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º≈°“√‡ª≈’ˬπ‡«≈“°“√„™â¬“≈¥·√ߥ—π‡≈◊Õ¥„πºŸâªÉ«¬

∑’Ë∂◊Õ»’≈Õ¥™à«ß‡¥◊Õπ√Õ¡ÆÕπ

π’≈π“∂ ‡®ä–¬Õ

*

*‚√ßæ¬“∫“≈ÀπÕß®‘° ®—ßÀ«—¥ªíµµ“π’

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·≈–·°â‰¢ ‡ªìπ ‘Ëß∑’Ë®”‡ªìπ.

§” ”§—≠: °“√‡ª≈’ˬπ‡«≈“°‘π¬“, ‚√§§«“¡¥—π‚≈À‘µ Ÿß, ·√ߥ—π‡≈◊Õ¥, √Õ¡ÆÕπ

Abstract Effects of Changing Antihypertensive Drug Administration Time during the Muslim Fasting Period of Ramadan

Nealanad Cheyor*

*Nongjik Hospital, Pattani Province

This study was conducted to determine the effect of changing antihypertensive drug administration time during the period January 1, 2008 to October 31, 2008 among patients who received treatment at Nongjik Hospital, Pattani Province. The 140 patients studied received antihypertensive drugs once daily.

Determination of the blood pressure before and during the Ramadan period were carried out among 70 patients without changing drug administration time, compared with those 70 patients with changing the time concerned. Data were collected from OPD cards, glucose level records of the patients, and monitor- ing change records during the Ramadan period. The SPSS for Windows software package was used to analyze the data.

The distributions by sex, age, and items of antihypertensive drug use were comparable between both groups. Both groups had significantly lower mean weight and systolic blood pressure during the Ramadan period, compared with figures before Ramadan. There were no statistically significant differ- ences in systolic and diastolic blood pressures between both groups.

It is suggested that before the Ramadan period, good health education about food intake, exercise, administration schedules, and hypotension should be given to Muslim patients with hypertension.

Key words: changing drug administration time, hypertension, blood pressure, Ramadan

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µ“√“ß∑’Ë Û · ¥ß·√ߥ—π‡≈◊Õ¥‡©≈’ˬ¢ÕߺŸâªÉ«¬∑—Èß Õß°≈ÿà¡

„π™à«ß°àÕπ√Õ¡ÆÕπ·≈–¢≥–√Õ¡ÆÕπ. ®“°°“√»÷°…“‡ª√’¬∫

‡∑’¬∫√–À«à“ߺŸâªÉ«¬∑—Èß Õß°≈ÿà¡ æ∫«à“·√ߥ—π‡≈◊Õ¥¢≥–À—«„®

∫’∫µ—«·≈–·√ߥ—π‡≈◊Õ¥¢≥–À—«„®§≈“¬µ—«‡©≈’ˬ‰¡à·µ°µà“ß

°—π‚¥¬π—¬ ”§—≠∑“ß ∂‘µ‘∑—Èß„π™à«ß°àÕπ√Õ¡ÆÕπ·≈–¢≥–

√Õ¡ÆÕπ.  ”À√—∫°“√‡ª≈’ˬπ·ª≈ߢÕß·√ߥ—π‡≈◊Õ¥¿“¬„π

°≈ÿࡇ¥’¬«°—π æ∫«à“∑—Èß°≈ÿࡺŸâªÉ«¬∑’ˉ¡à‡ª≈’ˬπ‡«≈“°“√„™â¬“

·≈–°≈ÿࡺŸâªÉ«¬∑’ˇª≈’ˬπ‡«≈“°“√„™â¬“®–¡’·√ߥ—π‡≈◊Õ¥¢≥–

À—«„®∫’∫µ—«‡©≈’ˬ„π¢≥–√Õ¡ÆÕπ≈¥≈ßÕ¬à“ß¡’π—¬ ”§—≠∑“ß

µ“√“ß∑’Ë Ò ¢âÕ¡Ÿ≈∑—Ë«‰ª¢Õß°≈ÿࡺŸâªÉ«¬µ—«Õ¬à“ß ®”·π°‡ªìπ°≈ÿà¡∑’ˉ¡à‡ª≈’ˬπ‡«≈“°“√„™â¬“·≈–°≈ÿà¡∑’ˇª≈’ˬπ‡«≈“°“√„™â¬“

