{"id":7347,"date":"2022-06-14T10:04:02","date_gmt":"2022-06-14T02:04:02","guid":{"rendered":"https:\/\/newsletter.cgust.edu.tw\/?p=7347"},"modified":"2022-06-16T09:51:34","modified_gmt":"2022-06-16T01:51:34","slug":"%e6%bc%ab%e8%ab%87%e4%ba%ba%e9%ab%94%e8%a9%a6%e9%a9%97%e5%85%a9%e4%b8%89%e4%ba%8b","status":"publish","type":"post","link":"https:\/\/newsletter.cgust.edu.tw\/?p=7347","title":{"rendered":"\u6f2b\u8ac7\u4eba\u9ad4\u8a66\u9a57\u5169\u4e09\u4e8b"},"content":{"rendered":"\n<p>\u4fdd\u5065\u71df\u990a\u7cfb\/\u5289\u73cd\u82b3\/2022.06.13<\/p>\n\n\n\n<p class=\"has-medium-font-size\">    \u5f9e 2 \u5e74\u591a\u4ee5\u524d COVID-19 \u75ab\u60c5\u958b\u59cb\uff0c\u75ab\u82d7\u7814\u767c\u3001\u529f\u6548\u78ba\u8a8d\u7b49\u8a66\u9a57\u4e4b\u9032\u884c\uff0c\u65b0\u805e\u4e2d\u5e38\u5e38\u51fa\u73fe\u8a31\u591a\u9032\u884c\u300c\u81e8\u5e8a\u4eba\u9ad4\u8a66\u9a57\u300d\u7684\u5c08\u6709\u540d\u8a5e -\u300c\u96d9\u76f2\u300d\u3001\u300c\u89e3\u76f2\u300d\u3001\u300c\u63a7\u5236\u7d44\u300d\u3001\u300c\u5b89\u6170\u7d44\u300d\u3001\u300c\u5be6\u9a57\u7d44\u300d\u7b49\uff0c\u8b93\u6211\u4e0d\u7981\u60f3\u4f86\u8207\u5927\u5bb6\u804a\u804a\u9032\u884c\u4eba\u9ad4\u8a66\u9a57\u53ca\u904e\u5f80\u7576\u300c\u767d\u8001\u9f20\u300d\u7684\u7d93\u9a57\u8207\u5fc3\u5f97\u3002<br>    \u4efb\u4f55\u79d1\u5b78\u5b78\u7406\u90fd\u9700\u8981\u6709\u8b49\u64da\uff0c\u6216\u8aaa\u662f\u5be6\u8b49 (evidence-base) \u4f5c\u70ba\u57fa\u790e\uff0c\u56e0\u6b64\u9700\u8981\u9032\u884c\u56b4\u683c\u7ba1\u63a7\u4e4b\u8a2d\u8a08\u8207\u57f7\u884c\u4e4b\u7814\u7a76\u6216\u5be6\u9a57\uff0c\u4ee5\u5f97\u5230\u53ef\u4ee5\u4fe1\u8cf4\u3001\u5ba2\u89c0\u53ca\u5177\u610f\u7fa9\u7684\u7d50\u679c\u3002\u800c\u4eba\u9ad4\u8a66\u9a57\uff0c\u5c24\u5176\u662f RCT (randomized clinical trail) \u7684\u7814\u7a76\u8a2d\u8a08\u66f4\u662f\u5728\u751f\u547d\u79d1\u5b78\u3001\u91ab\u5b78\u9818\u57df\u7814\u7a76\u4e0a\u91cd\u8981\u7684\u4e00\u74b0\u8207\u6a21\u5f0f (model)\u3002<br>    \u7b46\u8005\u904e\u5f80\u4e3b\u6301\u904e\u4e00\u4e9b\u7684\u4eba\u9ad4\u8a66\u9a57\uff0c\u4f46\u70ba\u4e86\u5be6\u969b\u9ad4\u9a57\u8a66\u9a57\u4e4b\u904e\u7a0b\uff0c\u6709\u6642\u4e5f\u6703\u8ddf\u8457\u53c3\u8207\u8a66\u9a57\uff0c\u7576\u7136\u81ea\u5df1\u7684\u6578\u64da\u662f\u4e0d\u80fd\u7528\u7684\u3002\u540c\u6642\u975e\u5e38\u559c\u6b61\u53c3\u52a0\u5176\u4ed6\u7814\u7a76\u8005\u7684\u8a66\u9a57\uff0c\u6975\u70ba\u4eab\u53d7\u7576\u300c\u767d\u8001\u9f20\u300d\u7684\u904e\u7a0b\uff0c\u9084\u53ef\u300c\u6559\u5b78\u76f8\u9577\u300d\uff0c\u4e00\u8209\u6578\u5f97!!