<font color="">甚麼叫錐體外症候群</font><br />
(EPS):指控制運動之系統受到影響所引起的症狀,如肢體發抖,僵硬或不平衡感等。<br />
常見藥物副作用:EPS,其藥物有...<br />
1.傳統抗精神病藥物 (第一代抗精神病藥物) 阻斷了黑質紋狀體多巴胺徑路之多巴胺D2 受體,而容易產生運動方面的副作用。<br />
2.多巴胺拮抗製劑 (dopamine antagonist):目前最常使用的抗嘔吐藥物,食道逆流的藥,整腸的藥 (最常見 如 primperan)。副作用是坐立難安,及錐體外症候群。<br />
3.好度(Haloperidol):一樣是多巴胺拮抗製劑,一般用於精神科病人,所以較少被用於抗嘔吐的作用。常見的副作用也是坐立難安和錐體外症候群。<br />
<br />
治療: 切記! 任何時候看病, 要提醒醫師 有此一"EPS病史"<br />
1.抗膽鹼藥物(Akineton, 1/2-1 amp( 5 mg) im或 2 mg 口服ㄧ日1-3次;Artane 1 mg/day或 5 -15 mg/day )為主。<br />
2. 抗組織胺製劑(antihistamine):除了可以對抗噁心嘔吐,還可以治療因抗多巴胺製劑所引發的坐立難安,以及錐體外症候群。副作用主要是嗜睡<br />
<br />
<font color="">長期服用Primperan造成月經不來</font><br />
您好:<br />
<br />
我現在在治療胃食道逆流和潰瘍,吃 primperan 5mg大概快兩個月。想請問這個藥會打亂生理期週期甚至造成生理期不來嗎?因我生理期一直很規律,可是這兩個月變亂,甚至遲到很久還沒來。所以想請問您,這個藥有可能會影響生理期嗎?謝謝~<br />
<br />
A家庭醫學科專科醫師張文華回答:<br />
妳的懷疑是正確的,妳的月經不來確實可能是長期服用primperan所造成的。<br />
<br />
primperan常用來作為止吐劑,或者用來促進腸胃蠕動,以及減少胃酸逆流食道的現象。所以醫師處方primperan來治療妳胃食道逆流問題是合理的。會發生這樣的副作用,有一大部份的原因是和個人體質有關,因為並不是每個人服用primperan都會出現這種情形。所以妳只要向醫師反應這個問題,醫師就會幫妳換用別的藥,問題就可完全解決。<br />
<br />
接下來我把長期服用primperan造成月經不來的原因,說明如下:<br />
primperan會阻斷中樞神經系統中多巴胺接受器(dopamine receptor,多巴胺是一種腦部的神經傳導物質)的作用,藉以達到止吐的效果。但腦下垂體泌乳激素的分泌卻以多巴胺的量來當負回饋,意即,當中樞神經系中的多巴胺不夠時,泌乳激素的分泌就會增加。所以當primperan把多巴胺接受器阻斷時,腦下垂體會誤以為多巴胺的量不夠,因而增加泌乳激素的分泌,就可能造成高泌乳激素血症(prolactinemia)。此時患者可能在沒有懷孕的情況下出現乳汁分泌,以及月經不順或停止的情形。這種情形在停藥後很快就可恢正常。<br />
<br />
<font color="">Primperan的副作用</font><br />
提問:<br />
幾個月前腸胃不適+整條食道有異物感,照了胃鏡後,為胃炎,吃了幾天的葯後,胃不再痛,食道已沒有異物感,但老是覺得有東西卡在喉嚨,看耳鼻喉科,醫師說是逆流性食道炎。<br />
<br />
開了 GOwell、Primperan、Fludiazepam、Fludiazepam藥袋上寫"抗焦慮",我告訴醫生我沒有焦慮症<br />
<br />
醫生說那是促進頸部血液循環的藥<br />
<br />
吃了三天後, 喉嚨已無異物感<br />
<br />
但很奇怪, 頸部一直覺得很緊<br />
<br />
請問GOwell , Primperan 是否有副作用---使得頸部緊緊的?<br />
<br />
(所以醫生才要開促進頸部血液循環的Fludiazepam)<br />
<br />
那 TOpaal 也會這些副作用嗎?<br />
<br />
解答:<br />
Primperan會引起錐體外症候群(EPS) 您頸部一直覺得很緊可能是 Primperan所造成 停藥後即可慢慢恢復<br />
錐體外症候群(EPS) :指控制運動之系統受到影響所引起的症狀,如肢體發抖,眼睛上吊,歪嘴,僵硬或不平衡感等。<br />
<br />
常見藥物副作用:EPS,其藥物有...<br />
1.傳統抗精神病藥物(第一代抗精神病藥物)阻斷了黑質紋狀體多巴胺徑路之多巴胺D2 受體,而容易產生運動方面的副作用。<br />
2.多巴胺拮抗製劑(dopamine antagonist):目前最常使用的抗嘔吐藥物(如primperan)。常見的副作用是坐立難安,及錐體外症候群。 <br />
3.好度(Haloperidol):一樣是多巴胺拮抗製劑,一般用於精神科病人,所以較少被用於抗嘔吐的作用。常見的副作用也是坐立難安和錐體外症候群。<br />
資料來原: <a href="http://tw.knowledge.yahoo.com/question/question?qid=1607051101535" target="_blank">http://tw.knowledge.yahoo.com/question/question?qid=1607051101535</a><br />
<br />
<font color="">Takepron的副作用</font><br />
藥物作用: <br />
本藥可以藉由抑制(H++K+)-Atpase的活性,進而抑制胃酸分泌,達到治療潰瘍的作用。十二指腸潰瘍、胃潰瘍、胃酸逆流產生的食道炎等。<br />
<br />
副作用: <br />
服用本藥偶而會發生起疹子等過敏症狀或肝功能指數上升的情形,如出現這種情形應立即停藥並給予適當的治療。本藥其他可能的副作用包括:頭痛、嗜睡、腸胃不適、口渴、貧血、白血球減少、膽固醇或尿酸上升等。<br />
<br />
注意事項: <br />
1.老人、肝功能不良者、有藥物過敏紀錄者應在醫師指示下,謹慎服用本藥。 <br />
2.本藥不適合長期服用,也不宜使用過高劑量。 <br />
3.本藥會使胃癌的症狀不明顯,所以要先確認不是胃癌,再使用本藥<br />
<br />
<font color="">Takepron(PPI)的副作用</font><br />
<br />
胃潰瘍的用藥:泰克胃通(lansoprazole)<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4OA_k_9eQ1ysNp7PD69_kpRoRMP3lVfnJCs64n5BQovq19ig4H7xCmE0iEVImLY32F0oeXe3iaZSqIfp1xsjCqqrgWkfhsPTxcdxTRiCg-1benriBmStiH4Zpb_W-4UtM3ud4_y8HskhG/s1600/2.jpg"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh4OA_k_9eQ1ysNp7PD69_kpRoRMP3lVfnJCs64n5BQovq19ig4H7xCmE0iEVImLY32F0oeXe3iaZSqIfp1xsjCqqrgWkfhsPTxcdxTRiCg-1benriBmStiH4Zpb_W-4UtM3ud4_y8HskhG/s1600/2.jpg" width="400" /></a><br />
<br />
Lansoprazole 泰克胃通口溶錠<br />
藥名(學名):LANSOPRAZOLE<br />
商品名(廠商):TAKEPRON(武田)<br />
<br />
副作用: <br />
1. 過敏症:偶有發疹、搔癢等症狀。 <br />
2. 肝臟:偶有GOT、GPT、ALP、LDH、y-GTP上升的現象。所以需細心觀察,如有異常現象出現應採取停藥等適當的處置。 <br />
3. 血液:偶有貧血、白血球減少、嗜酸球增多等症狀、血小板減少之症狀極少發生。 <br />
4. 消化氣:偶有便秘、下痢、口渴、腹脹等症狀。 <br />
5.精神神經系:偶有頭痛、嗜睡等症狀,失眠、頭暈等症狀極少發生。 <br />
6.其他:偶有發熱、總膽固醇及尿酸上升等症狀。<br />
<br />
用法用量:<br />
通常,成人每天1次,口服LANSOPRAZOLE 30mg。 治療胃潰瘍和逆流性食道炎通常需持續服用8週, 治療十二指腸潰瘍需持續服用6週。<br />
<br />
美心胃 膜衣錠 (mebeverine ) 135mg<br />
<br />
* 胃潰瘍***三合一療法<br />
<br />
1) 克那每欣膜衣錠(clarithromycin) 每天2次 每次2粒 (鮮黃長圓形狀的)<br />
2) 安莫西林膠囊(amoxycillin) 每天2次 每次4粒 (一半紅一半黃的膠囊)------每粒250mg<br />
3) 泰克胃通口溶錠(lansoprazole) 每天兩次 每次1粒 (白色圓扁形有橙色粒斑點)<br />
<br />
這是幽門桿菌除菌療法中,最有效果的三合一療法.<br />
醫師開的藥非常標準.<br />
其中抗生素應該只需吃一個禮拜,<br />
抑制胃酸分泌的藥,還要再繼續吃一陣子.<br />
除非對藥物過敏,<br />
否則這樣的服用方式是安全的.<br />
請一定要遵照醫師的醫囑按時服藥,<br />
避免日後胃潰瘍發生的機率增高,<br />
才能降低胃癌發生的機會<br />
</font><div><font face="verdana" size="3"><br /></font></div><div><font face="verdana" size="3"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></font></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-49453045760399953722011-12-01T10:55:00.001+08:002020-08-22T13:17:16.095+08:00腸道是人體的第二大腦-腹腦<font face="verdana" size="3"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div>
腸道健康對每一個人生命品質的維護非常重要,不只要了解腸道的重要性,還要知道如何做腸道保健,最重要的是要將知識轉化成每日的作息習慣,並持之以恆,在平均壽命五、六十歲的時代,我們重視的是如何活久一點;現代平均壽命已經是八、九十歲的時候,我們重視的是如何活得品質好一點,如何讓自己始終充滿青春活力。請聽我以下的健康宣言:「既然不可避免的,不管我們喜歡或不喜歡,我們都極可能會活到九十歲以上,那麼我就希望自己的健康指標始終走在紅色曲線,不論到什麼年紀,都能夠活得健康,活的美麗,活的富足。這就是我所謂的健康人生目標,要達到這樣的目標,就必須儘早設計規劃自己的健康人生方案,而且努力去執行。」<br />
<br />
腸道健康非常重要,且具有急迫性,目前台灣的腸癌發生率,正在快速攀升,腸癌的發生,主要是因為平常不重視腸道保健,腸道長期處於不健康狀態所致,不但腸癌如此,許多最新的醫學研究,也證明如心臟病、糖尿病、老年失智症等各種重大成人疾病,也都與腸道健康密切相關。<br />
<br />
一般人對腸道的態度,基本上是忽視,不然就認為它是製造便便的骯髒地方,很多人不知道兒童的自閉症和腸道有關,腸道和大腦之間有很密切的連結,許多專家甚至稱腸道是人的第二大腦,或者叫做「腹腦」,在做大體解剖時,可以觀察腸道壁上,附著兩層由神經束組成,薄如蟬翼的網狀結構,腸道神經系統有一億個以上的神經元,其數目甚至比骨髓的神經元還多,腸道神經系統(腹腦),和中樞神經系統(大腦)一樣的複雜、敏銳、纖細,它能夠獨立運作,自主判斷,發號施令。<br />
<br />
腹腦會藉著監控腸胃蠕動、血流速度及消化液分泌等,來調節消化速度。人體消化道中,口腔、食道及部分胃的功能受大腦控制,整個腸道則完全由腹腦負責,到最後的肛門控制權,才又回到大腦。腸道有非常強力的訊息接受系統,它能夠精確偵測成千上萬的化學物質,只要偵測到有害身體健康的外來毒素,腹腦馬上做出反應,引起下痢、嘔吐等預防動作,快速稀釋排出毒素。<br />
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從生理學角度來看,腹腦也和大腦一樣會指揮腸道分泌多種荷爾蒙,放出到血液中引發重要生理反應,換句話說,腸道和大腦一樣,會因應生理變化而發號施令。例如:十二指腸會分泌一種CCK神經胜?,使膽囊收縮放出膽汁,同時引起飽足感、幸福感,讓我們感到昏昏欲睡。有些神經荷爾蒙是大腦和腹腦都會分泌的,例如:血清素就是一種神經傳導物質,主要由腸道分泌,但是大腦松果體也有少量存在。血清素一方面會促進腸道蠕動,一方面也和我們的精神狀況有關,常用的抗憂鬱症藥,百憂解就是用來提高血液中血清素的量,不但可以用於治療憂鬱,也可以用於治療一些腸道疾病。<br />
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從心理學角度來看腸道和我們心理的關係,精神影響腸道最顯著的例子就是大腦急躁症候群,腸躁症和精神長期有關,雖然不會有生命的危險,不會讓腸道受到傷害,卻會讓你的生活帶來無限的困擾,腸道對於生命的運轉非常重要,為了要確保消化吸收基本功能的運作,腸道也發展成人體最重要的免疫器官,保護腸道黏膜的安全,同時,腸道更發展出獨特的神經體系,和我們的中樞神經體系密切合作協調,所以腸道是生命的動力,是健康的基石,千萬不能忽略它的健康喔!<br />
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資料來源:<a href="http://sites.google.com/site/982heconomics/wen-zhang-fen-xiang/changdaoshirentidedierdanao%E2%94%80%E2%94%80funao" target="_blank">幸福經濟學教學部落</a><br />
</font><div><br /></div><div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-47346883979568074542011-11-24T13:40:00.006+08:002020-08-22T13:16:57.032+08:0021 細嚼慢嚥,嚼出魔鬼身材<font face="verdana" size="2"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div>
不少胖哥、胖姊努力減肥,總是功虧一簣,專家指出,除了少吃、多動,想要遠離肥胖必須克服暴飲暴食的「心病」,若能開發自己的「味覺智能(Taste Quotient,TQ),平時細嚼慢嚥,體重自然不會飆升。<br />
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台大醫學院外科副教授趙世晃離開台大後,轉攻減肥門診,近年來陸續幫4萬多人成功減重,他發現,減重成敗關鍵來自於病人本身的「心病」。他說,有的肥胖者即使接受胃間隔減重手術,還是瘦不下來,問題就在於他們繼續以「胖子頭腦」吃東西,永遠吃不到滿足點。咀嚼少及吞嚥快,是易致肥胖的飲食特點。<br />
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趙世晃目前擔任台中大里仁愛醫院最高顧問,他曾比較肥胖者和正常體重者的飲食習慣,同樣面對一碗380公克的肉鬆稀飯,肥胖者平均咀嚼82次就吞下肚,標準體重者則平均咀嚼157次才吃完;一口18公克的蒟蒻乾,雖然不易咀嚼,但胖男嚼不到60下就解決,一般人至少嚼170多下。<br />
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趙世晃認為,每個人表現出來的「吃相」,不論細嚼慢嚥、狼吞虎嚥、漫不經心或談笑風生,都代表其「心性」,狼吞虎嚥型的人做事比較急躁,速戰速決,但戰鬥式的吃法,往往喪失味覺感知能力,即使已吃下肚,卻食不知味,也就是「味盲」。<br />
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他強調,大多數肥胖者由於味蕾得不到滿足,大腦感受不到「吃飽的滋味」,以致愈吃愈多,身材容易發胖。如果要減重,就要開發TQ,學會用「心」吃東西,細嚼慢嚥,當懂得品嘗食物美味,以及滿足的進食,自然而然就會控制飲食,不會暴飲暴食。<br />
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署立雙和醫院社區醫學部主任祝年豐表示,國外也有類似研究,發現進食習慣狼吞虎嚥者,比細嚼慢嚥的人來得重,除了用餐速度快,吃的東西比別人多,也與口腔及胃腸道荷爾蒙有關,吃得快,食物在胃裡存留時間太短,大腦飽足中樞就感受不到吃飽,也就吃得多。<br />
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不過,祝年豐認為,雖然吃得慢變胖機率變低,卻有但書,一方面是因人而異,另一方面則是少吃高熱量的食物,因為這類食物不管多嚼10下、20下、30下,還是可能會變胖。<br />
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<font color="">█</font> <b>味覺智能(TQ)訓練6招</b><br />
1. 細嚼慢嚥:每一口食物都多花一點時間<br />
2. 不分心:吃東西時不看電視或做其他事<br />
3. 讚美感恩:當做最後一餐,並說出自己的感動<br />
4. 分享與參與:品嘗食物美味並與他人討論<br />
5. 多食粗食與蔬食:避免精緻食物以及高油、高鹽、高糖等食物<br />
6. 平衡知足:學會餓肚子也不會心慌<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiighusWXzdor-KEhoyufwATiGeAU-oIiijBFEnwUmUbsJ9ByTRVgxYppnmsf8iF12L1s3LgfcEjFiS0eiYW36BaNyGTUfK7T0CYzAHAVhN363ln7HeAT-s6RqYJpsOlTrvr2_9KO1ElIa2/s400/26.jpg"><img border="0" height="379" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiighusWXzdor-KEhoyufwATiGeAU-oIiijBFEnwUmUbsJ9ByTRVgxYppnmsf8iF12L1s3LgfcEjFiS0eiYW36BaNyGTUfK7T0CYzAHAVhN363ln7HeAT-s6RqYJpsOlTrvr2_9KO1ElIa2/s400/26.jpg" width="280" /></a><br />
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資料來源:<a href="http://udn.com/NEWS/HEALTH/HEA2/6737639.shtml" target="_blank">聯合新聞網 健康醫藥</a><br />
</font><div><br /></div><div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-7440271781484889062011-11-18T17:08:00.021+08:002020-08-22T13:16:42.373+08:0020 胃食道逆流、食道炎、食道癌影片動畫<font face="verdana" size="2"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div>
多發性食道潰瘍<br />
Eadoscopia de multiples ulcers del estomago<br />
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長期胃食道逆流引起,為食道癌前期<br />
Endoscopia de Esofago de Barrett<br />
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長期胃食道逆流,引發食道黏膜病變,食道癌前期<br />
Sindrome de barret<br />
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下食道括約肌為單向(往下)瓣膜功能,可阻止胃內食物逆流至食道<br />
Gastro-Oesophaegal Reflux Disease (GORD)<br />
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GERD<br />
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What to do about Acid Reflex GERD GastroEsophageal Reflux<br />
下食道括約肌(les)鬆弛致胃酸逆流至食道<br />
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GERD surgery<br />
以腹腔錯做,胃食道逆流手術<br />
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ca stomach Edwin.avi<br />
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esophayx animation<br />
經由食道做胃食道逆流手術<br />
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Incision free acid reflux surgery with Esophyx<br />
經由食道做胃食道逆流手術<br />
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Candida (fungal) laryngitis and esophagitis<br />
咽及食道黴菌(念珠菌)感染(與色小點部份)<br />
<object style="height: 390px; width: 540px;"><param name="movie" value="http://www.youtube.com/v/PUWCl3o_OF0?version=3&feature=player_detailpage" /><param name="allowFullScreen" value="true" /><param name="allowScriptAccess" value="always" /><embed allowfullscreen="true" allowscriptaccess="always" height="360" src="http://www.youtube.com/v/PUWCl3o_OF0?version=3&feature=player_detailpage" type="application/x-shockwave-flash" width="540"></embed></object><br />
<br />
Esophageal Cancer with extension to trachea (CRCOC-4).MPG<br />
食道癌蔓延到氣管<br />
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<br />
Endoscopy and Biopsy of Oesphageal Cancer<br />
食道癌切片<br />
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<br />
Candidiasis of Esophagus<br />
食道免疫力降低引起黴菌(念珠菌)感染,吞嚥困難<br />
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<br />
les cordes vocales: larynx<br />
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<br />
Endoscopia de Esófago de Barrett<br />
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<br />
Swallowing Difficulty Due To Fungus-Endoscopy<br />
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<br />
Endoscopy and Biopsy of Oesphageal Cancer<br />
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</font><div><font face="verdana" size="2"><br /></font></div><div><font face="verdana" size="2"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></font></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-38037635532407640802011-11-17T19:02:00.001+08:002020-08-22T13:16:25.313+08:0019 主要腸胃荷爾蒙及神經調節物質<div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"> <div align="center" class="MsoNormal" style="line-height: 25pt;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><b><span lang="" style="font-size: 20pt;">The Major Gastrointestinal Regulatory Substances</span></b></div><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><b><span face="" style="font-family: 新細明體; font-size: 20pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">主要腸胃荷爾蒙及神經調節物質</span></b></div><br />
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border-color: initial; border-style: none; border-width: medium; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"><td style="background-color: transparent; border-color: initial; border-style: solid; border-width: 1pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span lang="" style="font-size: 10.5pt;">SUBSTANCE</span></b></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">物質</span></b><b><span lang="" style="font-size: 10.5pt;"></span></b></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: 1pt solid; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span lang="" style="font-size: 10.5pt;">STIMULUS FOR PRODUCTION</span></b></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">刺激其產生的因素</span></b><b><span lang="" style="font-size: 10.5pt;"></span></b></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: 1pt solid; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span lang="" style="font-size: 10.5pt;">TARGET TISSUE</span></b></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">標的組織</span></b><b><span lang="" style="font-size: 10.5pt;"></span></b></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: 1pt solid; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span lang="" style="font-size: 10.5pt;">EFFECT ON SECRETIONS</span></b></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">分泌物的效果</span></b><b><span lang="" style="font-size: 10.5pt;"></span></b></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: 1pt solid; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span lang="" style="font-size: 10.5pt;">EFFECT ON MOTILITY</span></b></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><b><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">對腸胃道蠕動之效果</span></b><b><span lang="" style="font-size: 10.5pt;"></span></b></div></td></tr>
<tr style="mso-yfti-irow: 1;"><td colspan="5" style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 541.45pt;" valign="top" width="722"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: red; font-size: 14pt;">A. Neuroregulators</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: red; font-size: 14pt;"> </span><span face="" style="color: red; font-family: 新細明體; font-size: 14pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">神經傳遞調節物質</span><span lang="" style="color: red; font-size: 14pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 2;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: blue; font-size: 10.5pt;">Acetylcholine</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">乙酸酸膽鹼</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Sight, smell, chewing food, stomach distention</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">視覺、嗅覺、咀嚼食物、胃擴張</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Gastric glands, other secretory glands, gastric and intestinal muscle</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃腺體、分泌腺體、胃及小腸肌肉</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Increased gastric acid</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">增加胃酸</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Generally increased; decreas sphincter tone</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">通常增加胃腸蠕動、降低括約肌張力</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 3;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: blue; font-size: 10.5pt;">Norepinephrine</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">正腎上腺素</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Stress, other various stimuli</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">壓力、其它各種刺激</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Secretory glands, gastric and intestinal muscle</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">分泌腺體、胃及小腸肌肉</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Generally inhibitory</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">通常為抑制</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Generally decreased; increase sphincter tone</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">通常降低胃腸蠕動,增加括約肌張力</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 4;"><td colspan="5" style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 541.45pt;" valign="top" width="722"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: red; font-size: 14pt;">B. Hormonal Regulators</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: red; font-size: 14pt;"> </span><span face="" style="color: red; font-family: 新細明體; font-size: 14pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">荷爾蒙調節物質</span><span lang="" style="color: red; font-size: 14pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 5;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: blue; font-size: 10.5pt;">Gastrin</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">促胃液素</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Stomach distention with food</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃因有食物而擴張時</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Gastric glands</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃腺體</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Increased secretion of gastric juice, which is rich in HCI</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">增加富含塩酸的胃液分泌</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">1. Increased motility of stomac decreased time required for gastric emptying</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">增加胃之蠕動,降低胃排空時間</span><span lang="" style="font-size: 10.5pt;"></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">2. Relaxation of ileocecal sphincter</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">鬆弛迴盲括約肌</span><span lang="" style="font-size: 10.5pt;"></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">3. Excitation of colon </span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">刺激興奮大腸</span><span lang="" style="font-size: 10.5pt;"></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">4. Constriction of gastroesophageal sphincter</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃食道括約肌收縮</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 6;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: blue; font-size: 10.5pt;">Cholecystokinin</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胆囊收縮素</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Fat in duodenum</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">十二指腸中的脂肪</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Gallbladder</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胆囊</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Release of bile into duodenum</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">釋放胆汁進入十二指腸</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td></tr>
<tr style="mso-yfti-irow: 7;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Pancreas</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胰</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Increased production of enzyme rich pancereatic secretions</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">增加分泌富含酶的胰分泌液</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td></tr>
