{"id":35812,"date":"2020-11-20T00:01:19","date_gmt":"2020-11-19T16:01:19","guid":{"rendered":"https:\/\/case.ntu.edu.tw\/blog\/?p=35812"},"modified":"2021-02-18T11:12:01","modified_gmt":"2021-02-18T03:12:01","slug":"nejm-2020-%e7%b6%9c%e8%ab%96%e6%96%87%e7%ab%a0%ef%bc%8d%ef%bc%8d%e7%b4%b0%e6%95%b8%e5%92%96%e5%95%a1%e5%b0%8d%e5%81%a5%e5%ba%b7%e7%9a%84%e5%88%a9%e8%88%87%e5%bc%8a","status":"publish","type":"post","link":"https:\/\/case.ntu.edu.tw\/blog\/?p=35812","title":{"rendered":"NEJM 2020 \u7d9c\u8ad6\u6587\u7ae0\uff0d\uff0d\u7d30\u6578\u5496\u5561\u5c0d\u5065\u5eb7\u7684\u5229\u8207\u5f0a"},"content":{"rendered":"

\u559d\u5496\u5561\u5c0d\u5065\u5eb7\u7684\u512a\u7f3a\u9ede\uff0c\u4e00\u76f4\u662f\u79d1\u5b78\u5bb6\u722d\u8ad6\u4e0d\u4f11\u7684\u8b70\u984c\u3002\u4e0d\u7ba1\u4f60\u662f\u6dfa\u5690\u5373\u6b62\u7684\u8f15\u5ea6\u611b\u597d\u8005\uff0c\u6216\u662f\u6bcf\u65e5\u5f97\u55d1\u4e0a\u5e7e\u676f\u7684\u8001\u9955\uff0c\u95dc\u65bc\u5496\u5561\u5c0d\u8eab\u9ad4\u7684\u5f71\u97ff\uff0c\u5927\u5925\u5152\u90fd\u61c9\u8a72\u4e00\u8d77\u4f86\u66b8\u89e3\u30022020 \u5e74 7 \u6708\u767c\u8868\u5728\u300a\u65b0\u82f1\u683c\u862d\u91ab\u5b78\u671f\u520a\u300b(NEJM<\/em>) \u7684\u4e00\u7bc7\u7d9c\u8ad6\u6587\u7ae0\uff0c\u662f\u7531\u65b0\u52a0\u5761\u570b\u7acb\u5927\u5b78\u8207\u54c8\u4f5b\u91ab\u5b78\u9662\u7684\u5408\u4f5c\u5718\u968a\u767c\u8868\uff0c\u70ba\u6211\u5011\u89e3\u60d1\u73fe\u968e\u6bb5\u7684\u7814\u7a76\u5c0d\u65bc\u5496\u5561\u8207\u5065\u5eb7\u4e4b\u9593\u5f97\u51fa\u4e86\u90a3\u4e9b\u7d50\u8ad6\u3002<\/strong><\/span><\/p>\n

\u64b0\u6587\uff0f<\/strong>\u694a\u671d\u5091<\/strong><\/p>\n

\"\"
\u5716\u7247\u51fa\u8655 @pixabay<\/figcaption><\/figure>\n

\u25cf\u5065\u5eb7\u6210\u4eba\u7684\u6bcf\u65e5\u5496\u5561\u56e0\u651d\u53d6\u91cf\u4e0d\u5b9c\u8d85\u904e 400 mg<\/span><\/strong><\/p>\n

