1. Definition of anorexia nervosa Anorexia nervosa refers to a common chronic appetite disorder in children who do not want to eat, have a poor appetite, or even refuse to eat, and it is a common and frequent disease in pediatrics, with a longer course of illness, usually more than 2 months. It can occur at any age, with 1 to 6 years old being the most common, and individual can be extended to school age. Symptoms are often aggravated in summer when summer dampness is in season and the spleen is trapped by dampness. This disease belongs to the categories of “bad food”, “hurt food”, “food accumulation” and “phlegm stagnation” in Chinese medicine. In recent years, this disease has been increasing. 2, pediatric anorexia etiology modern medicine, pediatric anorexia and pediatric gastric smooth muscle development is not yet perfect, fewer glands and cup cells, hydrochloric acid and a variety of enzyme secretion is less than the adult and enzyme viability is low, poor digestive function. Zinc, a trace element, is involved in the synthesis of many enzymes in the body and is related to protein synthesis. When zinc is lacking, the activity of acid decreases, thus affecting appetite. According to Chinese medicine, anorexia can be caused by dietary disorders, congenital deficiencies, prolonged illnesses, summer dampness, and environmental and mental factors. The “pediatric medicinal evidence straight tips・Weakness” cloud: “spleen and stomach disharmony, can not appetite, resulting in muscle thinness.” Among the many causes, the main reason is the irrational dietary structure, parents overly spoil their children, so that they arbitrarily over-eat cold, fat, sweet and thick flavors, etc., dietary disorders, partiality and polyphagia, hunger and satiety, over time, damage to the spleen and stomach, resulting in the dysfunction of the spleen, stomach and digestion. However, if the spleen is not and food is not chemical, stomach is not and food is not consumed, spleen and stomach are not and, then the water and grain essence is not four cloth to nourish the whole body, and then appeared to see the food is not greed, muscle emaciation, color is not glory and other symptoms. If the disease lasts for a long time, it can lead to the children’s body being thin and weak, and the positive qi is insufficient, so it is easy to feel all kinds of illnesses and evils, and it can lead to chancre, recurrent respiratory infections and other illnesses, and in serious cases, it can even affect the growth and development of the children. 3, pediatric anorexia clinical symptoms and harm The main symptoms of anorexia are loss of appetite, refusal to eat, eating too little, constipation, intermittent abdominal pain, night sweats, weight loss, repeated colds and so on. It can lead to diarrhea with insufficient nutritional intake, digestive disorders, poor body defenses leading to bacterial and viral infections or dysbiosis in the intestinal flora. It is also susceptible to respiratory diseases such as upper respiratory tract infections and pneumonia. If anorexia develops for a long time, it can lead to malnutrition, as well as the lack of various vitamins and trace elements, low immunity, which seriously affects the growth and development of children and makes them susceptible to various diseases. 4. Diagnosis of Anorexia Nervosa Western medicine diagnostic criteria: digestive dysfunction caused by decreased appetite, reduced food intake for more than 2 weeks, accompanied by abdominal distension or abdominal pain, nausea, vomiting, halitosis, loose or clotted stools, sour taste and smell, and to exclude the effects of organic diseases, psychiatric factors and medication, the diagnosis of Anorexia Nervosa. Chinese medicine diagnostic criteria: ①long-term loss of appetite, without other diseases. (2) The color of the face is less colorful, the body is thin, but the spirit is still good, no abdominal expansion. ③ There is a history of improper feeding, such as eating without fixed time and quantity, overeating cold and raw food, sweet and thick flavors, snacking or partiality, and so on. (5) Treatment of anorexia nervosa in children (a) Chinese herbal medicines: ①Spleen dysfunction type: it is common in infants and young children. The symptoms are: loss of appetite, or even aversion to eating, little food, tasteless, or food stored in the mouth for a long time, then vomiting. If one eats too much or is forced to eat, one can see fullness and distension in the stomach and abdomen, with a slightly thin body, less colorful face, good spirit, thin white or greasy tongue coating, and light purple fingerprints. The treatment is to strengthen the spleen and open the stomach, and harmonize the qi. Add and subtract Chen Pi, Codonopsis, Rhizoma Atractylodis Macrocephalae, Poria, Radix et Rhizoma Glycyrrhizae, Radix et Rhizoma Ophiopogonis, Radix et Rhizoma Gastrodiae, Radix Astragali, and so on. Accompanied by constipation, plus thick Park, Laptop; with nausea, plus cloves, lily, ginger half-summer, sand nuts. ② spleen and stomach qi deficiency type: young children and preschool children are common. Loss of appetite, do not take the initiative to eat, less food and lazy, yellowish color, depressed, loose stools, clip undigested food residue, pale tongue, thin white, pulse is fine. The treatment should strengthen the spleen and promote vital energy. The formula is Ginseng and Atractylodes Macrocephalae: Codonopsis pilosulae, Poria, Atractylodes macrocephala, licorice, Chinese yam, white lentil, lotus seed meat, sand nuts, Semen Coix lacryma, Platycodon grandiflorus, Jiao Sanxian and Jin Naijin (Chicken Nei Jin). Yin deficiency of the spleen and stomach: mostly seen in preschool children. Red lips and dry mouth, no desire to eat, eat less and drink more, less color, night annoyance, sleeplessness and impatience, skin loss of moisture, dry stools, red tongue with little fluid, little or flowery moss, and fine pulse. The treatment should benefit Qi and nourish Yin, appetizer and food. The formula is Sha Shen Maimendong Tang plus subtractions: Sha Shen, Maimendong, Dendrobium, Dendrobium, Bamboo, White