<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong><em>\u96d9\u76f2\u8a2d\u8a08\u3001\u89e3\u76f2<\/em><\/strong><\/p>\n\n\n\n<p class=\"has-medium-font-size\">    \u901a\u5e38\u8a66\u9a57\u90fd\u6703\u8a2d\u8a08\u6709\u5be6\u9a57\u7d44\u3001\u63a7\u5236\u7d44\u6216\u7a31\u5c0d\u7167\u7d44 (control) \u6216\u7a31\u5b89\u6170\u5291\u7d44(placebo)\u3002\u4f46\u4ea6\u5e0c\u671b\u80fd\u76e1\u91cf\u964d\u4f4e\u300c\u4e3b\u89c0\u6216\u5fc3\u7406\u7684\u56e0\u7d20\u300d\uff0c\u6216\u7a31\u70ba\u5b89\u6170\u5291\u6548\u61c9 (placebo effect) \u4f86\u5f71\u97ff\u4ecb\u5165 (intervention) \u7684\u8655\u7f6e\u6216\u6750\u6599 (treatment or material)\uff0c\u5305\u62ec\u91ab\u7642\u884c\u70ba\u3001\u85e5\u7269\u3001\u98df\u7269\u3001\u88dc\u5145\u5291\u3001\u6559\u80b2\u7b49\u5c0d\u65bc\u8a66\u9a57\u7684\u7d50\u679c\u3002\u904e\u901a\u5e38\u6703\u6709\u300c\u76f2\u300d(blind) \u7684\u8a2d\u8a08\u3002\u82e5\u53d7\u6e2c\u8005\u4e0d\u77e5\u9053\u81ea\u5df1\u662f\u6b78\u5c6c\u65bc\u300c\u63a7\u5236\u7d44\u6216\u662f\u5be6\u9a57\u7d44\u300d\uff0c\u5373\u662f\u4e00\u822c\u8aaa\u7684\u300c\u55ae\u76f2\u300d(single blind)\uff1b\u82e5\u53ea\u6709\u8a08\u756b\u4e3b\u6301\u4eba (principal investigator, PI) \u77e5\u9053\u6574\u500b\u7814\u7a76\u8a2d\u8a08\u8207\u5206\u7d44\u7684\u72c0\u6cc1\uff0c\u7d66\u4e88\u4e4b\u8655\u7f6e\u6216\u6750\u6599\u7684\u57f7\u884c\u4eba\u54e1\u4ea6\u4e0d\u77e5\uff0c\u5247\u7a31\u70ba\u300c\u96d9\u76f2\u300d( double blind)\u3002\u7d93\u904e\u4e00\u5b9a\u7684\u8a66\u9a57\u6642\u9593\u5f8c\uff0c\u8981\u6b63\u5f0f\u516c\u5e03\u5be6\u9a57\u7684\u7d50\u679c\uff0c\u5373\u6240\u8b02\u7684\u300c\u89e3\u76f2\u300d(Unblind)\u3002\u7576\u7136\u4e26\u975e\u6240\u6709\u7684\u5be6\u9a57\u5747\u53ef\u505a\u5230\u300c\u76f2\u300d\u7684\u8a2d\u8a08\uff0c\u5c24\u5176\u662f\u8ddf\u98df\u7269\u3001\u98f2\u98df\u6709\u95dc\u7684\uff0c\u4f8b\u5982\u64ec\u63a2\u8a0e\u6c34\u679c\u5c0d\u7761\u7720\u7684\u5f71\u97ff\u6642\uff0c\u5c31\u7121\u6cd5\u7a2e\u690d\u51fa\u4e0d\u542b\u8272\u80fa\u9178\u53ca\u7dad\u751f\u7d20 