\u4eba\u985e\u98f2\u7528\u5496\u5561\u5df2\u7d93\u6709\u5e7e\u767e\u5e74\u7684\u6b77\u53f2\uff0c\u6210\u70ba\u4e86\u4e00\u7a2e\u6587\u5316\u548c\u793e\u6703\u751f\u6d3b\u7684\u91cd\u8981\u7d44\u6210\uff0c\u4e26\u4e14\u4eba\u5011\u9084\u9760\u8457\u559d\u5496\u5561\u4f86\u63d0\u9ad8\u5927\u8166\u9748\u654f\u5ea6\u548c\u5de5\u4f5c\u6548\u7387\uff0c\u7814\u7a76\u7d71\u8a08\u7f8e\u570b\u7d04\u6709 85% \u7684\u6210\u4eba\u6bcf\u65e5\u98f2\u7528\u5496\u5561\uff0c\u800c\u5496\u5561\u56e0 (caffeine) \u7684\u5e73\u5747\u651d\u53d6\u91cf\u70ba\u6bcf\u65e5 135 mg\uff0c\u76f8\u7576\u65bc\u7d04\u4e00\u676f\u534a\u7684\u5496\u5561 (\u4e00\u676f\u7b49\u65bc 235 mL)\uff0c\u7814\u7a76\u5efa\u8b70\u6210\u4eba\u7684\u6bcf\u65e5\u5496\u5561\u56e0\u651d\u53d6\u4e0a\u9650\u70ba 400 mg\uff0c\u4e5f\u5c31\u662f\u4e0d\u8a72\u559d\u8d85\u904e 5 \u676f\u3002<\/p>\n

\u5496\u5561\u56e0\u53ef\u5728\u651d\u5165\u9ad4\u5167\u5f8c\u7d04 45 \u5206\u9418\u5167\u88ab\u5438\u6536\uff0c\u8840\u6db2\u4e2d\u7684\u5496\u5561\u56e0\u6fc3\u5ea6\u5728 15 \u5206\u9418\u81f3 2 \u5c0f\u6642\u5f8c\u9054\u5230\u5cf0\u503c\u4e26\u5206\u4f48\u5230\u5168\u8eab\uff0c\u4e5f\u6703\u7a7f\u904e\u8840\u8166\u969c\u58c1\u5230\u9054\u5927\u8166\u3002\u5496\u5561\u56e0\u5728\u809d\u81df\u5167\u88ab\u4ee3\u8b1d\uff0c\u6700\u7d42\u96a8\u8457\u5c3f\u6db2\u6392\u51fa\u4eba\u9ad4\uff0c\u5496\u5561\u56e0\u4ee3\u8b1d\u901f\u5ea6\u7684\u5feb\u6162\uff0c\u53d7\u5230\u4e00\u5b9a\u7a0b\u5ea6\u7684\u907a\u50b3\u56e0\u7d20\u5f71\u97ff\u3002\u5496\u5561\u56e0\u5728\u6210\u4eba\u9ad4\u5167\u7684\u534a\u8870\u671f\u4e00\u822c\u70ba 2.5\uff5e4.5 \u5c0f\u6642\uff0c\u7279\u5225\u8981\u6ce8\u610f\u61f7\u5b55\u5a66\u5973\u7684\u5496\u5561\u56e0\u4ee3\u8b1d\u901f\u5ea6\u6703\u660e\u986f\u6e1b\u7de9\uff0c\u5c24\u5176\u662f\u5728\u598a\u5a20\u665a\u671f\u7684\u5496\u5561\u56e0\u534a\u8870\u671f\u53ef\u9577\u9054 15 \u5c0f\u6642\uff0c\u5b55\u5a66\u5efa\u8b70\u651d\u53d6\u4e0a\u9650\u70ba 200 mg\u3002<\/p>\n

\u25cf\u5496\u5561\u63d0\u795e\u9192\u8166\u7684\u6548\u679c\u662f\u628a\u96d9\u9762\u5203<\/span><\/strong><\/p>\n

\u5496\u5561\u70ba\u4ec0\u9ebc\u6709\u63d0\u795e\u9192\u8166\u7684\u6548\u679c\uff1f\u9019\u662f\u7531\u65bc\u5496\u5561\u56e0\u7684\u5206\u5b50\u7d50\u69cb\u8207\u817a\u82f7 (adenosine) \u9577\u5f97\u5f88\u50cf\uff0c\u539f\u672c\u8166\u5167\u7684\u817a\u82f7\u8207\u5176\u53d7\u9ad4\u7d50\u5408\u5f8c\u6703\u589e\u52a0\u7761\u610f\uff0c\u4f46\u662f\u5496\u5561\u56e0\u80fd\u5920\u8207\u817a\u82f7\u7af6\u722d\u7d50\u5408\u81f3\u5176\u53d7\u9ad4\uff0c\u85c9\u6b64\u963b\u65b7\u817a\u82f7\u7684\u4f5c\u7528\uff0c\u6240\u4ee5\u624d\u6703\u6709\u63d0\u795e\u7684\u6548\u679c\u3002\u7576\u5496\u5561\u56e0\u5291\u91cf\u5728 40\uff5e300 mg \u6642\uff0c\u5c31\u5177\u6709\u6e1b\u8f15\u75b2\u52de\u3001\u63d0\u9ad8\u6e05\u9192\u7a0b\u5ea6\uff0c\u4ee5\u53ca\u7e2e\u77ed\u53cd\u61c9\u6642\u9593\u7684\u6548\u679c\u3002\u7136\u800c\uff0c\u9577\u671f\u7761\u7720\u4e0d\u8db3\u7684\u75b2\u52de\u611f\uff0c\u662f\u7121\u6cd5\u53ea\u9760\u5496\u5561\u56e0\u4f86\u62b5\u64cb\u7684\uff0c\u7761\u610f\u6c88\u91cd\u6642\u9084\u662f\u4e56\u4e56\u6d17\u6d17\u7761\u5427\u3002<\/p>\n

