60例厌食症患儿舌苔变化及运脾中药的干预作用

目的：探讨厌食症患儿舌苔变化机理及运脾中药的干预作用。方法：选取60例厌食症患儿,其中厚腻苔组30例,花剥苔组30例,分别给予运脾中药治疗,观察患儿舌苔变化、临床症状、外周血微量元素含量及疗效。结果：两组患儿治疗前有明显食欲差、恶心呕吐、嗳气、腹痛、多汗、疲乏、大便不调等症状,治疗后摄食量、体重等指标均升高,症状积分均降低,与治疗前比较有显著性差异（P〈0.01,或P〈0.05）;外周血微量元素检测,60例厌食症患儿有缺锌,花剥苔组更加明显,铁、铜、钙、镁均在正常水平,还发现厚腻苔组30例患儿有铅过量现象,治疗后缺锌和铅过量均改善,恢复到正常水平,与治疗前比较有显著性差异（P〈0.05）;两组疗效比较,厚腻苔组有效率为96.67%,花剥苔组有效率为93.33%,两组疗效接近,无显著性差异（P〉0.05）。结论：厌食症患儿的病机,从中医角度讲与脾胃虚弱、胃肠积滞有关;从营养角度讲可能与微量营养素锌缺乏和有害微量元素铅过量有关。运脾中药儿宝方有双向调节作用,既可健脾,又助运消食。也就是说：既能促进营养素锌的吸收,又加强了废物铅的排泄。

Tongue Changes and Interfering Effects of TCM Activating spleen in 60 Children with Anorexia

Objective:To evaluate mechanism of tongue changes and interfering effects of TCM activating spleen in children with anorexia.Methods:60 children with anorexia were chosen,30 in thick coating group,another 30 in peeling coating group,and treated with TCM activating spleen respectively.Tongue changes,clinical symptoms,trace elements(TE) in external circulation blood and curative effects were inspected.Results:Children in two groups had obvious symptoms,such as poor appetite,nausea and vomit,abdominal pain,Qi upward in wrong direction,surplus sweat,fatigue,irregular defecate,etc.before treated.Feed quantity and body weight were increased,while symptom integer were decreased after treated,and significant differences were found compared with those of before treated(P<0.01,or P<0.05).TE in external circulation blood were tested.60 children were lack of Zn.Peeling coating was more severe than others.Levels of Fe,Cu,Ca and Mg were normal,and level of Pb in 30 cases of thick coating group was excessive.Lack of Zn and excessive level of Pb were improved and returned to normal after treated.Significant differences were found compared with those of before treated(P<0.05).Effective rates of two groups were similar,96.67% and 93.33% respectively,and had no significant difference(P>0.05).Conclusion:Pathogenesis of children with anorexia was related with spleen-deficiency and stomach-intestines stagnation from TCM angle,and lack of Zn and excessive level of Pb from nutrition view.TCM activating spleen "Erbao Decoction" had double adjusting effects,not only activating spleen but also promoting digestion,as well as accelerating Zn absorbed and enhancing Pb excreted.