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沖凍水涼有益還是有害? 心臟科醫生提醒: 心血管病患者應該注意健康風險

Fion
編輯: Fion
日期: 2023-03-14

沖凍水涼有益還是有害? 心臟科醫生提醒: 心血管病患者應該注意健康風險

沖凍水涼真的有益健康?

國外研究提示,浸冷水(研究一般使用攝氏14至20 度左右的凍水), 可能對健康有以下好處:

  • 減少運動後肌肉疼痛及加速肌力恢復1,5
  • 促進新陳代謝2
  • 提升血液多巴胺水平2
  • 減少血液皮質醇(又稱壓力賀爾蒙)水平2
  • 提升胰島素敏感度3
  • 抑制促炎性細胞因子(如TNF-alpha) 的產生4
  • 改善痛楚和關節炎6
  • 改善情緒7,8
  • 改善血脂9

沖涼

但讀者應該注意,以上研究多針對健康人群,研究規模小、統計功效不足、亦多缺乏隨機對照試驗(Randomised controller trial), 因此從科學角度看,只能視為假定性結論,目前沒有足夠嚴謹的醫學實證支持洗冷水澡有益於心血管健康。

沖涼

沖凍水涼|注意事項:並非人人都適合沖凍水涼 1類人士應注意健康風險!

心臟專科醫生陳杰表示:「一般來說,對於身體健康的人士,若以循序漸進方式洗冷水澡,慢慢降低水溫,讓身體逐漸通應,一般不至於引至嚴重健康風險。
陳醫生稱,若急速將全身浸泡於冷水中,有機會引起冷休克反應(cold shock response)14,可導致皮膚血管急速收縮、心率、血壓、呼吸速度和腎上腺素急劇上升,加重心臟負荷。

美國國家冷水安全中心(National Center for Cold Water Safety)曾撰文提醒,若突然全身浸入10至15.5°C的冷水,或可致1分鐘內有生命危險10

亦有研究曾發現冬季游泳比賽參加者的心臟肌鈣蛋白(Troponin)水平較高,反映長時間浸泡在冷水中有機會可能導致心肌受損11

患有已知或隱性的心血管疾病人士亦可能因全身急速暴露於冷水中,出現心律失常或急性心肌缺血12,13,可對健康構成重大風險 。

沖凍水涼|水溫下調不應過急

因此,陳醫生不建議患有心血管疾病或高血壓未受控制的人士,全身急速浸泡於冷水之中。若要洗冷水澡,亦應注意水溫下調不應過急,時間亦不宜太長,若洗冷水澡時身體出現不適,應逐漸調升水溫,若洗澡後持續不調(如胸痛、胸悶、心跳、氣喘、頭暈或暈厥),便應盡快求醫診治。

沖凍水涼|注意事項:要留意身體狀況

那麼,洗冷水澡水溫多少度才適合?陳醫生指出:「沒有醫學證據顯示健康人士或心臟病患者有最佳理想沖涼水溫度。 反而應視乎你的身體健康狀況、水溫下調的速度、接觸冷水的時間等因素,長期遊冬泳或洗冷水澡人士,相比沒有如此習慣人士,身體亦比較容易適應低水溫。基本原則是循序漸進,不宜操之過急。」

註:以上內容僅供參考,人人體質有異,如有疑問,請向醫生查詢。

Text:Fion

參考資料:

  1. Bleakley C, McDonough S, Gardner E, Baxter GD, Hopkins JT, Davison GW. Cold-water immersion (cryotherapy) for preventing and treating muscle soreness after exercise. Cochrane Database Syst Rev. 2012 Feb 15;2012(2):CD008262. doi: 10.1002/14651858.CD008262.pub2.
  2. Srámek P, Simecková M, Janský L, Savlíková J, Vybíral S. Human physiological responses to immersion into water of different temperatures. Eur J Appl Physiol. 2000 Mar;81(5):436-42. doi: 10.1007/s004210050065.
  3. Gibas-Dorna M, Checinska Z, Korek E, Kupsz J, Sowinska A, Wojciechowska M, Krauss H, Piątek J. Variations in leptin and insulin levels within one swimming season in non-obese female cold water swimmers. Scand J Clin Lab Invest. 2016 Oct;76(6):486-91. doi: 10.1080/00365513.2016.1201851.
  4. Eimonte M, Paulauskas H, Daniuseviciute L, Eimantas N, Vitkauskiene A, Dauksaite G, Solianik R, Brazaitis M. Residual effects of short-term whole-body cold-water immersion on the cytokine profile, white blood cell count, and blood markers of stress. Int J Hyperthermia. 2021;38(1):696-707. doi: 10.1080/02656736.2021.1915504.
  5. Moore, E., Fuller, J.T., Buckley, J.D. et al. Impact of Cold-Water Immersion Compared with Passive Recovery Following a Single Bout of Strenuous Exercise on Athletic Performance in Physically Active Participants: A Systematic Review with Meta-analysis and Meta-regression. Sports Med 52, 1667–1688 (2022). https://doi.org/10.1007/s40279-022-01644-9
  6. Kurniasari MD, Monsen KA, Weng SF, Yang CY, Tsai HT. Cold Water Immersion Directly and Mediated by Alleviated Pain to Promote Quality of Life in Indonesian with Gout Arthritis: A Community-based Randomized Controlled Trial. Biol Res Nurs. 2022 Apr;24(2):245-258. doi: 10.1177/10998004211063547.
  7. Shevchuk NA. Adapted cold shower as a potential treatment for depression. Med Hypotheses. 2008;70(5):995-1001. doi: 10.1016/j.mehy.2007.04.052. Epub
  8. Kelly, JS, Bird, E. Improved mood following a single immersion in cold water. Lifestyle Med. 2022; 3:e53. https://doi.org/10.1002/lim2.53
  9. Eimonte M, Eimantas N, Baranauskiene N, Solianik R, Brazaitis M. Kinetics of lipid indicators in response to short- and long-duration whole-body, cold-water immersion. Cryobiology. 2022 Dec;109:62-71. doi: 10.1016/j.cryobiol.2022.09.003.
  10. https://www.coldwatersafety.org/the-danger
    Broz, Pavel & Rajdl, Daniel & Racek, Jaroslav & Zeman, Vaclav & Novák, Jaroslav & Trefil, L.. (2017).
  11. Relationship between cold water swimming and increased cardiac markers: A pilot study. Klinicka Biochemie a Metabolismus. 25. 27-31.
  12. Michael J Shattock and Michael J Tipton ‘Autonomic conflict’: a different way to die during cold water immersion? J Physiol. 2012 Jul 15; 590(Pt 14): 3219–3230.
  13. Kolettis TM, Katsouras CS, Pappas K, Goudevenos J. Myocardial ischemia caused by cold-water submersion. Int J Cardiol. 2005 Mar 30;99(3):467-9.
  14. Tipton M. Cold water immersion: sudden death and prolonged survival. Lancet. 2003 Dec;362 Suppl:s12-3. doi: 10.1016/s0140-6736(03)15057-x. PMID: 14698111.

專欄傳送門:心臟科專科陳杰醫生

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