\u5982\u679c\u559d\u7684\u6642\u9593\u4e0d\u5c0d\uff0c\u4e0b\u5348\u6216\u665a\u4e0a\u651d\u53d6\u5496\u5561\u56e0\u5c31\u6703\u964d\u4f4e\u7761\u7720\u54c1\u8cea\uff1b\u5982\u679c\u559d\u5f97\u592a\u591a\uff0c\u5496\u5561\u56e0\u6bcf\u6b21\uff1e200 mg\u6216\u8005\u6bcf\u65e5\uff1e400 mg\uff0c\u751a\u81f3\u6703\u5f15\u767c\u7126\u616e\u3002\u7fd2\u6163\u559d\u5496\u5561\u7684\u4eba\uff0c\u5728\u7a81\u7136\u505c\u6b62\u98f2\u7528\u5f8c\uff0c\u6709\u53ef\u80fd\u51fa\u73fe\u6212\u65b7\u75c7\u72c0\uff0c\u5305\u62ec\u982d\u75db\u3001\u75b2\u52de\u3001\u5927\u8166\u9748\u654f\u5ea6\u4e0b\u964d\u548c\u60c5\u7dd2\u4f4e\u843d\uff0c\u9084\u6709\u53ef\u80fd\u51fa\u73fe\u985e\u6d41\u611f\u75c7\u72c0 (influenza-like symptom)\uff0c\u6212\u65b7\u75c7\u72c0\u5728\u6700\u521d\u7684 1\uff5e2 \u5929\u6700\u56b4\u91cd (\u53ef\u6301\u7e8c 2\uff5e9\u65e5)\uff0c\u900f\u904e\u9010\u6f38\u6e1b\u91cf\u53ef\u4ee5\u7de9\u89e3\u75c7\u72c0\uff0c\u6240\u4ee5\u60f3\u6212\u5496\u5561\u9084\u662f\u6162\u6162\u4f86\u6bd4\u8f03\u597d\u3002<\/p>\n

\u25cf\u5496\u5561\u3001\u5496\u5561\u56e0\u548c\u6162\u6027\u75be\u75c5\u98a8\u96aa\u7684\u95dc\u806f<\/strong><\/span><\/p>\n

1. \u8840\u58d3\u3001\u8840\u8102\u548c\u5fc3\u8840\u7ba1\u75be\u75c5<\/strong><\/p>\n

