1. Basic information of megaloblastic anemia Megaloblastic anemia is a kind of macrocytic anemia caused by the lack of vitamin B12 or folic acid in the body, which causes impaired synthesis of deoxyribonucleic acid (DNA) and can lead to complete blood cytopenia and subacute joint degeneration of the posterior spinal cord in severe cases. The three main clinical categories include nutritional megaloblastic anemia, pernicious anemia, and pharmacologic megaloblastic anemia. The prevalence of megaloblastic anemia is regional, with a prevalence of 5.3% in Shanxi, Shaanxi, Henan and Shandong. Pernicious anemia is rare in China. 2.The principles and methods of health care for megaloblastic anemia The principles of megaloblastic anemia treatment mainly include removing the cause, treating the primary disease, supplementing folic acid or (and) vitamin B12, and paying attention to food regimen, which can often achieve satisfactory results. (1) Prevention and treatment of the cause Strengthen education on nutrition, correcting partial eating habits and incorrect cooking habits, and avoiding overcooking green vegetables. Infants should be breastfed, and supplementary foods should be added in time. Pregnant women should eat more fresh vegetables and animal proteins, and supplement folic acid in late pregnancy. In areas with a high prevalence of nutritional megaloblastic anemia, improved recipes should be actively promoted. Folic acid prophylaxis should be given to those with chronic hemolytic anemia or long-term antiepileptic drugs, and prophylactic intramuscular injection of vitamin B12 should be given once a month to those with total gastrectomy. The cause of folic acid or vitamin B12 deficiency and the primary disease should be actively treated. Vegetarians should consume animal protein. Correct habits of improper cooking that excessively destroy folic acid in green vegetables. Caution alcoholics to abstain from alcohol. Actively treat gastrointestinal diseases, hemolytic diseases, infections, hyperthyroidism, etc. Avoid the application of drugs that affect DNA metabolism such as methotrexate. (2) Dietary regimen Change poor dietary habits, do not be partial or picky, do not be a long-term vegetarian, take in folic acid and vitamin B12 from food, eat more fresh vegetables to increase the intake of folic acid, and eat more protein-rich food to ensure nutritional balance. Folic acid-rich vegetables, such as spinach, rape, chard, tomatoes, peanut kernels, yeast-flavored foods, beans and their products, and liver and kidney of animals. Eat more foods containing vitamin B12, such as liver, kidney and meat of animals, egg yolk, cow’s milk, flour, etc. Folic acid is very easy to be destroyed by high temperature, so it is not easy to cook at high temperature and for too long, it is best to fry quickly. If you add vitamin C to food, it can promote the absorption of folic acid; add calcium tablets, it can promote the absorption of vitamin B12. Avoid drinking alcohol. Most patients with chronic alcoholism are accompanied by folic acid deficiency. Therefore, patients with megaloblastic anemia should not drink alcohol. During infancy, feed reasonably and add supplementary foods containing folic acid and vitamin B12 in a timely manner. During the development of children, it is advisable to diversify the diet and prevent partial eating. Pregnant women should eat more fresh vegetables and fruits, and if they have had malnutrition anemia in the past, they should take folic acid 5mg daily during pregnancy as a preventive measure. Patients with chronic hemolytic anemia or those taking long-term antiepileptic drugs or antitumor drugs should also take oral folic acid as a preventive measure. Vegetable and fruit juices, cinnamon chicken, etc. can also be used as dietary supplements for recuperation. (3) Drug regimen The following traditional Chinese medicines are often used, mainly including: Pat Chun granules. Take 1 sachet with boiling water, 2 times a day. Efficacy: tonifying Qi and benefiting Blood. Indications: deficiency of qi and blood, yellowish complexion, loss of appetite, weakness of limbs, excessive menstruation. Gui Shen Wan. Take with warm water or ginger soup, 6g of water honey pill, 9g of small honey pill, 1 pill of large honey pill, 3 times a day. Effects: Benefiting Qi, strengthening the spleen, nourishing blood and calming the mind. Indications: Heart and spleen deficiency, shortness of breath and palpitations, insomnia and dreaminess, dizziness and lightheadedness, tiredness and fatigue, loss of appetite, blood in the stool. Beneficial Stomach Soup with Paeonia lactiflora and Glycyrrhiza glabra. Effects: Benefiting the stomach and promoting fluid production, moistening the lung and relieving cough. Indications: Yin deficiency of the spleen and stomach, tiredness and weakness, loss of appetite, irritable heat, thirst, etc. Radix Angelicae Sinensis Tonicum Tang. Effects: Tonifying the blood. Indications: deficiency of qi and blood, seen as atrophy, shortness of breath and palpitation, dizziness, insomnia and dreaminess, loss of appetite, etc. Nourishing Rong Tang. Effects: Benefiting Qi and replenishing Blood, nourishing the heart and calming the mind. Indications: Deficiency of Qi and Blood in the heart and spleen, manifesting as tiredness and weakness, poor appetite, palpitations and forgetfulness, restless sleep at night, sweating, dry throat and lips, emaciation, dry skin, coughing and shortness of breath, wheezing when moving; or deficiency of Qi and Blood after ulceration of sores, with cold and heat not subsiding and sores not converging for a long time.