第六章 結論與建議
第二節 建議
1. 衛生機關應繼續加強取締公共場所之吸菸行為，並積極推動台灣地區 無菸環境之計畫，以減少青少女暴露二手菸機會，避免產生經痛之症 狀與嚴重度、甚至影響未來青少女的健康及生理之發育。
2. 擴大持續推動無菸職場、無菸家庭、無菸餐廳、無菸校園、創造一個 無菸的環境，以避免菸害或暴露二手菸對嬰幼兒與青少年的傷害。
3. 加強宣導社會大眾對減少二手菸暴露正確之認知與態度，除避免在職 場或公共場所暴露二手菸外，尤其有吸菸習慣的父、母親，亦應隨時 注意避免在家中或陽台吸菸，以確保自己與家人的健康。
4. 本研究已證實暴露二手菸的青少女與其經痛具有相關性，因此，一般
學校除對部份的青少女發生經痛時給予適當之舒緩措施或休養，亦應
致力於推動無菸校園或成為健康促進學校外，以減少青少女在校園內
暴露二手菸，而可能更增加其發生經痛次數或嚴重度。
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表一 九十四學年度一至三年級青少女經痛與人口學特微之相關性
表二 九十四學年度一至三年級青少女經痛與飲食型態相關因子分析
從未 3 (02.2) 17 (03.2) 0.45
很少 15 (10.6) 78 (14.9)
偶而 58 (40.9) 213 (40.6)
經常 66 (46.5) 217 (41.3)
表三 九十四學年度一至三年級青少女經痛與生活型態相關因子分析
憂鬱分數(分)a 21.4±10.4 23.5±10.5 0.04 a:平均值±標準差
表四 九十五學年度一年級青少女經痛與其人口學變項之相關性
表五 九十五學年度一年級青少女經痛與生活型態之相關性
很少 4 (06.7) 17 (12.5)
偶而 28 (46.7) 42 (30.9)
經常 27 (45.0) 73 (53.7)
表六 九十五學年度一年級青少女經痛與其生活型態之相關性
課業壓力a 10.4±5.6 11.2±5.6 0.37
憂鬱分數a 21.1±9.2 23.0±8.9 0.17
a:平均值±標準差
表七 九十四學年度一至三年級青少女經痛與其月經生理變項及家族經痛之相關性
表八 九十五學年度一年級青少女經痛與其月經生理變項及家族經痛之相關性
表九 九十四學年度一至三年級暴露二手菸與青少女經痛之分布情況 經痛
類別 無 (N=145) 有 (N=463)
n (%) n (%)
p
暴露二手菸
無 52 (57.1) 162 (36.5) 0.21
有 39 (42.9) 370 (69.5)
家中菸蒂數(個)
0 95 (65.6) 310 (59.5) 0.30
1-3 21 (14.5) 66 (12.7) 3.5-5.5 15 (10.3) 63 (12.1)
>5.5 14 (09.7) 82 (15.7) 家中吸菸人數(人)
0 85 (58.6) 277 (51.8) 0.33
1 44 (30.3) 194 (36.3)
>2 16 (11.0) 64 (12.0)
表十 九十四學年度一至三年級青少女經痛與其他危險因子之相關性
表十一 以 Mutiple logistic regression 分析九十四學年度一至三年級暴露
*p<0.05, **p<0.01, ***p<0.001
控制變項包括身體質量指數(<18.5，18.5-22.9，>22.9)，咖啡因飲料飲用 (無，已戒，有)，魚類的攝取(1 次/週 以下，3 次/週 以上)，冰冷飲料 的飲用(無，有)，憂鬱分數(<16，16-22，23-30，>31)初經年齡(<11，11-13，
>13 歲)，母親經痛情況(無，有，不知道)
表十二 九十四學年度一至三年級暴露二手菸與青少女 MMDQ 分數分組之分布情 況
MMDQ 分數分組
低 (N=178) 中 (N=192) 高 (N=307)
類別 n (%) n (%) n (%)
p
暴露二手菸
無 70 (39.3) 62 (32.3) 82 (26.7) 0.02 有 108 (60.7) 130 (67.7) 225 (73.3)
家中菸蒂數(個)
0 122 (68.2) 125 (64.8) 172 (55.7) 0.01 1-3 21 (11.7) 15 (07.8) 51 (16.5) 3.5-5.5 19 (10.6) 18 (09.3) 41 (13.3)
>5.5 16 (08.9) 35 (18.1) 45 (14.6)
家中吸菸人數(人)
0 113 (63.5) 104 (53.3) 145 (46.9) 0.01 1 50 (28.1) 64 (32.8) 124 (40.1)
>2 15 (08.4) 25 (12.8) 40 (12.9) MMDQ=Moos Menstrual Distress Questionnaire
