探讨蔓越莓对预防泌尿道感染 之成效课件（可编辑）

探讨蔓越莓对预防泌尿道感染之成效课件探蔓越莓防泌尿道感染探探蔓蔓越越莓莓防防泌泌尿尿道道感感染染之成效之成效之成效外科美珍江雪黛外科美珍江雪黛秀郁文棋林步秀郁文棋林步大目的EBN步文1全院感染率16月份以泌尿道感染率最高1680/002外科病房的泌尿道感染率有偏高的95年16月9A病房410/003生常常告病人多喝蔓越莓汁院作的教也教病人多喝蔓越莓汁但究竟喝多少有何效果4院理之家住民有期食用蔓越莓汁之情形,WHY目的目的由EBN之精神,探索神奇的蔓越莓,透文集解蔓越莓功效何如何地用在床上五步STEP1整理出一可以回答的STEP2找文STEP3格文STEP4用於病人身上STEP5程行稽核STEP1整理出一可以回答的蔓越莓防泌尿道感染的成效蔓越莓防泌尿道感染的成效名解1蔓越又小莓,CRANBERRY,名又小莓,CRANBERRY,名VACCINIUMMACROCARPONVACCINIUMMACROCARPON蔓生植物果,正球1公分大小,呈、暗色,表面平滑富光。原地及大面耕的地是北美及加拿大,主要的季在九月及十月左右。MOWERYDBTHESCIENTIFICVLIDATIONOFHERBALMEDICINENEWCANAANCONNKEATSPUB,1986316名解2泌尿道感染URINARYTRACTINFECTION有症的泌尿道感染SYMPTOMATIC症菌尿症ASYMPTOMATIC出/0感染定有症的泌尿道感染症、急尿、小便困、骨上痛具有尿路感染的症任一且尿液培菌落每毫升大於或等於十5COLONYCOUNT10ML症的菌尿症尿液培之微生物七天次相同方式取得之尿液本,次相同,菌落每毫升大於或等於十STEP2找文EVIDENCEBASEDCOCHRANECOCHRANEMEDICINEREVIEWLIBRARYEEBBMMNGCNGCSEARCHSEARCH搜策略NATIONALGUIDECLEARINGHOUSEFFRRAAMMEEWWOORRKKMEDLINEMEDLINE搜文之架PUBMEDPUBMEDSYSTEMATICREVIEW全文子期刊政府研究料全博士文合作STEP3格文研究的值取於其品及效度文的金中,以盲照床盲照床得出的果最佳等THEEVIDENCEPYRAMID床研究等等USAGENCYFORHEALTHCAREPOLICYANDRESEARCHCLASSIFICATIONAHCPR,1992等具模具有取及控制RANDOMIZEDCONTROLLEDIA照所作之研究TRIALS,RCTMATAANALYSIS至少由一有良好之化及控制之研究RCTIB有控制但不於化,IIA至少有似或接近完整之方法QUASIEXPERIMENTALSTUDYIIB之研究由描述性之研究如比方法相之探或案,III告由家所表之告或家之意IV文推等DEVELOPBYJBIEFFECTIVENESSESTABLISHEDTOADEGREETHATGRADEAMERITSAPPLICATIONEFFECTIVENESSESTABLISHEDTOADEGREETHATGRADEBSUGGESTSAPPLICATIONEFFECTIVENESSESTABLISHEDTOADEGREETHATGRADECWARRANTSCONSIDERATIONOFAPPLYINGTHEFINDINGGRADEDEFFECTIVENESSESTABLISHEDTOALIMITEDDEGREEGRADEEEFFECTIVENESSNOTESTABLISHED文文文查蔓越莓防泌尿道感染作用尿液酸化一直被是蔓越莓防尿道感染的主要作用,但是多的研究后只是蔓越莓的作用之一。蔓越莓汁中分而得的酸CONDENSEDTANNINS,或初花青素PROANTHOCYANIDINS,其具有特殊的抗黏附活性成份,能抑制大菌ECOLI的P型毛黏附於尿道胞上。