六週次大運動訓練對B型肝炎學生肝功能及疲勞度之影響

Abstract

本研究旨在探討以次大運動為強度，進行六週的運動訓練，對B型肝炎學生肝功能生理指數（包括一般血液檢查、血清蛋白及血清酵素）及疲勞相關數值（包括自覺量數（RPE）、運動強度、運動心跳率）所產生的影響。受試對象為高中男生28人（平均年齡17.3±0.1歲），首先進行一般健康檢查及血液分析，篩選出B型肝炎健康帶原組12人、B型肝炎慢性帶原組6人、正常控制組10人參加實驗。實驗內容包含1.運動測試與運動訓練2.生理指數與疲勞相關數值分析；運動測試以原地跑步機進行，次大運動強度目標心跳率的範圍訂於85%~70%最大心跳率保留值，持續20分鐘。另以目標心跳率為強度，實施每週三次，每次30分鐘，為期6週的跑走運動訓練。實驗過程包括前測、第2週、第4週、第6週。測試所得數據以二因子變異數分析混合設計，考驗三組運動前後各變項的變化。 實驗結果發現，生理指數方面血液數值在運動訓練介入後，淋巴球數有顯著的上升（p＜.05），血球容積比下降（p＜.05）；血清白蛋白顯著下降（p＜.05）；值得一提的是，各實驗組的血清酵素指數AST、ALT在運動訓練前、後雖無顯著差異，且慢性帶原組也顯著高於二組（p＜.05），但運動訓練後AST、ALT皆有下降（25%、31%）且AST（36.67U/L）降至接近正常數值，ALP、r-GTP也有相同的趨勢；在CPK、LDH各組於第二週皆有上升的情況，特別是LDH（p＜.05），之後便逐漸下降。而於自覺量數三組皆有顯著下降（p＜.05），健康帶原組下降22.55%，慢性帶原組下降11.64%，正常控制組下降21.63%，於第八週時各組卻有上升的趨勢。在運動強度方面三組皆有顯著上升（p＜.05），健康帶原組上升6.20%，慢性帶原組上升20.97%，正常控制組上升20.44%。運動心跳率各組數值皆在目標心跳之範圍內，但健康帶原組顯著高於其他二組（p＜.05）。本研究發現以中高強度且長期的運動訓練，對於肝功能異常患者不會造成負面的影響，在肝功能生理的檢測項目中，有多項指數都有顯著的正面意義（p＜.05），且有提昇運動能力及降低自覺量數（RPE）的趨勢，顯示運動訓練對B型肝炎患者無論在生理及心理的影響有其正面意義。因此，本研究可提供B型慢性肝炎患者，在從事規律的中高強度運動或訓練時之參考。The purpose of this study is to examine the effects of 6 weeks of sub-maximal exercise on the liver function and ratings of perceived fatigue of the students infected with hepatitis B. The study analyzed (hematological test, serum protein, serum enzyme and ratings of perceived exertion（RPE）, exercise intensity, exercise of heart rates ) of the infected students to understand the effects of the exercise program. Participating subjects are chosen from high school male students with average age of 17.3. Total of twenty eight subjects are given general health check-up and blood test before dividing into three test groups: 12 Hepatitis B carriers whose liver is functioning normally（B1）, 6 Hepatitis B carriers who has liver problem（B2）, and 10 without Hepatitis B（B3）. The subjects were asked to use treadmill for 20 minutes to reach between the 85~ 70 percentages heart rate reserve. This training is performed three times a week, 30 minutes each session for 6 weeks. During the training, the subject’s ratings of perceived fatigue were taken and analyzed（2-way ANOVA mixed design）on the week pre, 2, 4, and 6 before and after the exercise sessions until 8th week. The study found lymphocytes increase after exercise training, but hematocrit lowered. In addition, albumin decreased obviously. Even though AST and ALT do not demonstrate obvious before and after exercise training, AST and ALT lowered among chronic carriers, closer to the normal value. Moreover, ALP and r-GPT indicate the similar tendency. All three groups demonstrated an increase in CPK and LDH but the number dropped back down. On the RPE that decreased significantly in each group（p<.05）after exercise training. The B1 group decreased 22.55%, the B2 group decreased 20.97%, the B3 group decreased 21.63%, but all three groups demonstrated an increase on 8th week. In addition, intensity increased obviously（p<.05）. The B1 group increased 6.20%, the B2 group increased 20.97%, the B3 group increased 20.44%. Moreover, all three groups demonstrated at target heart rates in exercise of heart rates, but the B1 group higher obviously（p<.05）than the others. The study found that given regular and mid to high intensity exercise or training, patients with abnormal liver function will be promoted physical ability and lowered ratings of perceived exertion（RPE）. Moreover, exercise training revealed positive influence in physiology and psychology of patients with hepatitis B chronic. Therefore, this study can be used as reference for hepatitis B patients interested in regular and mid to high intensity exercise or training.