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黑眼圈奶爸Dr. 徐嘉賢醫師, 藍昌路413號, Fengshan (2026)

08/05/2026

運動對過敏的幫助

今天天氣真好，就想要到戶外走走

久不久，我就會被問到這一個題目：「運動可以改善過敏嗎？」科學證實：可以！

氣喘：
規律的中等強度有氧運動，能改善症狀控制和生活品質，提升心肺適能，還能調節免疫系統。但是急性發作就不要急著那個時候運動了，先緩解。

過敏性鼻炎：快走、騎自行車等中等強度運動能降低炎症標記物，改善鼻部和眼部症狀。

異位性皮膚炎：適度運動有助於減輕皮膚炎症，但避免在高溫環境下，過度劇烈運動。

但也要量力而為喔

參考資料
2023 GINA Report, Global Strategy for Asthma Management and Prevention. Helen K. Reddel, Leonard B. Bacharier, Eric D. Bateman, et al. Global Initiative for Asthma. https://ginasthma.org/reports/

2025 Global Strategy for Asthma Management and Prevention. Helen Reddel, Eric Bateman, Gerard FitzGerald, et al. Global Initiative for Asthma. https://ginasthma.org/reports/

2024 Global Strategy for Asthma Management and Prevention. Helen K. Reddel, Leonard B. Bacharier, Eric D. Bateman, et al. Global Initiative for Asthma. https://ginasthma.org/reports/

Effect of Aerobic Exercise Training on Asthma in Adults: A Systematic Review and Meta-Analysis. Hansen ESH, Pitzner-Fabricius A, Toennesen LL, et al. The European Respiratory Journal. 2020;56(1):2000146. https://doi.org/10.1183/13993003.00146-2020

The Effectiveness of Physical Activity in Asthma Management: An Overview of Systematic Reviews. Liu W, Feng Z, Song S, Lei S. PloS One. 2025;20(7):e0325488. https://doi.org/10.1371/journal.pone.0325488

Physical Exercise Induces Immunoregulation of TREG, M2, and pDCs in a Lung Allergic Inflammation Model. Fernandes P, de Mendonça Oliveira L, Brüggemann TR, et al. Frontiers in Immunology. 2019;10:854. https://doi.org/10.3389/fimmu.2019.00854

Causal Effects of Different Types of Physical Activity on Allergic Rhinitis: A Mendelian Randomization Study. Yan X, Liu P, Wang W, et al. Medicine. 2025;104(35):e44159. https://doi.org/10.1097/MD.0000000000044159

Winter Exercise Reduces Allergic Airway Inflammation: A Randomized Controlled Study. Prossegger J, Huber D, Grafetstätter C, et al. International Journal of Environmental Research and Public Health. 2019;16(11):E2040. https://doi.org/10.3390/ijerph16112040

Resistance Exercise and Its Impact on Allergic Rhinitis. Yu T, Yue W, Zhang S. American Journal of Otolaryngology. 2025 May-Jun;46(3):104613. https://doi.org/10.1016/j.amjoto.2025.104613

Association Between Allergic Rhinitis and Regular Physical Activity in Adults: A Nationwide Cross-Sectional Study. Park J, Park JH, Park J, Choi J, Kim TH. International Journal of Environmental Research and Public Health. 2020;17(16):E5662. https://doi.org/10.3390/ijerph17165662

Can Moderate-Intensity Aerobic Exercise Ameliorate Atopic Dermatitis?. Son WK, Yoon W, Kim S, et al. Experimental Dermatology. 2020;29(8):699-702. https://doi.org/10.1111/exd.14138

Strong Exercise Stress Exacerbates Dermatitis in Atopic Model Mice, NC/Nga Mice, While Proper Exercise Reduces It. Orita K, Hiramoto K, Inoue R, et al. Experimental Dermatology. 2010;19(12):1067-72. https://doi.org/10.1111/j.1600-0625.2010.01130.x

Mild Exercise Suppresses Exacerbation of Dermatitis by Increasing Cleavage of the β-Endorphin From Proopiomelanocortin in NC/Nga Mice. Hiramoto K, Kobayashi H, Sekiyama A, et al. Journal of Clinical Biochemistry and Nutrition. 2013;52(1):58-63. https://doi.org/10.3164/jcbn.12-51

Machine Learning–Based Deep Phenotyping of Atopic Dermatitis: Severity-Associated Factors in Adolescent and Adult Patients. Maintz L, Welchowski T, Herrmann N, et al. JAMA Dermatology. 2021;157(12):1414-1424. https://doi.org/10.1001/jamadermatol.2021.3668