低=MMDQ 分數≦4。中= 4＜MMDQ 分數≦12，高=MMDQ 分數＞12
表十三 九十四學年度一至三年級青少女 MMDQ 分數分組與其他危險因子之相關性 MMDQ=Moos Menstrual Distress Questionnaire
低=MMDQ 分數≦4。中= 4＜MMDQ 分數≦12，高=MMDQ 分數＞12
表十四 以 Multiple logistic regression 分析比較九十四學年度一至三年級暴露二手菸
3.5-5.5 0.94 0.42-2.07 1.71 0.90-3.22
>5.5 2.25* 1.06-4.78 2.28* 1.17-4.44 家中吸菸人數(人)
0 1.00 － 1.00 －
1 1.35 0.80-2.29 2.05** 1.31-3.21
>2 1.68 0.75-3.77 2.30* 1.13-4.68
*p<0.05, **p<0.01, ***p<0.001
MMDQ=Moos Menstrual Distress Questionnaire
低=MMDQ 分數≦4。中= 4＜MMDQ 分數≦12，高=MMDQ 分數＞12
控制變項包括身體質量指數(<18.5，18.5-22.9，>22.9)，咖啡因飲料飲用(無，已戒，
有)，魚類的攝取(1 次/週 以下，3 次/週 以上)，冰冷飲料的飲用(無，有)，憂鬱分數 (<16，16-22，23-30，>31), 初經年齡(<11，11-13，>13 歲)，母親經痛情況(無，有，
不知道)
表十五 九十四學年度一至三年級家中暴露二手菸及母親有經痛在青少女 經痛之分布
經痛
無 有
媽媽有經痛 二手菸暴露 n (%) n (%)
p
無 無 25 (61.0) 16 (39.0) <0.0001
無 有 25 (36.8) 43 (63.2)
有 無 11 (11.2) 87 (88.8)
有 有 26 (12.3) 180 (87.4)
表十六 九十四學年度一至三年級家中暴露二手菸及母親有經痛在青少女經痛之 交互作用結果
經痛 經痛
媽媽有經痛 二手菸暴露 Crude OR 95% CI Adjusted OR 95% CI
無 無 1.00 － 1.00 －
無 有 2.69* 1.21-5.97 2.93* 1.18-7.26 有 無 12.36*** 5.01-30.01 15.24*** 5.29-43.89 有 有 10.82*** 5.11-22.91 10.07*** 4.37-23.2
*p<0.05, **p<0.01, ***p<0.001
控制變項包括身體質量指數(<18.5，18.5-22.9，>22.9)，咖啡因飲料飲用(無，已戒，
有)，魚類的攝取(1 次/週 以下，3 次/週 以上)，冰冷飲料的飲用(無，有)，憂鬱 分數(<16，16-22，23-30，>31), 初經年齡(<11，11-13，>13 歲)
表十七 九十四學年度一至三年級家中暴露二手菸及母親有經痛在青少女 MMDQ
表十九 九十五學年度一年級血清中的 8-OHdG, 尿液中的 Cotinine, PGE2的相關性(N=80)
類別 8-OHdG cotinine PGE2
8OHdG 1
Cotinine 0.07436 1
PGE2 0.15579 0.27948* 1 資料轉置成㏑(x)
*p<0.05
表二十 九十五學年度一年級血液中的 8-OHdG,尿液中的 Cotinine, PGE2的平均濃度分布(N=80)
類別 單伭 n 平均值± 標準差
8-OHdG (ng/ml) 66* 16.52 ± 16.18 8-OHdG (ng/ml) 80 14.26 ± 15.48 Cotinine (ng/ml) 38* 19.77 ± 29.98 Cotinine (ng/ml) 80 9.39 ± 22.79 Cotinine (ng/g cr.) 80 5.74 ± 11.65
PGE2 (pg/ml) 79 946.84 ± 1018.06 PGE2 (pg/g cr.) 79 897.13 ± 1088.27
*=去掉 ND 值, PGE2去掉一個極偏值
表二十一 九十五學年度一年級暴露二手菸對血清中的 8-OHdG, 尿液中的 Cotinine, PGE2濃度比較
8OHdG (ng/ml.) Cotinine (ng/g cr.) PGE2 (pg/g cr.) 暴露二手菸 n 平均值 ± 標準差
p
n 平均值 ± 標準差p
n 平均值 ± 標準差p
家中吸菸人數
0 34 15.6 ± 17.7 0.85 34 4.1 ± 10.0 0.32 34 705.9 ± 366.1 0.15