B6 \u7684\u9999\u8549\u6216\u4e0d\u542b\u9223\u53ca\u9382\u7684\u5947\u7570\u679c\u7b49\u3002<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong><em>\u57f7\u884c\u4eba\u9ad4\u5be6\u9a57\u7684\u7d93\u9a57<\/em><\/strong><\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u7814\u7a76\u8a2d\u8a08\u8207\u57f7\u884c\u5747\u7d93\u9700\u56b4\u683c\u63a7\u7ba1<\/strong><\/p>\n\n\n\n<p class=\"has-medium-font-size\">    \u6709\u4e9b\u8a66\u9a57\u662f\u77ed\u671f\uff0c\u534a\u5929\u30011-3 \u5929\u5373\u53ef\u5b8c\u6210\u7684\uff0c\u4e5f\u6709\u6301\u7e8c\u9032\u884c\u534a\u5e74\u4ee5\u4e0a\u7684\u9577\u671f\u8a66\u9a57\u3002\u4e0d\u8ad6\u9032\u884c\u6642\u9593\u4e4b\u9577\u77ed\uff0c\u56e0\u662f\u4eba\u9ad4\u8a66\u9a57\uff0c\u8a66\u9a57\u8a2d\u8a08\u9700\u56b4\u8b39\u3001\u5b89\u5168\u4e26\u517c\u9867\u4eba\u6b0a\u4fdd\u969c\uff0c\u9075\u5b88\u8207\u7b26\u5408\u8d6b\u723e\u8f9b\u57fa\u5ba3\u8a00\u7b49\u3002\u8a08\u756b\u7814\u7a76\u8005\uff0c\u5305\u62ec\u4e3b\u6301\u4eba\u3001\u57f7\u884c\u52a9\u7406\u7b49\u90fd\u9700\u8981\u7d93\u904e\u4e00\u5b9a\u6642\u6578\u4e4b\u76f8\u95dc\u8ab2\u7a0b\u4e4b\u8a13\u7df4\u4e26\u53d6\u5f97\u8b49\u66f8\u3002\u8a66\u9a57\u958b\u59cb\u524d\uff0c\u5747\u9700\u7d93\u904e\u4eba\u9ad4\u8a66\u9a57\u59d4\u54e1\u6703 (Institutional Review Board, IRB) \u7684\u56b4\u683c\u5be9\u67e5\u3002\u82e5\u6709\u91ab\u7642\u8655\u7f6e\uff0c\u4f8b\u5982\u62bd\u8840\uff0c\u5247\u5fc5\u9700\u5728\u5c08\u696d\u91ab\u8b77\u4eba\u54e1\u7684\u57f7\u884c\u53ca\u76e3\u7763\u4e0b\u9032\u884c\uff0c\u6b64\u5916\u53d7\u6e2c\u8005\u4ea6\u90fd\u9700\u586b\u5beb\u540c\u610f\u66f8 (informed consent)\u3002<br>    \u56e0\u7b46\u8005\u662f\u4fdd\u5065\u71df\u990a\u5b78\u5c08\u696d\uff0c\u6545\u904e\u5f80\u57f7\u884c\u7684\u8a66\u9a57\u5927\u90fd\u8207\u300c\u98f2\u98df\u3001\u98df\u7269\u6216\u71df\u990a\u7d20\u300d\u6709\u95dc\uff0c \u4f8b\u5982\u88fd\u5099\u4e0d\u540c\u5347\u7cd6\u6307\u6578\u4e4b\u9910\u98df\u3001\u751f\u916e\u9910\u98df\u3001\u4f4e\u71b1\u91cf\u9910\u98df\u3001\u4e0d\u540c\u8cea\u5730\u4e4b\u9910\u98df\u3001\u542b\u4e94\u8272\u852c\u679c\u4e4b\u9910\u98df\u6216\u852c\u679c\u6c41\u3001\u4ee5\u5805\u679c\u53d6\u4ee3\u6cb9\u8102\u4f86\u6e90\u7684\u9910\u98df\u7b49\uff0c\u7a2e\u985e\u76f8\u7576\u591a\u3002\u56e0\u98f2\u98df\u5c0d\u5065\u5eb7\u7684\u5f71\u97ff\u662f\u9577\u9060\u7684\uff0c\u6545\u901a\u5e38\u4e00\u9805\u8a66\u9a57\u6703\u9032\u884c 