°≈ÿࡺŸâªÉ«¬∑’ˉ¡à‡ª≈’ˬπ‡«≈“°“√„™â¬“ °≈ÿࡺŸâªÉ«¬∑’ˇª≈’ˬπ‡«≈“°“√„™â¬“

¢âÕ¡Ÿ≈∑—Ë«‰ª (˜ √“¬) (˜ √“¬) §à“æ’

®”π«π √âÕ¬≈– ®”π«π √âÕ¬≈–

‡æ»

™“¬ Òˆ ÚÚ.¯ˆ Ò˜ ÚÙ.Ú˘ .¯ÙÙ

À≠‘ß ıÙ ˜˜.ÒÙ ıÛ ˜ı.˜Ò

Õ“¬ÿ‡©≈’ˬ* (ªï) ˆÚ.Ù ± ÒÚ.Ò¯ ı˘.ı ± ˘.˘ˆ .Ò˜¯

‚√§√à«¡

¡’ Û˜ ıÚ.¯ˆ ˜ Ò. .

‰¡à¡’ ÛÛ Ù˜.ÒÙ  .

®”π«π¢π“π¬“∑’ˉ¥â√—∫

Ò Ú Ú¯.ı˜ Ú˘ ÙÒ.ÙÛ .˜¯

Ú Ú˘ ÙÒ.ÙÛ Ú˜ Û¯.ı˜

Û Ò˘ Ú˜.ÒÙ ÒÛ Ò¯.ı˜

¡“°°«à“ Û Ú Ú.¯ˆ Ò Ò.ÙÛ

*§à“‡©≈’ˬ ±±±±± §à“‡∫’ˬ߇∫π¡“µ√∞“π

(4)

100  ∂‘µ‘‡¡◊ËÕ‡∑’¬∫°—∫°àÕπ√Õ¡ÆÕπ.  à«π·√ߥ—π‡≈◊Õ¥¢≥–À—«„®

§≈“¬µ—«‡©≈’ˬæ∫«à“≈¥≈ß∫â“ß·µà‰¡à·µ°µà“ß°—πÕ¬à“ß¡’π—¬

 ”§—≠∑“ß ∂‘µ‘.

«‘®“√≥å

°≈ÿࡺŸâªÉ«¬∑’Ë»÷°…“‡ªìπÀ≠‘ß¡“°°«à“™“¬  Õ¥§≈âÕß°—∫º≈

°“√»÷°…“Õ◊ËπÀ≈“¬§√—Èß ∑’Ëæ∫ºŸâÀ≠‘߇ªìπ‚√§§«“¡¥—π‚≈À‘µ Ÿß

¡“°°«à“ºŸâ™“¬(ı,ˆ). ∑—Èßπ’ȇπ◊ËÕß®“°ºŸâÀ≠‘ß∑’Ë¡’Õ“¬ÿ Ù ªï‰ª·≈â«

¡—°®–¡’√Ÿª√à“ßÕâ«π¡“°°«à“ºŸâ™“¬ ·≈–ºŸâÀ≠‘ß®–ÕÕ°°”≈—ß°“¬

πâÕ¬°«à“ºŸâ™“¬®÷ß∑”„À⺟âÀ≠‘ß¡’‚Õ°“ ‡ªìπ‚√§§«“¡¥—π‚≈À‘µ  Ÿß¡“°°«à“™“¬.

„π™à«ß√Õ¡ÆÕπºŸâªÉ«¬‚√§§«“¡¥—π‚≈À‘µ Ÿß∑—Èß Ú °≈ÿà¡

¡’πÈ”Àπ—°≈¥≈ߪ√–¡“≥ Ò-Ò.ı °‘‚≈°√—¡´÷Ëß Õ¥§≈âÕß°—∫°“√

»÷°…“À≈“¬°√≥’»÷°…“(˜,¯). ∑—Èßπ’ȇπ◊ËÕß®“°„π™à«ß√Õ¡ÆÕπºŸâªÉ«¬

µ“√“ß∑’Ë Ú πÈ”Àπ—°µ—«‡©≈’ˬ¢ÕߺŸâªÉ«¬∑—Èß Õß°≈ÿà¡∑’Ë»÷°…“ „π™à«ß°àÕπ√Õ¡ÆÕπ·≈–¢≥–√Õ¡ÆÕπ

°≈ÿࡺŸâªÉ«¬∑’ˉ¡à‡ª≈’ˬπ‡«≈“°“√„™â¬“ °≈ÿࡺŸâªÉ«¬∑’ˇª≈’ˬπ‡«≈“°“√„™â¬“

™à«ß‡«≈“ (®”π«π ˜ √“¬) (®”π«π ˜ √“¬) §à“æ’*

§à“‡©≈’ˬ §à“‡∫’ˬ߇∫πœ §à“‡©≈’ˬ §à“‡∫’ˬ߇∫πœ

πÈ”Àπ—°µ—« (°°.)