Adult Atopic Dermatitis Patients and Physical Exercise: A Swedish Questionnaire Study. Lonne-Rahm SB, Sundström I, Nordlind K, Engström LM. Acta Dermato-Venereologica. 2014;94(2):185-7. https://doi.org/10.2340/00015555-1556

03/05/2026

吃鳳梨會覺得咬舌頭嗎？

其實這不是過敏，而是鳳梨中的「鳳梨酵素」在作怪

鳳梨酵素會分解我們口腔黏膜的蛋白質，造成短暫的刺痛感，但這只是生理反應，幾分鐘後就會消失，跟過敏完全無關，也跟遺傳無關

有些人會沒有刺刺的感覺，但有些人會很明顯

若要減少這種不適，可以試試以下方法：

用沾鹽巴、或鹽水浸泡(可以改變鳳梨酵素的反應）

還有一個比較反直覺的方法：「加熱」，可以破壞鳳梨酵素，不過應該很少人會這麼做吧？！冰冰涼涼的口感蠻好的說。

24/04/2026

一對夫妻來看診

先生坐在旁邊滑著手機，他是下一位。

太太：「醫生，我已經流鼻涕七八天了，我的鼻水都清清白白⋯（轉頭看先生）但是他，他一點都不清白」⋯

這時候先生才抬起頭來，察覺到狀況好像有點不對勁

他們⋯是不是跑錯棚了？

23/04/2026

孩子被蚊子叮，腫得很誇張，有時候還甚至起水泡。
這會是過敏體質嗎？

5歲以下的孩子，一般對於蚊子唾液中的蛋白質，他沒有耐受性，所以免疫系統的反應會比較激烈，尤其是過敏體質、身體 IgE 濃度會比較高的族群，反應會更激烈。

大部分在5歲之後，趨近於青少年時，這個反應會越來越少。

所以出現摸起來很硬、腫得很誇張，甚至起水泡，的確有可能是過敏體質沒錯，但並不是只有過敏體質的孩子才會這樣，只是過敏體質的人比例比較高。

門診表：https://reurl.cc/ORq8KA

預約掛號：https://reurl.cc/vK1jOA

診所地址：https://reurl.cc/R91loG

參考資料
1. Clinical Observations of Mosquito Bite Reactions in Man: A Survey of the Relationship Between Age and Bite Reaction. Oka K, Ohtaki N. The Journal of Dermatology. 1989;16(3):212-9. https://doi.org/10.1111/j.1346-8138.1989.tb01251.x

2. Evidence for Natural Desensitization to Mosquito Salivary Allergens: Mosquito Saliva Specific IgE and IgG Levels in Children. Peng Z, Ho MK, Li C, Simons FE. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2004;93(6):553-6. https://doi.org/10.1016/s1081-1206(10)61262-8

3. Mosquito Bite Hypersensitivity in Children: Clinical Features Outweigh Specific IgE in Diagnosis. Dolu KO, Unay IF, Tepe Y, et al. Allergy and Asthma Proceedings. 2026;47(2):112-119. https://doi.org/10.2500/aap.2026.47.250103

4. Update on Mosquito Bite Reaction: Itch and Hypersensitivity, Pathophysiology, Prevention, and Treatment. Vander Does A, Labib A, Yosipovitch G. Frontiers in Immunology. 2022;13:1024559. https://doi.org/10.3389/fimmu.2022.1024559

5. Basophil Activation by Mosquito Extracts in Patients With Hypersensitivity to Mosquito Bites. Sakakibara Y, Wada T, Muraoka M, et al. Cancer Science. 2015;106(8):965-71. https://doi.org/10.1111/cas.12696

6. Mosquito Allergy: Clinical Features and Natural Course. Kulthanan K, Wongkamchai S, Triwongwaranat D. The Journal of Dermatology. 2010;37(12):1025-31. https://doi.org/10.1111/j.1346-8138.2010.00958.x

7. Arthropod Bites and Stings. Herness J, Snyder MJ, Newman RS. American Family Physician. 2022;106(2):137-147.

8. Clinical Categories of Exaggerated Skin Reactions to Mosquito Bites and Their Pathophysiology. Tatsuno K, Fujiyama T, Matsuoka H, et al. Journal of Dermatological Science. 2016;82(3):145-52. https://doi.org/10.1016/j.jdermsci.2016.04.010

9. Hypersensitivity to Mosquito Bites as the Primary Clinical Manifestation of a Juvenile Type of Epstein-Barr Virus-Associated Natural Killer Cell Leukemia/Lymphoma. Tokura Y, Ishihara S, Tagawa S, et al. Journal of the American Academy of Dermatology. 2001;45(4):569-78. https://doi.org/10.1067/mjd.2001.114751