\u5496\u5561\u56e0\u96d6\u7136\u6703\u5728\u77ed\u671f\u5167\u63d0\u9ad8\u814e\u4e0a\u817a\u7d20\u53ca\u8840\u58d3\uff0c\u4f46\u8eab\u9ad4\u6703\u5728\u4e00\u9031\u5167\u5c0d\u5496\u5561\u56e0\u7684\u6548\u61c9\u7522\u751f\u8010\u53d7\uff0c\u7814\u7a76\u4e5f\u986f\u793a\u98f2\u7528\u5496\u5561\u8207\u9ad8\u8840\u58d3\u98a8\u96aa\u589e\u52a0\u4e0d\u76f8\u95dc\u3002\u7531\u65bc\u300c\u672a\u904e\u6ffe\u300d\u5496\u5561\u542b\u6709\u66f4\u9ad8\u7684\u5496\u5561\u9187 (cafestol)\uff0c\u6b64\u7269\u8cea\u5177\u6709\u5347\u9ad8\u81bd\u56fa\u9187\u7684\u4e0d\u597d\u4f5c\u7528\uff0c\u6240\u4ee5\u76e1\u91cf\u559d\u300c\u904e\u6ffe\u300d\u7684\u5496\u5561\uff0c\u6703\u6709\u52a9\u65bc\u63a7\u5236\u8840\u8102\u3002\u8a31\u591a\u7814\u7a76\u7d50\u679c\u90fd\u4e00\u81f4\u8868\u793a\uff0c\u98f2\u7528\u5496\u5561\u8207\u5fc3\u8840\u7ba1\u75be\u75c5\u98a8\u96aa\u964d\u4f4e\u6709\u95dc\uff0c\u6bcf\u65e5\u98f2\u7528 3\uff5e5 \u676f\u5496\u5561\u7684\u98a8\u96aa\u6700\u4f4e\u3002<\/p>\n

2. \u80a5\u80d6\u548c\u7b2c\u4e8c\u578b\u7cd6\u5c3f\u75c5<\/strong><\/p>\n

\u7814\u7a76\u986f\u793a\u5496\u5561\u56e0\u53ef\u901a\u904e\u964d\u4f4e\u98df\u617e\uff0c\u4ee5\u53ca\u63d0\u9ad8\u57fa\u790e\u4ee3\u8b1d\u7387\u4f86\u6539\u5584\u80fd\u91cf\u5e73\u8861\uff0c\u9019\u6709\u52a9\u65bc\u9ad4\u91cd\u7ba1\u7406\u3002\u6b64\u5916\uff0c\u5496\u5561\u56e0\u53ef\u5728\u77ed\u671f\u5167\u964d\u4f4e\u80f0\u5cf6\u7d20\u654f\u611f\u6027\uff0c\u96d6\u7136\u9577\u671f\u6578\u64da\u986f\u793a\u6c92\u6709\u660e\u986f\u5f71\u97ff\uff0c\u53e6\u6709\u7814\u7a76\u6307\u51fa\u7fd2\u6163\u6027\u98f2\u7528\u5496\u5561\u8207\u7b2c\u4e8c\u578b\u7cd6\u5c3f\u75c5\u98a8\u96aa\u964d\u4f4e\u6709\u95dc\u3002<\/p>\n

3. \u764c\u75c7\u548c\u809d\u81df\u75be\u75c5<\/strong><\/p>\n

\u8a31\u591a\u7814\u7a76\u7d50\u679c\u63d0\u4f9b\u4e86\u5f37\u6709\u529b\u7684\u8b49\u64da\u986f\u793a\uff0c\u98f2\u7528\u5496\u5561\u53ca\u651d\u53d6\u5496\u5561\u56e0\uff0c\u8207\u764c\u75c7\u767c\u75c5\u7387\u589e\u52a0\u6216\u764c\u75c7\u6b7b\u4ea1\u7387\u589e\u52a0\u5747\u7121\u95dc\uff1b\u4e0d\u904e\u8207\u9ed1\u8272\u7d20\u7624\u3001\u76ae\u819a\u764c\u3001\u4e73\u764c\u3001\u524d\u5217\u817a\u764c\u3001\u5b50\u5bae\u5167\u819c\u764c\u3001\u809d\u764c\u53ca\u81bd\u56ca\u764c\u7684\u98a8\u96aa\u964d\u4f4e\u6709\u95dc\u3002\u98f2\u7528\u5496\u5561\u53ca\u651d\u53d6\u5496\u5561\u56e0\uff0c\u4e5f\u8207\u809d\u6307\u6578\u3001\u809d\u7e96\u7dad\u5316\u53ca\u809d\u786c\u5316\u98a8\u96aa\u8f03\u4f4e\u6709\u95dc\uff0c\u5728\u52d5\u7269\u6a21\u578b\u4e2d\u4e5f\u767c\u73fe\u53ef\u6291\u5236\u809d\u764c\u767c\u751f\u3002<\/p>\n