°àÕπ√Õ¡ÆÕπ ıˆ.˘Û ÒÛ.ı¯ ˆı.Ûˆ ÒÒ.ÛÒ .

¢≥–√Õ¡ÆÕπ ıı.ˆÒ ÒÛ.ıı ˆÛ.¯Ò ÒÒ.Ú .

§à“æ’** . .ÚÒ

*‡ª√’¬∫‡∑’¬∫√–À«à“ß°≈ÿࡺŸâªÉ«¬∑’ˉ¡à‡ª≈’ˬπ‡«≈“°“√„™â¬“ °—∫°≈ÿà¡∑’ˇª≈’ˬπ‡«≈“°“√„™â¬“

**‡ª√’¬∫‡∑’¬∫√–À«à“ß°àÕπ√Õ¡ÆÕπ °—∫¢≥–√Õ¡ÆÕπ „πºŸâªÉ«¬°≈ÿࡇ¥’¬«°—π

µ“√“ß∑’Ë Û ·√ߥ—π‡≈◊Õ¥‡©≈’ˬ¢ÕߺŸâªÉ«¬∑—Èß Õß°≈ÿà¡∑’Ë»÷°…“ „π™à«ß°àÕπ√Õ¡ÆÕπ·≈–¢≥–√Õ¡ÆÕπ

°≈ÿࡺŸâªÉ«¬∑’ˉ¡à‡ª≈’ˬπ‡«≈“°“√„™â¬“ °≈ÿࡺŸâªÉ«¬∑’ˇª≈’ˬπ‡«≈“°“√„™â¬“

™à«ß‡«≈“ (˜ √“¬) (˜ √“¬) §à“æ’*

§à“‡©≈’ˬ §à“‡∫’ˬ߇∫π §à“‡©≈’ˬ §à“‡∫’ˬ߇∫π

¡“µ√∞“π ¡“µ√∞“π

·√ߥ—π‡≈◊Õ¥¢≥–À—«„®∫’∫µ—« (¡¡.ª√Õ∑)

°àÕπ√Õ¡ÆÕπ ÒÙÒ.ÚÒ Ò˘.Û˘ ÒÙÙ.Ù˘ Ò¯.Úı .Ûˆ

¢≥–√Õ¡ÆÕπ ÒÛÙ.ıÙ Ò¯.Ùı ÒÛ˜.Úˆ Ò¯.˜ı .Û˘

§à“æ’** .Ù .Ò

·√ߥ—π‡≈◊Õ¥¢≥–À—«„®§≈“¬µ—« (¡¡.ª√Õ∑)

°àÕπ√Õ¡ÆÕπ ¯Û.ÒÒ Ò.˜ı ¯. Ò.¯ˆ .˘

¢≥–√Õ¡ÆÕπ ˜˘.ˆ˘ Òı.¯ ˜¯.˜Û ÒÒ.˜Ú .ˆ˜ˆ

§à“æ’** .¯ .ÛÒÚ

*‡ª√’¬∫‡∑’¬∫√–À«à“ß°≈ÿࡺŸâªÉ«¬∑’ˉ¡à‡ª≈’ˬπ‡«≈“°“√„™â¬“ °—∫°≈ÿà¡∑’ˇª≈’ˬπ‡«≈“°“√„™â¬“

**‡ª√’¬∫‡∑’¬∫√–À«à“ß°àÕπ√Õ¡ÆÕπ °—∫¢≥–√Õ¡ÆÕπ „π°≈ÿࡺŸâªÉ«¬‡¥’¬«°—π

(5)

¡’«‘∂’™’«‘µ∑’ˇª≈’ˬπ·ª≈߉ª®“°‡¥‘¡‰¡à«à“®–‡ªìπ‡√◊ËÕ߇«≈“„π

°“√√—∫∫√‘‚¿§Õ“À“√, °“√ÕÕ°°”≈—ß°“¬ ·≈–°“√πÕπÀ≈—∫.