21/04/2026

過敏不想吃藥的解方之一：舌下減敏療法。

你希望孩子出門的背包，應該是要放過敏藥？還是要放課外繪本和球拍？

「難道過敏真的要吃一輩子的藥嗎」這是很多患者的困擾

有辦法改變這個窘境嗎？我們今天來聊一下這個新的解方。

Podcast連結：https://podcasts.apple.com/tw/podcast/%E7%A2%8E%E7%A2%8E%E5%BF%B5%E7%9A%84%E9%BB%91%E7%9C%BC%E5%9C%88%E5%A5%B6%E7%88%B8dr/id1846520865?i=1000762373758

歡迎來我們診所洽詢

門診表：https://reurl.cc/ORq8KA

預約掛號：https://reurl.cc/vK1jOA

診所地址：https://reurl.cc/R91loG

18/04/2026

一位媽媽因為喉嚨痛和聲帶沙啞來就診。

原來是因為感冒，再加上期中考陪小孩讀書、間歇性吼叫的關係。

她：「醫生，我下個禮拜怎麼樣可以趕快好起來？」

我：「很簡單，發考卷的時候、不要看分數，直接簽名就可以了。」

15/04/2026

喝牛奶覺得喉嚨有痰，是真的「生痰」了嗎？

長輩常會叮嚀：「咳嗽的時候不要喝牛奶」
或者我們自己喝牛奶後，感覺喉嚨會產生痰，感覺黏黏卡卡的。

但這是真的生痰了嗎？原理到底是什麼？

原來在醫學上也有討論到這一塊，研究發現並不是真的產生了痰液，而是牛奶的質地，讓喉嚨本身的「黏液感覺變濃稠了」，所以才讓人以為是產生了新的痰。

那要怎麼辦、怎麼解決呢？

其實只要喝一些開水，清一下喉嚨，就可以減輕這種感覺了。

Reference:
1. Milk Consumption Does Not Lead to Mucus Production or Occurrence of Asthma. Wüthrich B, Schmid A, Walther B, Sieber R. Journal of the American College of Nutrition. 2005;24(6 Suppl):547S-55S. https://doi.org/10.1080/07315724.2005.10719503

2. The Milk Mucus Belief: Sensations Associated With the Belief and Characteristics of Believers. Arney WK, Pinnock CB. Appetite. 1993;20(1):53-60. https://doi.org/10.1006/appe.1993.1005

3. The Milk-Mucus Belief: Sensory Analysis Comparing Cow's Milk and a Soy Placebo. Pinnock CB, Arney WK. Appetite. 1993;20(1):61-70. https://doi.org/10.1006/appe.1993.1006

4. Respiratory Effects of Acute Milk Consumption Among Asthmatic and Non-Asthmatic Children: A Randomized Controlled Study. Koren Y, Armoni Domany K, Gut G, et al. BMC Pediatrics. 2020;20(1):433. https://doi.org/10.1186/s12887-020-02319-y

5. Effect of a Dairy Diet on Nasopharyngeal Mucus Secretion. Frosh A, Cruz C, Wellsted D, Stephens J. The Laryngoscope. 2019;129(1):13-17. https://doi.org/10.1002/lary.27287

6. Mild Protein Hydrolysation of Lactose-Free Milk Further Reduces Milk-Related Gastrointestinal Symptoms. Turpeinen A, Kautiainen H, Tikkanen ML, et al. The Journal of Dairy Research. 2016;83(2):256-60. https://doi.org/10.1017/S0022029916000066

7. A Comparison of Symptoms after the Consumption of Milk or Lactose-Hydrolyzed Milk by People with Self-Reported Severe Lactose Intolerance. Suarez FL, Savaiano DA, Levitt MD. The New England Journal of Medicine. 1995;333(1):1-4. https://doi.org/10.1056/NEJM199507063330101

8. Milk Protein Digestion and the Gut Microbiome Influence Gastrointestinal Discomfort After Cow Milk Consumption in Healthy Subjects. Tagliamonte S, Barone Lumaga R, De Filippis F, et al. Food Research International (Ottawa, Ont.). 2023;170:112953. https://doi.org/10.1016/j.foodres.2023.112953