<tr style="mso-yfti-irow: 8;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Stomach</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Inhibits gastric secretion somewhat </span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">抑制胃之分泌</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td></tr>
<tr style="mso-yfti-irow: 9;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: blue; font-size: 10.5pt;">Secretin</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胰泌素</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">pH of chyme in duodenum below 4-5</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">十二指腸中的食糜之</span><span lang="" style="font-size: 10.5pt;"> pH </span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">低於</span><span lang="" style="font-size: 10.5pt;">4-5</span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">時</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Stomach</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Inhibits gastric secretion somewhat</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">抑制胃之分泌</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Inhibits stomach contractions</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">抑制胃收縮</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 10;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Pancreas</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胰</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Increased production of bicarbonate-rich pancreatic juice</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">增加分泌富含碳酸的胰液</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br />
</div></td></tr>
<tr style="mso-yfti-irow: 11;"><td colspan="5" style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 541.45pt;" valign="top" width="722"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: red; font-size: 14pt;">C. Local Regulator</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: red; font-size: 14pt;"> </span><span face="" style="color: red; font-family: 新細明體; font-size: 14pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">局部調節物質</span><span lang="" style="color: red; font-size: 14pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 12; mso-yfti-lastrow: yes;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.25pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="color: blue; font-size: 10.5pt;">Histamine</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">組織胺</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Unclear, substances in food</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">不明食物中的成份</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Gastric glands</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃腺體</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span lang="" style="font-size: 10.5pt;">Increased gastric acid production</span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">增加胃酸分泌</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 108.3pt;" valign="top" width="144"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><br /><br>
</div></td></tr>
</tbody></table>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-1548507507876058562011-11-17T18:40:00.003+08:002020-08-22T13:15:45.075+08:0018 腸胃道的酶/分泌物的來源及作用<span face="" style="font-family: 新細明體; font-size: 12pt; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-language: ZH-TW; mso-font-kerning: 1.0pt; mso-hansi-font-family: "Times New Roman";"> </span> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div><div><br /><div><span face="" style="font-family: 新細明體; font-size: 12pt; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-language: ZH-TW; mso-font-kerning: 1.0pt; mso-hansi-font-family: "Times New Roman";"> <span style="font-size: x-large;">腸胃道的酶</span></span><span style="font-size: x-large;"><span face="" lang="" style="font-family: "times new roman"; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 新細明體; mso-fareast-language: ZH-TW; mso-font-kerning: 1.0pt;">/</span><span face="" style="font-family: 新細明體; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-language: ZH-TW; mso-font-kerning: 1.0pt; mso-hansi-font-family: "Times New Roman";">分泌物的來源及作用</span></span><br />
<span face="" style="font-family: 新細明體; font-size: 12pt; mso-ansi-language: EN-US; mso-ascii-font-family: "Times New Roman"; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-fareast-language: ZH-TW; mso-font-kerning: 1.0pt; mso-hansi-font-family: "Times New Roman";"></span><br />
<table align="left" border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border-color: initial; border-style: none; border-width: medium; margin: auto 6.75pt; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-table-anchor-horizontal: margin; mso-table-anchor-vertical: margin; mso-table-left: left; mso-table-lspace: 9.0pt; mso-table-rspace: 9.0pt; mso-table-top: 27.6pt; mso-yfti-tbllook: 480;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"><td style="background-color: transparent; border-color: initial; border-style: solid; border-width: 1pt; mso-border-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><b><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">ENZYME/SECRETION</span></span></b></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><b><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">酶</span></b><b><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">/</span></span></b><b><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">分泌物名稱</span></b><b><span lang="" style="font-size: 10.5pt;"></span></b></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: 1pt solid; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><b><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">ENZYME SOURCE</span></span></b></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><b><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">酶的來源</span></b><b><span lang="" style="font-size: 10.5pt;"></span></b></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: 1pt solid; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><b><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">DIGESTIVE ACTION</span></span></b></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><b><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">消化功能</span></b><b><span lang="" style="font-size: 10.5pt;"></span></b></div></td></tr>
<tr style="height: 26.45pt; mso-yfti-irow: 1;"><td colspan="3" style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); height: 26.45pt; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 541.45pt;" valign="top" width="722"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: red; font-size: 14pt;"><span face="" style="font-family: "times new roman";">A. Action of Enzsymes That Digest Carbobydrates</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: red; font-size: 14pt;"><span face="" style="font-family: "times new roman";"> </span></span><span face="" style="color: red; font-family: 新細明體; font-size: 14pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">消化碳水化合物的酶之作用</span><span lang="" style="color: red; font-size: 14pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 2;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Ptyalin ( salivary amylase )</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">唾液酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Salivary glands</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">唾液腺</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Starch</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">dextrin, maltose, glucose</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">澱粉→葡聚糖、麥芽糖、葡萄糖</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 3;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Amylase</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">澱粉酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Pancreas and intestinal mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胰及小腸黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">1. Starch</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">dextrin, maltose, glucose</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">澱粉→葡聚糖、麥芽糖、葡萄糖</span><span lang="" style="font-size: 10.5pt;"></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">2. Dextrin</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">maltose glucose</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">葡聚糖→麥芽糖、葡萄糖</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 4;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Maltase</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">麥芽糖酶</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Intestinal mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">小腸黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Maltose</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">glucose</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">麥芽糖→葡萄糖</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 5;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Sucrase</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">蔗糖酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Intestinal mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">小腸黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Sucrose</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">glucose, fructose</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">蔗糖→葡萄糖、果糖</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 6;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Lactase</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">乳糖酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Intestinal mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">小腸黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Lactose</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">glucose, galactose</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">乳糖→葡萄糖、半乳糖</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 7;"><td colspan="3" style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 541.45pt;" valign="top" width="722"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: red; font-size: 14pt;"><span face="" style="font-family: "times new roman";">B. Action of Enzymes/Secretions That Digest Protein</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: red; font-size: 14pt;"><span face="" style="font-family: "times new roman";"> </span></span><span face="" style="color: red; font-family: 新細明體; font-size: 14pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">消化蛋白質的酶</span><span lang="" style="color: red; font-size: 14pt;"><span face="" style="font-family: "times new roman";">/</span></span><span face="" style="color: red; font-family: 新細明體; font-size: 14pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">分泌物之作用</span><span lang="" style="font-size: 14pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 8;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Pepsin</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃液素</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Gastric mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Protein</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Polypeptides</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">蛋白質→多胜肽</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 9;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Trypsin</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胰蛋白酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Pancreas</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胰</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Proteins and polypeptides</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">polypeptides, dipeptides, amino acids </span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">蛋白質及多胜肽→多胜肽、二胜肽、胺基酸</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 10;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Aminopeptidase</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">氨基肽酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Intestinal mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">小腸黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Polypeptides</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">dipeptides, amino acids</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">多胜肽→二胜肽、胺基酸</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 11;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Dipeptidase</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">二胜肽酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Intestinal mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">小腸黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Dipeptides</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">amino acids</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">二胜肽→胺基酸</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 12;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Hydrochloric acid</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">塩酸</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Gastric mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Protein</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">polypeptides, amino acids</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">蛋白質→多胜肽、胺基酸</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 13;"><td colspan="3" style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 541.45pt;" valign="top" width="722"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: red; font-size: 14pt;"><span face="" style="font-family: "times new roman";">C. Action of Enzymes That Digest Fat(Triglyceride)</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: red; font-size: 14pt;"><span face="" style="font-family: "times new roman";"> </span></span><span face="" style="color: red; font-family: 新細明體; font-size: 14pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">消化脂肪</span><span lang="" style="color: red; font-size: 14pt;"><span face="" style="font-family: "times new roman";">(</span></span><span face="" style="color: red; font-family: 新細明體; font-size: 14pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">三酸甘油脂</span><span lang="" style="color: red; font-size: 14pt;"><span face="" style="font-family: "times new roman";">)</span></span><span face="" style="color: red; font-family: 新細明體; font-size: 14pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">的酶之作用</span><span lang="" style="color: red; font-size: 14pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 14;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Pharyngeal lipase</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">咽頭脂肪分解酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Pharynx mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">咽頭黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Triglycerides</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">fatty acids, diglycerides, monoglycerides </span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">三酸甘油脂→脂肪酸、二酸甘油脂、單酸甘油脂</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 15;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Steapsin</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胰脂酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Gastric mucosa</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胃黏膜</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Triglycerides</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">fatty acids, diglycerides, monoglycerides</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">三酸甘油脂→脂肪酸、二酸甘油脂、單酸甘油脂</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 16;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Pancreatic lipase</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胰脂肪分解酶</span><span lang="" style="color: #993300; font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Pancreas</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胰</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Triglycerides</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">→</span><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">fatty acids, diglycerides, monoglycerides</span></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">三酸甘油脂→脂肪酸、二酸甘油脂、單酸甘油脂</span><span lang="" style="font-size: 10.5pt;"></span></div></td></tr>
<tr style="mso-yfti-irow: 17; mso-yfti-lastrow: yes;"><td style="background-color: transparent; border-bottom: 1pt solid; border-left: 1pt solid; border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.45pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="color: blue; font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Bile</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span face="" style="color: #993300; font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">胆汁</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Liver and gallbladder</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">肝臟及胆囊</span><span lang="" style="font-size: 10.5pt;"></span></div></td><td style="background-color: transparent; border-bottom: 1pt solid; border-left: rgb(236, 233, 216); border-right: 1pt solid; border-top: rgb(236, 233, 216); mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding: 0cm 5.4pt; width: 180.5pt;" valign="top" width="241"><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"><span face="" style="font-family: "times new roman";">Fat emulsification</span></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-element-anchor-horizontal: margin; mso-element-frame-hspace: 9.0pt; mso-element-top: 27.6pt; mso-element-wrap: around; mso-element: frame; mso-height-rule: exactly;"><span lang="" style="font-size: 10.5pt;"></span><span face="" style="font-family: 新細明體; font-size: 10.5pt; mso-ascii-font-family: "Times New Roman"; mso-hansi-font-family: "Times New Roman";">脂肪乳化</span></div></td></tr>
</tbody></table><br /></div></div><div><br /></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-60528072450010759312011-11-15T10:20:00.006+08:002020-08-22T13:15:05.945+08:0017 自律神經失調引發「胃食道逆流」的機轉<font face="verdana" size="2"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div>
<font color="">A. 自律神經對人體的作用</font><br />
<br />
<font color="">1. 人體神經系統的分類之作用</font><br />
人的神經分中樞及週邊神經,週邊神經又分為體神經及自律神經;自律神經再分為交感及副交感神經<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFfdWi_smxn6hff91Rcc0prxQrtDSDLuUvWnmx1VL9sspDYxcKmXHP4hqRwy54oRNXBqGwrCJPhbKApIPOzKCT2nEq3Lmlkfz0YWj6-gotvHdUnpcTGfmPnBC58WOKyznxxrYt91yX84nJ/s400/20.jpg"><img border="0" height="301" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFfdWi_smxn6hff91Rcc0prxQrtDSDLuUvWnmx1VL9sspDYxcKmXHP4hqRwy54oRNXBqGwrCJPhbKApIPOzKCT2nEq3Lmlkfz0YWj6-gotvHdUnpcTGfmPnBC58WOKyznxxrYt91yX84nJ/s400/20.jpg" width="400" /></a><br />
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人的不隨意肌(如腸謂道、心臟)100%受到自律神經的控制,人無法用意志力去操控它。隨意肌(如骨骼肌、橫紋肌)則受運動神經控制,可按人的意志做出各種動作。<br />
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<font color="">2. 自律神經控制了全身的細胞組織及器官</font><br />