4~12 \u9031\u3002\u671f\u9593\u7814\u7a76\u8005\u88fd\u5099\u904e\u7a0b\u56f0\u96e3\uff0c\u4f46\u5927\u90e8\u4efd\u7684\u53d7\u6e2c\u8005\u6a02\u65bc\u53c3\u52a0\u53ca\u6295\u5165\uff0c\u4e14\u5e0c\u671b\u5be6\u9a57\u4e45\u4e00\u9ede\uff0c\u591a\u5e74\u4f86\u4e5f\u7d2f\u7a4d\u4e86\u4e9b\u300c\u9435\u7c89\u300d\u2026<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u62bd\u8840\uff0c\u6536\u5c3f\u6db2\u53ca\u7cde\u4fbf\u662f\u57fa\u672c\u529f\uff0c\u4f46\u7537\u5973\u6709\u5225<\/strong><\/p>\n\n\n\n<p class=\"has-medium-font-size\">    \u958b\u59cb\u4e00\u500b\u8a66\u9a57\u524d\u90fd\u9700\u9032\u884c\u53d7\u6e2c\u8005\u7684\u7be9\u9078\uff0c\u9664\u586b\u5beb\u81ea\u8ff0\u7684\u5065\u5eb7\u554f\u5377\u3001\u9ad4\u4f4d (\u5305\u62ec\u9ad4\u91cd\u3001\u9ad4\u8102\u80aa\u7387\u3001\u808c\u8089\u91cf\u3001\u8170\u81c0\u570d\u7b49) \u6e2c\u91cf\u4e4b\u5916\uff0c\u62bd\u8840\u662f\u6700\u5e38\u9032\u884c\u7684\u3002\u9664\u4e86\u6aa2\u6e2c\u57fa\u672c\u7684 CBC (complete blood count) \u4e4b\u5916\uff0c\u5f80\u5f80\u9700\u8981\u66f4\u4e86\u89e3\u5176\u65b0\u9673\u4ee3\u8b1d\u4e4b\u72c0\u6cc1\uff0c\u6545\u300c\u8461\u8404\u7cd6\u8010\u53d7\u6027\u8a66\u9a57\uff0cOGTT\u300d\u662f\u7d93\u5e38\u9700\u57f7\u884c\u7684\u6aa2\u6e2c\u9805\u76ee\u3002\u7d93 10~12 \u5c0f\u6642\u7a7a\u8179\u5f8c\uff0c\u4e00\u5927\u65e9\u4f86\u5230\u5be6\u9a57\u5ba4\uff0c10 \u5206\u9418\u4e4b\u5167\u559d\u4e0b\u542b\u6709 75 \u516c\u514b\u7684\u4e00\u5927\u676f\u8461\u8404\u7cd6\u6c34\uff0c\u771f\u7684\u662f\u6709\u5920\u751c!!\u559d\u4e4b\u524d\u3001\u5f8c\u7684\u5169\u5c0f\u6642\u5167\u6bcf 30 \u5206\u9418\u8981\u62bd\u9ede\u8840\uff0c\u5171 5 \u6b21\uff0c\u9084\u597d\u662f\u5728\u624b\u81c2\u4e0a\u653e\u652f\u300c\u7559\u7f6e\u91dd\u300d\uff0c\u5404\u6642\u9593\u9ede\u518d\u62bd\u9ede\u8840\u5373\u53ef\uff0c\u4e0d\u7528\u518d\u531d\u91dd\uff0c\u5426\u5247\u5373\u4f7f\u662f\u518d\u6709\u52c7\u6c23\u7684\u4eba\uff0c\u4e5f\u6703\u5bb3\u6015\u7684\uff0c\u4f46\u671f\u9593\u662f\u4e0d\u80fd\u4e82\u8dd1\u8df3\u78b0\u7684\u3002\u9664\u4e86\u62bd\u8840\u4e4b\u5916\uff0c\u70ba\u4e86\u77ad\u89e3\u98df\u7269\u4e2d\u71df\u990a\u7d20\u6d88\u5316\u5438\u6536