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腸胃肝膽健康・醫學週報
整合台灣熱門醫學新聞與頂尖期刊（NEJM・Lancet）肝・膽・胃・腸・減重・代謝領域最新研究，每週自動更新
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台灣醫學新聞 TOP 5
小心脂肪肝，揮別肝苦人！醫籲：評估肝臟健康檢查要同時注意 2 關鍵
過去台灣人「肝苦」多與B、C型肝炎有關，隨著疫苗普及與抗病毒藥物進展，現代新「肝苦」已換成脂肪肝。聯安診所2025年三萬五千多筆健檢數據顯示：肝功能指數（GOT/GPT）異常者僅約10%，但腹部超音波檢出脂肪肝者高達64%。提醒「肝指數正常」不等於肝臟沒問題，建議搭配影像檢查。
對阿斯匹靈過敏連布洛芬也不能吃？藥師：止痛藥分2種 還有替代選擇
不少人對阿斯匹靈過敏後，醫師卻提醒連布洛芬（ibuprofen）也要避開。藥師洪正憲指出，阿斯匹靈、布洛芬、naproxen 等屬於「非類固醇消炎止痛藥（NSAIDs）」，主要作用是抑制 COX-1 酵素，因此會交叉反應。對 NSAIDs 過敏者可改用 acetaminophen（普拿疼）等不同機轉藥物。
藤黃果促進代謝、維持窈窕體態？專家曝藤黃果功效與營養價值
藤黃果（Garcinia cambogia）是東南亞熱帶果實，近年在減重保健食品市場討論度高。果皮含羥基檸檬酸（HCA），宣稱能抑制脂肪合成、增加飽足感。專家提醒，現有人體研究結果分歧，效果不如廣告強烈，且部分產品曾傳出肝毒性報告，孕婦、肝病患者及服用降血糖藥物者應避免使用。
健保擴大給付7項藥品，4項癌症用藥納入，每年最高省216萬
健保署宣布擴大給付7項新藥，其中4項為癌症用藥，包含肺癌、血液癌症等標靶藥物，每名病人每年最高可省下216萬元醫藥費用。其他給付項目涵蓋肺動脈高血壓、乾癬及黃斑部水腫等疾病，預計嘉惠數千名患者。
冷凍花椰菜比較不營養？流失關鍵不在冷凍，而是烹調方式
新鮮蔬菜從採收到上架通常需要3-7天，期間維生素C與葉酸即開始流失。藥師陳澤鈞指出，急速冷凍的蔬菜其實是在採收後最佳狀態鎖住營養，膳食纖維、礦物質與多酚保留度反而比放置數天的「新鮮」蔬菜高。真正影響營養的是過度水煮與長時間加熱，建議蒸、烤或快炒。
頂尖期刊
NEJM 近期研究
Phase 3 Trial of Semaglutide in Metabolic Dysfunction–Associated Steatohepatitis
In this Phase 3 randomized controlled trial, semaglutide — a glucagon-like peptide-1 (GLP-1) receptor agonist — was evaluated for treatment of metabolic dysfunction–associated steatohepatitis (MASH) with liver fibrosis. Resolution of steatohepatitis without worsening of fibrosis occurred in 62.9% of patients in the semaglutide group compared with 34.3% in the placebo group. Improvements in body weight, liver enzymes, and metabolic parameters were consistently observed. Gallbladder-related disorders occurred in 2.8% of semaglutide-treated patients versus 2.3% in the placebo group.
本第三期隨機對照試驗評估GLP-1受體促效劑Semaglutide用於治療代謝功能障礙相關脂肪性肝炎（MASH）合併肝臟纖維化。結果顯示，治療組中62.9%的患者達到脂肪肝炎緩解且無纖維化惡化，遠優於安慰劑組的34.3%。體重、肝酶及代謝指標均有顯著改善。膽囊相關不良事件發生率治療組為2.8%，安慰劑組為2.3%。
Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity
This randomized trial evaluated oral semaglutide 25 mg as an alternative to injectable formulations for weight management in adults with overweight or obesity. Results demonstrated significant reductions in body weight and waist circumference comparable to injectable semaglutide 2.4 mg. The oral formulation provides a convenient alternative delivery route for patients unable or unwilling to use injectable therapies, potentially expanding access to effective obesity pharmacotherapy.