連結:<a href="http://anstaiwan.blogspot.com/2011/10/c.html" target="_blank">自律神經對器官的作用</a><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjC2aLIU7oQOac39ycbmZTI6hnUKLr4nwV3YxTNgOhS5fsUQpeNth8AY0-9Y9Q4pdVAN4juqxy6dBNaXUdlrgyofFuWOBsNtbsaUq6e1yoc-I5sdDzJU_XluQkju8JbOobJx4MkfU8Wiq_k/s400/21.jpg"><img border="0" height="383" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjC2aLIU7oQOac39ycbmZTI6hnUKLr4nwV3YxTNgOhS5fsUQpeNth8AY0-9Y9Q4pdVAN4juqxy6dBNaXUdlrgyofFuWOBsNtbsaUq6e1yoc-I5sdDzJU_XluQkju8JbOobJx4MkfU8Wiq_k/s400/21.jpg" width="400" /></a><br />
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<font color="">3. 交感副交感神經的作用</font><br />
<font color="">a. 互相抗拮</font><br />
交感與副交感對器官的作用都是一正一反互相抗拮,也是互相協調的。對心臟而言,交感神經可以促進心肌收縮(inotropic),也可以增加心跳的速率。而副交感則是相反,可減低心肌收縮力,放慢心跳的速率,交感對心臟而言,好比催油門,副交感好比採煞車。<br />
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交感神經與副交感神經對胃腸道的作用則剛好相反。副交感可促進腸胃蠕動、唾液分泌、膽囊收縮,胃酸分泌,胰消化分泌,交感則仰制腸胃道蠕動。例如人在很急的時後,交感神經處於亢奮狀態,不會有想吃東西(沒胃口) ,這時如果勉強吞下些食物,就會覺得食物似乎卡在食道,吞了下去,那就是一種「食不下嚥」的感覺。<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5mVfGgKxfxg3JvAcOZIIj7g6SziYZSajXNUXMz5W7-YyvNlfZjS9TZtKxZRH0QYnj1wpqOCdbrK7xl3QxECXsgnWG9Er2eslt2QTasPPL6U-nn1sDhitf4qyJ-tPuXDp6vDELC9BnQd8L/s1600/22.jpg"><img border="0" height="281" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh5mVfGgKxfxg3JvAcOZIIj7g6SziYZSajXNUXMz5W7-YyvNlfZjS9TZtKxZRH0QYnj1wpqOCdbrK7xl3QxECXsgnWG9Er2eslt2QTasPPL6U-nn1sDhitf4qyJ-tPuXDp6vDELC9BnQd8L/s1600/22.jpg" width="400" /></a><br />
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<font color="">b. 自律神經有感覺及運動成份</font><br />
「古典自律神經學」比較強調自律神經之傳出神經(afferent fiber)的運動功能,描述腦都發出交感副交感指令來指揮控制某一器官,比較少去涉及自律神經的傳入纖維(efferent fiber)的功能,也就是感覺功能。<br />
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醫師們常會說皮膚有感覺神經,所以人會有痛、熱的感覺。而肝、胰等,因沒有感覺神經,所以即便長了很大的腫瘤也不會感覺到痛。<br />
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肝、胰長腫瘤不易感覺到痛是事實,但如果就此論定自律神經沒有傳入神經,把臟器的訊息傳到腦部,那是不正確的。<br />
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自律神經的傳入纖維能把臟器的現況傳輸到大腦,大腦才能發出恰當的自律神經指令,來指揮各臟器及協調免疫系統之功能。<br />
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<font color="">c. 自律神經透過神經傳遞物質來執行指令</font><br />
交感神經用來執行工作指令的化學物質主要是腎上腺(Epinephrne)及正腎上腺素(Norepinephrine)。副交感經用來執行工作指令的神經傳遞物質(化學物質)則是乙酸膽鹼(Acetylcholine)<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_2Q8iRTZXTAvOfFd0417ONH7JRPgZKx8XzEOIFLnSniepGTgHI_ULyjzu8uQoWpAuV-niyEdfv46UjQEgK2KrbOT68LRCLc-nc96N_p9b55ZkloyImM3wBVChQ3Lux3rw06Omch5GH0nM/s1600/23.jpg"><img border="0" height="254" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_2Q8iRTZXTAvOfFd0417ONH7JRPgZKx8XzEOIFLnSniepGTgHI_ULyjzu8uQoWpAuV-niyEdfv46UjQEgK2KrbOT68LRCLc-nc96N_p9b55ZkloyImM3wBVChQ3Lux3rw06Omch5GH0nM/s1600/23.jpg" width="400" /></a><br />
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<font color="">d. 自律神經協調全身細胞同調、同步、共振</font><br />
自律神經所扮演的角色是非常吃緊的,佔了全體神經活動的90%,其餘10%才是我們能感受得到的感覺神經及可以隨意志動作的運動神經。<br />
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自律神經系統就像一架飛機的自動駕駛系統,飛機上升至一定高度後,駕駛員只要按下自動駕駛控鈕,飛機就可以自動飛行,駕駛員甚至可以睡個覺。到了目的地,飛機甚至還會自行安全降落在機場跑道上。<br />
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一架飛機的自動駕駛操控系統正常的運作,飛機才能正常的飛行,人的自律神經也要能順利運作,如此人才會自律神經健康、平衡。各器官的運作才會有效率。人的身心靈才能達到合一的狀態。<br />
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<b>自律神經要做到平衡,需符合同調、同步及共振這三個條件</b><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi4_UU5wyyqjdMLIl2WMIN_ljUymFtGI2eobc3rRpF8J01DJg91y-rywCeEmrvO3ok8J1tzor_oJOFUYfAL4J_vu6Ze01LJeZU-vWdxfUn1G45K7bvICpoFZeR5xwL_lK_Ftr_9Jzpof8NS/s1600/24.jpg"><img border="0" height="301" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi4_UU5wyyqjdMLIl2WMIN_ljUymFtGI2eobc3rRpF8J01DJg91y-rywCeEmrvO3ok8J1tzor_oJOFUYfAL4J_vu6Ze01LJeZU-vWdxfUn1G45K7bvICpoFZeR5xwL_lK_Ftr_9Jzpof8NS/s1600/24.jpg" width="400" /></a><br />
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<font color="">e. 自律神經如調控腸胃道</font><br />
副交感神經主控人的腫眠胃腸道消化食物、吸收營養(Rest or ligest),並把營養輸送到全身,同時把代謝的廢物回收,排出體外<br />
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人消化食物,吸收營養,就像植物行光合作用一樣,是一種合成(anaboric)作用,這作用是由副交感神經來推動的,因此,當一個人的副交感神經活性不足時,上述的合成作用就會受到影響。<br />
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換一種通俗說法,副交感是管賺錢多的,交感則是負責花錢的,也就是推動catabolic(分解消耗)的。人在緊急時,要逃命或戰鬥(fight or Flight),這時候是由交感神經來擔綱的。<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaHuvM6tUXUQtZcxJZLeJsReJAO95YbkCtl-maTgKZYAoUoh8XMBeAimTYaWvE04tjq6gYCxYNrOC1rPRt2a3xP-2zmHmj181fjYYJCe8bziZ8mXIC7ML8r210vz3zxo82tFbbHX0bprnR/s1600/25.jpg"><img border="0" height="245" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaHuvM6tUXUQtZcxJZLeJsReJAO95YbkCtl-maTgKZYAoUoh8XMBeAimTYaWvE04tjq6gYCxYNrOC1rPRt2a3xP-2zmHmj181fjYYJCe8bziZ8mXIC7ML8r210vz3zxo82tFbbHX0bprnR/s1600/25.jpg" width="327" /></a><br />
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<font color="">B. 胃食道逆流的致病機轉:下食道括約肌運動不同步化</font><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv3gBGUQz5kgMZo-Jf7UkQFUV2m4X3NabJpKOuC3P3S3d9El2x1mROtgC0TqXIpQCWODGdVYBzJ7NUJEAkFpPyP86gZZ5I-MlGqWqxedF6iWR-_-Qjnu8zJ5_wf5NdSmqxNGpZNCOEPz4N/s400/17.GIF"><img border="0" height="270" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhv3gBGUQz5kgMZo-Jf7UkQFUV2m4X3NabJpKOuC3P3S3d9El2x1mROtgC0TqXIpQCWODGdVYBzJ7NUJEAkFpPyP86gZZ5I-MlGqWqxedF6iWR-_-Qjnu8zJ5_wf5NdSmqxNGpZNCOEPz4N/s400/17.GIF" width="400" /></a><br />
資料來源:<a href="http://www.nature.com/gimo/contents/pt1/fig_tab/gimo14_F1.html" target="_blank">http://www.nature.com/gimo/contents/pt1/fig_tab/gimo14_F1.html</a><br />
連結: <a href="http://anstaiwan.blogspot.com/2011/10/c.html" target="_blank">自律神經對器官的作用</a><br />
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<b>自律神經的分佈與作用</b><br />
1. 自律神經(交感與副交感)分部在整個腸胃道,調控腸胃道的蠕動。<br />
2. 副交感神經可促進食道及胃腸道的蠕動作用。<br />
3. 交感神經抑制腸胃道的蠕動作用。<br />
4. 下食道括約肌上同時有交感及副交感神經分佈,交感神經負責促進此括約肌收縮,使胃內容易不致於逆流到食道,副交感則負責把此括約肌放鬆,讓食物能經由食道進入胃。<br />
5. 人在吞嚥時,食道蠕動,把食物送到接近下食道括約肌前,支配此括約肌的副交感神經就會同步(synchronize)使括約肌放鬆,使食物能夠通過進入胃中,此時,交感神經又同步發揮作用,發出指令使括約肌收縮緊閉,使胃內容物不會逆流到食道。<br />
6. 胃食道逆流的病理變化就是括約肌無法同步收縮,導致胃內容物(胃酸)逆流至食道,產生火燒心、胃酸等症狀。<br />
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<iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/PGW3ywK58T0" width="420"></iframe><br />
參考網址:<a href="http://youtu.be/PGW3ywK58T0" target="_blank">http://youtu.be/PGW3ywK58T0</a><br />
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7. LES( Lower Esophageal Sphincter )括約肌之所以會無法收縮,係因為患者長期過度緊張,交感神經過度亢奮,交感/副交感比例(LF/HF)長期過高失衡,導致此括約肌過度緊繃收縮,導致彈性疲乏,就像一條原本只能承受十公斤拉力的小彈簧,被數噸的起重機拉直了,無法恢復原形。<br />
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<iframe allowfullscreen="" frameborder="0" height="315" src="http://www.youtube.com/embed/SW-QfyDSY5I" width="420"></iframe><br />
參考網址:<a href="http://youtu.be/SW-QfyDSY5I" target="_blank">http://youtu.be/SW-QfyDSY5I</a><br />
</font><div><br /></div><div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-1115675328546601822011-11-14T20:15:00.005+08:002020-08-22T13:14:51.125+08:0016 長期喉嚨卡卡不舒服 - 淺談咽喉胃酸逆流<div><span class="Apple-style-span" style="font-family: inherit; font-size: large;"><span class="Apple-style-span" style="background-color: white; line-height: 25px;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></span></span></div><span class="Apple-style-span" style="font-family: inherit; font-size: large;"><span class="Apple-style-span" style="background-color: white; line-height: 25px;"><div><span class="Apple-style-span" style="font-family: inherit; font-size: large;"><span class="Apple-style-span" style="background-color: white; line-height: 25px;"><br /></span></span></div>40歲身材微胖的林太太因為長期喉嚨卡卡、痛痛的及偶爾咳嗽前來就診,平常沒有抽煙、喝酒,話也不多。一問之下發現林太太愛吃甜食、油炸類食物,常常中午一吃飽就躺著睡覺。經內視鏡檢查發現咽喉及聲帶有慢性發炎的現象,診斷為咽喉胃酸逆流引起的慢性咽喉炎。在給予飲食衛教及藥物治療,3個月後症狀已有明顯改善。</span><br style="background-color: white; line-height: 25px; text-align: left;" /><br style="background-color: white; line-height: 25px; text-align: left;" /><span class="Apple-style-span" style="background-color: white; line-height: 25px; text-align: left;">咽喉胃酸逆流,顧名思義,就是胃的內容物逆流到咽喉部位。不管是致病機轉、逆流的方式、症狀表現及治療效果和食道胃酸逆流都不一樣。咽喉胃酸逆流及食道胃酸逆流,兩者最大的區別在於大部分前者沒有食道炎及胸口灼熱感等症狀,根據統計咽喉胃酸逆流只有小於40%的病人會有胸口灼熱感,只有25%合併有食道炎。</span><br style="background-color: white; line-height: 25px; text-align: left;" /><br style="background-color: white; line-height: 25px; text-align: left;" /><span class="Apple-style-span" style="background-color: white; line-height: 25px; text-align: left;">大部分咽喉胃酸逆流發生在白天直立的時候,然而食道胃酸逆流主要是在夜間躺著的時候發生。食道胃酸逆流的時間比咽喉胃酸逆流來的長。除此之外,食道胃酸逆流合併有蠕動異常及食道胃酸清除時間延長等現象,但咽喉胃酸逆流則沒有這個特性。食道胃酸逆流問題主要出在食道下段功能異常,而咽喉胃酸逆流則是食道上擴約肌出了問題。由於這些差異性,也造成兩者的臨床症狀及表現有所不同。儘管大部分咽喉胃酸逆流的患者沒有食道胃酸逆流典型的病症,但仍有些病患會兩者同時存在。</span><br style="background-color: white; line-height: 25px; text-align: left;" /><br style="background-color: white; line-height: 25px; text-align: left;" /><span class="Apple-style-span" style="background-color: white; line-height: 25px; text-align: left;">咽喉胃酸逆流的症狀千變萬化,但常見的有聲音沙啞、喉頭異物感、吞厭困難、咳嗽、經常清喉嚨、喉嚨痛、鼻涕倒流等。這些症狀通常是慢性、間歇性。</span><br style="background-color: white; line-height: 25px; text-align: left;" /><br style="background-color: white; line-height: 25px; text-align: left;" /><span class="Apple-style-span" style="background-color: white; line-height: 25px; text-align: left;">咽喉胃酸逆流最常見的臨床表現是逆流性喉炎合併有肉芽組織或肉芽腫。咽喉胃酸逆流跟下喉部阻塞、喉癌、聲帶息肉、咽喉痙攣、聲帶節結、聲帶運動異常有相關性。其他在頭頸部引發的疾病包括氣喘、鼻竇炎、中耳炎、睡眠呼吸中斷、嬰兒猝死症、喉頭軟化症等,都曾報導和胃酸逆流有相關性。有文獻估計約一半喉頭或嗓音有問題的病患其實合併有胃酸逆流的情形。</span><br style="background-color: white; line-height: 25px; text-align: left;" /><br style="background-color: white; line-height: 25px; text-align: left;" /><span class="Apple-style-span" style="background-color: white; line-height: 25px; text-align: left;">咽喉胃酸逆流的診斷,主要是靠病人的臨床症狀描述配合喉部內視鏡檢查。但當診斷無法確定時,還是要靠攜帶式24小時酸鹼值偵測儀來確定診斷。其他的診斷工具還包括有鋇劑顯影食道攝影或食道鏡檢查,也可用來檢查食道有無其他的病理變化。</span><br style="background-color: white; line-height: 25px; text-align: left;" /><br style="background-color: white; line-height: 25px; text-align: left;" /><span class="Apple-style-span" style="background-color: white; line-height: 25px; text-align: left;">治療方式主要取決於病人的臨床症狀、胃酸逆流的嚴重程度及病患對治療效果的反應。若病患有輕微、間歇性的症狀可以先飲食控制加上第二型組織胺拮抗劑治療。但大部分的病患還是需要一天兩次的氫離子幫浦抑制劑。有些嚴重的病患甚至同時需要第二型組織胺拮抗劑加上氫離子幫浦抑制劑。通常咽喉胃酸逆流的治療要更積極且時間要更長。有研究顯示咽喉胃酸逆流的情形即使一週只有三次也會對喉頭造成嚴重的傷害,主要是因為喉頭黏膜對胃酸的抵抗能力沒有食道黏膜那麼好。大部分的病患在治療2-3個月後症狀會有明顯的改善,喉部理學檢查的異常通常要6個月甚至更長的時間才會恢復。所以建議初次治療時間至少需要6個月,有些病患甚至需要更長的時間。除了藥物治療之外,胃底摺疊術(fundoplication)也是一個有效的選擇。</span><br style="background-color: white; line-height: 25px; text-align: left;" /><br style="background-color: white; line-height: 25px; text-align: left;" /><span class="Apple-style-span" style="background-color: white; line-height: 25px; text-align: left;">咽喉胃酸逆流的臨床表現及症狀和典型的食道胃酸逆流不一樣。診斷主要靠臨床症狀、喉部內視鏡檢查及24小時酸鹼值監測儀。對於大部分的病患,一般建議初次治療時間至少要6個月,有些甚至需要終身治療。那平常要如何避免胃酸逆流呢?飲食盡量少量多餐,睡前兩個鐘頭不要吃東西,避免吃油炸、洋蔥、薄荷、巧克力、咖啡、可樂、柳橙汁等食物,避免抽煙喝酒、穿緊身衣物及體重控制,都可以減少胃酸逆流的情形。</span></span><br />
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<span class="Apple-style-span" style="background-color: white; font-size: large; line-height: 25px; text-align: left;"><b>資料來源:</b></span><br />
<span class="Apple-style-span" style="font-size: large;"><a href="http://tw.group.knowledge.yahoo.com/3344-888/article/view?aid=794">http://tw.group.knowledge.yahoo.com/3344-888/article/view?aid=794</a></span><div><br /></div><div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-516203318176753702011-11-14T20:09:00.001+08:002020-08-22T13:14:31.019+08:0015 巴萊特食道炎的分期及處量<div><span face="" style="font-family: 新細明體;"><div align="center" style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"> <div align="center" class="MsoNormal" style="line-height: 25pt;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div>
</div></span><table border="1" bordercolordark="#666699" bordercolorlight="#CCCCFF" cellpadding="3" cellspacing="0"><tbody>
<tr><td><span face="" style="font-family: 新細明體;"><span style="font-size: small;">癌前期的處理原則</span></span></td></tr>
</tbody></table><span face="" style="font-family: 新細明體;"><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;">1. 要仔細追蹤。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;">2</span><span style="font-size: small;">. 目前沒有確定的藥物治療。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br />
</div></span><table border="1" bordercolordark="#666699" bordercolorlight="#CCCCFF" cellpadding="3" cellspacing="0"><tbody>
<tr><td><span face="" style="font-family: 新細明體;"><span style="font-family: Arial; font-size: small;">Barrett's esophagus(columnar lined esophagus</span><span style="font-family: Arial; font-size: small;">)</span>病理學<span style="font-size: small;">的演變</span></span></td></tr>
</tbody></table><span face="" style="font-family: 新細明體;"></span><div align="center"><span face="" style="font-family: 新細明體;"></span><center><span face="" style="font-family: 新細明體;"></span><table border="0" cellpadding="0" cellspacing="0"><tbody>
<tr><td align="center" width="100%"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">長期嚴重地胃食道逆流(<span style="font-family: Arial;">G-E reflux) </span></span></span></div></td></tr>
<tr><td align="center" width="100%"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">↓</span></span></div></td></tr>
<tr><td align="center" width="100%"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">做胃鏡檢查</span></span></div></td></tr>
<tr><td align="center" width="100%"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">↓</span></span></div></td></tr>
<tr><td align="center" width="100%"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">發現<span style="font-family: Arial;">4~10%</span>病人至少有<span style="font-family: Arial;">3</span>公分以上的正常鱗狀上皮被柱狀上皮取代<span style="font-family: Arial;">(long-segment<br />
Barrett's esophagus)</span></span></span></div></td></tr>
<tr><td align="center" width="100%"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">↓</span></span></div></td></tr>
<tr><td align="center" width="100%"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">癌前期<span style="font-family: Arial;">(premalignant)</span></span></span></div></td></tr>
<tr><td align="center" width="100%"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">↓</span></span></div></td></tr>
<tr><td align="center" width="100%"><span face="" style="font-family: 新細明體;"></span><div align="center" style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">有<span style="font-family: Arial;">15%</span>的危險性發展成食道腺癌<span style="font-family: Arial;">, </span>因此病患要定期做胃鏡、切片</span></span></div></td></tr>
</tbody></table><span face="" style="font-family: 新細明體;"></span></center><span face="" style="font-family: 新細明體;"></span></div><span face="" style="font-family: 新細明體;"><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"> </div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-family: Arial;">Lagergren(NEJM 1999)</span>的研究指出引起<span style="font-family: Arial; font-size: small;">Barrett's esophagus</span><span style="font-size: small;">的慢性食道逆流是食道腺癌發生率增加的危險因子</span><span style="font-size: small;">。</span><span style="font-family: Arial;">Koop(Endoscopy 2002)</span>也指出西方國家感染幽門螺旋桿菌流行率的</div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;">下降也和<span style="font-size: small;">食道腺癌發生率的增加有關</span><span style="font-family: Arial; font-size: small;">, </span><span style="font-size: small;">因為</span>幽門螺旋桿菌可能導致萎縮性胃炎和降低胃酸<span style="font-family: Arial;">, </span>幽門螺旋桿菌的感染降低可能相反地增加<span style="font-size: small;">胃食道逆流的發生, 因而增加<span style="font-family: Arial;">Barrett's esophagus</span></span><span style="font-size: small;">和食道腺癌的危險性</span><span style="font-size: small;">。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br />
</div></span><table border="1" bordercolordark="#666699" bordercolorlight="#CCCCFF" cellpadding="3" cellspacing="0"><tbody>
<tr><td><span face="" style="font-family: 新細明體;"><span style="font-size: small;">基因和細胞週期的異常</span></span></td></tr>
</tbody></table><span face="" style="font-family: 新細明體;"></span><div align="center"><span face="" style="font-family: 新細明體;"></span><center><span face="" style="font-family: 新細明體;"></span><table border="0" cellpadding="0" cellspacing="0"><tbody>
<tr><td align="center"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">對慢性胃內容物逆流產生反應<span style="font-family: Arial;">, 10~20%</span>病人發生<span style="font-family: Arial;">Barrett's metaplastic epithelium,</span>在<span style="font-family: Arial;">metaplastic epithelium</span>早期會發生<span style="font-family: Arial;">G1 fractions</span>增加<span style="font-family: Arial;">, </span>但此時<span style="font-family: Arial;">S fractions</span>仍正常<span style="font-family: Arial;">, G1</span>增加可能是慢性胃食道逆流造成損傷和需要細胞增生來取代損傷上皮的後果<span style="font-family: Arial;">, </span>在此時期<span style="font-family: Arial;">, </span>細胞週期的控制仍然可以預防細胞進入<span style="font-family: Arial;">S phase, G1</span>的增加是可逆的</span></span></div></td></tr>
<tr><td align="center"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">↓</span></span></div></td></tr>
<tr><td align="center"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;"><span style="font-family: Arial;">p53</span>和<span style="font-family: Arial;">p16</span>的異常<span style="font-family: Arial;">: (1) loss of p53 (2) loss of p16</span></span></span></div></td></tr>
<tr><td align="center"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">↓</span></span></div></td></tr>
<tr><td align="center"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">之後<span style="font-family: Arial;">, </span>由於突變和<span style="font-family: Arial;">17p LOH, </span>使<span style="font-family: Arial;">diploid cells</span>的 <span style="font-family: Arial;">p53 </span>不活性化, <span style="font-family: Arial;">p53</span>不活性化使得它在<span style="font-family: Arial;">DNA</span>損傷後預防細胞分裂的能力消失<span style="font-family: Arial;">, </span>因為與<span style="font-family: Arial;">4N(G2/tetraploid) fractions</span>的增加有關<span style="font-family: Arial;">, </span>允許之後發展<span style="font-family: Arial;">aneuploid cells</span>的情況發生。另外<span style="font-family: Arial;">, premalignant diploid cell</span>的<span style="font-family: Arial;">p16</span>在突變或甲醇化(<span style="font-family: Arial; font-size: small;">methylation)</span>出現下發生<span style="font-family: Arial;">9p LOH, </span>而 <span style="font-family: Arial;">loss of p16</span>阻斷透過<span style="font-family: Arial;">G1 transtion</span>轉換的正常調節</span></span></div></td></tr>
<tr><td align="center"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">↓</span></span></div></td></tr>
<tr><td align="center"><span face="" style="font-family: 新細明體;"></span><div style="line-height: 16px;"><span face="" style="font-family: 新細明體;"><span style="font-size: small;">因此<span style="font-family: Arial;">, </span>在<span style="font-family: Arial;">premalignant diploid Barrett's epithelial cells</span>失去<span style="font-family: Arial;">p53</span>和<span style="font-family: Arial;">p16</span>的功能, 導致<span style="font-family: Arial;">aneuploid cell populations</span>的發生<span style="font-family: Arial;">, </span>當它們被偵測到時<span style="font-family: Arial;">, </span>典型是有<span style="font-family: Arial;">S-phase fractions</span>的增加<span style="font-family: Arial;">, </span>和在其他染色體的許多位置有<span style="font-family: Arial;">LOH</span></span></span></div></td></tr>
</tbody></table><span face="" style="font-family: 新細明體;"></span></center><span face="" style="font-family: 新細明體;"></span></div><span face="" style="font-family: 新細明體;"><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br />