≧１ 30 14.7 ± 15.8 (0.88†) 30 6.9 ± 12.7
(0.04
†) 29
1101.9 ± 1532.9 (0.97†)家中的菸蒂數(model 1)
0 34 15.6 ± 17.7 0.72 34 4.1 ± 10.0 0.48 34 705.9 ± 366.1 0.24 1-3 18 13.4 ± 14.1 (0.95†) 18 7.5 ± 13.4 (0.15†) 18 1135.4 ± 1340.4 (0.99†)
>3 14 11.8 ± 8.7 14 7.1 ± 9.6 13 1277.3 ± 2068.3
家中的菸蒂數(model 2)
0 34 15.6 ± 17.7 0.69 34 4.1 ± 10.0 0.47 34 705.9 ± 366.1 0.16 1-5.5 24 12.0 ± 12.6 (0.50†) 24 7.1 ± 12.7
(0.04
†) 24
1305.8 ± 1857.0 (0.88†)>5.5 8 14.7 ± 9.7 8 8.3 ± 8.6 8 814.7 ± 483.8
家中的菸蒂數(model 3)
0 34 15.6 ± 17.7 0.74 34 4.1 ± 10.0 0.45 34 705.7 ± 366.07 0.21 1-4 20 12.4 ± 13.7 (0.53†) 20 6.7 ± 12.9 (0.06†) 20 1098.5 ± 1285.99 (0.98†)
>4 12 13.2 ± 8.4 12 8.3 ± 9.9 11 1370.2 ± 2237.91
†無母數統計
表二十二 九十五學年度一年級經痛在血液中的 8-OHdG,尿液中的 Cotinine, PGE2 濃 度比較
類別 單位 經痛 n 平均數± 標準差
p
8-OHdG ng/ml 無 25 12.3 ± 14.2 0.44
有 55 15.2 ± 16.1 (0.44†)
Cotinine ng/g cr. 無 25 6.2 ± 11.8 0.82 有 55 5.5 ± 11.7 (0.84†)
PGE2 pg/g cr. 無 25 681.4 ± 307.2 0.09 有 54 997.0 ± 1291.6 (0.83†)
† 無母數統計 p 值
表二十三 九十五學年度一年級 MMDQ 分數分組在血液中的 8-OHdG, 尿液中的 Cotinine, PGE2 濃度比較 8-OHdG (ng/ml.) Cotinine (ng/g cr.) PGE2 (pg/g cr.)
經痛症狀分數 n 平均數 ± 標準差
p
n 平均數 ± 標準差p
n 平均數 ± 標準差p
MMDQ 分數<4 30 10.2 ± 7.5
0.024 30
3.8 ± 7.0 0.18 30 893.3 ± 866.7 0.936≧4 49 18.3 ± 19.9 (0.232†) 49 7.0 ± 13.7 (0.283†) 49 914.0 ± 1222.2 (0.201†) MMDQ 分數
<5 39 10.4 ± 7.6
0.073 39
6.3 ± 10.9 0.696 38 859.7 ± 806.5 0.418 5-12 32 18.4 ± 19.5 (0.389†) 32 4.6 ± 10.3 (0.645†) 32 1060.5 ± 1452.1 (0.147†)表二十四 Multiple logistic regression 分析九十五學年度一年級血清中 8-OHdG ，尿中 Cotinine 及 PGE2與青少女經痛之相關性
經痛 經痛
類別 crude OR 95% CI
p
adjusted OR 95% CIp
8-OHdG (ng/ml)低 1.00 - 0.22 1.00 - 0.20
高 2.15 (0.64-7.28) 2.67 (0.60-11.96) Cotinine (ng/g cr.)
低 1.00 - 0.81 1.00 - 0.91
高 0.88 (0.30-2.54) 0.93 (0.26-3.29) PGE2 (pg/g cr.)
低 1.00 - 0.10 1.00 - 0.06
高 3.09 (0.81-11.80) 4.16 (0.95-18.29) N=80
調整變項包括身質量指數<18.5，18.5~22.9，>22.9; 有、無飲用含咖啡因的飲料; 有、無冰冷飲料 飲用; 魚類攝取為 1 次/月以下，1 次/週，3 次/週以上; 媽媽經痛分成無，有，不知道; 初經年齡<11
調整變項包括身質量指數<18.5，18.5~22.9，>22.9; 有、無飲用含咖啡因的飲料; 有、無冰冷飲料 飲用; 魚類攝取為 1 次/月以下，1 次/週，3 次/週以上; 媽媽經痛分成無，有，不知道; 初經年齡<11