4. \u7e3d\u6b7b\u4ea1\u7387\u98a8\u96aa<\/strong><\/p>\n

\u5168\u7403\u7814\u7a76\u91dd\u5c0d\u6b50\u6d32\u4eba\u3001\u975e\u6d32\u88d4\u7f8e\u570b\u4eba\u548c\u4e9e\u88d4\u65cf\u7fa4\u9032\u884c\u5206\u6790\u5f8c\u986f\u793a\uff0c\u6bcf\u65e5\u98f2\u7528 2\uff5e5 \u676f\u5496\u5561\u8207\u7e3d\u6b7b\u4ea1\u7387\u964d\u4f4e\u76f8\u95dc\uff0c\u6b64\u89c0\u5bdf\u7d50\u679c\u5728\u6392\u9664\u5065\u5eb7\u72c0\u6cc1\u7570\u5e38\u7684\u4eba\u7fa4\u5f8c\u4ecd\u7136\u76f8\u7b26\uff0c\u800c\u4e14\u4e5f\u6c92\u6709\u53d7\u5230\u5496\u5561\u56e0\u4ee3\u8b1d\u5feb\u6162\u7684\u5f71\u97ff\u3002<\/p>\n

\u25cf\u9069\u91cf\u98f2\u7528\u624d\u662f\u6b63\u78ba\u559d\u5496\u5561\u7684\u65b9\u5f0f<\/strong><\/span><\/p>\n

\u672c\u7bc7\u7d9c\u8ad6\u6587\u7ae0\u5728\u6700\u5f8c\u7684\u7d50\u8ad6\u662f\uff1a\u300c\u6839\u64da\u73fe\u6709\u8b49\u64da\uff0c\u4e0d\u80fd\u4fdd\u8b49\u5efa\u8b70\u901a\u904e\u98f2\u7528\u5496\u5561\u53ef\u4ee5\u9810\u9632\u75be\u75c5\u3002\u4f46\u9019\u4e9b\u8b49\u64da\u4ea6\u986f\u793a\uff0c\u5c0d\u65bc\u7121\u61f7\u5b55\u53ca\u975e\u54fa\u4e73\u671f\u5a66\u5973\uff0c\u800c\u4e14\u7121\u7279\u6b8a\u5065\u5eb7\u72c0\u6cc1\u7684\u6210\u4eba\uff0c\u9069\u91cf\u98f2\u7528\u5496\u5561\u53ef\u4ee5\u6210\u70ba\u5065\u5eb7\u751f\u6d3b\u65b9\u5f0f\u7684\u4e00\u90e8\u5206\u300d\u3002<\/p>\n

\u7d66\u4e86\u6211\u5011\u4e00\u500b\u76f8\u7576\u7e5e\u53e3\u7684\u7d50\u8ad6\uff0c\u5230\u5e95\u5496\u5561\u662f\u559d\u9084\u662f\u4e0d\u559d\uff1f\u5176\u5be6\u7c21\u55ae\u4f86\u8b1b\u5c31\u662f\uff0c\u5065\u5eb7\u7121\u865e\u7684\u6210\u4eba\u53ef\u4ee5\u300c\u9069\u91cf\u300d\u98f2\u7528\u5496\u5561\uff0c\u96d6\u7136\u79d1\u5b78\u8b49\u64da\u4e0d\u8db3\u4ee5\u652f\u6301\u559d\u5496\u5561\u80fd\u9810\u9632\u75be\u75c5\uff0c\u4f46\u300c\u9069\u91cf\u300d\u651d\u53d6\u4ea6\u7121\u5bb3\u8655\uff0c\u751a\u81f3\u9084\u8207\u6578\u7a2e\u6162\u6027\u75be\u75c5\u7684\u98a8\u96aa\u964d\u4f4e\u76f8\u95dc\u3002\u7e3d\u7d50\uff0c\u559d\u5496\u5561\u6642\u53ea\u8981\u8a18\u5f97\u4e00\u500b\u91cd\u9ede\uff0c\u300c\u9069\u91cf\u300d\u98f2\u7528\u5c31\u6c92\u554f\u984c\u4e86\uff01<\/p>\n

 <\/p>\n

\u53c3\u8003\u8cc7\u6599\uff1a<\/strong>van Dam RM, Hu FB, Willett WC. Coffee, Caffeine, and Health. N Engl J Med. 2020 Jul 23;383(4):369-378.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

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