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<tr><td><span face="" style="font-family: 新細明體;">合併<span style="font-size: small;">非倍數染色體</span><span style="font-family: Arial; font-size: small;">(Aneuploidy)</span></span></td></tr>
</tbody></table><span face="" style="font-family: 新細明體;"><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;">如果</span><span style="font-family: Arial; font-size: small;">Barrett's esophagus</span>合併 <span style="font-family: Arial; font-size: small;">aneuploidy, </span><span style="font-size: small;">則有</span><span style="font-size: 12pt;">≧</span><span style="font-family: Arial; font-size: small;"> 50%</span><span style="font-size: small;">的機會</span><span style="font-size: small;">發展為侵犯性癌症, 因此要非常積極且頻繁地篩檢</span><span style="font-family: Arial; font-size: small;">, </span><span style="font-size: small;">甚至可能的話做預防性食道切除。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br />
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<tr><td><span face="" style="font-family: 新細明體;"><span style="font-size: small;">美國胃腸病學會</span><span style="font-size: small;">的建議</span><span style="font-size: small;"></span></span></td></tr>
</tbody></table><span face="" style="font-family: 新細明體;"><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;">從良性</span><span style="font-family: Arial; font-size: small;">Barrett's esophagus</span><span style="font-size: small;">變成惡性腺癌的可能性是依照食道柱狀上皮的組織學外觀來考慮</span><span style="font-family: Arial; font-size: small;">(metaplasia</span><span style="font-size: small;">、</span><span style="font-family: Arial; font-size: small;">low-grade dysplasia</span><span style="font-size: small;">、</span><span style="font-size: small;">和</span><span style="font-family: Arial; font-size: small;">high-grade dysplasia), </span><span style="font-size: small;">因此</span><span style="font-size: small;">美國胃腸病學會</span><span style="font-size: small;">依照</span><span style="font-family: Arial; font-size: small;">dysplasia</span><span style="font-size: small;">的程度</span><span style="font-family: Arial; font-size: small;">, </span><span style="font-size: small;">為</span><span style="font-family: Arial; font-size: small;">Barrett's esophagus</span><span style="font-size: small;">的監視做了以下的建議</span><span style="font-family: Arial; font-size: small;">:</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"> </div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;"><span style="font-family: Arial;">1. Dysplasia (-):</span>每<span style="font-family: Arial;">2~3</span>年胃鏡再評估。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-family: Arial; font-size: small;"> </span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;"><span style="font-family: Arial;">2. Low-grade dysplasia:</span>每<span style="font-family: Arial;">6</span>個月胃鏡再評估<span style="font-family: Arial;">, </span>若<span style="font-family: Arial;">2</span>次的<span style="font-family: Arial;">low-grade dysplasia</span>都沒改變<span style="font-family: Arial;">, </span>則改為每<span style="font-family: Arial;">2</span>年一次。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"> </div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-family: Arial; font-size: small;">3. High-grade dysplasia</span><span style="font-size: small;">而無侵犯性癌症</span><span style="font-family: Arial; font-size: small;">: </span><span style="font-size: small;"><br />
若未手術</span><span style="font-family: Arial; font-size: small;">, </span><span style="font-size: small;">則每</span><span style="font-family: Arial; font-size: small;">3</span><span style="font-size: small;">個月胃鏡再評估。有一報告說</span><span style="font-family: Arial; font-size: small;">: high-grade dysplasia</span><span style="font-size: small;">可以穩定而不進展到癌症。有一機構報告</span><span style="font-family: Arial; font-size: small;">: </span><span style="font-size: small;">有</span><span style="font-family: Arial; font-size: small;">28%</span><span style="font-size: small;">病人在</span><span style="font-family: Arial; font-size: small;">4</span><span style="font-size: small;">個月</span><span style="font-family: Arial; font-size: small;">~7</span><span style="font-size: small;">年之間退化成較低的惡性度。是否所有或部分</span><span style="font-family: Arial; font-size: small;">high-grade dysplasia</span><span style="font-size: small;">會發展成侵犯性癌症仍有爭議。無疑地</span><span style="font-family: Arial; font-size: small;">, </span><span style="font-size: small;">胃鏡發現有</span><span style="font-family: Arial; font-size: small;">high-grade dysplasia</span><span style="font-size: small;">可能已經隱藏侵犯性癌症。有一報告指出因</span><span style="font-family: Arial; font-size: small;">high-grade dysplasia</span><span style="font-size: small;">而做切除的病人</span><span style="font-family: Arial; font-size: small;">41%</span><span style="font-size: small;">有侵犯性癌症。</span><span style="font-family: Arial; font-size: small;">Heitmiller(1996)</span><span style="font-size: small;">因</span><span style="font-family: Arial; font-size: small;">high-grade dysplasia</span><span style="font-size: small;">而手術發現侵犯性癌症的發生率介於</span><span style="font-family: Arial; font-size: small;">10~52%</span><span style="font-size: small;">。</span><span style="font-family: Arial; font-size: small;">Mckinney(1995)</span><span style="font-size: small;">以胃鏡監視</span><span style="font-family: Arial; font-size: small;">high-grade dysplasia, 19~26%</span><span style="font-size: small;">病人在</span><span style="font-family: Arial; font-size: small;">2~7.5</span><span style="font-size: small;">年發生明顯地侵犯性癌症。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br />
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<tr><td><span face="" style="font-family: 新細明體;"><span style="font-size: small;">1999年美國臨床腫瘤學會(ASCO)的建議</span></span></td></tr>
</tbody></table><span face="" style="font-family: 新細明體;"><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;">1. </span><span style="font-family: Arial; font-size: small;">DeMeester(1998)</span><span style="font-size: small;">指出對</span><span style="font-family: Arial; font-size: small;">high-grade dysplasia</span><span style="font-size: small;">的標準治療是食道切除。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br />
</div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;">2. </span><span style="font-size: small;">非手術治療</span><span style="font-family: Arial; font-size: small;">:<br />
a) </span><span style="font-size: small;">同步化電療</span><span style="font-family: Arial; font-size: small;">(CCRT): </span><span style="font-size: small;">對侵犯性癌症已是被接受的標準治療。<br />
b) </span><span style="font-family: Arial; font-size: small;">Laukka(1995)</span><span style="font-size: small;">使用黏膜剝除技術(</span><span style="font-family: Arial; font-size: small;">mucosal ablation</span><span style="font-size: small;">)保留食道。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br />
</div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;">3. </span><span style="font-size: small;">需要進一步證實是否最小的疾病需要最大的治療</span><span style="font-family: Arial; font-size: small;">(esophagectomy)</span><span style="font-size: small;">。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br />
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<tr><td><span face="" style="font-family: 新細明體;"><span style="font-size: small;">第五版</span><span style="font-family: Arial; font-size: small;">DeVita</span><span style="font-size: small;">的建議</span></span></td></tr>
</tbody></table><span face="" style="font-family: 新細明體;"><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-family: Arial; font-size: small;">1. Omeprazole</span><span style="font-size: small;">可能比起</span><span style="font-family: Arial; font-size: small;">H2 blockers</span><span style="font-size: small;">更能有效地造成</span><span style="font-family: Arial; font-size: small;">Barrett's esophagus</span><span style="font-size: small;">消退。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br />
</div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;">2. </span><span style="font-size: small;">對</span><span style="font-family: Arial; font-size: small;">Barrett's esophagus</span><span style="font-size: small;">而有</span><span style="font-family: Arial; font-size: small;">severe or high-grade dysplasia</span><span style="font-size: small;">的病人</span><span style="font-family: Arial; font-size: small;">, </span><span style="font-size: small;">手術是治療的選擇。</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;"><br />
</span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><span style="font-size: small;"><b>資料來源:</b></span></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><a href="http://cancer.idv.tw/08-abdomen/esophagus-precancer.htm">http://cancer.idv.tw/08-abdomen/esophagus-precancer.htm</a></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"><br /></div><div style="line-height: 24px; margin-bottom: 3px; margin-left: 30px; margin-top: 3px; text-indent: -15px;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div></span></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-51194490256751262412011-11-14T19:36:00.002+08:002020-08-22T13:14:14.559+08:0014 巴萊特食道炎<div><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 24px;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></span></span></div><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 24px;"><div><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 24px;"><br /></span></span></div>巴來特食道症(Barrett’s esophagus,BE)是指食道下段黏膜的複層鱗狀上皮被單層柱狀上皮所替代的一種病理現象。</span></span><br />
<span class="Apple-style-span" style="font-size: large;"><br style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 30px; text-align: left;" /></span><br />
<span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 24px; text-align: left;">廣義的概念包括食道的胃上皮化生或異位,以及柱狀上皮化生。為與食管下段的賁門黏膜柱狀上皮區分, 曾規定病變範圍在胃食道連接處(GEJ) 3cm以上(即所謂的3cm法則)。</span></span><br />
<span class="Apple-style-span" style="font-size: large;"><br style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 30px; text-align: left;" /></span><br />
<span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 24px; text-align: left;">近年來的概念傾向於指內鏡下發現並被病理組織學證實在食道與胃黏膜交界的連接線(GEJ)以上出現的任何長度的原有鱗狀上皮被柱狀上皮所取代情況。</span></span><br />
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<span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; font-size: large; line-height: 30px; text-align: left;">更嚴格的定義是指GEJ線以上原有鱗狀上皮被含杯狀細胞的特殊柱狀上皮替代情況。這些新的定義包容了短節BE,後者特別將與癌變關係密切的腸上皮化生才定義為BE, 提出了BE屬於癌前病變的概念,而將胃黏膜異位和胃上皮化生排除在BE之外。本病病因未明,臨床上多繼發於胃食道反流(GERD)、裂孔疝。反流的各種成分,包括胃液、鹼性膽汁、胰液等均可以引起食道下段的鱗狀上皮受損,由耐酸、再生能力強的柱狀上皮進行修復,從而形成BE。</span><br />
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</span><br />
<div style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; padding: 0px; text-align: left;"><span style="background-color: transparent; font-size: large;">Barrett食道症為癌前病變,可發展為食道<span face="" style="font-family: 新細明體;">賁</span>門腺癌,在英、美等國家,約占食道癌的30%~50%。本病目前在臨床上並不少見,但一些醫生因為概念不清,臨床上常只將桔紅色島狀黏膜才定義為BE, 因此文獻中報導的檢出率較低。 </span></div><div style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 30px; padding: 0px; text-align: left;"><span style="background-color: transparent; font-size: large;">患有這種病建議早點治療,分為保守治療和手術治療 </span></div><div style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 30px; padding: 0px; text-align: left;"><span style="background-color: transparent; font-size: large;">保守治療有:莫沙必利或嗎丁啉+埃索美拉唑鎂腸溶膠囊;治療一個月後復查胃鏡,若沒有好轉的考慮最好手術治療。</span></div><div style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; padding: 0px; text-align: left;"><span style="background-color: transparent; font-size: large;"><br />
</span></div><div style="background-color: white; padding: 0px; text-align: left;"><span face="" style="background-color: transparent; font-family: arial, helvetica, clean, sans-serif; font-size: large; line-height: 19px;"><b>資料來源:</b></span></div><div style="background-color: white; padding: 0px; text-align: left;"><span class="Apple-style-span" style="font-size: large;"><a href="http://tw.knowledge.yahoo.com/question/question?qid=1511032006886">http://tw.knowledge.yahoo.com/question/question?qid=1511032006886</a></span></div><div style="background-color: white; padding: 0px; text-align: left;"><br /></div><div style="background-color: white; padding: 0px; text-align: left;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-83218210354076756492011-11-14T19:30:00.004+08:002020-08-22T13:14:00.228+08:0013 為什麼「平菩賜」(Prepulsid)產生心率不整<table border="0" cellpadding="0" cellspacing="2" class="esfont_big" id="cfont" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; background-color: white; border-collapse: collapse; font-family: arial, helvetica, sans-serif; font-size: 17px; line-height: 25px;"><tbody>
<tr><td style="margin: 0px; padding: 0px;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div></div></div></div><br />「平菩賜」(Prepulsid),學名Cisapride是目前胃腸內科頗為常用<br />
的一種藥物,特別是針對胃食道逆流疾病,腸胃蠕動障礙如脹氣、便<br />
秘,使用「平菩賜」均可以得到症狀上的改善。與以往類似藥物如<br />
Primperam, Domperidone比較,「平菩賜」具有許多的優點:較佳之<br />
治療效果,上下腸胃道均具有療效,無椎體束外症候群的發生顧慮,<br />
因此「平菩賜」在近年來使用也越來越廣泛。事實上,「平菩賜」產<br />
生心率不整死亡案例,早有所聞,隨著死亡案例的增加,終於引起大<br />
家的注意。<br />
<br />
「平菩賜」引起的心率不整,是因為藥物交替作用下,產生心電圖上<br />
QT間隔延長,進而發生Torsade de pointes症候群致死。需注意的是<br />
並非只有「平菩賜」才具有此種情形,在某些藥物合併使用時,就有<br />
可能發生,例如某些治癬藥物(Ketoconazole)合併止癢藥物(Harnic)<br />
。以下是可能發生併發症的藥物合併情形:<br />
<br />
<span class="Apple-style-span" style="color: red;">1兩種同樣引起QT間隔延長藥物合併使用</span><br />
<span class="Apple-style-span" style="color: red;">2一種引起QT間隔延長藥物與一或多種引起其代謝障礙之藥物</span><br />
<span class="Apple-style-span" style="color: red;">或食物共用</span><br />
<span class="Apple-style-span" style="color: red;">3單一使用延長QT間隔藥物,但病人本身有低血鈣,低血鎂,</span><br />
<span class="Apple-style-span" style="color: red;">低血鉀,心肌缺氧,鬱血性心衰竭,腎衰竭,慢性阻塞肺病</span><br />
<span class="Apple-style-span" style="color: red;">,多重器官衰竭,末期癌症。</span><br />
<br />
除了「平菩賜」外,還有哪些藥物引起QT間隔延長:<br />
<br />
<span class="Apple-style-span" style="color: red;">1抗心率不整藥物Ia</span>, III族群,<br />
如Quinidine, Disopyramide, Amiodarone<br />
<span class="Apple-style-span" style="color: red;">2三環抗憂鬱藥物</span><br />
<span class="Apple-style-span" style="color: red;">3Phenothiazines</span><br />
<span class="Apple-style-span" style="color: red;">4巨環類抗生素</span>,如 Erythromycin, Clarithromycin。<br />
例外Azithromycin<br />
<span class="Apple-style-span" style="color: red;">5無嗜睡性抗組織胺</span>,<br />
如Terfenadine(Harnic, Teldane), Astemizole(Hismanal)。<br />
例外Loratadine(Clarityne),Cetirizine(Zyrtec)<br />
<br />
由於「平菩賜」代謝,是經由肝臟cytochrome P4503A,因此其它藥<br />
物經此途徑代謝的,與「平菩賜」合用時,會因競爭cytochrome<br />
P4503A,而使「平菩賜」代謝速率減緩,進而累積濃度增加。<br />
下列藥物會經由cytochrome P4503A代謝:<br />
<br />
<span class="Apple-style-span" style="color: red;">1無嗜睡性抗組織胺</span>,<br />
如Terfenadine(Harnic, Teldane), Astemizole(Hismanal)。<br />
例外Loratadine(Clarityne),Cetirizine(Zyrtec)<br />
<span class="Apple-style-span" style="color: red;">2鈣離子阻斷劑</span><br />
<span class="Apple-style-span" style="color: red;">3威而剛</span><br />
<span class="Apple-style-span" style="color: red;">4降膽固醇藥物</span><br />
<span class="Apple-style-span" style="color: red;">5抗癲癇藥物</span><br />
<span class="Apple-style-span" style="color: red;">6其他,</span>如紅黴素,Lidocaine,Tamoxifen,Quinidine…<br />
<br />
某些藥物在代謝過程中,會抑制cytochrome P4503A的活性,因而<br />
導致「平菩賜」代謝減緩,濃度增加。下列藥物會抑制cytochrome<br />
P4503A的活性:<br />
<br />
<span class="Apple-style-span" style="color: red;">1治癬藥物</span>,如Ketoconazole, Itraconazole, Fluconazole<br />
<span class="Apple-style-span" style="color: red;">2巨環類抗生素</span>,如 Erythromycin, Clarithromycin。<br />
例外Azithromycin<br />
<span class="Apple-style-span" style="color: red;">3三環抗憂鬱劑</span><br />
<span class="Apple-style-span" style="color: red;">4鈣離子阻斷劑</span><br />
<span class="Apple-style-span" style="color: red;">5泰胃美</span>(Cimetidine,Tagamet)<br />
<span class="Apple-style-span" style="color: red;">6grape juice</span><br />
<br />
因此醫師開立「平菩賜」時需考量患者狀態,是否同時服用其他藥物<br />
,而患者若因其他原因求醫時,也需告知醫師目前服藥狀態,以避免<br />
不必要的併發症。</td></tr>
</tbody></table><br />
<span face="" style="background-color: white; font-family: arial, helvetica, sans-serif; font-size: x-small;">本文由【臺安醫院】提供</span><br />
<span face="" style="background-color: white; font-family: arial, helvetica, sans-serif; font-size: x-small;"><b><br />
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<span face="" style="background-color: white; font-family: arial, helvetica, sans-serif;"><b>資料來源:</b></span><br />
<a href="http://hospital.kingnet.com.tw/essay/essay.html?pid=5804&category=%C2%E5%C3%C4%AFe%AFf&type=">http://hospital.kingnet.com.tw/essay/essay.html?pid=5804&category=%C2%E5%C3%C4%AFe%AFf&type=</a><div><br /></div><div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-5742900688691136229.post-64425550227835705542011-11-14T19:26:00.002+08:002020-08-22T13:13:40.709+08:0012 聽聲觀相 慢性咳嗽有解<span id="newcontent" style="background-color: white; text-indent: 15px;"></span><br />
<div style="letter-spacing: 1px; line-height: 19px;"></div><div style="text-align: right;"><span class="Apple-style-span" style="font-size: large;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></span></div><div style="text-align: right;"><span class="Apple-style-span" style="font-size: large;">記者鍾麗華/台北報導</span></div><span class="Apple-style-span" style="font-size: large;"><br />
</span><br />
<div style="letter-spacing: 1px; line-height: 25px;"><span class="Apple-style-span" style="font-size: large;"><br />
</span></div><div style="letter-spacing: 1px; line-height: 25px;"><span class="Apple-style-span" style="font-size: large;">長期咳不停,問題出在哪?醫師說,咳嗽超過3個星期以上的慢性咳嗽,最常見原因為鼻涕倒流、氣喘及胃食道逆流。可依照夜咳發作時間、說話、唱歌、聲音及面相幾點特徵,簡易判斷原因。不過,最後仍應該找醫師做診斷,接受治療。</span></div><div style="letter-spacing: 1px; line-height: 25px;"><span class="Apple-style-span" style="font-size: large;">長庚紀念醫院胸腔內科系主任郭漢彬表示,如依照夜咳發作時間分辨,若是一睡下去就開始咳,且是短促、頻繁的乾咳,原因可能出在「鼻涕倒流」;至於氣溫低或在睡後3、4小時開始咳,夜咳加重,則問題恐在「氣喘」;在睡著放鬆的狀態下,不定時咳嗽,則可能有微量胃酸吸入呼吸道引起刺激,及「胃酸逆流」至食道中段,刺激迷走神經,引起相關症狀。</span></div><div style="letter-spacing: 1px; line-height: 25px;"><span class="Apple-style-span" style="font-size: large;">若<span class="Apple-style-span" style="color: red;">依照「聲音」分辨</span>,鼻子問題所造成的,說話或唱歌會有痰音;若是胃食道逆流引起者,說話尾音顫抖、唱歌高音唱不上去,或較以往高音降低一至兩個key,說話聲音沙啞,且容易失聲。</span></div><div style="letter-spacing: 1px; line-height: 25px;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="color: red;">依照「面相」觀察</span>:鼻子問題所造成的長期咳嗽,患者平時習慣張口呼吸、口乾舌燥、雙眼內側容易有黑眼圈;至於胃食道逆流所造成,容易門齒腐蝕,呈現鋸齒狀,主要是因為胃酸逆流至口腔,長期侵蝕所造成,舌頭容易潰瘍、口臭等。</span></div><div style="letter-spacing: 1px; line-height: 25px;"><span class="Apple-style-span" style="font-size: large;">長庚紀念醫院胸腔內科呼吸道疾病科主任王圳華表示,真正難治療的慢性咳嗽,是胃食道逆流所引起,高達4成患者沒有症狀,加上一般人對胃食道逆流所引起的呼吸道疾病認識不深,也常會誤以為是一般感冒,導致無法對症下藥。</span></div><div style="letter-spacing: 1px; line-height: 25px;"><span class="Apple-style-span" style="font-size: large;">王圳華說,8成以上患者可有效改善咳嗽及胃酸逆流等症狀,僅兩成無效,主要是與生活作息及個性有關,因此患者除控制用餐時間和食物外,最重要的是,減低生活壓力,調整情緒,才能回應身體所發出的警訊,找回健康的生活。</span></div><div style="letter-spacing: 1px; line-height: 25px;"><b><span class="Apple-style-span" style="font-size: large;"><br />
</span></b></div><span class="Apple-style-span" style="font-size: large; letter-spacing: 1px; line-height: 19px;"><b>資料來源:</b></span><br />