LOWE,FC2001每100G蔓越莓汁成分WATER929SOLIDR71CALORIES27TOTALCARBOHYDRATEG68其他的成分包括SUGARG37DIETARYFIBERG01酮FLAVONOIDS、PROTEING01FATG01前花青素MINERALPROANTHOCYANIDINS、SODIUMMG38POTASSIUMMG852茶素CATECHINCALCIUMMG68IRONMG033VITAMINCMG2PH25LOWE,FC2001文查蔓越莓防泌尿道感染作用ROLEOFCRANBERRYJUICEONMOLECULARSCALESURFACECHARACTERISTICSANDADHESIONBEHAVIOROFESCHERICHIACOLIYATAOLIU,MATTHEWABLACK,LIZABETHCARON,TERRIACAMESANOBIOTECHNOLOGYANDBIOENGINEERING,VOL93,NO2,FEBRUARY5,2006RESULT298102收案族群40/21位所小朋友,有神性膀胱需歇性尿平均935盲、交叉措施每天15ML/KGCRANBERRY尾酒汁成分30,持6月CRANBERRY尾酒汁,6月水果有症的上泌尿道感染CRANBERRY19/112MONTHS17PLACEBO20/117MONTHS171症的上泌尿道感染CRANBERRY27/112MONTHS241PLACEBO34/117MONTHS29AHCPR文等IIA文查相研究二年份1999篇名EFFECTOFCRANBERRYJUICEONBACTERIURIAINCHILDRENWITHNEUROGENICBLADDERRECEIVINGINTERMITTENTCATHETERIZATIONJPEDIATR1999135698702作者SCHLAGERTA,ANDERSONS,TRUDELLJ,HENDLEYJO收案族群15/15小朋友,有神性膀胱需歇性尿218/DOUBLEBLIND/交叉措施每天300CCCRANBERRY成分30,控制PLACEBOCONTROLLED安慰看起和起相似的果汁,持3月CRANBERRYJUICE,持3月安慰果有症的上泌尿道感染CRANBERRY3TIMESUTIIN2CHILDRENPLACEBO3TIMESUTIIN3CHILDREN症的上泌尿道感染CRANBERRY120/160MONTHS75PLACEBO114/151MONTHS75AHCPR文等IA文查相研究三年份2002篇名RANDOMIZEDTRIALTOEVALUATEEFFECTIVENESSANDCOSTEFFECTIVENESSOFNATUROPATHICCRANBERRYPRODUCTSASPROPHYLAXISAGAINSTURINARYTRACTINFECTIONINWOMENCANJUROL20029155862作者WALKEREB,BARNEYDP,MICKELSENJN,WALTONRJ,MICKELSENRAJR收案族群19/10有性交活的女性2844收案件未孕有性交活的女性1845有UTI病史DOUBLEBLIND/交叉措施CRANBERRY400MG控制PLACEBO安慰持3月CRANBERRY,持3月安慰果有症的上泌尿道感染CRANBERRY6TIMESUTIPLACEBO15TIMESUTIAHCPR文等IIA文5文查相研究四年份2005目DOSEINGESTIONOFCRANBERRYJUICEREDUCESYMPTOMATICURINARYTRACTINFECTIONINOLDERPEOPLEINHOSPITAL作者/URDO,LINDAYBISSETT,ROSEMARY/CE,GABBYPHILLIPS,LAINK,CROMBIE象376在院的老年人方法、盲措施予300ML/DAYCRANBERRYJUICEORMATCHINGPLACEBOBEVERAGENOSIGNIFICANTDIFFERENCESWEREFOUNDBETWEENTREATMENTGROUPAHCPR文等IA文查相研究五RANDOMIZEDTRIALOFCRANBERRYLINGOBERRYJUICEANDLACTOBACILLUSGGDRINKFORTHEPREVENTIONOFURINARYTRACTINFECTIONSINWOMENTEROKONTIOKARI,KAJSUNDQVIST,MNUUTINEN,TPOKKA,MKOSKELAANDMUHARIBMJ20013221571AHCPR文等IA一TODETERMINEWHETHERRECURRENCESOFURINARYOBJECTIVETRACTINFECTIONCANBEPREVENTEDWITHCRANBERRYLINGONBERRYJUICEORWITHLACTOBACILLUSGGDRINKOPEN,RANDOMIZEDCONTROLLED12MONTHFOLLOWUPDESIGNTRIALHEALTHCENTERSFORUNIVERSITYSTUDENTSANDSTAFFSETTINGOFUNIVERSITYHOSPITAL150WOMENWITHURINARYTRACTINFECTIONCAUSEDBYPARTICIPANTSESCHERICHIACOLIRANDOMLYALLOCATEDINTOTHREEGROUPSINTERVENTION50MLOFCRANBERRYLINGONBERRYJUICECONCENTRATEDAILYFORSIXMONTHSOR100MLOFLACTOBACILLUSGGDRINKFIVEDAYSAWEEKFORONEYEAR,ANDTHETHIRDGROUPSERVEDASANOPENCONTROLGROUP二THISISA20REDUCTIONINABSOLUTERISKINTHECRANBERRYGROUPCOMPAREDWITHTHECONTROLGROUP文查相研究六REDUCTIONOFESCHERICHIACOLIADHERENCETOUROEPITHELIALBLADDERCELLSAFTERCONSUMPTIONOFCRANBERRYJUICEPDIMARTINOARAGNIELAKDAVIDACTEMPLERJLGAILLARDAPDENYSAHBOTTOPUBLISHEDONLINE6JANUARY2006SPRINGERVERLAG2006一TODETERMINETHEEFFICACYOFTHEABSTRACTCONSUMPTIONOFCRANBERRYJUICEVERSUSPLACEBOWITHREGARDTOTHEPRESENCEOFINVITROBACTERIALANTIADHERENCEACTIVITYINTHEURINEOFHEALTHYVOLUNTEERSTWENTYHEALTHYVOLUNTEERS,10MENAND10PARTICIPANTSWOMEN,WEREINCLUDEDTHESTUDYWASADOUBLEBLIND,RANDOMIZED,DESIGNPLACEBOCONTROLLED,ANDCROSSOVERSTUDYWITHAWASHOUTPERIODOFATLEAST6DAYSBETWEENEVERYCHANGEINREGIMENAHCPR文等1A二INTRODUCTIONECOLITYPE1ANDTYPEPFIMBRIAEADHERENCECRANBERRYPROANTHOCYANIDINSCRANBERRYJUICETYPEPJUICECONSTITUENTSFRUCTOSEMANYFRUITJUICETYPE1ZAFRIRID,OFEKI,POCINOM,SHARONN1989INHIBITORYACTIVITYOFCRANBERRYJUICEONADHERENCEOFTYPE1ANDTYPEPFIMBRIATEDECOLITOEUKARYOTICCELLS三成份比CRANBERRYJUICEPLACEBOCALORIESKCAL416427TOTALCARBOHYDRATESG104107ASCORBICACIDMG6363TOTALORGANICACIDSG1816TOTALPHENOLICSMG179161TOTALANTHOCYANIDINSMG9342PROANTHOCYANIDINSMG40ND四RESULTANTIADHERENCEACTIVITYOFTHECRANBERRYJUICECOMPARISONOFTHEREGIMENS,MEANSFORTHE20VOLUNTEERSAND6TYPESOFECOLISTRAINSREGIMENSDECREASEINBACTERIALADHERENCE250MLPLACEBO500MLMINERALWATER750MLPLACEBO12250MLCRANBERRY45500MLMINERALWATER750MLCRANBERRY65四RESULTNOSIGNIFICANTDIFFERENCESINTHEPHORSPECIFICGRAVITYBETWEENTHEURINESAMPLESCOLLECTEDAFTERCRANBERRYORPLACEBOCONSUMPTIONWEOBSERVEDADOSEDEPENDENTSIGNIFICANTDECREASEINBACTERIALADHERENCEASSOCIATEDWITHCRANBERRYCONSUMPTION文查相研究七REDUCTIONOFBACTERIURIAANDPYURIAAFTERINGESTIONOFCRANB