®“°°“√»÷°…“‰¡àæ∫§«“¡·µ°µà“ß∑’Ë™—¥‡®π¢Õß·√ߥ—π

‡≈◊Õ¥√–À«à“ß°≈ÿࡺŸâªÉ«¬∑’ˉ¡à‡ª≈’ˬπ‡«≈“„π°“√„™â¬“°—∫°≈ÿࡺŸâ ªÉ«¬∑’ˇª≈’ˬπ‡«≈“„π°“√„™â¬“ ∑—Èß„π™à«ß°àÕπ√Õ¡ÆÕπ·≈–

¢≥–√Õ¡ÆÕπ.  à«π°“√‡ª√’¬∫‡∑’¬∫·√ߥ—π‡≈◊Õ¥¿“¬„π°≈ÿà¡

‡¥’¬«°—π√–À«à“ß„π™à«ß°àÕπ·≈–¢≥–√Õ¡ÆÕπ æ∫«à“ºŸâªÉ«¬∑—Èß Ú °≈ÿà¡¡’·√ߥ—π‡≈◊Õ¥≈¥≈ß„π™à«ß√Õ¡ÆÕπ‚¥¬‡©æ“–·√ߥ—π

‡≈◊Õ¥¢≥–À—«„®∫’∫µ—« ´÷Ëß Õ¥§≈âÕß°—∫À≈“¬°“√»÷°…“∑’Ëæ∫ºŸâ ªÉ«¬‚√§§«“¡¥—π‚≈À‘µ Ÿß¡’·√ߥ—π‡≈◊Õ¥≈¥≈ßÕ¬à“ß¡’π—¬

 ”§—≠∑“ß ∂‘µ‘„π™à«ß√Õ¡ÆÕπ(˘). ∑—Èßπ’ÈÕ“®‡π◊ËÕß®“°πÈ”Àπ—°µ—«

¡’§«“¡ —¡æ—π∏å°—∫·√ߥ—π‡≈◊Õ¥¢≥–À—«„®∫’∫µ—« ·≈–·√ߥ—π

‡≈◊Õ¥¢≥–À—«„®§≈“¬µ—«(ˆ) ·≈–Õ“®‡π◊ËÕß®“°°“√∂◊Õ»’≈Õ¥

‡ªìπ°“√ߥ®“°°“√°‘π·≈–°“√¥◊Ë¡ ∑”„Àâ√–¥—∫‚´‡¥’¬¡„π‡≈◊Õ¥

≈¥≈ß; °“√ߥ Ÿ∫∫ÿÀ√’Ë ·≈–°“√‰ª≈–À¡“¥°Á‡ªìπ°“√‡æ‘Ë¡°“√

ÕÕ°°”≈—ß°“¬. πÕ°®“°π—ÈπºŸâªÉ«¬∑’Ë∂◊Õ»’≈Õ¥„π‡¥◊Õπ√Õ¡

ÆÕπ®–‡ªìπºŸâ∑’Ë¡’§«“¡ ÿ¢ ≈¥§«“¡‡§√’¬¥‰¥â¡“°°«à“‡¥◊ÕπÕ◊Ëπ Ê

∑’ˉ¡à„™à‡¥◊Õπ√Õ¡ÆÕπ(Ò).

ª√–‡∑»‰∑¬¡’ºŸâªÉ«¬‚√§§«“¡¥—π‚≈À‘µ Ÿß∑’ˇªìπ¡ÿ ≈‘¡Õ¬Ÿà

‰¡àπâÕ¬. ¥—ßπ—Èπ°“√‡µ√’¬¡ºŸâªÉ«¬°àÕπ‡¢â“ Ÿà™à«ß‡¥◊Õπ√Õ¡ÆÕπ

‚¥¬„Àâ§«“¡√Ÿâ§«“¡‡¢â“„®∑’Ë∂Ÿ°µâÕ߇°’ˬ«°—∫惵‘°√√¡°“√

∫√‘‚¿§Õ“À“√, °“√ÕÕ°°”≈—ß°“¬, °“√„™â¬“≈¥·√ߥ—π‡≈◊Õ¥,

¿“«–·∑√°´âÕπ∑’ËÕ“®‡°‘¥¢÷Èπ ·≈–·π«∑“ß„π°“√ªÑÕß°—π·°â‰¢

®÷߇ªìπ ‘Ëß∑’Ë®”‡ªìπÕ¬à“߬‘Ëß.