<span class="Apple-style-span" style="font-size: large;"><a href="http://www.libertytimes.com.tw/2008/new/dec/26/today-health3.htm">http://www.libertytimes.com.tw/2008/new/dec/26/today-health3.htm</a></span><div><span style="font-size: large;"><br /></span></div><div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-50522174465590527412011-11-14T19:16:00.001+08:002020-08-22T13:13:27.465+08:0011 胃不和則臥不安 失眠與胃有毛病相牽連<div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; font-size: 13px; text-align: right;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="color: black; font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="color: black; font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="color: black; font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div><div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; font-size: 13px; text-align: right;"><br /></div><div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; font-size: 13px; text-align: right;"><label style="text-align: left;"><a href="http://tw.rd.yahoo.com/referurl/news/logo/tssdnews//SIG=10sjj8itq/*http://www.tssdnews.com.tw" rel="nofollow" style="border-color: white; border-style: solid; border-width: 0px; color: #ff3300; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;" target="_blank"><img alt="台灣新生報" src="http://l.yimg.com/f/i/tw/news/cp_logo/tssd_logo.jpg" style="border-color: white; border-style: solid; border-width: 0px; color: #333333; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;" /></a> </label> 更新日期:<q style="border-color: white; border-style: solid; border-width: 0px; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;">2009/09/30 00:07</q> <span style="border-color: white; border-style: solid; border-width: 0px; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;">【記者李叔霖/台北報導】</span></div><div class="w" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; font-size: 13px; text-align: left;"><div id="ynwsartcontent"><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">傳統中醫認為,失眠跟胃不好有關。署立豐原醫院中醫科主治醫師張盈瀅表示,古籍《黃帝內經》即有「胃不和則臥不安」的記載,一般民眾因容易緊張焦慮造成胃酸分泌過多、便秘,加上沒有適當的飲食調養,以致於讓胃部出現毛病,當胃有毛病時就容易影響到睡眠。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"></div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">張醫師指出,胃病患者在日積月累下,容易造成腹部壓力大,甚至出現胃酸食道逆流、心悸、胃灼熱感、消化不良、腸胃脹氣、食慾不振等症狀,精神上的問題影響到胃的健康,又影響到睡眠品質,彼此會惡性循環,這時除了調養胃腸以外,精神方面的開導或是肝氣的疏導都是很重要的。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"></div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">《黃帝內經》有云:「胃者,六腑之海,其氣亦不行。陽明逆,不得從其道,故不得臥也。」意思是說當陽明經氣上逆時,將導致胃氣不得下行,進而「胃不和」、「臥不安」。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"></div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">張盈瀅醫師進一步指出,凡以失眠為主的神經衰弱患者,在發病過程中多半會有胃口不好、脘腹脹滿、胸悶、打飽嗝、嘔吐吞酸、大便失調等胃氣不和症狀,所以胃不和引起臥不安而導致的神經衰弱,應採調和胃氣為治療原則,視病情加減用藥,使胃氣調和收功。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="color: black; font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-16934817415477507702011-11-14T19:10:00.002+08:002020-08-22T13:13:09.527+08:0010 胸痛、喉嚨啞痛 當心是胃食道逆流<div style="text-align: right;"><span class="Apple-style-span" face="" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></span></div><div style="text-align: right;"><span class="Apple-style-span" face="" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu;">轉自中廣新聞網</span></div><br />
<div style="text-align: right;"><span class="Apple-style-span" face="" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu;">因為工作壓力大、飲食習慣改變,罹患胃食道逆流的病患越來越多,最近台北市就有一位年輕的上班族病患,最近常常覺得胸悶、喉嚨沙啞,一開始誤以為是感冒,不過就診之後才發現,原來是罹患胃食道逆流,經過治療,病況已經好轉,醫師表示,胃食道逆流的病因,主要還是與飲食作息有關,儘管一般症狀是脹氣、胃酸逆流,不過有時也會出現胸痛、咽喉乾痛等,不可輕忽。</span></div><br />
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<span class="Apple-style-span" face="" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: left;"> 因為工作的緣故,許多上班族用餐時間常常不固定,甚至工作壓力一大還造成食慾不佳,最近台北市立聯合醫院就有一位年輕的女性病患,最近常常覺得胸口悶痛,喉嚨也常覺得有東西卡住,說話時動不動就要清喉嚨,甚至感覺吞嚥困難,一開始陳小姐以為自己只是感冒、也可能是因為生理期的不舒服,不過一段時間沒有改善,到醫院就診才發現,原來胸悶、喉嚨沙啞的病狀,是因為飲食不正常引發的胃食道逆流,聯合醫院中醫師許中嚴表示,儘管胃食道逆流症狀多是胃酸逆流到咽喉或口部,胸口有燒灼感,甚至還會打嗝、脹氣,不過有時其實也會出現胸痛、咽喉乾痛、咳嗽、氣喘等非典型的症狀。</span><br />
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<span class="Apple-style-span" face="" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: left;"> 醫師表示,胃食道逆流是常見的腸胃道疾病,大多在晚間發作,發生原因是上班族因為工作繁忙緊張、飲食習慣改,生活工作壓力大,導致胃食道逆流的病患越來越多。而果汁、湯麵、糯米、油炸麵包,甚至是比較甜的巧克力都可能誘發胃食道逆流,飲食定時定量、少量多餐,飯後不要立刻躺臥、趴睡等。</span><br />
<span class="Apple-style-span" face="" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: left;">轉自中廣新聞網</span><br />
<span class="Apple-style-span" face="" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: left;"><br />
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<span class="Apple-style-span" style="background-color: white; text-align: left;"><span class="Apple-style-span" face="" style="color: #333333; font-family: arial, mingliu, pmingliu;"><b>資料來源:</b></span></span><br />
<a href="http://tw.group.knowledge.yahoo.com/3344-888/article/view?aid=2715">http://tw.group.knowledge.yahoo.com/3344-888/article/view?aid=2715</a><div><br /></div><div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-254380942145700502011-11-14T19:05:00.001+08:002020-08-22T13:12:54.967+08:0009 醫定要注意/久咳不癒? 小心是胃酸逆流惹禍!<div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: right;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div><div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: right;"><br /></div><div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: right;"><label style="font-size: 13px; text-align: left;"><a href="http://tw.rd.yahoo.com/referurl/news/logo/ettoday//SIG=10pugg0rl/*http://www.nownews.com/" rel="nofollow" style="border-color: white; border-style: solid; border-width: 0px; color: #ff3300; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;" target="_blank"><img alt="NOWnews" src="http://l.yimg.com/tw.yimg.com/i/tw/news/newspartner2006/ettoday.jpg" style="border-color: white; border-style: solid; border-width: 0px; color: #333333; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;" /></a> </label><span class="Apple-style-span" style="font-size: 13px;"> </span><span face="" style="font-family: 細明體;">更新日期:</span><q style="border-color: white; border-style: solid; border-width: 0px; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;">2008/12/17 21:50</q> <span face="" style="font-family: 細明體;">生活中心/綜合報導</span></div><div class="w" style="background-color: white; text-align: left;"><div id="ynwsartcontent"><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">您有久咳不癒,甚至看了耳鼻喉科、吃了藥,咳嗽症狀也沒改善嗎?醫師表示,可能不是喉嚨或支氣管出問題,而是「胃食道逆流」!因為很多胃食道逆流病患晚上平躺後,胃酸會逆流刺激到喉嚨,引發咳嗽,因此如果看過耳鼻喉醫師,也服用藥物,卻還是好不了,就應該去看看腸胃科!</div><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"></div><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">嗽咳不停,總以為是喉嚨發炎,但看了醫生吃了藥,卻還是不見改善,很可能問題出現在胃腸!胃腸肝膽科主任王志堂說,當作是一個氣管炎或是呼吸道感染的治療,但是效果不好的話,有時候我們要考慮是不是胃食道逆流,胃酸逆流造成的咳嗽,睡覺以後因為平躺受到胃酸逆流刺激到食道上面的神經,或是直接有部分胃酸跑到氣管,刺激氣管造成咳嗽。</div><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"></div><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">咳嗽不一定是喉嚨有問題,而是胃食道逆流,飲食習慣不正常、愛吃甜食或酸性食物,胃酸就會分泌過多,容易逆流引發咳嗽,一旦發現治療,咳嗽症狀馬上改善。</div><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"></div><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">胃腸肝膽科主任王志堂說,「一直咳嗽用氣管炎治療效果不好,到胃腸門診來看,按照胃食道逆流方式做治療,大概一個月左右,整個症狀就消失掉。」</div><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"></div><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">醫師提醒,如果咳嗽持續看耳鼻喉科或是吃藥都還是好不了,可能就須看看腸胃科,檢查是否是胃食道逆流惹的禍。(新聞來源:東森新聞記者舒夢蘭、何佳陽).</div><div style="border-color: white; border-style: solid; border-width: 0px; color: #333333; font-family: arial, mingliu, pmingliu; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"><br />
</div><div style="border-color: white; border-style: solid; border-width: 0px; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; word-break: break-all;"><span class="Apple-style-span" face="" style="color: #333333; font-family: arial, mingliu, pmingliu;"><span class="Apple-style-span" style="line-height: 24px;"><b>資料來源:</b></span></span></div><div style="border-color: white; border-style: solid; border-width: 0px; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; word-break: break-all;"><a href="http://tw.group.knowledge.yahoo.com/oldboy-jay/article/view?aid=1652">http://tw.group.knowledge.yahoo.com/oldboy-jay/article/view?aid=1652</a></div><div style="border-color: white; border-style: solid; border-width: 0px; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; word-break: break-all;"><br /></div><div style="border-color: white; border-style: solid; border-width: 0px; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; word-break: break-all;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-2953462072997758302011-11-14T17:51:00.004+08:002020-08-22T13:12:39.250+08:0008 為什麼咳嗽咳不停<div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;"><div align="center" class="MsoNormal" style="font-family: "Times New Roman"; line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div> <div align="center" class="MsoNormal" style="line-height: 25pt;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div></div></div></span></div><span style="font-size: large; text-align: left;"></span></div></div></span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">冷風吹,「咳!咳!」聲也跟著多起來了。</span><span style="font-family: Arial;">台灣有幾百萬人飽受咳嗽之苦,可能只是感冒或過敏,</span><span style="font-family: Arial;">卻也可能是討厭的其它病灶,哪種咳嗽該小心?</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;"><br />
一位企業界大老,身體向來硬朗,注重養生,因為連續乾咳兩個星期,到醫院檢查,竟發現肺部長了一個2公分腫瘤,做完必要檢查之後,立即開刀治療。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">***</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">63歲的吳先生感冒兩個多星期,常覺得疲倦,有時體溫熱熱的,持續咳嗽且有黃痰,問醫生需不需要照胸部X光,「不用,吃我的藥就可以了,」醫生回答,隨即看下個病人。吳先生咳一個月受不了,換了另個醫師幫他照片子,赫然發現整個肺臟已經是嚴重肺炎白茫茫一片,立刻住院,但一星期後吳先生就過世了。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">***</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">李媽媽幾個月前做老人健康檢查發現血壓高,經過一陣子飲食控制和運動,血壓依舊下不來,開始服用降血壓藥物。回診時醫生問李媽媽服藥有沒有不舒服?「沒有,」李媽媽回答,「不過,最近老是咳嗽,沒什麼痰,以為是感冒吃了止咳藥,還是咳。」經過醫生檢查,換過血壓藥,咳嗽就好了。李媽媽才知道原來自己的咳嗽是降血壓藥物副作用引起的。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">同樣是咳嗽,結果卻大大不同。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><div><span style="color: red; font-family: Arial;"><strong style="border-color: white; border-style: solid; border-width: 0px; font-weight: bold; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;">「咳」一聲,威力超過17級強風!</strong></span></div><div></div><div><span style="font-family: Arial;">咳嗽是呼吸道受刺激時,清除氣管和支氣管內刺激物的一種有益和保護性反射動作。</span></div><div></div><div><span style="font-family: Arial;">當刺激物碰到位於鼻腔、咽喉、胸腔、橫膈膜或者食道的神經末梢接受器,將衝動傳至腦部的咳嗽中樞,就會引發咳嗽。</span></div><div></div><div><span style="font-family: Arial;">吸氣後,會厭和聲帶緊縮關閉,把空氣關在肺部,腹部和肋骨間的肌肉強力收縮,壓迫肺臟,推動橫隔膜,當壓力到達最高點時,聲帶和會厭突然打開,一股氣流快速通過呼吸道,經由口腔噴出,並將呼吸道內異物或分泌物帶出。</span></div><div></div><div><span style="font-family: Arial;">這股氣流的最快風速可以達到每秒160~240公尺,遠超過17級(每秒56~61公尺)超級強烈颱風,平均尖峰流量約每秒12公升,能瞬間吹飽一顆氣球。</span></div></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">咳嗽可說是病人痛苦、醫生頭痛的老問題。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">台語有句俗諺:「總舖驚吃午,做土水的驚捉漏,醫生驚治嗽」,就是形容咳嗽病難治。報紙廣告強打「專治久咳不癒」,藥局裡止咳化痰藥擺在最醒目位置,從天花板陳列到地板,可見咳嗽藥市場需求驚人。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">成藥鎮咳還不夠,咳嗽更是胸腔科病人最常就醫的原因之一。美國每年有3,000萬門診人次是看咳嗽,曾任職台大、台安醫院,自己估計治療過近10萬個咳嗽病例的內科醫師劉建輝估計,「台灣少說也有100多萬人有咳嗽毛病」。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">咳嗽雖惱人,卻是身體必要防禦機制。當正常人的呼吸道受到外在刺激,比如濃煙,或者氣管發炎有分泌物,刺激位於呼吸道的神經接受器,將訊息傳至腦部咳嗽中樞,就會引發咳嗽,清除刺激物。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">氣虛體弱的人常需藉助外力維持呼吸道通暢。比方中風、脊髓損傷、長期臥床的病人,橫膈膜和胸腔肌肉無力,經常不能有效咳嗽,痰液積在呼吸道,容易孳生細菌造成肺炎,這時需藉助拍背、抽痰等方式,維持氣道通暢。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">咳嗽也是許多疾病的警訊方式。劇烈咳嗽可能傷害聲帶、氣管黏膜破裂出血、拉傷腹肌甚至折斷肋骨,即使是輕微咳嗽也會影響睡眠。因此,老是咳咳不休,就需找出病因。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="color: red; font-family: Arial;"><strong style="border-color: white; border-style: solid; border-width: 0px; font-weight: bold; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;">咳嗽最常見的原因</strong></span></div><blockquote dir="ltr" style="border-color: white; border-style: solid; border-width: 0px; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-align: left; text-decoration: none;"><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">台大胸腔內科主治醫師郭壽雄表示,一般臨床上將咳嗽分為急性和慢性咳嗽兩大類。急性咳嗽最常見原因是上呼吸道感染(感冒),常會合併發燒、喉嚨痛、流鼻水等症狀,一般約在1~2週內會改善。急性鼻竇炎、喉炎、支氣管炎、肺炎也會引起急性咳嗽。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;"><br />
如果咳嗽超過3個星期,稱為慢性咳嗽。這些病人遊走於胸腔科、家庭醫學科、耳鼻喉科,歸納出的的病因排名也不盡相同。最常見的原因有:</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white;"><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="color: blue; font-family: Arial;">抽菸:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">很多老菸槍早晨睡醒第一個動作就是咳嗽。香菸的煙霧會刺激呼吸道產生分泌物,引發咳嗽,長期更可能造成慢性支氣管炎。美國有研究指出,每天抽一包菸的癮君子,58%有咳嗽痰多的毛病。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white;"><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="color: blue; font-family: Arial;">氣喘:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">有些人連咳一兩個月,以為是感冒後遺症,所以民間有「久咳變喘」的說法,「應該是有氣喘才會咳很久,」郭壽雄醫師表示,這類氣喘病人症狀不是喘、而是咳嗽,尤其在半夜或清晨四、五點最嚴重。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">氣喘在幼年比較常發作,因為幼童呼吸道發育還沒成熟,等到青少年呼吸系統發育成熟,抵抗力較強,少發作以為氣喘好了。等到中老年,壓力大或免疫系統功能漸差,尤其在季節交替冷熱溫差大、感冒、接觸花粉、動物皮毛等狀況下,又開始咳得厲害。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white;"><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="color: blue; font-family: Arial;">過敏體質:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">劉建輝醫師說,有的病人並沒有達到氣喘的臨床診斷標準,但在感冒後常連咳好幾週好不了,這時就要懷疑是過敏體質作祟。有過敏困擾的人,翻開眼皮會看到結膜(眼白)發紅、鼻子過敏、皮膚搔癢長濕疹、富貴手,氣管也比一般人敏感容易受刺激而咳嗽。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white;"><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="color: blue; font-family: Arial;">慢性阻塞性肺病(COPD):</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">連續兩年,每年咳嗽超過3個月。包括慢性支氣管炎、肺氣腫、還有因為氣喘、支氣管擴張等疾病,造成慢性且不可逆的呼吸道阻塞。症狀有長期咳嗽、早晨起床痰多且稠、容易疲倦、反覆呼吸道感染等。這類病人常被誤會「感冒很久」、「氣管弱」,不知道肺部功能已經產生不可逆變化。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white;"><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="color: blue; font-family: Arial;">鼻液倒流:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">因為過敏性或非過敏性鼻炎、鼻竇炎引起。耳鼻喉科醫師黃清浩指出,病人老是感覺有東西流到喉嚨,常常要清喉嚨,「用後鼻鏡照鼻咽部可以看到膿性或黏性分泌物。」</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="background-color: white; color: blue; font-family: Arial;">胃食道逆流:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">因為胃和食道之間的括約肌功能不佳,胃酸容易逆流至食道,刺激食道上咳嗽神經接受體引發咳嗽,病人還常覺得胸口灼熱痛、躺下更嚴重,半夜睡醒口乾口苦,聲音沙啞等,馬偕醫院家醫科主治醫師陳鼎達說。這類病人可做24小時胃酸濃度監測確定診斷。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white;"><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="color: blue; font-family: Arial;">胃酸咽喉逆流:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">台北榮總耳鼻喉部喉科主治醫師蔡東龍表示,2002年美國耳鼻喉科醫學會定義胃酸咽喉逆流為一正式診斷,這類病人常覺得喉嚨有東西卡住怪怪的,咳嗽半天咳不出什麼,聲音沙啞等,利用喉部內視鏡和24小時胃酸濃度檢測可以診斷。蔡醫師說:「久咳不癒來我的門診的病人,有6~7成是胃酸咽喉逆流問題。」</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white;"><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="color: blue; font-family: Arial;">藥物副作用:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">比如治療高血壓的血管升壓素轉換抑制劑(ACE),會引發乾咳,但真正機轉至今不清楚。使用這類藥物的西方人約有一成會出現咳嗽反應,陳鼎達醫師說:「我的經驗,台灣約有30%病人吃了ACE類藥物會咳嗽,」這些病人的肺功能是正常的,換過藥後咳嗽很快緩解。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">另外,新光醫院藥劑科主任王春玉表示,慢性阻塞性肺病患者,若有使用全身性或局部使用乙型交感神經阻斷劑,也可能引起咳嗽反應。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white;"><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="color: blue; font-family: Arial;">吸入異物:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">一般人吃東西嗆到咳出來就好,但老人家因為年紀大聲門關不緊,常容易把碎骨頭、甚至把假牙吸進氣管,或者熟睡放鬆時口水跑到氣管而咳嗽。郭壽雄醫師說:「從氣管夾出小排骨,病人才想起幾個月前曾經嗆到。」</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="background-color: white; color: blue; font-family: Arial;">空氣污染:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">這是常被忽略的咳嗽原因。一位企業總裁有陣子每天進了辦公室就覺得喉嚨癢開始咳嗽,很怕是肺部長了壞東西,但就醫檢查結果一切正常。直到大樓維修空調才發現,總裁辦公室的空氣濾網藏污納垢是最髒的,等大樓空調管道清洗後,咳嗽不藥而癒。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white;"><ul style="font-family: arial, mingliu, pmingliu;"><li><span class="Apple-style-span" style="color: blue; font-family: Arial;">肺癌:</span></li>
</ul></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">當腫瘤刺激支氣管壁或阻塞空氣進出時會引起咳嗽反應,這是咳嗽最可怕的病因。台北榮總胸腔腫瘤科主任蔡俊明特別提醒,如果有抽菸的人,咳嗽的型態改變,比方愈咳愈厲害,以前是早上咳、現在整天都咳,或者咳嗽帶血,呼吸困難,要非常小心。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">還有一些其他疾病會出現慢性咳嗽,例如心臟衰竭、肺結核或其他慢性肺部感染,食道或縱膈腔腫瘤等。一位醫院高階主管常覺得疲倦、咳嗽,肺部檢查沒問題,腹部超音波發現,原來是肝臟腫瘤頂到橫隔膜常受刺激才咳嗽。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;">曾有位年輕女孩因為長期咳嗽、肺炎住院,接受支氣管鏡探查時,竟然從氣管裡夾出一顆花生米。醫師納悶她這麼年輕,吸入花生米怎麼沒咳出來還演變成肺炎?進一步檢查揪出元兇,原來女孩腦部有腫瘤壓迫咳嗽中樞,致使她無法有效咳出異物。</span></div></blockquote><br />
<div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="color: red; font-family: Arial;"><strong style="border-color: white; border-style: solid; border-width: 0px; font-weight: bold; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;">看醫生時怎麼說?</strong></span></div><blockquote dir="ltr" style="background-color: white; border-color: white; border-style: solid; border-width: 0px; font-family: arial, mingliu, pmingliu; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-align: left; text-decoration: none;"><div><span style="font-family: Arial;">咳嗽背後原因這麼錯綜複雜,而且有的病人咳嗽還不只一個病因,比方氣喘加胃食道逆流問題,難怪俗語要說「醫生驚治嗽」,醫師也常因治不好而對病人說:「你的咳嗽沒救了。」可憐病人又得另覓醫師治療他的咳嗽。</span></div><div><span style="font-family: Arial;"><br />
究竟慢性咳嗽該看哪一科?在台灣分科、轉診聯繫混亂的情況下,家庭醫學科、胸腔內科、呼吸治療科、感染科、耳鼻喉科都可以看咳嗽,很難有正確統一答案。但不管看哪科治療咳嗽,醫師們提醒有幾個重點病人一定要講清楚:</span></div><div></div><div><span style="color: blue; font-family: Arial;">● 咳多久了?</span></div><div><span style="font-family: Arial;">很多人會說「咳很久了」,但每個人的「很久」定義不同,要說明確時間,比如三個星期、一個月。</span></div><div></div><div><span style="color: blue; font-family: Arial;">● 怎麼咳?</span></div><div><span style="font-family: Arial;">是咳的又急又喘、還是覺得喉嚨癢想清喉嚨的咳法。如果常常想清喉嚨,可能有鼻液倒流或咽喉胃酸逆流問題。</span></div><div></div><div><span style="color: blue; font-family: Arial;">● 是乾咳還是有痰?痰的顏色?</span></div><div><span style="font-family: Arial;">高血壓藥物副作用引起的咳嗽多是沒有痰的乾咳;而支氣管炎、肺炎、支氣管擴張、慢性阻塞性肺病多半有痰。痰液是白色、黃色、綠色或者帶血。</span></div><div></div><div><span style="color: blue; font-family: Arial;">● 何時咳得厲害?</span></div><div><span style="font-family: Arial;">氣喘的咳嗽常發生在清晨,胃食道逆流或鼻液倒流的咳嗽則多半在剛就寢的上半夜發生。</span></div><div></div><div><span style="font-family: Arial;">另外,抽菸和其他藥物使用史,工作環境有沒有污染源,還有沒有別的症狀,比如發燒、體重減輕、疲倦等,以及家族病史,都是醫師需要了解的訊息。</span></div><div></div><div><span style="font-family: Arial;">根據病人提供的資訊、聽診、觸診,醫師會有初步判斷,必要時加上痰液、胸部X光片、肺功能試驗、電腦斷層、有時還需支氣管鏡檢查才能確立診斷。</span></div><div></div><div><span style="font-family: Arial;">「如果你的咳嗽持續治療兩週沒有改善,應該要求照胸部X光片,」劉建輝醫師強調,很多人怕接受太多放射線而不願照X光片,但胸部X光的放射線劑量低,卻是評估肺臟、心臟和胸腔其他組織最基本且必要檢查。</span></div></blockquote><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="color: red; font-family: Arial;"><strong style="border-color: white; border-style: solid; border-width: 0px; font-weight: bold; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;">咳嗽要治完全不咳嗎?</strong></span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">不論是哪種病造成咳嗽,規律作息是醫師們共同的處方。有時好好睡一覺,充分休息後,咳嗽就改善很多。再來是針對不同病症治療。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">氣喘需使用氣管擴張劑、抗發炎藥物、類固醇;過敏、鼻液倒流用抗組織胺、減少充血藥物、必要時用抗生素;慢性阻塞性肺病使用氣管擴張劑、類固醇、胸腔復健運動,改善和阻止肺疾惡化。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">藥物副作用引起的咳嗽,則停用或改用其他藥物;胃食道逆流的病人,常需減重、少碰咖啡、茶、可樂與油炸品、睡前兩小時不吃東西、使用抑制胃酸和促進腸胃蠕動藥物,若還是無效可能要考慮手術治療。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">陳鼎達醫師表示,有時真的無法找出病因,或者沒辦法給什麼治療時,醫師會以非嗎啡類止咳藥片或藥水鎮咳,若還是無效,則可能要用到麻醉性藥物可待因(Codine)壓制咳嗽。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">咳嗽要治完全不咳嗎?有時當病人的咳嗽改善,醫師就會認為不需再用藥,這時很多病人會要求「再開藥,要把咳嗽斷根」,郭醫師說,這不一定正確。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">郭醫師指出,如果咳嗽有痰,不應該用藥物完全鎮咳,否則痰液無法清除乾淨。而且,支氣管擴張、慢性阻塞性肺病或抽菸的人,也不要用藥物強力抑制咳嗽排痰。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">另外,習慣吃胃藥的人注意。有一類咳嗽藥物作用原理是刺激胃黏膜,引發迷走神經反射使支氣管分泌液體稀釋痰液,幫助排出,應該空腹使用才能發揮效果。所以若註明飯前或空腹使用,就不要飯後或配胃藥服用。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;">除了對症止咳,美國《預防》雜誌提供4個自我止咳的做法:</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="color: blue; font-family: Arial;"> 1.戒菸,拒吸二手菸:</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;"> 香菸會直接殘害呼吸道、且已被證明含有致癌的毒物。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;"> <span class="Apple-style-span" style="color: blue;">2.保暖:</span></span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;"> 尤其天氣變冷時,驟然吸入乾冷空氣很容易引發劇咳,穿高領衣、裹上圍巾、口罩吧。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="color: blue; font-family: Arial;"> 3.喝水化痰:</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="font-family: Arial;"> 多喝溫水、熱湯等液體稀釋痰液,以便咳出。</span></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"></div><div style="background-color: white; font-family: arial, mingliu, pmingliu; text-align: left;"><span style="color: blue; font-family: Arial;"> 4.洗澡時多吸暖濕空氣:</span></div><div style="background-color: white; text-align: left;"><div style="font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;"> 打開熱水龍頭讓熱氣充滿整個浴室,藉此吸入暖濕水氣,有助於化痰。</span></div><div style="font-family: arial, mingliu, pmingliu;"><span style="font-family: Arial;"><br />
