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1 J. Jpn. Acad. Midwif., Vol. 23, No. 2, , 2009 原 著 成熟期女性を対象とした冷水負荷試験による冷え症の評価 Evaluation of hiesho using a cold-water load test in adult females Yuriko KUSUMI Yoko EMORI 抄 録 目的 対象と方法 結果 r0.501 r0.392r 結論 キーワード : Abstract Purpose As a preliminary investigation prior to a study involving pregnant women, we conducted a cold-water lord test in adult females to objectively evaluate chilliness (hiesho). In addition, we examined its association with symptoms and physical findings. Subjects and Methods The subjects were 45 healthy females. They were instructed to immerse their left hands in cold water (15 ) 1 Doctoral Program in Human Care Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba J. Jpn. Acad. Midwif., Vol. 23, No. 2,

2 for 1 minute (cold-water loading). We measured the finger skin temperature and peripheral blood flow for 10 minutes after loading, and calculated the level of recovery of the dermal temperature as a percentage of the pre-immersion value (recovery rate). Results In 9 females (20%), the recovery rate after 10 minutes of the finger skin temperature was less than 90% (unfavorable recovery group). In this group, the finger skin temperature before loading, pre-lording peripheral blood flow, basal metabolic rate, body mass index, and percent body fat were significantly lower than in the favorable recovery group. There was no significant difference in the Hiesyo Sensation Scale. The finger skin temperature before lording (r=0.501), peripheral blood flow before loading (r=0.392), and basal metabolic rate (r=0.368) were correlated with the recovery rate after 10 minutes. However, the accuracy was estimated to be low using regression analysis. Conclusion The recovery rate of the dermal temperature after cold-water loading was lower in females showing a lower dermal temperature, peripheral blood flow, and basal metabolic rate. However, there was no association with hieshorelated symptoms. Key words: hiesyo, cold-water loading, female, dermal temperature, blood flow Ⅰ. 緒言 50% a Ushiroyama,

3 Body Mass Index BMI Ⅱ. 方法 1. 研究対象 冷水負荷試験の手順 , 2006b Lukaski, 1996 Oldham, 1996 HBF-362 Houtkooper et al., TVS-200 2TBF- LN PE professional J. Jpn. Acad. Midwif., Vol. 23, No. 2,

4 温 指 部皮膚温 99 手背部皮膚温 度 605% 安 20 分 調査 の 入 血 拍体温 体組 計体 基礎代謝量体 率 率 サーモグラフィ レーザー組織血流計図 1 冷水負荷試験の手順 3. 分析方法 SPSS for windows Mann-Whitney UFisher Pearson 倫理的配慮 2. 手指皮膚温の冷水負荷 10 分後回復率の分布 SD 回復良好群 36 ( 冷水負荷 10 分後回復率 0%) 15 回復不良群 ( 冷水負荷 10 分後回復率 0% 満 ) 10 Ⅲ. 結果 5 1. 対象者の属性 SD 図 冷水負荷 10 分後の皮膚温回復率 (%) 冷水負荷 10 分後の手指皮膚温回復率の分布

5 3. 回復良好群, 回復不良群別の冷水負荷後 10 分間の皮膚温の回復の推移 34.5SD SD 2.7 p SD SD 1.1p SD SD 1.9p 末梢血流量 r SD 9.6ml//100g 24.2SD 6.1p SD SD 3.9 p SD SD 12.9 p 冷え症評価尺度得点の分布 453.5SD 図 3 サーモグラフィによる回復良好群, 回復不良群の冷水負荷後 10 分間の皮膚温の回復の推移 J. Jpn. Acad. Midwif., Vol. 23, No. 2,