本隨機試驗評估口服Semaglutide 25mg作為過重/肥胖成人體重管理的替代方案。研究顯示口服劑型在體重及腰圍降低方面與注射劑型（2.4mg）效果相當，提供不願使用注射療法患者更便利的給藥選擇，有望擴大有效肥胖藥物治療的可及性。
Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) — Review
MASLD has emerged as the most common chronic liver disease worldwide, closely linked to obesity, insulin resistance, and systemic metabolic dysfunction. This comprehensive review covers the updated nomenclature (MASLD replacing NAFLD), pathophysiology, non-invasive biomarkers for fibrosis staging, and emerging pharmacological treatments. FDA-approved therapies including resmetirom (a thyroid hormone receptor-β agonist) and semaglutide are discussed, along with pipeline agents targeting multiple metabolic pathways.
MASLD（代謝功能障礙相關脂肪性肝病，原稱NAFLD）已成為全球最常見慢性肝病，與肥胖、胰島素阻抗及全身性代謝功能障礙密切相關。本綜述涵蓋最新命名更新、病理生理機制、非侵入性纖維化分期生物標記，及新興藥物治療。討論FDA核准藥物包括Resmetirom（甲狀腺素受體-β促效劑）與Semaglutide，以及多個靶向代謝路徑的開發中新藥。
頂尖期刊
Lancet 近期研究
Gastric Cancer — Seminar
This Lancet Seminar provides a comprehensive update on gastric cancer, the fifth most common cancer and third leading cause of cancer death globally. Key risk factors include Helicobacter pylori infection, dietary factors (high salt intake, processed meats), obesity, and smoking. Molecular classification (EBV-positive, MSI, GS, CIN subtypes) now guides therapeutic decisions. Immune checkpoint inhibitors combined with chemotherapy have significantly improved survival in HER2-positive and high PD-L1 expressing tumors, representing a paradigm shift in advanced gastric cancer management.
本文全面更新胃癌知識，胃癌為全球第五常見癌症，癌症死亡第三大原因。主要風險因子包括幽門螺旋桿菌感染、飲食因素（高鹽、加工肉品）、肥胖及吸菸。分子分型（EBV陽性、MSI、GS、CIN亞型）現已指導治療決策。免疫檢查點抑制劑結合化療在HER2陽性及高PD-L1表現腫瘤中顯著改善存活，代表晚期胃癌治療的典範轉移。
The Lancet Commission on Addressing the Global Hepatocellular Carcinoma Burden: Comprehensive Strategies from Prevention to Treatment
Liver cancer is the sixth most common cancer and the third leading cause of cancer-related mortality globally, with hepatocellular carcinoma (HCC) accounting for 90% of cases. Without intervention, new HCC cases will nearly double from 870,000 in 2022 to 1.52 million by 2050. The Commission identifies key drivers including chronic viral hepatitis (HBV/HCV), metabolic dysfunction-associated steatotic liver disease, alcohol use, and aflatoxin exposure. Comprehensive strategies encompass HBV vaccination expansion, HCV elimination programs, surveillance in high-risk populations, and systemic therapies including atezolizumab plus bevacizumab.
肝癌為全球第六常見癌症，癌症死亡第三大原因，其中肝細胞癌（HCC）占90%病例。若無干預，HCC新病例將從2022年87萬幾乎翻倍至2050年152萬。委員會指出主要驅動因素包括慢性病毒性肝炎（B/C型）、MASLD、飲酒及黃麴毒素暴露。全面策略涵蓋擴大B肝疫苗接種、消除C肝計畫、高風險族群監測，及系統性治療如Atezolizumab加Bevacizumab。
歷史紀錄