</span></div><span style="font-family: Arial;"><b>資料來源:</b></span><br />
<div style="font-family: arial, mingliu, pmingliu;"><a href="http://tw.group.knowledge.yahoo.com/emotion-world/article/view?aid=201">http://tw.group.knowledge.yahoo.com/emotion-world/article/view?aid=201</a></div><div style="font-family: arial, mingliu, pmingliu;"><br /></div><div style="font-family: arial, mingliu, pmingliu;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-80036316228112819602011-11-11T21:00:00.003+08:002020-08-22T13:12:17.698+08:0007 患有胃食道逆流(GERD)或食道炎<div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div><b><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px;"><div><b><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px;"><br /></span></b></div>◎胃液逆流 , 是一種腸胃科臨床上面'常見的小毛病, 原因是食道與胃部相接</span><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">的區域, 解剖學上稱之為" 賁門"的區域, 不知原因地時常在不恰當的時間突然打</span><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">開,導致胃的強酸反流湧入食道中,造成食道的不適或傷害,這就是胃食道逆流</span><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">疾病(Gastro-Esophageal Reflux Disease, GERD) 。如同胃潰瘍的症狀有許多不同的</span><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">表現方式,胃食道逆流疾病也有有許多不同的症狀。胃食道逆流的症狀較常發生於飯後、平躺、吃了油膩、過甜或過辣的食物, 如果</span><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">能夠調整生活方式, 就能收到治療效果, 比較嚴重者也可以用手術來治療。</span></b><br />
<br />
<ul><li><span class="Apple-style-span" face="" style="background-color: white; color: red; font-family: arial, helvetica, clean, sans-serif; line-height: 19px;"><b>何謂胃食道逆流:</b></span></li>
</ul><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">正常吃東西時如同開車進入單行道,食物入口後便是只向前推進,進入消化道中逐漸消化吸收,進餐時食物是先在嘴巴內咀嚼,與唾液充分混合後,再吞嚥經過食道而到逹胃中,食道為口腔到胃的通道,食道與胃聯接處有括約肌(賁門),作用如同自動門般,可防止食物進入胃後逆流回口腔。而胃食道逆流則是胃中的胃酸及食物,反逆流回食道內。食道括約肌功能不佳、肥胖導致腹內壓力過高、胃及食道接合的角度改變…等因素,皆有可能造成胃食道逆流,而咖啡因、香煙中的尼古丁、高脂或辛辣食物,更會促進胃食道逆流的發生。</span><br />
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<ul><li><span class="Apple-style-span" face="" style="background-color: white; color: red; font-family: arial, helvetica, clean, sans-serif; line-height: 19px;"><b>胃食道逆流的檢查:</b></span></li>
</ul><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">當懷疑有胃食道逆流或其合併症時,醫師可能會安排下列檢查項目:</span><br />
<br />
<span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">1. X光檢查:檢查前先喝下顯影劑藥水(鋇劑),然後拍攝X光照片,可了解是否有胃食道逆流,或食道狹窄、阻塞。</span><br />
<br />
<span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">2. 胃酸逆流檢查:醫師使用探針進入食道內,測量食道上、下段的酸鹼值,可判別胃食道逆流的情形,也可以進行24小時的連續監測,了解胃食道逆流發生的次數、持續的時間。除了可以測酸鹼值外,也可以使用壓力感應器了解賁門壓力的變化。</span><br />
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<span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">3. 上消化道內視鏡(胃鏡)檢查:內視鏡檢查雖無法觀察到胃酸逆流發生,但醫師可以透過內視鏡,直接觀察到食道黏膜是否有受到侵襲,是否有發炎、潰瘍、出血症狀,食道結構是否有狹窄或異常。</span><br />
<div style="text-align: left;"><span class="Apple-style-span" face="" style="font-family: arial, helvetica, clean, sans-serif;"><span class="Apple-style-span" style="line-height: 19px;"><br />
</span></span></div><b><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px;">◎</span></b><b><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">食道炎是指食道的發炎,其原因有許多;像是嚴重嘔吐後,長期放置鼻胃管或服用阿斯匹寧、強酸強鹼、非類固醇類消炎藥或接受化學治療、放射治療之患者或是病患本身抵抗力下降而受結核菌或念珠菌或病毒感染導致食道炎。</span><br style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;" /><br style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;" /><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;">食道炎其症狀主要是以吞嚥疼痛、困難、心口灼熱及胸骨後疼痛居多,當食道炎嚴重時可引起食道痙攣及食道狹窄。當食道下端因發炎導致黏膜變性繼而長出胃的柱狀上皮細胞時叫做巴洛氏食道,此為食道癌之前身,必須長期追蹤其變化。一般食道炎之出血較輕微,但也可能引起吐血或解瀝青便。</span></b><br />
<b><br style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px; text-align: left;" /></b><br />
<ul><li><b><b style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px;"><span class="Apple-style-span" style="color: red;">何謂食道炎:</span></b></b></li>
</ul><span class="Apple-style-span" face="" style="background-color: white; font-family: arial, helvetica, clean, sans-serif; line-height: 19px;">食道炎主要靠內視鏡切片來確定診斷,例如愛滋病患者容易發生的結核性或念珠菌性食道炎等。我們可運用偵測下食道括約肌的壓力及24小時酸鹼度來證實胃酸逆流的情形,而胃食道閃爍描繪(scintiscan)也可測得胃-食道逆流。感染性的食道炎常是發生於免疫力低下之患者,如癌症、愛滋病或服用類固醇之患者,因此在針對病原菌治療時也需同時考慮原始疾病之狀況。逆流性食道炎治療主要是中和胃酸及減少逆流情形,因此除了藉助藥物外,生活習慣也很重要。太刺激性、太油膩及酸性飲料均可加重症狀,抽菸、喝酒也會使逆流增加,睡前不進食以免胃酸增加。睡覺時把頭墊高可減少逆流,減肥可減低逆流現象,此外增加腹壓的動作也應予避免。</span><br />
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</span> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div><div><br /></div></div></div></span></div><span style="font-size: large; text-align: left;"></span></div></div>
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</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-34678903296113051852011-11-11T20:37:00.005+08:002020-08-22T13:11:59.389+08:0006 身處壓力鍋 胃食道逆流 蛀牙者增<div class="life-tex_4-1" style="float: left; font-family: arial, helvetica, sans-serif; line-height: 20px; margin-bottom: 15px; text-align: right; width: 600px;"><span class="Apple-style-span"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></span></div><div class="life-tex_4-1" style="float: left; font-family: arial, helvetica, sans-serif; line-height: 20px; margin-bottom: 15px; text-align: right; width: 600px;"><span class="Apple-style-span"><br /></span></div><div class="life-tex_4-1" style="float: left; font-family: arial, helvetica, sans-serif; line-height: 20px; margin-bottom: 15px; text-align: right; width: 600px;"><span class="Apple-style-span">2009/1/3 </span>中廣新聞網 徐韻翔報導</div><div class="life-tex_4-2" style="float: left; text-align: left; width: 600px;"><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;">不景氣衝擊,產業紛傳裁員與放無薪假,上班族個個神經緊繃。依據臨床觀察,近來蛀牙及胃食道逆流的患者比例有增加趨勢,不少患者都是處於生活負擔沈重的壓力鍋中, 導致胃食道逆流症狀惡化,有些出現胸悶胸痛求診,有些甚至胃酸溢滿口腔,結果開始蛀牙。</div><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;"><br />
</div><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;">一項針對科技、金融保險、大眾傳播等上班族所進行健康指數問卷調查,結果發現,這三大產業的工作者中,約六成有胃食道逆流,不過,有些民眾卻因為考量到經濟問題,捨不得花錢看病,調查也發現,有四分之一疑似胃食道逆流的患者放棄就診。</div><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;"><br />
</div><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;">北榮內科部胃腸肝膽科主治醫師陳志彥表示,近來因胃食道問題而前來門診就醫的人數有增加趨勢,不少患者其實都是老病號了,有些是口腔酸苦、胸悶、胸痛的症狀加劇,被轉介到腸胃肝膽科,還有患者胃食道逆流問題甚至影響到了口腔健康,無論再怎麼認真刷牙,還是出現蛀牙問題,原來可能是因為胃酸溢滿口腔所致。</div><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;"><br />
</div><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;">醫師提醒,長期輕忽胃食道逆流問題不治療,食道容易反覆發炎及潰瘍,甚至有導致食道癌的風險,呼籲民眾要儘早就醫,養精蓄銳才有元氣拼經濟。</div><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;"><br />
</div><span class="Apple-style-span" face="" style="font-family: arial, helvetica, sans-serif;"><span class="Apple-style-span" style="line-height: 20px;"><b>資料來源:</b></span></span><br />
<div style="font-family: arial, helvetica, sans-serif; line-height: 20px;"><a href="http://www.genesys.tw/life_1_show.asp?top=life&title_seq=1&area_seq=10&seq=291">http://www.genesys.tw/life_1_show.asp?top=life&title_seq=1&area_seq=10&seq=291</a></div><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;"><br /></div><div style="font-family: arial, helvetica, sans-serif; line-height: 20px;"><span style="text-align: right;"> </span><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div><div><br /></div></div></div></span></div><span style="font-size: large; text-align: left;"></span></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-27478927531786607672011-11-11T20:34:00.003+08:002020-08-22T13:21:34.378+08:0005 文明壓力病 高壓長工時者易胃食道逆流<div style="text-align: right;"><span class="Apple-style-span" face="" style="background-color: white; font-size: 14px; line-height: 14px;"><br /></span></div><div style="text-align: right;"><span class="Apple-style-span" face="" style="background-color: white; font-size: 14px; line-height: 14px;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></span></div><div style="text-align: right;"><span class="Apple-style-span" face="" style="background-color: white; font-size: 14px; line-height: 14px;">新唐人電視 www.ntdtv.com 2008-12-17 23:48</span></div><span class="Apple-style-span" face="" style="background-color: white; font-size: 14px; line-height: 14px;"><br />
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<span class="Apple-style-span" face="" style="background-color: white; color: #414141; font-size: 16px; line-height: 23px;">(中央社記者陳清芳台北17日電)網路站104市調中心今天發布調查,科技、金融保險、傳播業的上班族,多數疑似胃食道逆流。醫師表示,這種火燒心、喉頭異物感、口臭症狀的文明壓力病,常讓患者跑錯科看錯病。</span><br />
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<span class="Apple-style-span" face="" style="background-color: white; color: #414141; font-size: 16px; line-height: 23px; text-align: left;">市調中心表示,這項自今年10月起進行一個月的網路問卷調查,共取得 1913份有效問卷;53%的受訪者有胃酸逆流、口酸口臭、胸部疼痛、上腹或胸口燒灼感、喉嚨痛或聲音吵啞、火燒心造成睡眠障礙、胸部或胸後有燒灼感等至少一項疑似胃食道逆流的症狀,其中5.7%已獲醫師確定診斷。</span><br />
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<span class="Apple-style-span" face="" style="background-color: white; color: #414141; font-size: 16px; line-height: 23px; text-align: left;">調查同時顯示,疑似胃食道逆流的病症,並不單純是中高階層主管會得的疾病,而是以工時長且作息較不規律的職務性質為主,而且也較出現在高學歷、經常吃油炸、刺激性食物的民眾身上。</span><br />
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<span class="Apple-style-span" face="" style="background-color: white; color: #414141; font-size: 16px; line-height: 23px; text-align: left;">台北榮民總醫院醫師陳志彥表示,胃食道逆流是都會區、上班族常見的文明壓力病,很多病患覺得心窩燒灼感而求治心臟內科、神經內科,也因為有口酸口臭、如鯁在喉而求治耳鼻喉科,最後才轉診到胃腸肝膽科。 </span><br />
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<span class="Apple-style-span" face="" style="background-color: white; color: #414141; font-size: 16px; line-height: 23px; text-align: left;">陳志彥說,這些患者經胃鏡確定診斷後,健保給付4個月的抗胃酸藥物治療,可獲大幅改善 。當然患者需要學著調適壓力,最好戒菸,少喝酒及含咖啡因飲料,因為酒精及尼古丁可能促使胃酸分泌,並導致食道下括約肌開合異常問題。</span><br />
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<span class="Apple-style-span" face="" style="background-color: white; color: #414141; font-size: 16px; line-height: 23px; text-align: left;"><b>資料來源:</b></span><br />
<a href="http://www.ntdtv.com/xtr/b5/2008/12/17/a235080.html">http://www.ntdtv.com/xtr/b5/2008/12/17/a235080.html</a><div><br /></div><div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-53926770688411284522011-11-11T20:23:00.003+08:002020-08-22T13:21:22.350+08:0004 久咳不癒常失聲,小心是胃腸道逆流<div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: right;"><a href="http://tw.rd.yahoo.com/referurl/news/logo/ctnews//SIG=10veeisi5/*http://www.chinatimes.com.tw/" rel="nofollow" style="border-color: white; border-style: solid; border-width: 0px; clear: left; color: #0151b2; float: left; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 1em; margin-right: 1em; margin-top: 0px; padding: 0px; text-decoration: none;" target="_blank"><img alt="中時" src="http://l.yimg.com/tw.yimg.com/i/tw/news/newspartner2006/ctnews.jpg" style="border-color: white; border-style: solid; border-width: 0px; color: #333333; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;" /></a><label></label><div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: right;"><br /></div><div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: right;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></div><div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: right;"><br /></div><div class="offer" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: right;"><br /></div> <span face="" style="font-family: 細明體;">更新日期:</span><q style="border-color: white; border-style: solid; border-width: 0px; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-decoration: none;">2008/12/26 11:58</q> <span face="" style="font-family: 細明體;">中時健康 黃曼瑩/台北報</span></div><div class="w" style="background-color: white; color: #333333; font-family: arial, mingliu, pmingliu; text-align: left;"><div id="ynwsartcontent"><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"><br />
</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">如果久咳三星期以上仍然未痊癒,有時常被誤診為感冒,其實可能是鼻塞、鼻涕倒流,或是胃食道逆流,依據林口長庚胸腔內科的臨床資料顯示,門診慢性咳嗽的患者中約有60%是鼻塞、鼻涕倒流所引起,約30%是胃食道逆流引起,其症狀多以胸悶、胸痛及咳嗽來表現。長庚醫院計劃於2009年2月起開辦「咳嗽門診」,協助患者找出慢性咳嗽的真正原因,以便對症下藥。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">Emily是個三十多歲的忙碌上班族,近三個月來,白天幾乎不咳,唯獨晚上躺下睡著的一、兩小時後,便開始咳嗽,但咳的時間不見得規律,有時是睡著三小時後才咳,有時天快亮才咳。常常咳起嗽來就會咳到無法呼吸的地步,並伴有胸悶及窒息感,即使坐起來還是咳,有時一咳就好幾小時都不會好,但咳嗽始終沒有痰。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"></div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">慢性咳嗽是指咳嗽超過三個星期以上,沒有合併咳血及其他肺部相關疾病,咳嗽是唯一臨床上的表現,有時可能伴隨有痰或無痰,在美國每年約有三千萬人次的門診是這類的病患,並且是第五常見的門診症狀,佔胸腔專科門診38%的病人,每年花費美金十億元以上。在國內抽煙者中,超過30%的男性及超過25%的女性罹患慢性咳嗽,非抽煙族群約有5%的人因慢性咳嗽而煩惱,其中最常見的原因主要為鼻涕倒流、氣喘及胃食道逆流。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">長庚紀念醫院胸腔內科系主任郭漢彬表示,咽喉異常感症及咳嗽是耳鼻喉科及胸腔科門診常見的疾病,症狀期在2週以上者的鑑別診斷會比不足2週者多(大多屬慢性咳嗽),其約佔總門診數3成以上。而依據林口長庚胸腔內科的臨床資料顯示,門診慢性咳嗽的患者中約有60%是鼻塞、鼻涕倒流所引起,約30%是胃食道逆流引起,其症狀多以胸悶、胸痛及咳嗽來表現,另外,將近10%是氣喘、慢性阻塞性肺病所造成。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">該如何分辨自己的咳嗽是鼻子問題所造成,還是因為胃食道逆流引起,長庚紀念醫院胸腔內科呼吸道疾病科主任王圳華表示,可依照夜咳發作的時間、聽說話唱歌的聲音及面相幾點特徵,就可簡易的判斷造成自己長期慢性咳嗽的原因。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">依照夜咳發作時間分辨,鼻涕倒流指的是若是一睡下去就開始咳,且咳嗽常是短促、頻繁的乾咳。氣喘則為氣溫低或於睡後3~4小時開始咳,夜間咳嗽加重等現象。胃食道逆流症狀是在睡著放鬆的狀態下,不定時的咳嗽。主要造成這些症狀的機制,包括有微量的胃酸吸入呼吸道引起的刺激及胃酸逆流至食道中段,刺激迷走神經,使得氣管反應性增加而引起症狀。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">除了依夜咳發作時間分辨,也可依照聲音分辨,如果是鼻子問題所造成,說話或唱歌有痰音,如果為胃食道逆流所造成,說話尾音顫抖,唱歌高音唱不上去或較以往高音降低1~2key,說話聲音沙啞,且容易失聲。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">依照面相觀察,鼻子問題所造成包括平時張口呼吸、口乾舌燥、兩眼內側容易有黑眼圈;如果是胃食道逆流所造成,門齒腐蝕呈現鋸齒狀,主要是因為胃酸逆流至口腔長期侵蝕所造成;還有舌頭容易潰瘍與口臭等。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">對於鼻涕倒流所造成的咳嗽,其主要包括過敏性的、非過敏性及血管性鼻炎,急性鼻咽炎及鼻竇炎。若能找出過敏原,那避免過敏原的接觸是最重要的治療。然而在藥物治療方面,主要則使用抗組織胺及減少充血的藥物。較早期的抗組織胺雖然中樞神經的副作用較大,引起精神不佳的症狀,但對於此類疾病引起的慢性咳嗽其療效較新一代的抗組織胺佳。另外就是使用局部類固醇,效果通常在使用後幾天就出現。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">另外,王圳華主任表示,真正難治療的慢性咳嗽,其實就是胃食道逆流所引起的咳嗽,主要是一般人對胃食道逆流所引起呼吸道疾病認識不深,也常會誤以為是一般感冒,而導致無法對症下藥,終結久咳。胃酸逆流引發慢性咳嗽的病人中,有高達四成的病人沒有症狀。有幾個因素與此症引起咳嗽有關,包括上呼吸道的感受器受到胃酸刺激、胃酸嗆入後引起下呼吸道的感受器受到刺激,以及食道上咳嗽感受器受胃酸刺激。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;">為了正確診斷是否為胃酸逆流所起,除了透過24小時食道酸鹼值監測,來檢測是否有胃食道逆流的情況,也可透過咳嗽激發試驗來正確診斷,將檸檬酸吸入食道下段,病人發生咳嗽的頻率明顯增加,而在使用吸入性支氣管擴張劑或在食道使用局部麻醉劑後,咳嗽頻率就不會增加。而治療方式則可藉由服用質子幫浦抑制劑及抗組織胺或鼻類固醇搭配使用,治療2個月可改善。</div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"><b>資料來源:</b><br />
<a href="http://health.chinatimes.com/contents.aspx?cid=5,66&id=4101">http://health.chinatimes.com/contents.aspx?cid=5,66&id=4101</a></div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"><br /></div><div style="border-color: white; border-style: solid; border-width: 0px; line-height: 1.5; list-style-image: initial; list-style-position: initial; list-style-type: none; margin-bottom: 12px; overflow-wrap: break-word; padding: 0px; text-decoration: none; word-break: break-all;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="color: black; font-family: "times new roman"; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-700095087865021992011-11-11T19:59:00.004+08:002020-08-22T13:20:14.130+08:0003 胃食道逆流性疾病(GERD)之成因及治療<div class="MsoNormal" style="font-family: arial, mingliu, pmingliu; line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span style="background-color: white;"><span style="word-break: break-all;"><span style="font-family: serif; font-size: large; word-break: break-all;"><span style="color: red;"> </span><div align="center" class="MsoNormal" style="color: red; line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="color: red; font-size: large; text-align: left;"></span><span style="color: red; text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="color: red; text-align: left; text-indent: 36pt;"><div style="color: black; font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="color: black; font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="color: black; font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></span></span></span></div><div class="MsoNormal" style="font-family: arial, mingliu, pmingliu; line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span style="background-color: white;"><span style="word-break: break-all;"><span style="color: red; font-family: serif; font-size: large; word-break: break-all;"><b>一<span lang="" style="word-break: break-all;">.</span>什麼是胃食道逆流性疾病<span lang="" style="word-break: break-all;"> (GERD)</span></b></span></span><span style="word-break: break-all;"></span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="font-family: arial, mingliu, pmingliu; line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span style="background-color: white; font-size: small;"><span style="font-family: serif; word-break: break-all;">胃食道逆流性疾病,是一常見的消化道疾病;患有胃食道逆流性疾病患者,胃內的食物或胃液會反流<span lang="" style="word-break: break-all;">(</span>逆流<span lang="" style="word-break: break-all;">)</span>至食道,而造成不適。</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="font-family: arial, mingliu, pmingliu; line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span style="font-size: small;"><span style="background-color: white; font-family: serif; word-break: break-all;">患有此疾病的患者,發生的症狀雖不盡相同,但都有經驗過部份或全部以下所列的症狀:</span></span></div><table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; font-family: arial, mingliu, pmingliu; width: 513px;"><tbody>
