Macrocytic anemia is also known as nutritional megaloblastic anemia. It shows large cells with positive pigmentation under the microscope. Mainly due to deficiency of vitamin B₁₂ or folic acid. 1. Clinical manifestations are waxy color, fatigue and weakness. It may be accompanied by enlargement of liver, spleen and lymph nodes. Hair is sparse and yellow, and occasional skin hemorrhages are seen. Dull, drowsy and unresponsive expression, tremor, increased muscle tone and even convulsions in the limbs, head, tongue and even the whole body. Lack of appetite, lingual inflammation, sublingual ulcers, and diarrhea. Some patients show burning pain in the oral mucosa, patients with oral mucosa pallor or multi-piece flaming red congestion is characteristic; the back of the tongue can also be atrophied papillae are mirrored. It can be accompanied by Candida albicans infection. 2. Blood tests often show a decrease in red blood cells and a slightly lower white blood cell count. Bone marrow hyperplasia is active, with erythrocyte hyperplasia being the mainstay, and the ratio of granulocytes to erythrocytes is normal or inverted. The erythrocyte lineage is large in size. Blood biochemical examination suggests serum vitamin B₁₂ deficiency and serum folic acid deficiency. 3. Treatment is mainly to strengthen nutrition, improve diet; according to the condition of the disease can be appropriate oral drug supplementation of vitamin B₁₂ or folic acid. For patients with oral mucosal ulcers, local anti-inflammatory, analgesic and healing treatment is needed; if combined with oral candida infection, antifungal treatment will be carried out. If there are uncomfortable symptoms need to go to the hospital as soon as possible after examination and treatment, do not self-medication, so as not to delay the timing of treatment, increase the difficulty of subsequent treatment.