03/04/2026

為什麼總是有一些氣喘患者，明明都已經按照標準治療，卻效果不好？

如果以免疫路徑來區分氣喘的話，可以分為兩種：

1. 第一種叫做「第二型氣喘」
這就是典型的過敏型，對於典型的標準治療效果很好。

2. 第二種叫做「非第二型」
有些人會把它稱為第一型。這類的治療效果不好，就算用了標準治療，效果依然欠佳。

要怎麼區分呢？有兩種比較精準的檢測方法：

(a) 第一種是「一氧化氮呼氣檢測（FeNO）」，檢測氣管裡面的一種特別物質。

(b) 第二種檢測則是「驗血」。

你也有這樣的困擾嗎？想要知道自己可能是哪一型？或是治療效果不曉得為什麼一直欠佳？

歡迎洽詢，讓我們來評估您是否需要安排檢測。

門診表：https://reurl.cc/ORq8KA

預約掛號：https://reurl.cc/vK1jOA

診所地址：https://reurl.cc/R91loG

reference:

1. 2025 Global Strategy for Asthma Management and Prevention. Helen Reddel, Eric Bateman, Gerard FitzGerald, et al. Global Initiative for Asthma. https://ginasthma.org/

2. Transcriptomic Profiles in Nasal Epithelium and Asthma Endotypes in Youth. Yue M, Gaietto K, Han YY, et al. JAMA. 2025;333(4):307-318. https://doi.org/10.1001/jama.2024.22684

3. 2024 Difficult-to-treat and Severe Asthma. Helen K. Reddel, Leonard B. Bacharier, Eric D. Bateman, et al. Global Initiative for Asthma. https://ginasthma.org/

4. Asthma. Porsbjerg C, Melén E, Lehtimäki L, Shaw D. Lancet (London, England). 2023;401(10379):858-873. https://doi.org/10.1016/S0140-6736(22)02125-0

5. Biologic Therapies for Severe Asthma. Brusselle GG, Koppelman GH. The New England Journal of Medicine. 2022;386(2):157-171. https://doi.org/10.1056/NEJMra2032506

6. T-Helper Cells and Their Cytokines in Pathogenesis and Treatment of Asthma. Ji T, Li H. Frontiers in Immunology. 2023;14:1149203. https://doi.org/10.3389/fimmu.2023.1149203

7. Non-T2 Asthma. Duffus EK, Holguin F, Rastogi D. Current Opinion in Pulmonary Medicine. 2025;31(3):287-293. https://doi.org/10.1097/MCP.0000000000001154

31/03/2026

兒童發展篩檢，原來也有加分題?

話說前幾天幫一位2歲多的孩子，做兒童發展篩檢

在發展篩檢項目裡面，其中有一張圖卡，上面有四個格子（見附圖）

其中有一題：孩子能描述3個圖中人物正在做什麼，才算過關。

我指到右下角的時候，孩子出人意表地回答：「在拜拜」

雖然標準答案是「拍手」，但是「拜拜」好像也沒有什麼不對，也顯示出這個孩子觀察力很好

這一題屬於2分，但我想要給20分🤪🤪🤪（沒有20分這個選項啦）

這麼有創意的孩子，當然全部項目高標通過

家長讓孩子多接觸不同的文化和活動，幫助孩子更多理解社會，都是屬於很好的事情

28/03/2026

異位性皮膚炎：游泳池注意事項

游泳對身體很好，可以增加心肺功能，而且在運動的時候，可以減少汗水對於我們的皮膚刺激（水裡面散熱比較有效率）。

但是過敏的族群，尤其是異位性皮膚炎的朋友，要留意在游泳池裡面他的消毒劑類型是否含氯？（消毒劑有種類有很多）

含氯的游泳池消毒劑，對於過敏的患者如果過量的話將可能有傷害的風險。

對異位性皮膚炎，他會破壞皮膚屏障、角質層的含水量可能會減少，增加發作的機率。

現在很多游泳池在櫃檯，就會公告他們所使用的消毒劑是哪一種？而且含量是多少

對於過敏族群而言，濃度2.0mg/L才會有影響。

大家不妨可以直接詢問游泳池的工作人員，或者留意他們櫃檯的公告

（當然游泳池所使用的，也不是只有含氯的消毒劑類型，現在有非常多種安全消毒方法。若使用含氯的也不要太過度擔心，重點是含量）

參考資料：
1. Health Effects of Exposure to Chlorination by-Products in Swimming Pools. Couto M, Bernard A, Delgado L, et al. Allergy. 2021;76(11):3257-3275. https://doi.org/10.1111/all.15014

2. Chlorination Products: Emerging Links With Allergic Diseases. Bernard A. Current Medicinal Chemistry. 2007;14(16):1771-82. https://doi.org/10.2174/092986707781058940