<tr style="height: 169.5pt;"><td style="border-bottom-style: initial; border-bottom-width: initial; border-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-style: initial; border-right-width: initial; border-top-style: initial; border-top-width: initial; height: 169.5pt; padding: 0cm; text-align: left; width: 467px;" width="91%"><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span lang="" style="font-family: serif; word-break: break-all;">1.</span><span style="font-family: serif; word-break: break-all;">頻發的火燒心<span lang="" style="word-break: break-all;">(</span>最常見的症狀<span lang="" style="word-break: break-all;">)</span></span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span lang="" style="font-family: serif; word-break: break-all;">2.</span><span style="font-family: serif; word-break: break-all;">胃逆流液<span lang="" style="word-break: break-all;">(</span>物<span lang="" style="word-break: break-all;">)</span>造成口腔酸或苦的感覺</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span lang="" style="font-family: serif; word-break: break-all;">3.</span><span style="font-family: serif; word-break: break-all;">吞嚥不易或吞嚥痛苦</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span lang="" style="font-family: serif; word-break: break-all;">4.</span><span style="font-family: serif; word-break: break-all;">聲音嘶啞</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span lang="" style="font-family: serif; word-break: break-all;">5.</span><span style="font-family: serif; word-break: break-all;">夜間喘或乾咳</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span lang="" style="font-family: serif; word-break: break-all;">6.</span><span style="font-family: serif; word-break: break-all;">經常地、重覆地需要清理喉嚨</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span lang="" style="font-family: serif; word-break: break-all;">7.</span><span style="font-family: serif; word-break: break-all;">飲食後,彎身或躺下時,會有症狀<span lang="" style="word-break: break-all;">(</span>泛酸、燒心<span lang="" style="word-break: break-all;">)</span>加劇的感覺</span></span></div><div class="MsoNormal" style="list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span style="color: red; font-family: serif; font-size: large; word-break: break-all;"><b>二<span lang="" style="word-break: break-all;">.</span>一般的火燒心與胃食道逆流性疾病的差異</b></span></span></div><table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; width: 507px;"><tbody>
<tr><td style="border-bottom-style: initial; border-bottom-width: initial; border-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-style: initial; border-right-width: initial; border-top-style: initial; border-top-width: initial; padding: 0cm; text-align: left; width: 426px;" width="84%"><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span style="background-color: white; font-family: serif; word-break: break-all;">火燒心是因為胃部的內容物逆流至食道,而感覺到胸骨後有灼熱甚至痛的感覺,多數人只偶有之;但如果您是胃食道逆流性疾病患者,火燒心及其他相關症狀將經常性地發生,會影響甚至造成您日常生活的不便。</span><br />
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<b style="background-color: white; font-family: serif; line-height: 24px; text-align: -webkit-auto;"><span class="Apple-style-span" style="color: red; font-size: large;">三<span lang="" style="word-break: break-all;">.</span>如何會引起<span lang="" style="word-break: break-all;">GERD (</span>胃食道逆流性疾病<span lang="" style="word-break: break-all;">)</span></span></b><br />
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<div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; font-size: small;"><span style="font-family: serif; word-break: break-all;">胃液返回至食道的原因,與一個位於食道與胃接處的肌肉環有關,稱之為<span lang="" style="word-break: break-all;">"</span>下食道括約肌<span lang="" style="word-break: break-all;">(LES)"</span>;它的功能只有單向,即能開放允許食物及口水進入胃部,當不是進食或吞嚥狀態,下食道括約肌以緊密的狀態維持著,使得胃內容物不致返流。</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"></div><table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; line-height: 1.5em; width: 501px;"><tbody>
<tr><td style="border-bottom-style: initial; border-bottom-width: initial; border-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-style: initial; border-right-width: initial; border-top-style: initial; border-top-width: initial; padding: 0cm; text-align: left; width: 421px;" width="84%"><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span style="font-family: serif; word-break: break-all;">但胃食道逆流性疾病患者,下食道括約肌可能無法適當的發揮功能;日常生活裏會有突然鬆開而造成短暫時間的不正常,即所謂的<span lang="" style="word-break: break-all;">"</span>自發性的下食道括約肌鬆弛<span lang="" style="word-break: break-all;">"</span>。部份此類病人因括約肌的缺陷而無法正常適當的操作。</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div></td><td style="border-bottom-style: initial; border-bottom-width: initial; border-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-style: initial; border-right-width: initial; border-top-style: initial; border-top-width: initial; padding: 0cm; text-align: left; width: 80px;" width="16%"><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"></span></div></td></tr>
</tbody></table><div style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; font-size: small;"><span style="font-family: serif; word-break: break-all;">當下食道括約肌不能適當地發揮其功能時,胃液會回流至食道;這些含酸的胃液將使得食道壁受損,而發生心灼熱感及酸逆流等令人難受的症狀。</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; color: blue; font-size: small;"><span style="font-family: serif; word-break: break-all;"><u>不可忽視的症狀</u></span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; font-size: small;"><span style="font-family: serif; word-break: break-all;">胃液逆流的症狀是不可忽視的,它可能是一種疾病。吃錯食物,吃得太多,喝得過多或過重等雖不一定會造成胃食道逆流性疾病,但這些情形可以使火燒心症狀加劇。</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span><br />
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</span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span style="font-family: serif; font-size: large; word-break: break-all;"><b>四<span lang="" style="word-break: break-all;">.</span>胃食道逆流性疾病是很嚴重的事嗎?</b></span><span style="word-break: break-all;"></span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; font-size: small;"><span style="font-family: serif; word-break: break-all;">如果不治療胃食道逆流性疾病,就會引起嚴重的併發症;如果沒有適時控制,咳嗽、失聲、食道出血及食道狹窄等併發症發生的可能性亦增加;有極少數的患者,在試過適當之治療,仍無法有效改善其症狀者,才需推薦其手術治療。</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; color: blue; font-size: small;"><span style="font-family: serif; word-break: break-all;"><u>好消息是:醫師將能有效協助您克服此症</u></span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; font-size: small;"><span style="font-family: serif; word-break: break-all;">治療胃食道逆流性疾病,通常需要病人與醫師之間有一良好的溝通,這可能需要一段不算短的過程,病人的症狀是由不同的情形所引發刺激而成,醫師可協助您瞭解起因並免除症狀的發作。醫師可藉由藥物的治療,使得逆流食道的胃酸減少,使得症狀緩解。</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; color: blue; font-size: small;"><span style="font-family: serif; word-break: break-all;"><u>您也能幫你自己</u></span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><br />
<ul><li><span class="Apple-style-span" style="background-color: white; font-family: serif;">定期地與您的醫師溝通是非常重要的,如此可協助您的症狀不再發作或次數漸少,使您能有舒適的生活品質。您需要作的是:讓醫師瞭解您的症狀為何?發作的頻率?如何影響您的生活型態?什麼會讓您覺得情況轉壞或轉好?藥物的治療是否使症狀改善?您能與醫師共同設計一治療計劃,將對您的病情會有最佳助益。例如:依症狀引發的原因,特定習性的改變或接受建議來改變生活型態以協助症狀的減少。</span></li>
<li><span class="Apple-style-span" style="background-color: white; font-family: serif; line-height: normal;">若某種食物會引發症狀,醫師將建議您要避免食用。這些食物可能是咖啡、巧克力、辛辣、高油脂物、碳水化合物、薄荷、柑橘、蕃茄、全脂牛奶及洋蔥等。多數的這些食物並不一定會造成您的不適,但可能其中有部份會引起不舒服感,如果有這樣問題,您的醫師將會依您的狀況,為您訂定一飲食計劃。</span></li>
</ul></div><span class="Apple-style-span" style="font-family: serif;"><br />
</span><span class="Apple-style-span" style="background-color: white; font-family: serif;">◎</span><span class="Apple-style-span" style="background-color: white; font-family: serif;">躺下時,若有症狀產生,醫師會建議您睡前勿進食。</span><br />
<ul style="line-height: normal; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0px; padding: 0px; text-align: -webkit-auto;" type="disc"><li><span class="Apple-style-span" style="background-color: white; font-family: serif;">◎若身體過重,醫師會要求您減輕體重,以減低症狀發生。</span></li>
</ul><span class="Apple-style-span" style="background-color: white; font-family: serif;">◎</span><span class="Apple-style-span" style="background-color: white; font-family: serif;">若您有抽煙,醫師會要求您少抽,甚至戒煙。</span><br />
<span class="Apple-style-span" style="background-color: white; font-family: serif;">◎</span><span class="Apple-style-span" style="background-color: white; font-family: serif;">若您正接受藥品治療,請告訴醫師使用情形。切記,沒有與醫師作進一步討論前,不要擅自更改用藥情形。</span><br />
<span class="Apple-style-span" style="background-color: white; font-family: serif;">◎</span><span class="Apple-style-span" style="background-color: white; font-family: serif;">若您的症狀會於睡覺時發生,醫師會要求您調整睡姿—頭部高於腳部約</span><span lang="" style="background-color: white; font-family: serif; text-align: -webkit-auto; text-indent: 32px; word-break: break-all;">15-25</span><span class="Apple-style-span" style="background-color: white; font-family: serif; text-align: -webkit-auto; text-indent: 32px;">公分。</span><br />
<div class="MsoNormal" style="list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; word-break: break-all;"></div><div style="text-align: -webkit-auto; text-indent: 32px;"><span class="Apple-style-span" style="font-family: serif;"><br />
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<ul><li><span class="Apple-style-span" style="background-color: white; font-family: serif;">醫師將會選擇適當的藥品為您治療;不同的治療可能效果會有差異,因此利用記錄卡記錄您每天的情況,就診時給予醫師參考、討論,將會使您的病情得到最佳的控制。</span></li>
<li><span class="Apple-style-span" style="background-color: white; font-family: serif;">有一點必需瞭解的是,胃食道逆流性疾病是極個人化的疾病,只有確實的讓醫師瞭解您的生活是如何遭受病情的影響,醫師方能有效協助您解決它。</span></li>
</ul></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; font-size: small;"><span style="font-family: serif; word-break: break-all;"><br />
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</span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span style="color: red; font-family: serif; font-size: large; word-break: break-all;"><b>五<span lang="" style="word-break: break-all;">.</span>胃食道逆流性疾病的藥物治療</b></span><span style="word-break: break-all;"></span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; font-size: small;"><span style="font-family: serif; word-break: break-all;">為了解決酸過多的問題,目前有下列藥品治療方式:</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><span class="Apple-style-span" style="color: blue;"><span class="Apple-style-span" style="background-color: white; font-family: serif;">◎</span><span class="Apple-style-span" style="background-color: white; font-family: serif;"><b>制酸劑</b></span></span><br />
<div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white;"><span style="font-family: serif; word-break: break-all;">市面上的制酸劑,有中和胃酸的功效。當您有胃逆流症狀時,才可以用這些制酸劑;或聽醫師的指示服用,以免產生不良的反應。</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><span class="Apple-style-span" style="color: blue;"><span lang="" style="background-color: white; font-family: serif; text-align: -webkit-auto; text-indent: 32px; word-break: break-all;">◎<b>H-2</b></span><span style="background-color: white; font-family: serif; text-align: -webkit-auto; text-indent: 32px; word-break: break-all;"><b>拮抗劑</b></span></span><br />
<div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white;"><span style="font-family: serif; word-break: break-all;">如果只服用制酸劑並不能有效改善您的症狀,您的醫生可能就會建議您開始服用一些藥效較強的藥。這種藥一般統稱為<span lang="" style="word-break: break-all;">H-2</span>拮抗劑,可減少胃酸的分泌。</span><span lang="" style="font-family: serif; word-break: break-all;"></span></span></div><span class="Apple-style-span" style="color: blue;"><span class="Apple-style-span" style="background-color: white; font-family: serif;">◎</span><span class="Apple-style-span" style="background-color: white; font-family: serif;"><b>氫離子幫浦抑制劑</b></span></span><br />
<div class="MsoNormal" style="line-height: 1.5em; list-style-image: initial; list-style-position: initial; list-style-type: none; margin: 0cm 0cm 0pt; padding: 0px 0px 1em; text-align: -webkit-auto; word-break: break-all;"><span style="background-color: white; font-family: serif; word-break: break-all;">目前藥界發展出的氫離子幫浦抑制劑—<span lang="" style="word-break: break-all;">omeprazole</span>—,作用於酸產出的最後步驟,可更有效地抑制胃酸,使食道內的酸性環境回復正常。其一天一次的治療效果,對症狀的改善及火燒心的解除,比前述藥品有更卓越的效果。</span><br />
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<span style="background-color: white; font-family: serif; word-break: break-all;"><b>資料來源:</b></span><br />
<span style="background-color: white; font-family: serif; font-size: x-small; word-break: break-all;"><a href="http://tw.myblog.yahoo.com/jw!U_6K2PWeGRkf4YOI6D4mYQ--/article?mid=4074">http://tw.myblog.yahoo.com/jw!U_6K2PWeGRkf4YOI6D4mYQ--/article?mid=4074</a> </span></div></td></tr>
</tbody></table><br /><div><span style="background-color: white; color: red; font-family: serif; font-size: large;"> </span><div align="center" class="MsoNormal" style="background-color: white; color: red; font-family: serif; font-size: large; line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="background-color: white; font-family: serif; font-size: large; line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div><div><br /></div></div></div></span></div><span style="color: red; font-size: large; text-align: left;"></span></div></div></div>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-5742900688691136229.post-55913161784025448072011-11-11T19:03:00.007+08:002020-08-22T13:19:55.840+08:0002 胃食道逆流之成因及治療<div><span class="Apple-style-span" style="background-color: white; font-size: large;"> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;">王群光自然診所:台北市羅斯福路三段271號10樓</div>諮詢電話:886-2-23671086</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;">LINE ID:0919730053</div><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"> Wechat ID: <span style="font-size: large;"><span style="font-size: medium;">a0919730053</span></span></div><div><span style="font-size: large;"><span style="font-size: medium;"><br /></span></span></div></div></div></div></span></div><span class="Apple-style-span" style="background-color: white; font-size: large;"><div><span class="Apple-style-span" style="background-color: white; font-size: large;"><br /></span></div>「胃食道逆流症」 Gastroesophageal Reflux Disease (GERD)</span><br />
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<span class="Apple-style-span" style="background-color: white; font-size: large;"><span lang="" style="font-family: serif; line-height: 24px; word-break: break-all;">新店慈濟醫院肝膽胃腸科主任王嘉齊表示,胃食道逆流症患者增加的原因,也許和國人飲食西化及肥胖盛行率愈來愈高有關係,值得重視。他分析各家醫院的統計數字有些許差異,估計目前台灣的盛行率大約是</span><span class="Apple-style-span" style="font-family: serif; line-height: 24px;">10</span><span lang="" style="font-family: serif; line-height: 24px; word-break: break-all;">~</span><span class="Apple-style-span" style="font-family: serif; line-height: 24px;">20</span><span lang="" style="font-family: serif; line-height: 24px; word-break: break-all;">%(每</span><span class="Apple-style-span" style="font-family: serif; line-height: 24px;">100</span><span lang="" style="font-family: serif; line-height: 24px; word-break: break-all;">個人就有</span><span class="Apple-style-span" style="font-family: serif; line-height: 24px;">10</span><span lang="" style="font-family: serif; line-height: 24px; word-break: break-all;">~</span><span class="Apple-style-span" style="font-family: serif; line-height: 24px;">20</span><span lang="" style="font-family: serif; line-height: 24px; word-break: break-all;">人有胃食道逆流症)</span></span><br />
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<h5 style="list-style-type: none; margin: 10pt 0in 0pt; padding: 0px;"><ul style="font-weight: normal; line-height: 22px;"><li><span class="Apple-style-span"><span lang="" style="background-color: white; color: red; font-family: serif; font-size: large; word-break: break-all;"><b style="font-weight: bold;"><span lang="" style="line-height: 24px; word-break: break-all;">控制的閘門鬆弛</span></b><b style="font-weight: bold;"><span lang="" style="line-height: 24px; word-break: break-all;">了</span></b></span></span></li>
</ul></h5><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">胃食道逆流症是因為下食道括約肌的張力鬆弛,造成關閉不緊,使得胃裡的胃酸或氣體容易跑到食道裡。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">「胃食道逆流分為飯後型及夜晚型,」王嘉齊表示,有些人是在吃完飯後胃酸分泌旺盛,胃酸就容易嘔上來;而有些人則是因為晚上睡覺時平躺的姿勢,讓胃酸容易平順地逆流到食道裡。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">正常情況下食道括約肌在沒有進食時,應該呈現關閉狀態,當吞嚥、食道蠕動時再打開,將食物送進胃裡。但是胃食道逆流症患者的食道括約肌關不緊,造成胃部裡的食物、胃酸容易跑到食道來。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">長庚醫院肝膽胃腸科主治醫師陳益程</span><span lang="" style="word-break: break-all;">表示,造成食道括約肌張力遲緩的原因,至今醫學界仍不完全清楚,但就目前所知的,可大致分為幾類:</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">1.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: blue;">生理構造問題</span>:例如老化、肥胖、食道疝氣等。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">2<span class="Apple-style-span" style="color: blue;">.</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: blue;">藥物引起</span>:例如某些治療氣喘、高血壓的藥物,有可能造成括約肌鬆弛。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">3.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: blue;">食物引起</span>:例如油脂類、巧克力、薄荷類、甜食、菸、酒等食物。</span></span></span></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;"></span></span></span></div><h5 style="list-style-type: none; margin: 10pt 0in 0pt; padding: 0px;"><ul style="font-weight: normal; line-height: 22px;"><li><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><b style="font-weight: bold;"><span lang="" style="color: red; font-size: large; line-height: 24px; word-break: break-all;">阻止逆流三部曲</span></b></span></span></li>