6 図 4 冷水負荷後の皮膚温のサーチ画像 図 5 レーザー組織血流計による冷水負荷後 10 分間の末梢血流量の推移

7 SD SD 2.0 p 冷え症評価尺度得点 4~8 点 ( 冷え症状が強い ) n=24 冷え症評価尺度得点 0~3 点 ( 冷え症状が弱い ) n=21 6. 身体的所見 2BMI22.6SD SD 2.4p SD SD 4.0p SD 132kcal1101SD 93kcalp 0.006BMI ( 冷え症評価尺度得点 ( 点 ) n=45 図 6 冷え症評価尺度の得点分布 7. 手指皮膚温, 血流量, 基礎代謝量と冷水負荷 10 分後回復率との関連 r0.504 r0.392r0.368 R 表 1 手指皮膚温の回復良好群と回復不良群別の冷え症の自覚の程度 n 45 回復良好群 (n =36) 回復不良群 (n =9) 冷え症評価尺度 3.4SD SD 2.0 p 冷え症の認識 p 値 p p Mann-Whitney U 2 Fisher 表 2 手指皮膚温の回復良好群と回復不良群の身体的所見 n 45 収縮期血圧 (mmhg) 拡張期血圧 (mmhg) 脈拍 ( 回 / 分 ) *BMI(kg/m 2 ) 体脂肪率 (%) 骨格筋率 (%) 基礎代謝量 (kcal) 回復良好群 (n =36) 111.3SD SD SD SD SD SD SD 132 回復不良群 (n =9) 106.2SD SD SD SD SD SD SD 93 p 値 *Body Mass IndexMann-Whitney U J. Jpn. Acad. Midwif., Vol. 23, No. 2,

8 表 3 手指皮膚温, 末梢血流量, 基礎代謝量と冷水負荷 10 分後回復率 (%) との回帰分析 n 45 相関係数 回帰式 p 値 回帰係数 p 値 R 2 手指皮膚温 ( ) 末梢血流量 (mg/ 分 /100g 組織 ) 基礎代謝量 (kcal) r r r p0.000 p0.008 p0.013 p0.000 p0.008 p Ⅳ. 考察 BMI 1. 冷水負荷試験による冷え症の評価 a SD SD a BMI Nagashima BMI 2005 BMI 2. 回復不良群における末梢血流量の低下

9 Ushiroyama, Nagashima, Sadakata 妊婦を対象とした研究への示唆 20 Ⅴ. 結論 BMI 文献 (3) Houtkooper, L.B., Lohman, T.G., Goina, S.B. & Howell, W.H. (1996). Why bioelectrical impedance analysis should be for estimating adiposity. American Journal of Clinical Nutrition, 64(3), 436S-448S (6) Progress in Medicine, 27(8), Biomedical thermology, 11(2), Biomedical Thermology, 27(2), (1) (1) Lukaski, H.C. (1996). Biological indexes considered in derivation of the bioelectrical impedance. American Journal of Clinical Nutrition, 64(3 Suppl), 397S-404S. 2006a Biomedical thermology, 25(4), b Biomedical thermology, 26(2), J. Jpn. Acad. Midwif., Vol. 23, No. 2,

10 Biomedical thermology, 21(2), (4) Nagashima, K., Yoda, T., Yagishita, T., Taniguchi, A. et al. (2002). Thermal regulation and comfort during a mildcold exposure in young Japanese women complaining of unusual coldness, Journal of Applied Physiology, 92, Biomedical thermology, 45(3), Oldham, N.H. (1996). Overview of bioelectrical impedance analyzers. American Journal of Clinical Nutrition, 64(3), 405S-412S (2) Sadakata, M. & Yamada, Y. (2007). Perception of foot temperature in young women with cold constitution: Analysis of skin temperature and warm and cold sensation thresholds, Journal of Physiological Anthropology, 26(4), Biomedical Thermology, 27(1), Biomedical thermology, 24(3), (5) (11) Ushiroyama, T., Kajimoto, Y., Sakuma, K. et al. (2005). Assessment of chilly sensation in Japanese women with laser doppler fluxmetry and acceleration plethysmogram with respect to peripheral circulation, Bulletin of the Osaka Medical College, 51(2), (1) (3) (5)

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