3. Health Effects of Disinfection by-Products in Chlorinated Swimming Pools. Florentin A, Hautemanière A, Hartemann P. International Journal of Hygiene and Environmental Health. 2011;214(6):461-9. https://doi.org/10.1016/j.ijheh.2011.07.012

4. Free Residual Chlorine in Bathing Water Reduces the Water-Holding Capacity of the Stratum Corneum in Atopic Skin. Seki T, Morimatsu S, Nagahori H, Morohashi M. The Journal of Dermatology. 2003;30(3):196-202. https://doi.org/10.1111/j.1346-8138.2003.tb00371.x

5. Pooling the Evidence: A Review of Swimming and Atopic Dermatitis. O'Connor C, McCarthy S, Murphy M. Pediatric Dermatology. 2023 May-Jun;40(3):407-412. https://doi.org/10.1111/pde.15325

21/03/2026

手部汗皰疹，其實並不是跟汗腺異常有關，名稱有點誤導，
實際上33-50%跟過敏有關，另外接觸物的刺激，例如：水、清潔液、沙子、金屬⋯等有關

有蠻高比例患者會變成慢性、反反覆覆。手部清潔固然重要，但手部的皮膚保養也很重要喔。

網路掛號：https://reurl.cc/184neV

門診表：https://reurl.cc/lpdEDY

診所地址：https://reurl.cc/dp5dm6

參考資料：
1. Hand Eczema. Weidinger S, Novak N. Lancet (London, England). 2024;404(10470):2476-2486. https://doi.org/10.1016/S0140-6736(24)01810-5

2. Hand Eczema. Coenraads PJ. The New England Journal of Medicine. 2012;367(19):1829-37. https://doi.org/10.1056/NEJMcp1104084

3. Dyshidrotic Eczema and Occupation: A Descriptive Study. Lehucher-Michel MP, Koeppel MC, Lanteaume A, Sayag J. Contact Dermatitis. 2000;43(4):200-5. https://doi.org/10.1034/j.1600-0536.2000.043004200.x

4. Position Statement: Nickel Sensitivity. American Academy of Dermatology (2022).

5. Nickel Allergy and Allergic Contact Dermatitis: A Clinical Review of Immunology, Epidemiology, Exposure, and Treatment. Ahlström MG, Thyssen JP, Wennervaldt M, Menné T, Johansen JD. Contact Dermatitis. 2019;81(4):227-241. https://doi.org/10.1111/cod.13327

6. Life-Style Factors and Hand Eczema. Anveden Berglind I, Alderling M, Meding B. The British Journal of Dermatology. 2011;165(3):568-75. https://doi.org/10.1111/j.1365-2133.2011.10394.x

7. Hand Eczema and Lifestyle Factors in the Dutch General Population: Evidence for Smoking, Chronic Stress, and Obesity. Loman L, Schuttelaar MLA. Contact Dermatitis. 2022;86(2):80-88. https://doi.org/10.1111/cod.14005

8. Role of Stress in Skin Diseases: A Neuroendocrine-Immune Interaction View. Zhang H, Wang M, Zhao X, et al. Brain, Behavior, and Immunity. 2024;116:286-302. https://doi.org/10.1016/j.bbi.2023.12.005

9. A Sympathetic-Eosinophil Axis Orchestrates Psychological Stress to Exacerbate Skin Inflammation. Tian J, Cao Y, Li Y, et al. Science (New York, N.Y.). 2026;391(6791):1269-1277. https://doi.org/10.1126/science.adv5974

10. Stress-Induced Interaction of Skin Immune Cells, Hormones, and Neurotransmitters. Pondeljak N, Lugović-Mihić L. Clinical Therapeutics. 2020;42(5):757-770. https://doi.org/10.1016/j.clinthera.2020.03.008

11. What Causes Worsening of Eczema? A Systematic Review. Langan SM, Williams HC. The British Journal of Dermatology. 2006;155(3):504-14. https://doi.org/10.1111/j.1365-2133.2006.07381.x

12. FDA Orange Book. FDA Orange Book.

13. Interventions for Hand Eczema. Christoffers WA, Coenraads PJ, Svensson Å, et al. The Cochrane Database of Systematic Reviews. 2019;4:CD004055. https://doi.org/10.1002/14651858.CD004055.pub2

14. Hand Eczema—prognosis and Consequences: A 7-Year Follow-Up Study. Petersen AH, Johansen JD, Hald M. The British Journal of Dermatology. 2014;171(6):1428-33. https://doi.org/10.1111/bjd.13371

黑眼圈奶爸Dr. 徐嘉賢醫師

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