</ul></h5><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">有胃食道逆流的症狀,應該先從生活習慣的改變做起,如果無法緩解,就要看醫生。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; color: blue; font-family: serif; font-size: large; word-break: break-all;"><u><b>Step1<span lang="" style="word-break: break-all;">:改變生活飲食型態</span></b></u></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">這是最基本且有效的方法,症狀輕微者,可因此而改善不必吃藥。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">1.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">避免影響食道括約肌張力的食物</span>,例如油脂類、巧克力、薄荷類、甜食、菸、酒等。另外,王嘉齊醫師還提醒患者,平時多留意吃了哪種食物會更不舒服,例如有些人吃了麵包、可樂、或果汁,會感覺酸得更厲害,就要避免。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">2.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">吃完東西不要立刻躺平</span>,因為平躺的姿勢,胃部的東西更容易逆流到食道。「至少要等</span>30<span lang="" style="word-break: break-all;">分鐘到</span>1<span lang="" style="word-break: break-all;">小時,」王嘉齊進一步說明,如果吃的是不容易消化的食物,甚至要等</span>3<span lang="" style="word-break: break-all;">~</span>4<span lang="" style="word-break: break-all;">小時才能排空,而且「不要吃太飽,否則胃部的壓力會更大。」</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">3.<span class="Apple-style-span" style="color: red;"><span lang="" style="word-break: break-all;">睡前</span>2<span lang="" style="word-break: break-all;">~</span>3</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">小時不要吃東西</span>,王嘉齊提醒,夜晚型的患者更要戒掉吃宵夜的習慣。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">4.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">夜晚型的患者,睡覺時可多放一個枕頭</span>,把頭部墊高</span>15<span lang="" style="word-break: break-all;">~</span>20<span lang="" style="word-break: break-all;">公分,減低胃酸逆流的機會。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">5.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">不要穿太緊的衣服</span>,陳益程醫師表示這樣會增加胃部的壓力,使得食道括約肌更無力抵抗。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">6.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">減肥</span>。美國西北大學胃腸科教授彼得.卡利拉斯(</span>Peter J Kahrilas,<span lang="" style="word-break: break-all;">)在《北美臨床胃腸內視鏡》中指出,肥胖不僅是造成胃食道逆流症的原因之一,也是腐蝕性食道炎及食道腺癌的危險因子。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">7.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">促進唾液的分泌</span>,可以中和逆流上來的胃酸濃度。彼得.卡利拉斯建議嚼口香糖、或口服甘味藥片(例如喉糖),也有助於改善輕微的心口灼熱症狀。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; color: blue; font-family: serif; font-size: large; word-break: break-all;"><u><b>Step2<span lang="" style="word-break: break-all;">:藥物治療</span></b></u></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">如果症狀嚴重,或是調整生活飲食型態後仍然無法改善,就得藉助藥物治療。常用藥物有:</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">1.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">制酸劑</span>:俗稱的「胃藥」,可以中和胃酸。陳益程認為,如果症狀輕微且經過醫生確定診斷者,可以自行到藥局購買服用。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">2.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">黏膜保護劑</span>:保護食道的黏膜,減輕胃酸的傷害。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">3.<span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">促進食道蠕動的藥物</span>:加速食道排空逆流上來的胃酸。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">王嘉齊表示,如果以上的症狀治療無法改善,就要考慮做胃鏡,一來排除合併其他嚴重疾病的問題(例如癌症、食道狹窄、食道細胞變性等),再者是確定食道損傷的程度,包括發炎、破皮、潰瘍等,再依診斷考慮服用以下抑制胃酸分泌的藥物。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span class="Apple-style-span" style="color: red;">1.<span lang="" style="word-break: break-all;">組織氨受體拮抗劑(</span>H2 blocker</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">)</span>:抑制胃酸分泌,但是彼得.卡利拉斯醫師認為,組織氨受體拮抗劑的效果,並不如質子幫浦抑制劑。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span class="Apple-style-span" style="color: red;">2.<span lang="" style="word-break: break-all;">質子幫浦抑制劑(</span>PPI, Proton Pump Inhibitor</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: red;">)</span>:完全抑制胃酸分泌,是目前最有效的藥物。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">陳益程醫師表示,胃食道逆流症的藥物治療,「可以直接服用</span>PPI<span lang="" style="word-break: break-all;">,不一定要漸進式的。」但是受限於健保局的規定,必須是胃鏡檢查結果出現異常者才能給付,依食道的損傷程度不同分為兩級,最多分別給予</span>4<span lang="" style="word-break: break-all;">個月或</span>1<span lang="" style="word-break: break-all;">年的療程。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">國內外的研究皆顯示,高達</span>70<span lang="" style="word-break: break-all;">~</span>90<span lang="" style="word-break: break-all;">%的胃食道逆流患者是「無破皮的逆流性疾病」(</span>NERD, non erosive reflux disease<span lang="" style="word-break: break-all;">),即有明顯的典型症狀,卻在胃鏡檢查下沒有發現食道受損的情況。王嘉齊醫師觀察這群患者,雖然胃鏡檢查一切正常,但明顯的症狀已嚴重危害</span><span lang="" style="word-break: break-all;"> </span><span lang="" style="word-break: break-all;">他們的生活品質。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">「國外的做法是有症狀先給藥,有必要再做胃鏡,國內則是先做胃鏡才決定要不要給藥,」王嘉齊推論國內外的做法不同,是因為國外的胃鏡檢查比較貴(約</span> 1500<span lang="" style="word-break: break-all;">美元、</span>4<span lang="" style="word-break: break-all;">萬多台幣),而</span>PPI<span lang="" style="word-break: break-all;">的藥比較便宜,但是國內則相反,胃鏡檢查只須台幣約</span>1500<span lang="" style="word-break: break-all;">元,一顆</span>PPI<span lang="" style="word-break: break-all;">的藥則要</span>40<span lang="" style="word-break: break-all;">~</span>50<span lang="" style="word-break: break-all;">元,</span>4<span lang="" style="word-break: break-all;">個月的療程就需</span> 5000<span lang="" style="word-break: break-all;">元左右的費用。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">王嘉齊引用國外的研究結果表示,胃食道逆流症病患的一年內復發率高達</span>70<span lang="" style="word-break: break-all;">~</span>80<span lang="" style="word-break: break-all;">%,</span>PPI<span lang="" style="word-break: break-all;">的藥物對於有胃食道逆流困擾的病人(無論胃鏡檢查有無異常),不僅可以緩解症狀,還能延緩停藥後復發的時間。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; color: blue; font-family: serif; font-size: large; word-break: break-all;"><u><b>Step3<span lang="" style="word-break: break-all;">:手術治療</span></b></u></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">當症狀非常嚴重,以上方法都無法解決時,「手術是沒有辦法時的辦法,」王嘉齊醫師多年的臨床觀察,需要走到這一步的患者非常的少,一年遇不到幾個案例。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">他曾經見過一位中年的女性患者,「吃了就吐,像動物的反芻一樣,」王嘉齊形容,這位患者的嚴重程度連</span>PPI<span lang="" style="word-break: break-all;">的藥物都無法改善,最後只好利用手術補強食道括約肌的張力。但手術也不一定能根除疾病,可能還是需要長期吃藥。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">審稿專家:新店慈濟醫院肝膽胃腸科主任王嘉齊</span></span></span></div><h5 style="list-style-type: none; margin: 10pt 0in 0pt; padding: 0px;"><ul style="font-weight: normal; line-height: 22px;"><li><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><b style="font-weight: bold;"><span lang="" style="color: red; font-size: large; line-height: 24px; word-break: break-all;">症狀</span></b></span></span></li>
</ul></h5><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">胃食道逆流症的症狀五花八門,大部份的人都是典型的症狀,但仍有少數人因為症狀非典型,而容易被忽視,或找不出真正的致病原因。</span></span></span></div><h5 style="list-style-type: none; margin: 10pt 0in 0pt; padding: 0px;"><ul style="font-weight: normal; line-height: 22px;"><li><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><b style="font-weight: bold;"><span lang="" style="color: red; font-size: large; line-height: 24px; word-break: break-all;">典型症狀</span></b></span></span></li>
</ul></h5><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">1.<span lang="" style="word-break: break-all;">火燒心(</span>heart burn<span lang="" style="word-break: break-all;">)或心口灼熱:「是最常見、最典型的症狀,」王嘉齊醫師表示,跟心臟沒有關係,而是從胃或下胸部朝頸部這段距離,會有灼熱的感覺。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">2.<span lang="" style="word-break: break-all;">酸液逆流:「感覺喉嚨有液體跑上來,」陳益程醫師形容,有些夜晚型的患者,常常半夜被嗆醒。</span></span></span></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;"></span></span></span></div><h5 style="list-style-type: none; margin: 10pt 0in 0pt; padding: 0px;"><ul style="font-weight: normal; line-height: 22px;"><li><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><b style="font-weight: bold;"><span lang="" style="color: red; font-size: large; line-height: 24px; word-break: break-all;">非典型症狀</span></b></span></span></li>
</ul></h5><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">有下列症狀,但沒有明顯的火燒心或酸液逆流感覺,建議先找各專科醫師排除其他器官的疾病後,再轉診至胃腸科檢查。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span class="Apple-style-span" style="color: blue;">1.</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: blue;">慢性喉嚨發炎:</span>胃酸長期逆流侵蝕所導致。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span class="Apple-style-span" style="color: blue;">2.</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: blue;">慢性咳嗽:</span>胃酸刺激氣管所產生。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span class="Apple-style-span" style="color: blue;">3.</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: blue;">氣喘:</span>胃酸嗆到支氣管,造成支氣管痙摩,而產生類似氣喘的症狀。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span class="Apple-style-span" style="color: blue;">4.</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: blue;">喉嚨異物感:</span>「好像有一顆蛋一直吞不下去,」王嘉齊描述病人的主訴。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span class="Apple-style-span" style="color: blue;">5.</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: blue;">胸痛或胸悶:</span>一定要先排除心臟方面的疾病。陳益程解釋,內臟神經對於痛的感覺是一整片的,雖然刺激點在食道,但也可能表現為胸部的疼痛。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span class="Apple-style-span" style="color: blue;">6.</span><span lang="" style="word-break: break-all;"><span class="Apple-style-span" style="color: blue;">嗝氣:</span>一般認為是胃食道逆流的初期症狀,一開始只有氣體被嗝出來,慢慢地連胃酸及食物都可能跑上來。症狀輕微者,容易被忽略,但會造成社交上的不禮貌。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">王嘉齊提醒有以上非典型症狀卻一直檢查不出原因,則要考慮可能是胃食道逆流症,須找胃腸科專科醫師進一步診斷。</span></span></span></div><h5 style="list-style-type: none; margin: 10pt 0in 0pt; padding: 0px;"><ul style="font-weight: normal; line-height: 22px;"><li><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><b style="font-weight: bold;"><span lang="" style="color: red; font-size: large; line-height: 24px; word-break: break-all;">不理它,會致癌</span></b></span></span></li>
</ul></h5><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">許多人因為症狀輕微或非典型,患有胃食道逆流而不自知,以為小小的不舒服忍一忍就過去了。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">但是食道長期被胃酸侵蝕,可能引發食道潰瘍、食道狹窄,造成吞嚥困難。此外,陳益程醫師還指出,食道的上皮細胞長期被胃酸破壞,久了可能為了適應強</span><span lang="" style="word-break: break-all;"> </span><span lang="" style="word-break: break-all;">酸的環境而產生變性,造成「巴瑞特氏食道」(</span>Barrett"s Esophagus<span lang="" style="word-break: break-all;">),「這也許是病變的開始,會增加罹患食道腺癌的機率。」</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">王嘉齊醫師呼籲不可小看這些症狀,「雖然導致嚴重疾病的機率不高,但對於生活品質的影響卻是很大,」他發現不少患者因為胃食道逆流而長期睡不好、吃不好,嗝氣的症狀還可能破壞社交關係。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;">有症狀最好請醫生做檢查,症狀輕微者要注意調整生活飲食習慣。</span></span></span></div><div style="line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; word-break: break-all;"><span lang="" style="font-size: large; word-break: break-all;"></span></span></span></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span style="word-break: break-all;">*************************************************************</span><br />
<span lang="" style="word-break: break-all;"></span></span></span></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="font-weight: bold; line-height: 17px; word-break: break-all;">*有格友提供自身經驗 – </span><span lang="" style="font-weight: bold; line-height: 17px; word-break: break-all;">也必須注意 *</span></span></span></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">沒有以上症狀</span><span style="word-break: break-all;">- </span><span lang="" style="word-break: break-all;">只有喉中有異物感</span><span style="word-break: break-all;">(</span><span lang="" style="word-break: break-all;">卡卡的</span><span style="word-break: break-all;">)</span></span></span></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">也沒有以上發生的原因</span><span style="word-break: break-all;">-<span style="word-break: break-all;"> </span></span><span lang="" style="word-break: break-all;">作息正常</span><span style="word-break: break-all;">+</span><span lang="" style="word-break: break-all;">不吃零食</span><span style="word-break: break-all;">+</span><span lang="" style="word-break: break-all;">三餐定時</span><span style="word-break: break-all;">(</span><span lang="" style="word-break: break-all;">食肉不多</span><span style="word-break: break-all;">) +</span><span lang="" style="word-break: break-all;">壓力不大</span><span style="word-break: break-all;"></span></span></span></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;">醫師診斷</span><span style="word-break: break-all;"> : <span lang="" style="font-weight: bold; word-break: break-all;">不明原因的胃食道逆流</span></span><span style="word-break: break-all;"></span></span></span></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;">*************************************************************</span></span></div><div style="list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span style="word-break: break-all;">Source: </span><strong style="font-weight: bold; text-decoration: none;">Mayo Clinic, </strong><span style="word-break: break-all;"><a href="http://www.mayoclinic.com/health/gerd/DS00967" style="font-weight: bold;">http://www.mayoclinic.com/health/gerd/DS00967</a></span></span></span></div><div style="font-family: arial, mingliu, pmingliu; line-height: normal; text-align: center;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><img alt="" src="http://www.mayoclinic.com/images/image_popup/ans7_esophagus.jpg" style="height: 524px; width: 250px;" /> ←<b>圖一</b><br />
</span></span><br />
<div style="font-family: serif; line-height: 24px; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: left; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; word-break: break-all;"><span class="Apple-style-span" face="" style="font-family: arial, mingliu, pmingliu; line-height: normal;"><b>◎圖一說明:</b></span><b style="font-weight: bold;"><span lang="" style="word-break: break-all;">食道是肌肉管連接嘴和胃。環肌(括約肌</span></b><span style="word-break: break-all;">sphincters</span><b style="font-weight: bold;"><span lang="" style="word-break: break-all;">)在上,下部分的收縮和放鬆,讓食物和液體通過</span></b><b style="font-weight: bold;"><span style="word-break: break-all;"></span></b></span></span></div></div><span class="Apple-style-span"><span lang="" style="font-size: large; word-break: break-all;"><br style="font-family: arial, mingliu, pmingliu; line-height: normal;" /></span></span><br />
<div style="background-color: white; font-family: serif; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: center; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="font-size: large; word-break: break-all;"><img alt="" src="http://www.mayoclinic.com/images/image_popup/r7_heartburn.jpg" style="height: 316px; width: 494px;" />←<b>圖二</b></span></span></div><div style="background-color: white; font-family: serif; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: left; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="font-size: large; word-break: break-all;"><span lang="" style="word-break: break-all;"><b>◎圖二說明:</b></span><b style="font-family: arial, mingliu, pmingliu; line-height: 17px;"><u>胃灼熱和胃食管反流病是怎樣發生的</u></b></span></span></div><div style="background-color: white; font-family: serif; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: left; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="font-size: large; word-break: break-all;"><b style="font-weight: bold; line-height: 24px;"><span lang="" style="word-break: break-all;">當在食道</span></b><span class="Apple-style-span" style="line-height: 24px;">esophagus</span><b style="font-weight: bold; line-height: 24px;"><span lang="" style="word-break: break-all;">下端 的括約肌</span></b><span class="Apple-style-span" style="line-height: 24px;">sphincter</span><b style="font-weight: bold; line-height: 24px;"><span lang="" style="word-break: break-all;">在錯誤的時間放寬,使胃酸回流到食道,</span></b><b style="font-weight: bold; line-height: 24px;"><span lang="" style="word-break: break-all;">這可能會導致胃灼熱和其他症狀和體徵。頻繁或持續回流可能會導致胃食道逆流。</span></b></span></span></div><div style="background-color: white; font-family: serif; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: center; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="font-size: large; word-break: break-all;"><img alt="" src="http://www.mayoclinic.com/images/image_popup/mcdc7_fundoplication.jpg" style="height: 279px; width: 493px;" />←<b>圖三</b></span></span></div><div style="background-color: white; font-family: serif; line-height: 1.5em; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: left; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="word-break: break-all;"><strong style="font-weight: bold; text-decoration: none;"><span lang="" style="font-size: large; word-break: break-all;"><b style="line-height: normal;">◎圖三說明:</b></span></strong></span></span></div><div style="background-color: white; font-family: serif; line-height: 1.5em; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: left; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="font-size: large; word-break: break-all;"><strong style="font-weight: bold; text-decoration: none;"><span lang="" style="word-break: break-all;">手術治療胃食管反流病可能涉及來加強食管下括約肌過程稱為 尼森胃底折疊術</span></strong><strong style="font-weight: bold; text-decoration: none;"><span style="word-break: break-all;"> (Nissen fundoplication) <span lang="" style="word-break: break-all;">在此過程中,醫生以胃的頂部包圍食道下段。</span></span></strong></span></span></div><div style="background-color: white; font-family: serif; line-height: 1.5em; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: left; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="word-break: break-all;"><strong style="font-weight: bold; text-decoration: none;"><span lang="" style="font-size: large; word-break: break-all;">這加強了食管下括約肌,使酸性不太可能在食道倒流</span></strong></span></span></div><div style="background-color: white; font-family: serif; line-height: 1.5em; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: left; word-break: break-all;"><div style="text-align: center;"><span class="Apple-style-span"><span lang="" style="word-break: break-all;"><strong style="font-weight: bold; text-decoration: none;"><span lang="" style="font-size: large; word-break: break-all;"><br />
</span></strong></span></span></div></div><div style="font-family: serif; line-height: 1.5em; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; text-align: left; word-break: break-all;"><div style="text-align: center;"><span class="Apple-style-span"><span lang="" style="word-break: break-all;"><strong style="font-weight: bold; text-decoration: none;"><span lang="" style="font-size: large; word-break: break-all;"><embed allowfullscreen="true" allowscriptaccess="never" height="385" src="http://www.youtube.com/v/EBBGrdoS9yg&hl=en_US&fs=1&" style="background-color: #7de1bb; color: #0b620b; font-family: arial, mingliu, pmingliu; font-weight: normal; line-height: normal;" type="application/x-shockwave-flash" width="480"></embed></span></strong></span></span></div></div><div align="center" style="color: #0b620b; font-weight: normal; line-height: 1.5em; list-style-type: none; margin-left: 0in; margin-right: 0in; padding: 0px 0px 1em; word-break: break-all;"><span class="Apple-style-span"><span lang="" style="word-break: break-all;"><strong style="font-weight: bold; text-decoration: none;"><span class="Apple-style-span" style="background-color: white; font-size: large;">Madonna -Take A Bow </span></strong></span></span></div><span class="Apple-style-span"><span lang="" style="font-size: large; word-break: break-all;"><b>資料來源:</b> </span></span><br />
<div style="font-family: serif;"><span class="Apple-style-span"><span lang="" style="font-family: serif; font-size: large; line-height: 24px; word-break: break-all;"><span class="Apple-style-span" style="background-color: white;"><span style="line-height: 17px; word-break: break-all;">2006/11 康健雜誌 96 期</span><a href="http://www.commonhealth.com.tw/contents/index.jsp?id=96"><span style="word-break: break-all;"></span></a><a href="http://www.commonhealth.com.tw/article/index.jsp?id=382">http://www.commonhealth.com.tw/article/index.jsp?id=382</a></span> </span></span></div><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; line-height: 24px; word-break: break-all;"><div><span class="Apple-style-span"><span lang="" style="background-color: white; font-family: serif; font-size: large; line-height: 24px; word-break: break-all;"><br /></span></span></div> <div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><a href="http://ckwclinic.com.tw/" style="font-family: "times new roman"; margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="94" data-original-width="275" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1WxzK0ImOkOe96NurXtrUWc5cAVZNFxoRChVlXTwYKvZktILYDB4M-076gXiK6dLcXxuXu7N2fBVZPBb1ADiLA2Zj1P63oxWkNBbW1cVjHEX2Ru5-obmjMh7BfvpRObV1nxdj13DBg2I/s0/%25E5%259C%2596%25E7%2589%25871.gif" /></a></div><div align="center" class="MsoNormal" style="line-height: 25pt; text-align: center;"><div class="separator" style="clear: both;"><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><span style="text-indent: 0px;"><div style="text-align: right;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-family: "times new roman";"> (點擊上方圖片進入王群光自然診所官網)</div></div></div></span></div><span style="font-size: large; text-align: left;"></span><span style="text-align: left;"></span><br style="text-align: left;" /><div class="MsoNormal" style="text-align: left; text-indent: 36pt;"><div style="font-family: "times new roman"; font-size: medium; text-align: right; text-indent: 0px;"><div class="separator" style="clear: both;"><br /></div></div></div></div></div></span></span>Unknownnoreply@blogger.com0