°“√»÷°…“§√—Èßπ’È ¡’°≈ÿࡵ—«Õ¬à“ß‡æ’¬ß ÒÙ √“¬ ´÷ËßÕ“®

‡ªìπ¢âÕ®”°—¥„π°“√π”º≈°“√»÷°…“‰ª„™âÕ¬Ÿà∫â“ß. ¥—ßπ—Èπ®÷ß§«√

¡’°“√»÷°…“„πµ—«Õ¬à“ߪ√–™“°√∑’Ë¡“°°«à“π’È √«¡∑—Èß§«√¡’°“√

»÷°…“‡™‘ß§ÿ≥¿“æ ‚¥¬‡®“–≈÷°„π‡√◊ËÕß§«“¡√à«¡¡◊Õ„π°“√„™â¬“

·≈–°“√„™â¬“¢—∫ªí  “«–¢ÕߺŸâªÉ«¬„π√–À«à“߇¥◊Õπ√Õ¡ÆÕπ.

°‘µµ‘°√√¡ª√–°“»

‡®â“Àπâ“∑’Ë‚√ßæ¬“∫“≈ÀπÕß®‘° ·≈–ºŸâªÉ«¬‚√§§«“¡¥—π

‚≈À‘µ Ÿß∑ÿ°∑à“π‰¥â„Àâ§«“¡√à«¡¡◊Õ„π°“√¥”‡π‘π°“√«‘®—¬‡ªìπ Õ¬à“ߥ’¬‘Ëß. 𓬷æ∑¬å«‘∑¬“  «— ¥‘«ÿ≤‘æß»å ‰¥â„Àâ§”ª√÷°…“

·π–π”„π°“√∑”√“¬ß“π ®π∑”„Àâ°“√«‘®—¬§√—Èßπ’È ”‡√Á®≈ÿ≈à«ß≈ß

¥â«¬¥’.

‡Õ° “√Õâ“ßÕ‘ß

Ò. ‡™§¡ÿŒ—¡À¡—¥ Õ—∫¥ÿ√‡√“–Œå¡“π Õ—µµ—√°’͵. √Õ¡ÆÕπ. æ‘¡æå§√—Èß∑’Ë Û.

°√ÿ߇∑æ¡À“π§√: ÕÕø‡´Á∑‡æ√ °“√æ‘¡æå; ÚıÙ˜.

Ú. Aadil N, Houti IE, Mousssamih S. Drug intake during Ramadan.

Br Med J 2004;329:778-82.

Û. ‡™§Õ—∫¥ÿ≈≈ÕŒ⁄ ∫‘π ≠“√‘≈≈“Œ⁄. §Ÿà¡◊Õ‡µ◊Õ𠵑 ºŸâ»‘¬“¡. æ‘¡æå§√—Èß∑’Ë Ò.

 ß¢≈“: Õ“≈’æ“≥‘™¬å; ÚıÙˆ.

Ù. Al-Arouj M, Bouguerra R, Buse J, Hafez S, Hassanein M, Ibrahim MA, et al. Recommendations for management of diabetes during Ramadan. Diabetes Care 2005;28:2305-11.

ı. «—≈≈¿ ‰∑¬‡Àπ◊Õ. ºŸâÀ≠‘ß°—∫‚√§À—«„®Õ—¡æ“µ Ú¯. [cited 2008 June 10]; [1 screen]. Available from: URL: http://www. samunpai.

com.

ˆ. π‘¿“ ®√Ÿ≠‡« ¡å. À≈—°°“√√—°…“‚√§§«“¡¥—π‚≈À‘µ Ÿß. °√ÿ߇∑æ¡À“π§√:

∫ÿ≠»‘√‘°“√æ‘¡æå; ÚıÙ.

˜. Perk G, Ghanem J, Aamar S, Ben-Ishay D, Bursztyn M. The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives. J Hum Hypertens 2001;15:723-5.

¯. Beebani MK. Ramadan fasting and cardiac diseases. [cited 2008 January 20]; [3 Screens]. Available from: URL: http://www24.

brinkster.com

˘. Akhtar S. Advice on health during Ramadan. [cited 2008 Febrary 1]; [5 Screens]. Available from: URL: http://www.central-mosque.

com/fiqh/ramhealth2.htm

Ò. Habbal R, Azzouzi L, Adnan K, Tahiri A, Chraibi N. Variations of blood pressure during the month of Ramadan. Arch Mal Coeur Vaiss 1998;91:995-8.

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