Lentil, Smallpox Powder, Mulberry Leaf, Plum, Glycyrrhiza Uralensis, Yam, etc.. For those with excessive sweating, add calcined dragon peony, ephedra root, floating wheat; for those who have heartburn and heatiness, and sleeplessness at night, add hu huanglian, dictyostelium, dragon’s tooth, oyster. Liver-exuberant and spleen-deficient type: Most common in school-age children. Anorexia or refusal to eat, impatient and irritable, active and crying, teeth grinding, loose stools and ulcer, tongue light and moss clean, pulse fine string. Treatment is to dredge the liver and regulate qi, harmonize the stomach and strengthen the spleen. The formula is Chai Hu Shun Liver San plus subtractions: Chai Hu, Paeonia lactiflora, Rhizoma Ligustici Chuanxiong, Pericarpium Citri Reticulatae, Fried Citrus Aurantium, Roasted Glycyrrhiza Uralensis, Prepared Fragrant Parsley, Sheng Maidenhair, Chicken Nai Jin. The epigastric distention belching plus sand nuts, nutmeg, green skin, Buddha’s hand; moss greasy nausea plus Chen Pi, Zhu Ru, ginger and half-sia; bowel irregularity plus abdominal skin, fire Ma Ren, fried Lai Telescope; sleeplessness at night plus Poria cocos, cypress kernel, cordyceps. ⑤ Weakness of qi and blood: mostly seen in young children. The child is pale, thin, does not want to eat, low and timid voice, yellow hair, loose stools or constipation. The tongue is pale and white, the body is small, the moss is little or no moss, and the pulse is weak. The treatment is to tonify Qi and Blood. (Acupuncture treatment Acupuncture of the four suture points in the treatment of anorexia in children has achieved better results. Positioning: The four suture points are located on the palmar surface of the second, third, fourth and fifth fingers, at the midpoint of the transverse lines of the proximal phalangeal joints. Needling method: Sterilize the three-pronged needle with alcohol cotton ball, puncture the four suture points, and squeeze out a little yellowish-white transparent mucus. To prevent bleeding, let the child bend the fingers. Through the meridians, the four seams and the body’s internal organs directly or indirectly related to the middle finger point is the syncopal pericardium meridian, the hand syncopal pericardium meridian and the hand shaoyang Sanjiao meridians with the surface, so there is the operation of the triple jiao qi, regulating the function of the five viscera and six bowels, needling four seams point, both diarrhea and the spleen heat, but also to strengthen the spleen and the stomach, eliminating food and stagnation. Can also be through the role of meridians, adjusting the body’s functions, so that the qi and blood smooth, yin and yang secret, promote the recovery of the spleen and stomach function, enhance appetite, so as to lift the anorexia of the disease. Modern medical research has confirmed that acupuncture four seam point can make the intestinal pancreatic amylase, pancreatic lipase, pancreatic protease content increases, and promote gastrointestinal transport function to achieve the therapeutic purpose. According to the relevant reports, acupuncture on the four seam points can increase the blood calcium and phosphorus levels, decrease alkaline phosphatase, and consequently increase the calcium-phosphorus product, which can help the development and growth of children’s bones. Acupuncture of specific points on the human body can cause significant and sustained release of plasma gastric motility. Acupuncture of the four suture points has an important role in adjusting the movement of the digestive tract, secretion and digestion and absorption functions, and can effectively improve gastrointestinal motility dysfunction, which is effective in treating anorexia nervosa. (C) chiropractic therapy chiropractic through the massage of the spinal acupuncture points, invigorate Yang qi to help the spleen, so as to regulate qi and blood, and internal organs, through the meridians, cultivate vital energy, and safe and effective, eliminating the pain of the children to take medication, has a simple, practical, and fewer adverse effects of the characteristics. The operation is as follows: adjust the room temperature, the child take off or loosen the shirt, expose the whole back, take the prone position or half-prone position, make the back flat and loose. The chiropractic area is the center line of the spine. First in the child’s back from top to bottom gently knead, so that the muscle relaxation, and then from the sacrococcygeal long strong point to start, both hands of the thumb finger belly and show, middle finger belly, clamping the skin, show the finger, middle finger in the front, the thumb in the back, at the same time, force to lift the skin, show the finger, the middle finger to the back of the twisting, the thumb forward to promote, from bottom to top, continuous hostage lifting the skin, and has been pinched to the neck and occipital part of the (general to the great vertebrae point, can also be extended to the Fengfu point), so repeated three times in the fourth, and then in the fourth, and the back of the child’s back. So repeated 3 times, in the 4th and 5th time, every pinch 3 times to force the skin upward 1 time, the technique should be gentle, gentle, flexible, natural, both hands force uniformity, forward speed and frequency should not be too fast. Finally, use your thumbs to rub both sides of the stomach, spleen, liver, kidney Yu 10 times each, after the completion of the clothes can be put on. Prevention of anorexia nervosa: Anorexia nervosa prevention is very crucial: first of all, the diet should be reasonable. Food nutrition is scientifically diversified. Try to achieve the best color and flavor, control snacks before meals, and eat in moderation. Secondly, we should guide the child’s interest in eating. Through storytelling, analogies to bring children eating fun, and to patiently explain the flavor and nutritional value of various foods. Third, for long-term anorexia, poor appetite, micronutrient deficiencies can be supplemented with zinc, calcium and iron preparations.