探讨蔓越莓对预防泌道感染之成效.ppt

探討蔓越莓對預防泌尿道感染 之成效 動機 目的 EBN問題與步驟 文獻評讀 結論 討論 實證五步驟 Step 1: 整理出一個可以回答的問題 Step 2: 尋找文獻證據 Step 3: 嚴格評讀文獻 Step 4: 應用於病人身上 Step 5: 對過程進行稽核 蔓越莓對預防泌尿道感染的成效? 有症狀的泌尿道感染 症狀：發燒、急尿、小便困難、恥骨上 壓痛 ☆具有尿路感染的症狀任一項且尿液培養--菌落數每毫升大於或等於十萬個 （colony count ≧ 105ml) ☆尿液培養之微生物七天內連續兩次相同方式 取得之尿液標本，連續兩次相同，菌落數每 毫升大於或等於十萬個 Step 3: 嚴格評讀文獻 文獻評讀 尿液酸化一直被認為是蔓越莓預防尿道感染的主要作用，但是經過許多的研究後證實這只是蔓越莓的作用之一。 蔓越莓汁中分離而得的濃縮單寧酸（condensed tannins） ，或稱初花青素（proanthocyanidins），發現其具有特殊的抗黏附活性成份，能抑制大腸桿菌E.coli 的P型纖毛黏附於尿道細胞上。  Role of Cranberry Juice on Molecular-Scale Surface Characteristics and Adhesion Behavior of Escherichia coli RESULT DISCUSSION Exposure to cranberry juice resulted in a decrease in the equilibrium length of the p-fimbriae on the surface of E. coli Cranberry juice blocks adhesive action of P-fimbriae (proanthocyanidin) Cranberry juice causes loss of expression of P-fimbriae （一） （二）This is a 20% reduction in absolute risk in the cranberry group compared with the control group P. Di Martino A R. Agniel A K. David A C. TemplerJ. L. Gaillard A P. Denys A H. BottoPublished online: 6 January 2006 Springer-Verlag 2006 （一） （二）INTRODUCTION (三)成份比較 Cranberry juice Placebo Calories (Kcal) 41.6 42.7 Total carbohydrates (g) 10.4 10.7 Ascorbic acid (mg) 63 63 Total organic acids (g) 1.8 1.6 Total phenolics (mg) 179 161 Total anthocyanidins (mg) 9.3 42 Proanthocyanidins (mg) 40 ND (四)Result Anti-adherence activity of the cranberry juice: comparisonof the regimens, means for the 20 volunteers and 6 types of E coli strains (四)Result No significant differences in the pH or specific gravity between the urine samples collected after cranberry or placebo consumption. We observed a dose dependent significant decrease in bacterial adherence associated with cranberry consumption. Re