\u4ee3\u8b1d\u7684\u60c5\u5f62\uff0c\u6536\u96c6\u5c3f\u6db2\u53ca\u7cde\u4fbf\u4e5f\u662f\u5e38\u6709\u7684\u5be6\u9a57\u8a2d\u8a08\u3002\u6bd4\u8f03\u8d77\u4f86\uff0c\u6536\u7cde\u4fbf\u662f\u8f03\u70ba\u7c21\u55ae\uff0c\u5c07\u65bc\u4e0b\u4e00\u6bb5\u518d\u9673\u8ff0\u3002\u6536\u5c3f\u6db2\u5c31\u9ebb\u7169\u4e86\uff0c\u5c24\u5176\u662f\u8981\u6536 24 \u5c0f\u6642\u5c3f\u6db2\u6642\uff0c\u771f\u7684\u5c31\u662f\u300c\u7537\u5973\u6709\u5225\u300d\u3002\u53ea\u8981\u63d0\u4f9b\u7537\u6027\u53d7\u6e2c\u8005\u4e00\u500b\u990a\u6a02\u591a\u7684\u74f6\u5b50\uff0c\u653e\u7684\u9032\u53bb\u5373\u53ef\uff0c\u5973\u751f\u53ef\u5c31\u9ebb\u7169\u4e86\uff0c\u6703\u62ff\u5230\u8a31\u591a\u7d19\u676f\u548c\u4e00\u500b\u5927\u5851\u81a0\u6876\uff0c\u70ba\u4e86\u505a\u5230\u300c\u6ef4\u6c34\u4e0d\u6f0f\u300d\uff0c\u53ef\u662f\u60f3\u76e1\u8fa6\u6cd5\uff0c\u7df4\u4e86\u300c\u5169\u624b\u300d\u597d\u6280\u8853\u3002<\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong><em>\u53c3\u8207\u4eba\u9ad4\u5be6\u9a57\u7684\u7d93\u9a57<\/em><\/strong><\/p>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u5b89\u6170\u5291\u7d44\u9084\u662f\u5be6\u9a57\u7d44<\/strong><\/p>\n\n\n\n<p class=\"has-medium-font-size\">    \u7b46\u8005\u7576\u300c\u767d\u8001\u9f20\u300d\u53c3\u52a0\u904e\u7684\u8a66\u9a57\u4f86\u81ea\u5404\u9818\u57df\u4e94\u82b1\u516b\u9580\uff0c\u4f8b\u5982\u4fdd\u990a\u54c1\u76ae\u819a\u6e2c\u8a66\u3001\u8166\u90e8\u8a18\u61b6\u529b\u8207\u8a8d\u77e5\u529f\u80fd\u6e2c\u8a66\u3001\u5c08\u6ce8\u529b(\u773c\u52d5\u5100)\u7684\u8a66\u9a57\u3001\u5404\u7a2e\u904b\u52d5\u8655\u65b9\u4ecb\u5165\u8207\u6e2c\u8a66\u3001\u4fdd\u5065\u98df\u54c1\u529f\u6548\u6027\u8a55\u4f30\u7b49\uff0c\u5176\u4e2d\u5f8c\u8005\uff0c\u662f\u53c3\u52a0\u6700\u591a\u7684\u4e00\u985e\u3002\u5e02\u9762\u4e0a\u6709\u8a31\u591a\u6709\u300c\u5065\u5b57\u300d\u865f\u7684\u7522\u54c1\uff0c\u90fd\u662f\u9700\u8981\u7d93\u904e\u56b4\u683c\u7ba1\u63a7\u7684\u8a66\u9a57\u624d\u80fd\u53d6\u5f97\u570b\u5bb6\u8a8d\u8b49\u7684\u3002\u5f88\u591a\u5e74\u524d\uff0c\u66fe\u53c3\u52a0\u4e00\u9805\u9577\u671f\u7684\u300c\u96d9\u76f2\u300d\u8a66\u9a57\u3002\u6bcf\u5929\u559d\u5169\u74f6\u767c\u9175\u4e73\u98f2\u54c1\uff0c\u6bcf\u5468\u7d00\u9304 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