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目的:观察捏脊、刺四缝穴加中药治疗脾失健运型小儿厌食的临床疗效.方法:按随机数字表法将64例患儿分为观察组和对照组,每组32例.两组均根据中医辨证给予健脾开胃散治疗;观察组在此基础上加用捏脊和刺四缝穴,捏脊每周2次,针刺四缝穴每周1次,连续2周为1疗程.治疗2个疗程后对比两组各时间点(治疗前,治疗1个及2个疗程后)体重指数(BMI)、患儿外周血中的血清瘦素(leptin)水平及微量元素锌、铁和硒的含量,并比较两组治疗后临床疗效及起效时间.结果:2个疗程结束时,两组各有31例获得治疗后评估.与本组治疗前比较,观察组治疗第1及第2疗程后,BMI及血清锌、铁及硒含量均明显升高(均P0.05).与对照组比较,观察组治疗第1个及第2个疗程后,BMI,血清锌、铁和硒含量增加更明显(均P0.05). After the 1st and the 2nd courses of treatment, the BMI, serum Zn, Fe and Se levels increased more significantly (all P<0.05), and the serum leptin level decreased more significantly (both P<0.05) in the observation group than in the control group. After the 2nd course, the total effective rate and recovery rate in the observation group were both higher than those in the control group (both P<0.05), together with a quicker onset time (P<0.05). Conclusion: Nie-pinching the spine, puncturing Sifeng (EX-UE 10) plus Chinese herbs is effective for pediatric anorexia due to dysfunction of spleen in transportation. It can decrease leptin, increase Zn, Fe and Se levels, alleviate apositic symptoms and increase BMI in the kids.