系統性文獻回顧：蔬果汁對運動後延遲性肌肉痠痛的好處

莊崇怡¹ 陳韋任^2,3 林名男^1*
 

目的：探討蔬果飲食的使用是否能改善運動後所造成的延遲性肌肉痠痛(delayed onset muscle soreness, DOMS)。
方法：首先我們檢索了2021年12月以前文獻資料庫。並於2022年1月時第二次搜尋相關新發表文獻。檢索關鍵字如下：延遲性肌肉痠痛及蔬菜(vegetable)或果汁(juice)。最後所選用的文獻均發表於2017年至2019年。納入的文獻為(1)隨機對照研究；(2)天然蔬果汁的介入；(3)包括延遲性肌肉疼痛的結果。資料收集是根據：作者、國家、臨床試驗設計、實驗組和對照組的數量、年齡、性別、蔬果汁的介入方式與種類及介入時間長度、還有兩組在蔬果汁介入前後的結果比較。探討方式為身體的(1)功能性；(2)生物標記；(3)量表。
結果：我們從收錄的72篇文獻中篩選出5篇符合條件的研究。介入的果汁有9種，其中酸櫻桃及石榴能改善最大等長肌力(maximal isometric voluntary contraction)，但無法有效減少肘關節活動範圍(range of motion, ROM)的下降，有一半的研究顯示對於DOMS的改善有益處，但另外一半則是發現沒有治療效果。而視覺模擬量表(visual analogue scale)的結果如同DOMS。酸櫻桃有降低肌酸激酶(creatine kinase, CK)及C反應蛋白(C-reactive protein, CRP)的趨勢，但在統計上無明顯差異。對於離心運動後的發炎指標「腫瘤壞死因子α(TNF-α, tumor necrosis factor-α)」、「干擾素-γ(INF-γ, interferon-gamma)」、「白細胞介素(IL, interleukin)」亦無統計上顯著差異。石榴則無顯著降低肌酸激酶CK水平。越橘在半馬拉松比賽前後使用的研究顯示在CK及CRP無顯著差異，但有研究卻指出越橘汁降低CK的程度低於對照組，CRP則是有中等程度的升高，DOMS亦有些微高。使用富含花青素的果汁進行下坡跑步96小時後的CK值比對照組顯著降低。
結論：回顧分析發現，蔬果汁確實對於運動引起的肌肉損傷有一定的幫助，在功能性、生物標記、量表等指標上呈現肌肉損傷的下降趨勢。
(台灣家醫誌 2023; 33: 1-12) DOI: 10.53106/168232812023033301001

關鍵詞：延遲性肌肉痠痛、蔬菜、果汁、生物標記、運動引起的肌肉損傷

Systematic Review: Benefits of Juices for Delayed Onset Muscle Soreness after Exercise

Chorng-Yi Chuang¹, Wei-Jen Chen^2,3 and Ming-Nan Lin^1*
 

Objective: This review aimed at investigating the benefits of fruit and vegetable juices for alleviating the symptoms of delayed onset muscle soreness (DOMS) after exercise.
Methods: An initial search was performed to identify from related databases previous studies in the literature published before December 2021, and a second search was conducted for locating subsequent studies published before January 2022. The keywords of search we used included "delayed onset muscle soreness" and ("vegetable" or "juice"). Those studies we finally selected for review were published between 2017 and 2019; most of them were randomized controlled studies examining dietary interventions based on natural fruits and vegetables and presenting DOMS-related results. The reviewed studies could be grouped by author, country, clinical trial design, number of experimental and control groups, age and gender of participants, kinds of vegetable juices used as interventions, period of interventions, and outcomes in both experimental and control groups before and after intervention. The review focused on body functionality, biomarkers, and scale.
Results: Five eligible studies from 72 previous works in the literature were selected. There were 9 kinds of juices for intervention. Tart cherries and pomegranates appeared to be able to mitigate MIVC (maximal isometric voluntary contraction) but failed to prevent reduced elbow ROM (range of motion). Half of the studies reported benefits on DOMS, while the other half found no obvious intervention effect. The result of VAS (visual analogue scale) was similar to that of DOMS. A tendency of reducing concentrations of creatine kinase (CK) and C-reactive protein (CRP) was observed in tart cherries, but there was no statistical significance. Nor was statistical significancy detected in TNF-α (tumor necrosis factor-α), INF-γ (interferon-gamma), and IL (interleukin) following the eccentric exercise. Pomegranate did not significantly reduce CK levels. Studies on the use of bilberry juice before and after a half-marathon indicated no significant difference in CK and CRP, while some studies found the degree of reducing CK by bilberry juice lower in the experimental group. There was a moderate increase in CRP and a slight elevation in DOMS. Compared to the performance of the control group, CK values were significantly lower after 96 hours of downhill running with anthocyanin-rich fruit juice in the experimental group.
Conclusion: Results of the retrospective analysis suggest that fruit juice is indeed helpful in alleviating exercise-induced muscle damage, and the functionality, biomarker, scale and other indicators show a downward trend in the degree of muscle damage.
(Taiwan J Fam Med 2023; 33: 1-12) DOI: 10.53106/168232812023033301001

Key words: delayed onset muscle soreness, exercise-induced muscle damage, juice, vegetable